Healthlink child centred approaches memory work


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  • S & M Limitations Although there were set criteria to guide the choice of geographical area and groups to ensure a good spread of factors, the reality was that other issues came into play which also determined which areas to visit, and whom was to be visited . This included issues such as the availability of project field staff , the availability of children (although we tried to timetable children’s work during out of school hours and in particular at the weekend), distances involved to travel to some communities especially where time was a limiting factor. A number of key staff had left the project since August 2008, or were away at the time of data collection (KANCO,TILLA, HAPSCO, NACWOLA-Luwero). Many interviews required the use of a translator and these were not ‘official translators’. This resulted in ‘summary’ information sometimes being provided during discussions. In relation to the attitudinal information collected, every effort was made to check for clarity. In some settings the memory work was one of a number of projects being implemented by the partner organisation. This sometimes posed a challenge around disentangling the activities and trainings which were part of the memory project, and the impact that they had. In these cases, care was taken to look at the ‘added value’ of memory work. There was some baseline data collected in three out of the five countries (In Ethiopia, Tanzania, and Zimbabwe). These baseline studies provided some insight into key issues, but were small scale and qualitative in nature. No quantitative data was collected at the start of the project, such as the number of people on treatment, or taking up other types of services. It is therefore difficult to measure change over the four years and attribute this specifically to the memory work project. Where relevant, information from the baseline is referred to and comments made about any changes observed. Unfortunately because of the recent political stability in Zimbabwe the evaluators were not able to carry out field work in Zimbabwe. A face to face interview with the programme manager was carried out in Ethiopia, and other key staff sent a questionnaire by email. In terms of beneficiaries, the FACT staff were keen to do some direct evaluation with young people and parents, and made use of the same evaluation tools to conduct two FGDs. This material was not included within the analysis but was a useful secondary source of data. Despite these limitations, a very broad range of secondary data was used to triangulate the findings and to ensure the validity and reliability of findings (see section 2 above for the full list of materials), and both consultants worked closely together to discuss the emerging issues and key themes on an ongoing basis. Ethical issues – around interviews with children . Also agreement to provide feedback to children
  • In explaining this, focus on the practical aspects of what we do in the countries eg. improving their access to health services, improving the delivery of services by health centres by addressing the communication angle. We address the role of communication in research-policy-practices
  • Memory work enables children to: understand more about HIV and AIDS, understand what may be happening to their parent, guardian or family member who is affected by HIV and start to prepare for a future where they may be separated from their parents.
  • Healthlink child centred approaches memory work

    1. 1. Child Centred Approaches International Memory Project
    2. 2. <ul><li>Presented by: </li></ul><ul><li>David J N Musendo </li></ul><ul><li>[email_address] </li></ul>
    3. 3. Overview <ul><li>What is Healthlink Worldwide? </li></ul><ul><li>What do we do and how we do it? </li></ul><ul><li>Healthlink Worldwide’s International Memory Project </li></ul><ul><li>What difference does Memory work make? </li></ul><ul><li>Lessons learned </li></ul><ul><li>Key challenges </li></ul>
    4. 4. What is Healthlink Worldwide? <ul><li>International NGO that focuses on communication for health and disability in the development sector. </li></ul><ul><li>Head office in London (UK), regional offices in Nairobi (Kenya) and Kolkata (India) with partners based in over 30 countries in Asia, Africa and Latin America </li></ul><ul><li>We work in collaborative partnership with local organisations and communities, national organisations, governments and academic institutions. </li></ul>
    5. 5. What do we do? <ul><li>work to improve the health and well- being of disadvantaged and vulnerable communities in developing countries. </li></ul><ul><li>help them to develop their skills to: </li></ul><ul><li>- identify the issues and priorities that affect their lives, and </li></ul><ul><li>- communicate these effectively so that their voices can be heard. </li></ul><ul><li>coordinate the Source international information support service. </li></ul>
    6. 6. How we work? <ul><li>rights-based approach to health and disability; </li></ul><ul><li>use participatory methods to strengthen communication and develop a sustainable approach; </li></ul><ul><li>seek to increase two-way dialogue and information flows, and </li></ul><ul><li>to increase the evidence base from marginalised communities. </li></ul>
    7. 7. Healthlink Worldwide and Memory Work
    8. 8. Background of memory work in Africa <ul><li>Memory work was first developed as a response to HIV and AIDS by Barnardo’s, working closely with African families affected by HIV and living in the UK in the 1990s. </li></ul><ul><li>The approach is rooted in oral history approaches, valuing the transmission of knowledge between generations as a way of building cultural identity. </li></ul><ul><li>Memory work is increasingly employed as a response to a crisis being experienced in many African countries where children and young people are disproportionately affected by the HIV and AIDS epidemic. </li></ul>
    9. 9. Healthlink’s International memory project (IMP) <ul><li>The IMP focuses on the use of memory work as a way to encourage families to communicate about HIV. </li></ul><ul><li>By increasing communication in a safe environment, children are supported to develop increased resilience to the impact of HIV on their lives. </li></ul>
    10. 10. Partners <ul><li>Funded by Comic Relief between 2003 – 2009, IMP has been implemented by: </li></ul><ul><ul><li>Kenya : (KANCO) Kenya AIDS NGOs Consortium </li></ul></ul><ul><ul><li>Uganda : (NACWOLA) National community of women living with HIV and AIDS </li></ul></ul><ul><ul><li>Zimbabwe : (FACT) Family AIDS Caring Trust </li></ul></ul><ul><ul><li>Tanzania : (Kiwakkuki) Women against AIDS in Kilimanjaro </li></ul></ul><ul><ul><li>Ethiopia : TILLA association of women living with HIV and AIDS and (HAPCSO) HIV/AIDS prevention care and support organization </li></ul></ul>
    11. 11. Memory Work’s 4 main pillars <ul><li>improving communication between parents and other family members living with HIV and their children </li></ul><ul><li>supporting parents to disclose their HIV status if that is their choice and other important health information </li></ul><ul><li>succession planning , including writing a will and choosing guardians for children </li></ul><ul><li>documenting important family history and information in a memory book </li></ul>
    12. 12. IMP Activities (1) <ul><li>Since 2003, partners have developed a range of </li></ul><ul><li>activities which support the 4 pillars. </li></ul><ul><ul><li>Parents and guardians receive training and support in child development, improving communication with children, and making plans for the future. </li></ul></ul><ul><ul><li>Support groups enable parents, guardians and children to explore issues in a supportive environment and receive support from other people who are experiencing similar situations. </li></ul></ul>
    13. 13. IMP Activities (2) <ul><ul><li>Children are involved in activities which aim to increase their knowledge about HIV and AIDS, develop and strengthen life skills and develop peer support groups </li></ul></ul><ul><ul><li>Activities with children use child-centred approaches, which ensure that they are appropriate for the child’s stage of development </li></ul></ul>
    14. 14. Memory work encourages communication between guardians and their children
    15. 15. What difference does memory work make for children, adults and communities? (1) <ul><li>Increased parent – children communication </li></ul><ul><li>Increased levels of confidence and wellbeing </li></ul><ul><li>Parents begin to write wills and plan for their children’s future. </li></ul><ul><li>When memory work is combined with testimonials there is evidence that stigma and discrimination around HIV and AIDS are reduced in the community </li></ul>
    16. 16. Sharing some testimonies on Memory Work <ul><li>A group of participants in Ethiopia discussing the most important change in their lives brought about by memory work </li></ul><ul><li>A woman living with HIV from Uganda </li></ul><ul><li>A positive man from Zimbabwe </li></ul>
    17. 17. Lessons Learnt (1) <ul><li>Collaborating with legal institutions supports access to legal rights for men, women and children </li></ul><ul><li>Effective involvement of the media strengthens advocacy of issues that affect children </li></ul><ul><li>Formation of MW clubs builds resilience in children to cope with effects of the impact of HIV at family level </li></ul>
    18. 18. Lessons Learnt (2) <ul><li>Sustaining memory work requires community, government and development partners’ good will to adopt the process . </li></ul><ul><li>Meaningful community participation in implementing memory work is crucial for community ownership </li></ul><ul><li>More advocacy efforts around memory work will mean policy makers and other development agencies will be aware of the positive benefits of memory work </li></ul>
    19. 19. Key challenges <ul><li>Lack of funding and resources to continue and expand memory work </li></ul><ul><li>Unsupportive legislation and policies at national level for memory work </li></ul><ul><li>Limited male involvement </li></ul><ul><li>Marginalization of grandparents and children heading households as they take up their new roles of parenting </li></ul>
    20. 20. Thank you <ul><li>For more info: </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul>