The perceptions of social auxiliary workers in their role and competencies in addressing biopsychosocial needs of children living with HIV at drop-in-centres

Abstract

South Africa bears the largest burden of children living with HIV in Sub-Saharan Africa, with 450 000 of the continent's over 3 million children living with HIV estimated to be in the country (UNAIDS, 2013:87). Children living with HIV have various intrinsic biopsychosocial needs, and the meeting of these needs within drop-in-centres is primarily the responsibility of Social Auxiliary Workers, a ?frontline? category of social welfare workforce whose roles are viewed as critical in enabling the identification and facilitation of provision of health and other services. The study was informed by a concern that, in spite of their envisaged roles, Social Auxiliary Workers have very limited paediatric HIV knowledge, skills and experience. The goal of the study was to explore the perceptions of Social Auxiliary Workers on their role and competencies in addressing biopsychosocial needs of children living with HIV at drop-in-centres. The researcher conducted this study from a qualitative approach. The study was applied in a natural setting and a collective case study design was utilised. The work experiences of a purposive sample of participants that was randomly sampled were gathered by means of semi-structured one-on-one interviews. A total sample of 10 participants was drawn from a pool of 40 Social Auxiliary Workers who were employed in 18 drop-in-centres that are in Sedibeng District Municipality. The study's findings indicate that children living with HIV had many complex biological, psychological and social needs that were exacerbated by stigma, discrimination and non-disclosure of the children's HIV status by parents. This created underlying debilitating barriers for Social Auxiliary Workers to efficiently identify, and get children into treatment, care and social support services. The findings also revealed that Social Auxiliary Workers had limited, non-standardised and highly imperceptible HIV knowledge and skills to competently work with children living with HIV. Furthermore, findings showed that Social Auxiliary Workers face institutional and resource challenges that stem from poverty, insufficient financial resources within drop-in-centres and lack of structured large scale programmes to mobilise and educate communities on children and HIV. The study concluded that many of the biopsychosocial needs that children living with HIV face are not being comprehensively and sustainably addressed as Social Auxiliary Workers are not effective in their role, amongst other things, due to lack of skills and knowledge on how to address factors that contribute to the exclusion; and consequently, disproportionate low access of services by children living with HIV. The study proposes the training and capacitation of Social Auxiliary Workers on paediatric HIV so as to increase the depth and breadth of services rendered to children living with HIV. It is also important that regular and on-going supervision and debriefing opportunities for Social Auxiliary Workers should be strengthened to promote optimal consolidation of skills and knowledge. The provision of simplified practice guidelines and procedures should also be prioritised in order to ensure consistency in understanding amongst Social Auxiliary Workers of their role and obligations. Furthermore, it is recommended that Government and the Department of Social Development should consider scaling-up funding for drop-in-centres as well as implementation of HIV-related stigma and discrimination mitigation programmes in communities.