Tailoring Health Services For Children
Children can sometimes be overlooked in government health services, particularly in health programmes that focus on services more typically associated with adults.
A new qualification, designed for people working directly with children, is demonstrating the value of building child-sensitive skills across all government sectors, including health. The Certificate Course in Community Based Work With Children and Youth has been enthusiastically adopted by the Swazi government, with students on the course being drawn from state education, health and social services.
An example is Nurse Sophie Nsibande, who is working on community outreach within the Swazi Non-Communicable Diseases (NCD) Programme.
As a result of the skills she learned in the Certificate, Sophie has helped transform the approach of her programme. She realised that, even though her unit was aware of the link between poor health due to HIV and other, non-communicable, illnesses, “We are always looking at the HIV+ parent, but we have forgotten about the child.”
To change this, she began to listen to children, take their suggestions and feelings into account, and consider services from their point of view. For example, adherence to diabetes treatment has increased among children in her programme, following a change in the equipment used when Sophie listened to children complaining about the size of the needles. And at their biggest referral hospital, she has ensured that their procedure dictates children are treated first, so that their illness interferes minimally with their school attendance. “The children are given first priority,” she explains, “so that they get their services and go back to class as soon as possible.”
Secondly, her unit had previously established support groups for people living with NCDs, but only for adults. Since the Certificate, she has now formed both a diabetes and an epilepsy support group for children.
Thirdly, and most ambitiously, at her suggestion, the NCD Unit has begun a school-based screening programme with the Ministry of Education, to identify children at risk of developing NCDs. A pilot has been conducted in 100 schools across Swaziland, testing children for body mass index and blood and glucose, and survey their diet and physical activity levels. Her unit is currently collecting data, and hope to use it to intervene with Ministry of Education to change their policies on nutrition and physical education in schools.
Her programme manager has seen the importance of the Certificate, and another member of the Unit is now on the course.
The skills developed throughout the Certificate are applicable to anyone working directly with children at community level: teachers, volunteers, community leaders, and health workers. Developed by REPSSI (the Regional Psychosocial Support Initiative) and UNICEF, and accredited through the University of KwaZulu-Natal, many state employees were among the 117 students who graduated from the course in Swaziland last month. More than seven hundred additional students from nine other countries in the region also graduated in April and May of this year.
“We’ve been privileged to participate [in the Certificate programme],” says Makhosazana Mabuza, from the National Children’s Coordinating Unit with the government of Swaziland. “It is important that as communities, as governments, we ensure that all our service providers [are given] guidance.”
As a result of a partnership with REPSSI, the government is now using their understanding of psychosocial support to develop “neighbourhood care points”. While these were originally conceived to provide children with food,they have been turned into centres that provide a wide variety of health, education and social services to children in distress.
“We feel that, going forward, this will make an impact on the lives of children,” concludes Makhosazana.
Mainstreaming Guides for Holistic Health Care
In addition to the broader training available through the Certificate Course, REPSSI and it’s partners have developed two short training manuals to help governments and organizations look at their health services holistically.
“Mainstreaming Psychosocial Care and Support within Paediatric HIV and AIDS Treatment” is designed specifically for Health Care Workers working with Children and Families Affected by HIV and AIDS. The “Trainer’s Guide For Training Health Workers in Emergency Settings”, is designed specifically for organizations working in emergency settings.
More information on REPSSI’s training guides mentioned above can be found on the Publications page of REPSSI's website.