36 • Plan for seasonal stresses, like school fees and food shortages, which often increase pressure to
exchange sex for gifts or money • Access entitlements, including HIV-related ones such as social grants for affected households
• Deal with prolonged illness, death, inheritance, and succession planning • Access voluntary counseling and testing for HIV or ART directly or on referral
5.2.3 Mentorship programs
Mentorship programs can mitigate grief among children and youth, especially those without an adult caregiver. One randomized control trial in Rwanda showed that
… despite disturbingly high levels of depression, maltreatment, and marginalization, and low levels of adult support reported at baseline,
follow- up data o e … o ths of i te e tio indicate positive changes in these psychosocial
outcomes among youth participating in the mentor program.
95
Overall, the Rwandan mentoring program appears to have enhanced social protection and community connectedness and minimized
psychological problems among youth participants.
For more severe forms of depression among youth, more focused supports should accompany mentorship whenever possible. However, the positive outcomes of this intervention show that this is a
scalable approach to addressing psychosocial issues, especially among youth and children in vulnerable households without an adult caregiver.
96
5.2.4 Community caregiver support
It is centrally important to provide emotional and psychosocial support for primary care guardians as well as frontline caregivers such as teachers, community volunteers, health workers, and staff working in
AIDS-affected communities. Many of those who provide support to others in these roles live with the trauma of HIVAIDS in their own lives. Support for caregivers can affect the care they provide to
children, and the distress of children may not be reduced without efforts to address the personal suffering of the caregiver.
97
A lack of recognition and recompense for volunteer caregivers can be a barrier to long-term program sustainability.
98
Program implementers found that practices contributing to higher volunteer retention rates included:
Involving volunteers in key program decisions Holding monthly support meetings
Fo all e og izi g a d app e iati g the olu tee s o k
Providing access to income-generating opportunities
99
Another study of OVC caregivers in Kenya fou d that p o idi g suppo t to a egi e s is a effe ti e a
to serve the needs of vulnerable children. The study found that members of a support group reported
95
Horizons. 2007. Psychosocial Benefits of a Mentoring Program for Youth-headed Households in Rwanda. Accessible at: www.popcouncil.orghorizonsprojectsRwanda_PsychOVC.htm
96
Brown L, Thurman T, Snider L, Boris N, Rice J, Ntaganira J, Kalisa E, Hutchinson S. 2008. Impact of Mentoring on the Psychosocial Wellbeing of Vulnerable Youth: Results from a Longitudinal Evaluation in Rwanda. Abstract WEPE0599. XVII International AIDS Conference. Mexico City,
Mexico.
97
Richter L, Foster G, Sherr L. 2006. Where the heart is: Meeting the psychosocial needs of young children in the context of HIVAIDS. The Hague, The Netherlands: Bernard van Leer Foundation. 46.
98
Schenk, K, Michaelis A, Sapiano TN, Brown L, Weiss E. 2010. Improving the Lives of Vulnerable Children: Implications of Horizons Research Among Orphans and Other Children Affected by AIDS. Public Health Rep. 1252, 325-336.
99
Ibid.
37 less social marginalization, better family functioning, and more positive feelings toward the children in
thei a e tha o suppo t g oup e e s. Fu the o e, hild e ith a egi e s i suppo t g oups
exhibited fewer behavioral problems, higher rates of pro-social behavior, and reported lower incidence of abuse from adults in their household.
100
Support groups are a relatively straightforward and scalable approach to dealing with the psychosocial needs of caregivers.
5.3 Prioritization of Recommended Interventions
