Showing posts with label HIV-affected households. Show all posts
Showing posts with label HIV-affected households. Show all posts

Friday, March 11, 2016

Re-Thinking Children’s Agency in Extreme Hardship: Zimbabwean Children’s Draw-and-Write About Their HIV-Affected Peers

We compare two analyses of the same ‘draw-and-write’ exercises in which 128 Zimbabwean children represented their HIV-affected peers. The first, informed by the ‘New Social Studies of Childhood’, easily identified examples of independent reflection and action by children. The second, informed by Sen’s understandings of agency, drew attention to the negative consequences of many of the choices available to children, and the contextual limits on outcomes children themselves would value: the support of caring adults, adequate food, and opportunities to advance their health and safety. Conceptualisations of agency need to take greater account of children’s own accounts of outcomes they value, rather than identifying agency in any form of independent reflection and action per se.

…In line with the New Social Studies of Childhood, our first analysis dutifully sought out and documented instances of independent reflection and action by children. To what extent might we regard these as evidence for agency? Children were depicted as exercising agency in the sense of reflecting and acting, but because they often had so little access to significant power, resources or support, the actions they performed did not bring them closer to the outcomes they would value. We argue for the need for renewed debate about how best to conceptualise children’s actions in contexts that (i) provide them with a highly constrained set of options for exercising initiative, (ii) where the exercise of choice in one arena of their lives might be associated with negative long term outcomes in another; and/or (iii) where the outcomes of their actions may not take them any closer to their own perceptions of a good life. In conceptualising agency, instead of positing independent action as an end in itself, we prefer to regard independent action as the means to end that actors themselves would value.

In a tangentially related debate in the field of gender studies, critical researchers of women in the global south are increasingly concerned by a tendency to exaggerate the agency of women in situations of extreme subordination and coercion. Attempts by well-meaning academics, activists and policy makers to avoid depicting marginalised women as victims have led to a situation where “the search for agency in the least favourable situations has reached almost epidemic proportions” (: loc 554). In the process, they argue that feminist scholars – motivated by the desire to avoid potentially offensive depictions of ‘third world women’ as passive victims – have sometimes unwittingly aligned themselves with individualistic neoliberal understandings of agency and personhood. They have done this through advancing understandings of agency as any form of decontextualised individual choice and through celebrating actions by women that lead to nothing more than their basic survival. In the process they “neglect the oppressive structures of material and discursive power”, generating understandings of agency that undermine attention to, and analysis of, gendered oppression (): loc 2253)…

There is no doubt that, as the NSCC has now firmly established, children are able to act, show resourcefulness and survive, often with little help or input from adults. To that extent they are ‘competent social actors’. This was a vitally important point to make in the 1990s. However in the light of the strong body of research generated by the NSCC tradition, we believe this can now be taken as a given. We argue that the next step for researchers is to pay greater attention to the factors that mediate between so-called agency and its outcomes, and, most important, pay particular attention to children’s own accounts of their hopes for the future, and children’s own visions of what would constitute a ‘good life’ from one social setting to another.

Below:  Draw-and-write of a child suffering with HIV/AIDS




Below:  Draw-and-write about a child carer



Full article at:   http://goo.gl/w98rLE

aDepartment of Social Psychology, The London School of Economics and Political Science, London WC2A 2AE, United Kingdom
bBiomedical Research and Training Institute, Harare, Zimbabwe
cSchool of Applied Human Sciences, University of KwaZulu Natal, Durban, South Africa
dDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark
eDepartment of Infectious Disease Epidemiology, Imperial College School of Public Health, London SW7 2AZ, United Kingdom
*Corresponding author. Tel.: +44 207 955 7701. 




Friday, July 31, 2015

Coping strategies of HIV-affected households in Ghana

Below:  Coping strategies instituted by household affected by HIV. Legend: Figure 1 explores the concept of coping. Prevalence of various short-term different behavioral responses (food consumption coping strategies) in response to threat of, or actual food insecurity are presented. The strategies range from limiting portion size at mealtimes (61.3%) to sending household members to go begging (5.6%).


Various dehumanizing coping strategies instituted by the HIV-affected households included skipping an entire day’s meal (13%), reducing portion sizes (61.3%), harvesting immature crops (7.6%), and begging (5.6%). Two-thirds of the households were asset poor. Asset-poor households had higher CSI than asset-rich households (p <0.001). CSI were also higher among female-headed households and lower where the education level of the household head is higher. Households caring for chronically ill members recorded higher CSI in comparison with their counterparts without the chronically ill (p < 0.05).

Institution of degrading measures by HIV-affected households in reaction to threat of food insecurity was prevalent. The three most important coping strategies used by households were limiting portion size (61.3%), reducing number of meals per day (59.5%) and relying on less expensive foods (56.2%). The least employed strategies included household member going begging (5.6%), eating elsewhere (8.7%) and harvesting immature crop (7.6%).

Given that household assets, and caring for the chronically ill were associated with high CSI, a policy focusing on helping HIV-affected households gradually build up their asset base, or targeting households caring for chronically ill member(s) with conditional household-level support may be reasonable.

Via:   http://ht.ly/JLY0m HT @McGillU