Healthlink Worldwide

Overview

CCATH - Child-Centred Approaches to HIV/AIDS - places children at the centre of communication about HIV and AIDS in order to help them cope with the extremely difficult circumstances they face due to the effects of HIV and AIDS on their families and communities.

Healthlink Worldwide was one of six organisations that worked together from 2000 - 2004 in Uganda, Kenya and the UK on the project, funded by Comic Relief.

As well as Healthlink Worldwide, the five partners were:

• ACET-Uganda
• Child-to-Child Trust, UK
• Child-to-Child Trust, Uganda
• KANCO (Kenya AIDS NGOs Consortium)
• NACWOLA (National Community of Women Living with HIV/AIDS), Uganda

The four-year project came to an end in June 2004. At this time end-of-project evaluations were made by external consultants in Kenya and Uganda identified by the project partners, and by the partners themselves, who conducted a participatory evaluation through visits to the various project sites. They gathered information from children, parents, CBOs and community members.

Findings: from isolation to acceptance
The results indicate that the project has contributed to lessening the impact of HIV and AIDS on children, their families and their communities. For example, school authorities have reported that the formation of peer counselling clubs had succeeded in breaking down the culture of silence surrounding HIV and AIDS. Children are now seen discussing HIV and AIDS issues freely in the schools.

Children affected by HIV and AIDS are accepted by their friends and they play and share their fears and problems together. In some schools, children have set up an emergency fund for orphans and poor children, providing an avenue for those from more secure
backgrounds to contribute some money or clothing to their friends.

Case study: effects on school children in Uganda
In Uganda, over one million children have been orphaned by AIDS. In the education sector, the culture of silence surrounding HIV/AIDS in primary schools has made many of these children feel like outcasts, preventing them from participating fully in school and instilling fear, anxiety, worry and low self-esteem.

Many drop out of school prematurely. In the worst cases, girls are made vulnerable to sexual exploitation and early marriages while other children resort to child labour.

David Ngobi works with one of the CCATH partner organisations, Child-to-Child Uganda. He reports the following outcomes from using the approach in schools in the capital, Kampala:

• A warm relationship now exists between children. They play, eat, and share things together, which is a sign of acceptance. It gives them a sense of belonging and improves their resilience.
• Orphans and children whose parents are ill now get support from peers and their school administration in the form of stationery or meals.
• Teachers in the project schools better understand the problems of these children. This has improved relationships and learning in general.
• All children, whether affected by HIV and AIDS or not, take special interest in HIV and AIDS patients.
• Unlike before, children have opened up to peers and adults (especially teachers). They can confide in them and discuss their day-to-day challenges.
• Children in project schools are more aware of how they can avoid risky situations such as accepting lifts, being sent on errands late at night, and sharing razor blades to sharpen pencils or shave their heads.
• Drawings in which children express their feelings about their families and HIV and AIDS form a basis for adults to build discussions on.
• Children have developed self-esteem, decision-making skills, and empathy. These have helped them in their day-to-day challenges.
• The orphans now have a positive attitude towards the future, even in the absence of parents.
• Many children now have the ambition of becoming a doctor or social worker to help people living with HIV and AIDS.
  

As David Ngobi’s reports, CCATH is seen by beneficiaries as a project which does not only address HIV and AIDS issues, but also has a positive impact on areas like teacher–child relations, improving learning. And children from a school for deaf children attended the stakeholders’ meeting; this had the unforeseen outcome of the educational institutions and non-government organisations (NGOs) present seeing the need to look more at the issue of disability in their projects.

Looking to the future
Working with children using child-centred approaches has proved very attractive to schools and NGOs. The profile of CCATH partners has been raised as a result of the innovative methods they have been using to communicate about HIV and AIDS issues with children. They have had many requests to assist in introducing the approach in the work of other NGOs and government institutions.

So far the project has concentrated on very small areas in Kenya and Uganda. For example, it is operating in only 11 primary schools in Kampala, just one-eighth of the whole district. As David Ngobi says: “There is a clear need to expand the activities of the project.” In response, the partners are currently developing a concept for submission to possible funders for the project’s expansion.

The lessons learned from CCATH have informed the development of one of Healthlink’s projects that started in 2004: ‘Improving the well-being of children and families affected by HIV and AIDS in Pallisa, Uganda’.

The experiences of CCATH have also contributed to the production of the CCATH manual, which will be available later in 2006.