How to tell children the truth in a child-friendly way?

How to tell children the truth in a child-friendly way?

"It’s incredibly important to explain children about HIV in an understandable way." Nokuthula Heath works as training manager at Zoëlife in South Africa. She tells us all about ‘good night’ medication to keep HIV asleep, sticker award systems and why child-friendly services are crucial. In addition, she will introduce to us: 'Rona Corona'.

Why are child friendly services so important for children with HIV?

Not involving the child often leads to stop taking medication at a later stage, as they don’t understand why they are treated. Or because of anger, when they were not informed about their HIV status. HIV is still surrounded by a lot of stigma. Often parents are ashamed and they don’t want other people to know because of looming discrimination and ignorance. This eventually will lead to an increase of HIV infections and AIDS-related deaths in the country. Child-friendly services are therefore necessary.

What makes HIV services child-friendly?

“It all starts with attitude and behaviour of health workers. When a child comes into the clinic, they should properly greet the child, ask its name and… smile! It’s important that a child feels welcome and is not scared to come. The health worker then needs to explain in understandable words what is going to happen. For example, ‘now we are going to put you on the scale to see your weight’, instead of just grabbing the child and putting it on a scale straight away. Also, it helps to use posters with colourful images that they can relate to.

To achieve this, we need to educate our health workers and inform both them and parents about the needs of children. It is also important to ensure health workers and parents to work together and communicate to the child about their HIV status in a similar way. This is exactly where our KidzAlive project comes in.”

Child-friendly

What does child friendly communication looks like?

"The KidzAlive project trains health workers to become more child-friendly and develops toolkits that can be used to communicate with children in a fun and friendly way. For example, when testing a child’s blood, we explain to them there are different types of ‘germs’ that can be found. Some germs are not good and need to be put asleep, such as HIV. To make it go to sleep, a child needs to take ‘good night’ medication every day. If not taken, the germ might wake up and start fighting with the healthy soldiers in the body, and this can cause sickness. We have nice pictures and a digitized animation supporting this story, making it understandable and even exciting for a child to listen.

When the child starts HIV treatment, we work with award systems such as stickers. Every day medication is taken, the child can choose a sticker to show it successfully keeps the germ asleep. In this way, the treatment is becoming a game, and children actually like it. On top of that, this system makes it easier for the health worker to monitor the treatment."

When do you tell children that the ‘germ’ is HIV?

"Around ten years old, they should know that the germ we’ve been talking about is called HIV. However, it also really depends on the individual child and the personal situation as some already know about HIV and all the rumours attached to it, but others have never heard about it. Our role is to coach the caregivers as it is their responsibility to tell the child the truth, not ours. We continue to give support as they are going through difficult times."

And... who is Rona Corona?

It is very important that children are not left behind in the Corona crisis. We have adapted our tools to support caregivers to explain what is Corona to children in a child-friendly manner. For example we have decided to name the coronavirus Rona Corona. This will be able to assist children to better understand the virus and how it is transmitted.

Illustrations of Coronavirus

What do you hope to achieve with KidzAlive?

"The project is already acknowledged and supported by the government, enabling us to implement it on a much larger scale. My dream is to also bring it to countries outside South Africa so we can have more impact."

Want to know more?
‘KidzAlive’, a project implemented by South African organisation Zoëlife, is a child-centred, holistic model to help children understand their illness using age-appropriate language and fun tools. It is developed to find children with undiagnosed chronic diseases such as HIV and TB, support caregivers with information, assist health care facilities with psychosocial support to children and their families.

This project fully corresponds with Aidsfonds’ priority to improve paediatric HIV care and child-centred services in health clinics. With Aidsfonds funding, the KidzAlive approach is currently being expanded with a community component, bringing the training and tools to organisations who provide services in the communities. For more information visit the website of Zoëlife, find more of its talk tools on Facebook or contact Nokuthula Heath of Zoëlife.

Nokuthula Heath

This article was published in the Children & HIV e-news of April 2020: COVID-19 and the paediatric HIV response

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