Author: Winfrida Mwashala
Mwashala, Winfrida, 2018 ‘The forgotten homeless children’ Health worker perceptions of the needs of children living with HIV AIDS in Arusha, Tanzania, Flinders University, College of Nursing and Health Sciences
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Reference to homeless children living with HIV/AIDS is absent in the Tanzanian government national costed plan of action (NACPA) for Most Vulnerable Children (MVC). The NACPA plan aims to enhance the lives of the most vulnerable children in the areas of shelter, nutrition, education, psychosocial support, and health. Lack of inclusion in the plan has had detrimental effects on children living with HIV/AIDS and has resulted in them facing challenges including abuse and maltreatment, poor adherence to clinical care for treatment, and failure to meet clinical and psychosocial needs resulting in premature death. Furthermore, there is significant risk of abandoned children infecting other street children with whom they engage in unprotected sexual activity. Previous studies have shown that the government is significantly challenged in how to care for these homeless children. In order to bridge the gap in the literature on what care is available for these children, this study aims to explore how healthcare professionals manage the care and health needs of abandoned and homeless children living with HIV/AIDS in Tanzania.
This study employs a qualitative, descriptive approach to obtain an in-depth understanding of the experiences of healthcare professionals working in the Care and Treatment Centre (CTC), a hospital department which provides care for people living with HIV/AIDS. Data were collected through semi-structured interviews from seven healthcare professionals (HCPs) working in Arusha Tanzania. The data were analysed through the thematic analysis approach of Braun and Clark’s (2013) six step method.
Five themes and eight sub-themes emerged from the data, representing the selected healthcare professionals’ experiences in managing the health needs of homeless children living with HIV/AIDS. The themes are outlined below.
The lived experience of homeless children living with HIV/AIDS presents explanations of why children escape to live on the street as well as an overview of the complexity of their lives as their day unfolds on the street. HIV/AIDS treatment, care, and support services offered in CTC centres presents the experiences of HCPs in the provision of care for children living with HIV/AIDS and the challenges they face as service providers. Community mobilization and networking demonstrates the share of responsibilities and resources among community members. Health promotion and primary prevention health services for HIV/AIDS among homeless children living with HIV/AIDS presents the range of public health preventative measures available on the street. Finally, Utilization of policy and guidelines in the care of homeless children living with HIV/AIDS presents the current community awareness of available policies, which aim to protect children, and of guidelines for ensuring local implementation of these policies.
The findings contribute to knowledge about healthcare professionals’ experiences in the management of the health needs of homeless children living with HIV/AIDS. The findings of this research indicate that the lives of HIV positive children on the street is very difficult, often leading to premature death. Therefore, this study suggests a need for greater public awareness about the policies, which support and protect children, and also recommends that the development of practice guidelines is crucial in order to implement health guidelines in Tanzania. Finally, strategies to restore HIV/AIDS preventative services for the community, and particularly for homeless children, need to be implemented. Further research on end-of-life needs for homeless children should be explored along with innovative interventions to reduce child abuse and neglect.
Keywords: Children, Homeless, HIV/AIDS, CTC, End of life, Prevention, vulnerable
Subject: Nursing thesis
Thesis type: Masters
Completed: 2018
School: College of Nursing and Health Sciences
Supervisor: Julian Grant