Community-based Family Programmes

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"My children were scared of me but now I have learned how to be with them. Now we talk and I play with them. The children can see the joy in my face, not the animal I was before. I love them.” – 62 year-old caregiver, South Africa

Overview

Clowns Without Borders South Africa works closely with community organisations to provide ongoing support to vulnerable children and families. Our arts based programmes incorporate the best-available evidence within local socio-cultural context so that caregivers may develop effective ways of coping with stress and improving their relationships with their children.

We have 3 specific family programmes that are targeted to different stages of child development:

1. Sinovuyo Caring Families Programme for children ages 3-8

2. Injabulo Family Programme for children ages 8-12

3. Injabulo Teen HIV Prevention Programme for children ages 13-18

Sinovuyo Caring Families Programme

The Sinovuyo Caring Families Programme is a parenting intervention focused on reducing the risk of child maltreatment in vulnerable families. Child abuse prevention is urgently needed in Southern Africa Child abuse rates are exceptionally high in South Africa, including physical, sexual and emotional abuse (Jewkes, Dunkle et al. 2010). Families with HIV-infected parents, foster parents, and/or parents who are victims of intimate partner violence are particularly high-risk groups for child abuse. For these parents and caregivers, the stresses of their health problems, of caring for multiple orphaned children and of their own childhood experiences can make parenting more difficult (Cluver, Orkin et al. 2011). Parenting interventions have been shown to reduce risk of child abuse in Australia, the US, and the UK (Barlow, Johnston et al. 2006).

The Sinovuyo Caring Families Programme focuses on families who are at the highest risk for child abuse: those experiencing HIV/AIDS, caring for AIDS-orphaned children or caregivers who have been victims of intimate partner violence. It uses the most rigorous scientific evidence from internationally-developed parenting programmes to increase positive parenting, improve child-caregiver relationships, and reduce harsh parenting and abuse. Developed in collaboration between Clowns Without Borders and Ikamva Labantu, alongside researchers and experts in parenting interventions from the Universities of Cape Town, Oxford and Bangor, it is currently in a 6-month process of adapting and intensively piloting evidence-based practices to the South African cultural context. It includes 10 weekly group sessions with 15 caregivers in each session, and home visits to support skills learnt in the home environment. Using participatory social learning activities, caregivers develop skills in positive parenting, non-violent discipline and protecting their children from abuse outside the home. Starting in 2013, the programme will be evaluated in a randomised controlled trial and implemented on a wide scale throughout the isiXhosa townships of Cape Town, Western Cape.

Injabulo Parenting Programme

The Injabulo Family Programme ("injabulo" means "joy" in isiZulu) aims at developing positive caregiving relationships and emotional wellbeing for families with orphans and vulnerable children ages 8 to 12 who are affected by HIV/AIDS and poverty. In 2009, UNAIDS estimated that 33.4 million people are living with HIV throughout the world (UNAIDS 2009). South Africa faces one of the largest impacts of the global pandemic with 5.7 million HIV+ people and 350,000 AIDS deaths annually. Approximately 1.4 million children have been orphaned by AIDS (UNAIDS 2008), the majority of whom are cared for by extended family (Monasch and Boerma 2004). The impact of HIV/AIDS on children is further compounded when considering those affected by the pandemic, including orphans, those living with AIDS-sick caregivers, and HIV-infected children; (Richter, Foster et al. 2006). Recent research shows that AIDS-affected children experience higher prevalence of psychosocial problems than other children including depression, anxiety, post-traumatic stress disorder, reduced school attendance and concentration, and isolation from peers (Cluver 2011). In addition, adult caregivers also bear an emotional burden in providing care to orphans and AIDS-affected children (Kuo 2009). Grandmothers and other elderly guardians find themselves having to suddenly take care of the orphaned grandchildren left behind by their late daughters and sons. This causes a lot of stress in the family and little time invested in better life for the future.

The Injabulo Family Programme is an integration of three evidence-based training and support strategies: (1) Mindfulness Based Cognitive Therapy (MBCT), (2) Positive Parenting programmes, and (3) ongoing Peer Support Groups. The programme is implemented in two parts for both caregivers and children: an initial 10-day PSS intervention and a 5-day follow-up which helps community partners establish ongoing monthly support groups for both vulnerable children and adult caregivers. It has been implemented throughout Southern Africa for more than 2,000 families and has received positive qualitative feedback from both beneficiaries and community partners. Through storytelling, play, music, dance, and awareness exercises participants explore ways to connect to each other at home and thus strengthen the bond between children and their guardians. Particular attention is given to learning how to cope with bereavement and stress as well as learning ways of playing and interacting with their children in a positive way. A manualized version of the Injabulo Family Programme is available upon request in English and isiSwathi.

Injabulo Teen Programme

The Injabulo Teen HIV Prevention Programme for children 13 to 18 focuses on psychosocial as well as HIV prevention and sexual behavior for vulnerable families. Developed in collaboration with the MacAIDS Foundation, the Injabulo Teen HIV Prevention Programme has 3 main objectives: 1) to provide bereavement counseling and stress reduction techniques to children and their guardians, 2) to raise awareness on sexual health at puberty and adulthood, and 3) to raise awareness on ways to prevent HIV infection for guardians and children. The Intervention is implemented over 10 sessions in the community. The children and their guardians use therapeutic play methods and art based techniques to understand their situations (i.e. the death of a loved one (s), perceived lack of control over their circumstances.) At the same time, the programme focuses on sexuality issues and HIV prevention so that they can have control over through the way that they think and act. In addition, the Teen HIV Prevention Programme also works with the children’s guardians to help them understand how children are affected by death and how they can draw from their own childhood memories of loss to recognise the need to support these children.

The programme also equips the guardians with simple ways they can be supportive and loving to their children. Furthermore, the guardians are educated about how they can protect themselves from being HIV infected, to help them live longer healthier lives. Such support structure is essential as children need to have at least one meaningful relationship with a caring and supportive adult. Such a relationship is critical for them as they enter adolescence. A healthy guardian-to-child relationship especially provides a non-judgemental environment for children, one that enhances the support to children to remain HIV negative and continue to make wise decisions, and to seek help if they encounter problems, including those related to sexuality issues.

For more information, please contact us at info@cwbsa.org.