Family support begins with a couple’s decision to utilize the methods available on the market to prevent the transmission of HIV. Partners need to discuss and agree on how best they can protect each other. Selecting an appropriate prevention method is not a unilateral decision. Gone are the days when it was solely the woman’s responsibility to attend the health center for pre- and post-child care. Both partners must be responsible for their health and for the health of their children, should they decide to conceive naturally. Both must go to prenatal care, and together, both partners must follow the advice and guidance from the health personnel.
Family members are also a good support system in times of hardship, e.g. when an HIV-positive couple or partner struggles with the challenges posed by the disease & its treatment. Family members can make sure that the affected person is taking the treatment correctly and with the necessary meals.
In situations when parents are not alive, the next of kin and the community can provide those crucial social safety nets for the surviving children. Having an adult mentor and a shoulder to cry on is important for the child’s growth and development. Strong community and family social networks can have a more direct impact on a child than NGOs and governments that are not based in the community. Many child-targeted interventions managed outside the community are challenged to unveil the layers of structures that need to be supported for the benefit of the child. Investing in strategies that engage the family and community and equip them with the necessary tools and knowledge to strengthen these existing structures is crucial.
The Bantwana Initiative‘s work in Swaziland is predicated on the family/community model. Working through schools and partnering with school committees, Bantwana helps build their management, technical, and advocacy skills so they can better care for children. We have developed a number of tools and resources to assess the needs of individual children and small, community-based NGOs which helps these communities identify which services are most needed.
The greatest challenge for the family/community model is the cost involved, as was noted in all of the discussions at the CCABA pre-conference meeting and the International Conference on AIDS. The donor community is focusing on the cost-benefit analysis, and they will find as they look more closely at this issue, that there are many layers that need support in order for this methodology to be effective. Providing comprehensive services to children can be quite expensive and challenging for the donor community, yet despite the price tag, the family/community support model is the right way to go. The million dollar question remains: Who will fund comprehensive care as projections indicate that it is a steeper hill than the previous methodologies?