Psychosocial well-being: introduction and overview

UNAIDS (2008) estimated that by the end of 2007, nearly 12 million children in sub-Saharan Africa have lost one or both parents to AIDS. Millions of additional children in the region feel the triple effects and impact of HIV/AIDS, poverty and conflict. While there is no doubt that all these children have to be provided with basic services like food, shelter, education and healthcare, they also need care and support to cope with the emotional side of these difficult life situations. The Novartis Foundation supports REPSSI, a regional capacity building organization working in thirteen countries in East and Southern Africa. Its aim is to increase psycho-social well-being of children affected by HIV/AIDS, poverty and conflict.

Psycho-social care and support (PSS) embodies values, principles, actions, hopes and dreams that people have for the well-being of their lives. PSS focuses on the social and emotional needs of a child and forms part of a comprehensive and holistic understanding of health and well-being. The child’s emotional, spiritual, social, cultural, physical, political, mental, and economic needs are all essential for meaningful and positive aspects of human development.

PSS is explicitly present within mental health services interventions for a small percentage of children with clinical mental health diagnoses who need specialized psychiatric or psychological interventions.

PSS can also be offered via focused non-specialist interventions by paraprofessionals (e.g. structured group therapy interventions) to children exhibiting symptoms of distress and trauma. However, the most sustainable and important PSS is provided by friends and family, household and community members as part of everyday life. Externally provided assistance needs to support, and not undermine, these natural systems of care.

However, in order to reach the millions of children that have lost their parents or are victims of violence and conflict, PSS has to be mainstreamed in existing services, programs and activities – i.e. in educational and healthcare services delivered principally by governments.

REPSSI, along with its partners, has developed a range of tools and approaches in order to maximize both the quality of psycho-social care and support, as well as the numbers of children who are able to access various levels of PSS. Working through dozens of organizations and institutions in sub-Saharan Africa, REPSSI has reached around 3 million AIDS orphans by the end of 2008. Its goal is to reach 5 million by 2011.

Links
www.repssi.org/ REPSSI - Regional Psychosocial Support Initiative for Children affected by Aids, Poverty and Conflict
www.unaids.org UNAIDS - United Nations Programme on HIV/AIDS