Our goal is to make health care accessible to as many HIV+ orphans and vulnerable children living in the comunity of Matero as we can. Accordingly, our plan is to add 50 children to our pediatric HIV care program in October 2019 to make the total number of children under our care 450. Given below is the process of enrolling children and various elements of the program to ensure better health for these children.
Beneficiary selection process: We partner and work closely with several community-based organizations, local churches, and government clinics. These organizations provide referrals. In addition, our health care staff identifies children who are sick during their regular home visits. At any time, the Project Nurse has a list of 40-60 children who can be added based on availability of funds.
Training provided to family members: Once the children are selected, one family member (who is the primary caregiver) for each child is provided with an intensive 5-day training in basic hygiene, caring for an HIV+ child, HIV prevention, identification of infections, and how and when to escalate care to the next higher level. Training is participative, hands-on and in the local language as most trainees have never been to school and many cannot read or write. On successful completion of training by family members, the children are enrolled. Training family members ensures that the child is under the care of a trained caregiver 24/7.
Provision of food, medicines, and a package of life saving health care services: Once enrolled, all children receive mealie meal (a Zambian staple), beans, cooking oil, medicines, and a comprehensive package of health care services. The package includes regular home visits by the health care team, psychosocial counseling, education in HIV prevention and monitoring and training in adherence to medication. Children who are malnourished/undernourished receive high protein soya supplement, in addition to mealie meal, beans and cooking oil.
As part of the health care package, all children are visited regularly in their homes by our health care team. During a typical home visit, a health care worker records the height, weight, BP, oxygen level, and temperature, checks for rashes, sores, symptoms of infections, and counsels the child and family. Health records of children are updated, and the Nurse informed about the progress of the child.
Ongoing education in HIV prevention and counseling is provided to family members of all children. In addition, women are encouraged to go in for cervical cancer screening.
School support is provided to children who come from families who cannot afford expenses for school such as fees, uniforms, shoes and school bags,. This ensures that all school age children are able to attend school.
Prevention of Mother to Child Transmission (PMTCT) of HIV: Family members of children are provided with training in PMTCT to maximize chances of the child being born HIV free.
Ongoing discussion and action taken for more serious cases: Children who need additional care are monitored closely by the Project Nurse. Difficult cases are discussed, and care escalated to the next higher level - for example, the child is taken to the doctor/hospital as needed.
Children graduated and encouraged to volunteer: Children who turn 18 years of age and pass high school (whichever comes later) graduate from the program. Older children and graduates are encouraged to volunteer in our “Safe Park” program by leading workshops in HIV prevention and mentoring younger children. A few graduates volunteer regularly and have become role models/mentors for younger children.
The goal of all program activities is to provide high quality care to children living with HIV, educate families in HIV prevention, prevent new infections in infants, and reduce HIV related stigma. The long-term goal is for children and families to become self-reliant in taking care of their own health.