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HIV and AIDS - Child-Centred Approaches to HIV and AIDS (CCATH)

Lessons Learned: Listening to children - children as partners in research

children, Uganda

Many people work in organisations that focus on children’s issues and are familiar with all the talk about children’s participation. Yet they often feel uncertain about how to communicate with children effectively. One of the most important aspects of working with children is learning how to listen and learn from them – so that children can truly participate in analysing, planning, implementing and evaluating activities.

Learning to listen to children can transform how an adult perceives children. They learn how children can analyse their situation and provide constructive ideas with competence and imagination.

In recent years many tools and methods have been developed to help this communication. Current methods of child-centred participatory research are helping adult researchers and programmers to find appropriate ways to listen to and learn from children – methodologies that will be interesting and unthreatening for children themselves. Many ideas have been adapted from the tools developed working with communities using PRA (participatory rural/rapid appraisal) and PLA (participatory learning and action).

The following are examples of research tools that have helped researchers and programmers in the CCATH project to listen to children and learn more about their lives. All of these cases use drawing as a tool. Once the child has drawn her or his example, the researcher sits quietly with each individual to find out more about the meaning of the drawing.

Communication Mapping
In Communication Mapping children are asked to first draw a picture of themselves and then add the people with whom they live or who are important to them. They are then asked to draw lines between themselves and the other people in their picture, drawing up to three lines for each person depending on how important that person is to them. Finally, the children write on the lines the subjects they discuss with these people.

Open communication with parents or other trusted adults and the ability to express one’s emotions and fears are key aspects of children’s resilience. Communication Mapping provides insights into the children’s lives, who they relate to, who gives them support, and who they in turn are supporting.

The following two examples indicate the kind of insights this process provides. These two boys, from Kampala, both had mothers who were living with HIV. The names of all the children have been changed.

Jo's drawing, click to enlarge"Joseph is a quiet but confident boy. He lives with his big brother, whom he has drawn in a karate position. He said that this shows how strong his brother is and how his brother can protect him. His emotional support comes from his older sister. His mother is sick and lives in the village. His communication with her, when they do meet, is more formal – about his studies and his life. There was no mention of Joseph's father – and he did not volunteer any information. The interviewer was sensitive not to probe on this, although it was presumed that the father is either dead or fully separated from the family. Discussion with Joseph illustrated the importance of siblings remaining together, for economic and emotional support."

Mark's drawing, click to enlarge"Mark was an articulate and well-adjusted boy. Compared to some of the other children, Mark seemed genuinely calm about his situation. Mark's drawing shows the support he gets from the wider family. Most significant is his relationship with his mother. In contrast to other children, Mark and his mother were open about her HIV status. He knew that she was sick and, as his drawing shows, he is able to talk with her and bring her comfort. "I talk about the beautiful day. I talk to mummy about how she is feeling." He drew comfort from his close relationship with his mother. Mark is also able to talk with his brothers about his problems - in this case, cruel teachers. He also is able to help others, talking with his nephews about their lives. Mark's communication map illustrates how he is able both to share his worries and to support others. Again, Mark’s example demonstrates some important areas of resilience: open communication with his mother, an ability to express his emotions openly and an opportunity to gain self-esteem by helping others."

River of Life
Children at a Ugandan youth centre, supported by ACETThe River of Life is another research tool. Here children are asked to draw a river of their life, starting from their birth and projecting five years into the future. The river flows up at good times and down at bad times. The children put small pictures and/or labels on their drawing to explain the events which make their rivers flow up and down.

"Mary has drawn the river flowing up on her entrance to school. The downward turn was when her parents got sick. What is most significant here is that Mary believes that her future is positive. She feels that her community is supportive and that after her parents have died she will get a scholarship to continue in school. Mary shows herself in Senior 2 class in five years' time.”

By looking at a large sample of children, the direction of the line into the future will give researchers an indication of the degree to which these children feel supported by their environment (including by the interventions of the initiative). It will also show the extent to which they have a positive self-image and a realistic and constructive goal for the future. These are all significant elements in determining children’s resilience. The belief in a positive future may be crucial in determining whether or not young people engage in risky behaviour in relation to HIV and other issues.

Happy and Sad
In this example, children draw and label a picture of what makes a child of their age and gender happy and, in another picture, what makes a child sad. A collection of such drawings from a school or community reveals an enormous amount about the children’s social environment: about peer group stigmatisation or inclusion of children affected or living with HIV and AIDS; about the attitudes, positive and negative, of teachers and other adults towards children; about support for children’s basic needs; and about children’s spirituality. When this information is compiled and then fed back to children, their teachers and parents and/or guardians, it gives them insights into the positive aspects of their environment that need to be celebrated and promoted, while also revealing the negative aspects that need to be challenged.

Sharing the findings
With children and communities as partners in research, it is very important that the findings of the research are fed back to the community for them to consider what actions they want to take.

For example, in Kenya, KANCO (Kenya AIDS NGO Consortium) worked with community-based organisations using the CCATH approach to child-centred participatory research. Once the findings were compiled, the research team returned to the various communities to share the results and discuss the analysis. After fun sports activities, both children and adults discussed what had been learnt about their community through the research and considered their practical response.

Children as evaluators
The Child-to-Child approach provides an example of how children can be actively involved in planning, monitoring and evaluating activities. Children can also participate in defining indicators. For example, in Bangladesh adolescents have made large drawings to illustrate what makes a community ‘adolescent-friendly’. The criteria they give can be monitored by the adolescents to see whether their environment is improving. In Uganda this approach has been used to monitor adolescent-friendly health services.

Once children become partners in research and evaluation, they gain the confidence and competence to claim active participation in community-level activities. And significantly, listening and learning from children also makes a profound impact on the attitude of adults to children’s competence and ability to act.