KidzAlive@Home

UNAIDS reported that 320,000 children aged 0-14 years were living with HIV in South Africa in 2016. However, 45% of those children are not  enrolled in antiretroviral therapy. The majority of HIV infection in children is theresult of vertical transmission from mother to baby which has prompted government action to prevent this mode of transmission. Despite some successes from the initiative, a high number of children are lost to follow up after 12 months of age. 2 HIV disclosure in South Africa is hindered by significant stigma and discrimination associated with HIV, leading to fear of rejection, isolation, and bullying for children and their families. In addition, children and their caregivers often lack accurate knowledge about HIV, including its transmission and treatment, making effective disclosure challenging. Therefore, age-appropriate communication is crucial when disclosing HIV status to children as younger children struggle to comprehend complex medical concepts. Caregivers should be supported with  information and tools to disclose the HIV status of their children in an age-appropriate way to them.

• Create a community environment that is supportive for enabling comprehensive service provision related to HIV, tuberculosis, malnutrition, child abuse and other health related issues pertaining to children, adolescents, and their caregivers in two targeted communities in eThekwini and uMgungundlovu districts in KwaZulu-Natal province.
• Diagnose children and adolescents living with HIV as early as possible and link them to care and treatment and ongoing psychosocial support effectively and sustainably.
• Improve the quality of HIV services (child-friendly care) and health outcomes (adherence, disclosure, viral suppression and mental health, nutrition) of HIV-infected and affected children and adolescents.
• Provide capacity building and training to healthcare workers on the provision of child-friendly disclosure to enhance their knowledge, skills, and confidence in effectively.
• Share evidence of the KidzAlive@Home community intervention model.
  

Zoe-life’s success with the KidzAlive@Home project has led to their inclusion in the Department of Health technical working group, where they advocate for child-friendly paediatric HIV services. The government has endorsed the KidzAlive@Home approach as an intervention to improve children’s health outcomes.

The project has had numerous impacts during the implementation period – from 2019 to 2022:

• 192 healthcare workers were trained in the KidzAlive Foundations of working with children HIV Testing Services, Disclosure and Adherence
• 147 healthcare workers were mentored on KidzAlive@Home family support activities
• 15 child-friendly spaces were created at health facilities
• 5,329 children were tested for HIV, of which 201 tested positive
• 235 children were linked to care and initiated HIV medication (34 returning to care who were lost to follow up)
• 1,097 caregivers received disclosure support and 748 children received age-appropriate disclosure
• 22 KidzAdherence clubs were started supporting 157 children and 157 caregivers
  

The Aidsfonds Kids to Care model empowers communities to strengthen the links between communities and health facilities to find, test, treat and retain children, and pregnant and lactating mothers, living with HIV. The Kids to Care model is built on the following foundational principles:

• Community-owned and community-led
• Builds on existing community structures
• Child and family centred
• Builds on government frameworks and policies
• Key stakeholders are meaningfully involved from the beginning
• Interventions are informed by data
• Committed to sustainability and long-term support

More info on the Kids to Care model can be found here