What about HIVAIDS in Children Youth in Rural Areas of South Africa

1
What about HIV/AIDS in Children Youth in
Rural Areas of South Africa?

• Adri Vermeer
• Faculty of Social Sciences
• Utrecht University
• The Netherlands

2
How I became involved

• 2001 met Dr. Hugo Tempelman (Ndlovu Medical
  Centre, Elandsdoorn, 130 km north-east of
  Pretoria)
• We (from university) offered to assist in
  evaluating their health care programs and
• Developing regimes for Monitoring Evaluation

3
Now involved in (I)

• Elandsdoorn (NMT)
• - Effects of Awareness program for school
  children
• - Adherence of PMTCT
• - Effects of Nutritional program for under- and
  malnourished children
• Bronkhorstpruit (Sizanani Village)
• - Effects of a newly introduced stimulation
  program for children with neurological
  disabilities

4
Now involved in (II)

• Pretoria (SACBC-AIDS Office)
• - social-emotional development of children with
  HIV/AIDS
• - their cognitive development
• - evaluation of the quality of care of the homes
  where they live

5
Published results

• Vermeer Tempelman (Eds) (2006). Health Care in
  Rural South Africa An Innovative Aproach.
  Amsterdam VU University Press
• Look at www.adrivermeer.nl
• Research reports based on the research done by
  Master Degree students of the
• Faculty of Social and Behavioural Sciences
• students stay 4 months, 2 per project 8
  students per half a year

6
Side effects of our cooperation (I)

• 2006 a train-the-trainer program for the NMT
  AIDS Awareness Team
• Results
• - Train-the-trainer manual (to be published mid
  2008)
• - Effects of the training on
• team members (didactic coaching skills)
• effects of the workshops in the schools

7
Side Effects of our cooperation (II)

• 2008-2009 two year in-service training of the
  management team of NMT in applied research
  methodology
• Aims
• - development of evidence-based practises by
  means of carrying out applied research projects
• - construction of MR regimes to evaluate the
  carrying out of the projects itself

8
Some outcomes (NMT)

• AIDS Awareness Program
• - the more participation the better knowledge
  increase
• - knowledge increase is not a strong predictor
  of save sex and VCT
• - factors of influence (based on the Model of
  Planned Behaviour) differ for boys and girls
  strong predictor for save sex in girls is
  perceived behavioural control
• - stronger relationship with religion than with
  other cultural factors
• PMTCT
• - still testing an instrument to measure
  adherence (knowledge, attitude, subjective norm,
  perceived behavioural control, environmental
  factors)

9
Some outcomes (SACBC)

• Children with HIV/AIDS
• social-emotional development (5 measurements over
  3 years of depression/anxiety, withdrawal, social
  problems) significant increase of social
  problems compared with children without HIV/AIDS)
• more traumatic experiences in the control group
  (children without)
• lower level of cognitive development (IQ tests)
• Lower level of a specific aspect of abstract
  thinking (neuro-psychological test)

10
Experiences in these rural settings

• Applied research in resource poor setting is
  applicable (with good help of the NGO)
• Parents, care takers, professionals are very
  willing to participate in research
• Effects of external subsidized health care
  projects could be established by means of applied
  research (which is a good message to sponsors and
  governments)
• Finally, I tried to involve several SA
  universities, but there was very little response
  and interest

11
To close the cooperation is very rewarding for
both sides

• Thank you!