Abstract
Introduction Child-centred care approaches are increasingly gaining traction in healthcare; and are being applied in the delivery of HIV care for children in resource constrained settings. However, very little is known about their potential benefits. Methods We synthesised literature from primary and secondary publications exploring the philosophical underpinnings of the concept of child-centred care, and its application to HIV service delivery for children in resource constrained settings. We concluded the review by suggesting a conceptual framework for mainstreaming and integrating child-centred care approaches in the management of HIV in resource constrained settings. Results The philosophical underpinnings of child-centred care stem from human rights (child-rights), holism, the ecological model, and life-cycle approaches. Although there is no standard definition of child-centred care in the context of HIV, the literature review highlighted several phrases used to describe the “child-centredness” of HIV care for children. These phrases include: (i) Respect for child-healthcare rights. (ii) Using the lifecycle approach to accommodate children of different ages. (iii) Provision of age-appropriate HIV services. (iv) Meaningful participation and inclusion of the child in the healthcare consultation process. (v) Using age-appropriate language to increase the child's understanding during healthcare consultations. (vi) Age-appropriate disclosure. (vii) Primary caregiver (PCG) participation and preparation (equipping the PCGs with information on how to support their children). (viii) Creation of a child-friendly healthcare environment. (ix) Consideration of the child ecological systems to have a holistic understanding of the child. (x) Partnership and collaborative approach between children, PCGs, and healthcare workers (HCWs). Conclusion Child-centred care approaches can potentially increase child-participation, promote positive health outcomes and resilience in children living with a communicable, highly stigmatised and chronic condition such as HIV. More evidence from controlled studies is required to provide concrete results to support the application of child-centred care approaches in HIV care services.
Highlights
Child-centred care approaches are increasingly gaining traction in healthcare; and are being applied in the delivery of HIV care for children in resource constrained settings
[1]. e UNCRC gave substance to the rights of children and a rmed that children under the age of 18 years should be a orded age-sensitive healthcare [1, 2]. is watershed convention gave children a voice in healthcare service. is unconventional approach by the UNCRC constituted a paradigm shi from the pervasive paternalistic behaviour demonstrated by doctors and endorsed by the Primary caregiver (PCG) of children [1, 2]
In the context of this study, HIV services for children included; HIV counselling and testing (HCT), anti-retroviral therapy (ART) initiation, treatment adherence, disclosure, counselling and support. e term “children” in this study refers to young people between the ages of 0–17 years, in accordance with the UNCRC (1989) [4]
Summary
Child-centred care approaches are increasingly gaining traction in healthcare; and are being applied in the delivery of HIV care for children in resource constrained settings. We synthesised literature from primary and secondary publications exploring the philosophical underpinnings of the concept of childcentred care, and its application to HIV service delivery for children in resource constrained settings. We concluded the review by suggesting a conceptual framework for mainstreaming and integrating child-centred care approaches in the management of HIV in resource constrained settings. E philosophical underpinnings of child-centred care stem from human rights (childrights), holism, the ecological model, and life-cycle approaches. There is no standard de nition of child-centred care in the context of HIV, the literature review highlighted several phrases used to describe the “child-centredness” of HIV care for children. The concept of child-centred care is growing in prominence, it still lacks a concrete definition, application, and conceptual clarity [3, 6, 7]. is is due to the diverse interpretations offered in different contexts. ere is still confusion regarding what child-centred care entails. e confusion emanates from the overlap between child-centred care and other pervasive healthcare approaches, including patient-centred care and family-centred care [3, 6, 7]
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