An Assessment of the Strengths and Challenges of a Residential approach and a Community based approach to Caring for HIV positive Orphans :a case study of Grace Children's Center and the Lea Toto program

Abstract

The objective of this study was to assess the strengths and challenges of a community based model and a residential model of care for HIV positive orphans. In order to achieve this purpose, research was carried out with two different ministries in Nairobi, Kenya: Lea Toto, a community based model, and Grace Children's Center, a residential model. The research was a qualitative study and data was collected primarily through ethnographic interviews with caregivers and staff members from each program. Questionnaires were also used to gather background information about each program. The researcher examined the strengths and challenges of Grace Children's Center and Lea Toto in light of literature discussing HIV/AIDS, orphans, and programs to care for orphaned children. The findings revealed that both programs have many strengths and are effectively caring for HIV positive orphans. The main strengths of Lea Toto are that they empower willing caregivers, the caregivers are familiar adults, their impact extends to the entire community, and they have the capacity to address stigma in the community. The main strengths of Grace Children's Center is that they are able to provide care for children who are abused, neglected, or threatened, the home functions as a family rather than an institution, and they are able to provide total care for the children. Both ministries also face challenges. Lea Toto faces the challenges of poverty in the community and monitoring the administration of drugs by the caregivers. Grace Children's Center faces the challenges of stigma and limited travel outside of the residential home for the children. Based on these findings, recommendations were made for community based programs and residential homes to work together to meet the needs of HIV positive orphans. Recommendations were given for community based programs to economically empower caregivers and to engage and empower the entire community. Recommendations were given for residential homes to foster a family environment and to integrate their children into the surrounding communities.