Abstract
Background: Designing a need-based social protection intervention for children comes as comprehensive tool for addressing the overall quality of life of HIV positive children. Not much has been examined on what constitute the desired social protection framework for HIV positive children. Methods: This study was informed by a qualitative descriptive exploratory design approach. The study drew insights from the shared perspectives of 27 participants sampled from positive HIV status disclosed children—10 - 17 years, healthcare workers, Social and Development worker, HIV positive caregivers and parents from 7 ART clinics in rural and urban Brong Ahafo and Ashanti regions of Ghana. Data was collected through interviews and two focus group discussions with study participants. Drawing on the emerged themes from the transcripts, thematic content analysis was used to analyze the data using comparative thematic framework approach. Findings: The eclectic perspectives on the type of social protection policy/intervention preferred demonstrated the need for an interrelated and integrated social protection policy. This should not be designed in isolation towards addressing the child vulnerability. The study found that social protection policies aimed at addressing vulnerability levels of children should consider the dual vulnerability situation within which HIV positive children and adolescents are located. A set of unique specific tailored approach and package reflecting minimum combination social protection package to HIV positive children was considered essential for inclusion. The themes that emerged covered social policy/intervention package inclusive of a disease ending/eradication intervention package, cash transfer for children and their caregivers, free comprehensive health insurance integrating all consultancy and laboratory services charges, direct food supplements supply and nutritional support, research, target specified with evidenced-based monitoring. Counseling support and preferential treatment for children visiting ART for treatment were to be included. Conclusion: Combination social protection intervention packages remain the pathway to yielding maximum dividends on any social intervention that seeks to address the vulnerability levels of HIV positive children in Ghana. This should be designed taking into consideration the preference of the main target beneficiaries (HIV positive children) while accounting for the inclusion of the technical expertise of implementing stakeholders in the policy design from conceptualization to evaluation.
Highlights
Designing a need-based social protection intervention for children comes as comprehensive tool for addressing the overall quality of life of HIV positive children
Key informant interviews were held with nine (9) healthcare workings directly engaged in ART clinic and child and adolescent HIV care and management and 2 officers involved in policy and welfare issues for HIV positive children
Our study contends and establishes that, the type of social protection policy initiatives that despite the similarity that may be associated with social protection interventions for children in general, a unique set of well-tailored approach and package is to be designed for HIV positive children
Summary
Designing a need-based social protection intervention for children comes as comprehensive tool for addressing the overall quality of life of HIV positive children. A multi sectoral approach and perspectives have been shared on how to address the multiplicity of challenges that comes along with caring for HIV and AIDS infected children. This has been due to the increased survival of children resulting improved medication. The search for a combination intervention to address the needs of HIV and AIDS infected children due to the multidimensional effect of HIV illness on them has been a long-standing academic inquiry. Scholars such as McCord and Himmelstine and Pettifor and colleagues have reiterated such calls [2] [3]. In 2004, the United States President’s Emergency Plan for AIDS Relief (PEPFAR) initiated a Public-Private Partnered intervention in ten African countries and dubbed the intervention Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS)
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