Towards an effective linkage system for HIV positive foster care children between social workers and community volunteers in the city of Johannesburg

Abstract

The goal of the study was to determine services provided to children in foster care living with HIV by social workers and community volunteers in the City of Johannesburg to develop an effective linkage system. Three theoretical frameworks underpinned this study which are social support theory, knowledge management theory and systems theory. The study employed a mixed methods approach in the form of an explanatory sequential design which implies that quantitative data was collected and analysed first followed by qualitative data. The sample consisted of foster care social workers from Department of Social Development (DSD) and community volunteers consisting of social auxiliary workers and community caregivers from Drop-in Centres (DICs). For quantitative data, 42 social workers and 100 community volunteers were selected using cluster sampling. A collective administration questionnaire was used to collect data and the data were analysed using R Core Team, 2020. For the qualitative part, purposive sampling technique was used to select 14 social workers and 20 community volunteers. Semi-structured interviews were used to collect data that were analysed thematically using Nvivo. Both the quantitative and qualitative findings revealed that the social workers were playing a critical role in foster care placement in terms of supervision, disclosure support, linkage to care and referrals, psycho-social support, and informational support. However, there were fundamental challenges in foster care placements such as lack of timely supervision by the social workers, lack of training on HIV services, poor communication within DSD directorates, high volume of caseloads, lack of community profiling and lack of knowledge about the DICs. These challenges hindered social workers to carry out their mandate comprehensively and impacted on the lives of the children and their foster parents. Additionally, the social workers did not view children living with HIV as deserving more attention and that they were the responsibility of the Department of Health and HIV directorate from the DSD. On the other hand, the findings from community volunteers established that they provided HIV services to children and families in communities but mostly the beneficiaries of the community volunteers’ services were not children in foster care, but other orphan and vulnerable children. The study concluded that the gap in services from social workers could be filled by community volunteers. Consequently, the study developed guidelines for a linkage system between the social workers and community volunteers to provided services to children in foster care living with HIV.