Care and support for HiV/AIDS affected Children in Thailand

Transcription

1 Commission ECCE and HIV/AIDS Care and support for HiV/AIDS affected Children in Thailand Darunee Rujkorakarn World Conference on Early Childhood Care and Education September 2010 Moscow, Russian Federation

2 Care and support for children affected by HIV in Thailand Darunee Rujkorakarn, RN, EdD Mahasarakham University, Thailand Dr.Darunee Rujkorakarn 1

3 Situation of children in Thailand 5,751,652 children under 6 years old 3 groups of children *Children in difficult situations *Talented children *Normal children Dr.Darunee Rujkorakarn 2

4 Abandoned Children in difficult situations Misbehave Handicapped Rights violated Underprivileged HIV affected Dr.Darunee Rujkorakarn 3

5 Planning for future caregiver of HIV orphans Main caregiver Main caregiver Aunt * GP * Aunt Diseased dad Main caregiver Sick mom* Joint caregiver GP* Joint caregiver Mom died Future Present Past Mom GP= Grandparents Dr.Darunee Rujkorakarn 4

6 Routes to Residential Care for Affected Children in Thailand Mother HIV+ Child Diagnosed HIV+ Death or Abandonment of Mother/ Father Increased Role of Hospitals and Support Groups Extended Family Group Home Government Welfare Home Temple Foster Care Adoption Child Diagnosed HIV- Decreased Role of Hospitals and Support Groups Homeless / Self Care Dr.Darunee Rujkorakarn 5

7 Impacts of HIV on children * Before being orphaned *Being orphaned Dr.Darunee Rujkorakarn 6

8 Impacts of HIV on early childhood HIV infected children are vulnerable to - abandonment by parents - social discrimination - school attrition - be stigmatized and excluded from learning and peer group activities Dr.Darunee Rujkorakarn 7

9 Impacts of HIV on early childhood HIV affected children - do not feel different from other students - being children of infected parents place a stigma on them - living with an elderly caregiver, they feel alone Dr.Darunee Rujkorakarn 8

10 Impacts on Children Infected and Affected by HIV/AIDS Government Community Family No support structure Inconsistent support from local officials, Schools Lack of Knowledge & Misconceptions about HIV/AIDS Economic Problems Lack of appropriate care Psycho-social Problems for children infected& affected by HIV/AIDS Psychological distress No peer group No consistent adherence to ARV treatment Dr.Darunee Rujkorakarn Increased risk of school attrition 9

11 At School School/education Infected child Attend/not Caregivers Frequent sickness Fear infection Rejection Image of illness Attitude/ knowledge Teachers, parents of Dr.Darunee Rujkorakarn other children 10

12 Non infected Regular school children Supports from teachers and students Resource Ill /poor parent Dr.Darunee Rujkorakarn Financial status 11

13 Growth and Development Infected Frequent illness affected growth &development and social skill Non infected Normal Sometime aggressive growth Dr.Darunee Rujkorakarn 12

14 Government Policy 1.Provide antiretro viral drug (ARV) 2. Social services 3. Provide education Dr.Darunee Rujkorakarn 13

15 Existing care and support for children affected and infected by AIDS Institutional based care - GO Home - NGO Home (Group Home) Community based care Family based care Dr.Darunee Rujkorakarn 14

16 Key success of Group Home Clear philosophy of Group Home Ability to raise fund Administration system and leadership Dr.Darunee Rujkorakarn 15

17 Family based care 1. Family care By grandparents -Planned - Unplanned Pros - Willing & love Cons -Generation gap -Familiar environment -Maintain self identity Dr.Darunee Rujkorakarn -Too old -no income 16

18 Community based care 1. Home visit -Infected volunteer -Health personnel 3.Child Friendly School 4. Holistic care centered 5. Support from HIV local group/network 6. Community day care Dr.Darunee Rujkorakarn center 17

19 Activities of Holistic Community based Care 1. PLWA peer group support, monitoring and counseling for HIV+ adults and schools. 2.Parents/caregivers meeting. 3.Affected children s play and therapy group. Meeting of HIV affected children. 4. Capacity building for parents and teachers in early childhood development centers. Dr.Darunee Rujkorakarn 18

20 Major Challenges 1. Teachers negative attitudes 2. The need to provide flexible education for the children 3. The lack of structured care and support system Dr.Darunee Rujkorakarn 19

21 Recommendations 1) A policy to eradicate discrimination in schools and a school guideline to provide care and support for the infected children and their families. 2) A health care and social program to extend the lives of the infected mothers. Dr.Darunee Rujkorakarn 20

22 3. Increase an effectiveness of the holistic care centers. 4. Provide financial help for foster care. 5. Funding research into teacher s attitude to stimulate a change in thinking and provide a more flexible educational system for young children affected by HIV/AIDS. Dr.Darunee Rujkorakarn 21