Browsing by Author "Osafo, Joseph"

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The experiences of caregivers of children living with HIV and AIDS in Uganda: a qualitative study
(Springer Nature: Globalization and Health, 2017-09-12) Osafo, Joseph; Knizek, Birthe Loa; Mugisha, James; Kinyanda, Eugene
Home-based care for HIV patients is popular in contexts severely affected by the epidemic and exacts a heavy toll on caregivers. This study aimed at understanding the experiences of caregivers and their survival strategies. Methods A total of 18 caregivers (3 males and 15 females) were interviewed using a semi-structured interview guide, and thematic analysis was used to analyse the data. Results Analysis suggests that the caregivers are burdened with insecure provisions for food and difficulties in accessing health care. They however survived these strains through managing their relationships, sharing burden with care-recipients, social networks and instrumental spirituality. These findings are discussed under two major themes: 1). Labour of caregiving and 2). Survivalism. Conclusions Home-based care presents huge opportunities for community response to the HIV/AIDS epidemic in African settings. It is however burdensome and thus should not be left for families alone to shoulder. There is therefore an urgent need for protecting home-based care for HIV children in Uganda. Implications for improving and strengthening social interventions in home-based care of HIV/AIDS in the Ugandan context are addressed.
Growing up HIV-positive in Uganda: “psychological immunodeficiency”? A qualitative study
(Springer Nature: BMC Psychology, 2017) Knizek, Birthe Loa; Mugisha, James; Osafo, Joseph; Kinyanda, Eugene
This study is part of a longitudinal study among children and adolescents with HIV in both urban and rural Uganda: ‘Mental health among HIV infected CHildren and Adolescents in KAmpala and Masaka, Uganda (CHAKA)’. Method The study is constructed of both quantitative and qualitative components. In this article we report a qualitative study on the experiences of 21 adolescents (twelve to seventeen years) living with HIV in Uganda. The purpose of the study was to investigate both the protective and the risk factors in HIV-infected adolescents’ care environment in order to understand what might contribute to negative outcomes and what might provide a protective buffer against harmful life events. Semi-structured interviews with vignettes about mental disorders were employed and a phenomenological analysis was done. Results The findings uncovered that the adolescents’ families were mostly characterized by instability and diffuse relationships that provided an insecure basis for secure attachment and emotional support. Even in stable and secure family environments, there was no guarantee for getting sufficient emotional support in order to develop a positive self-concept due to the fate being the only infected child in the family. Both secure attachment and positive self-concept are known psychological protective mechanisms that provide the individual with resilience. The adolescents in this study seemed hampered in the development of protective mechanisms and consequently seemed psychologically vulnerable and badly equipped for coping with challenges, which paves the way for the possible development of mental disorders. Conclusion To change the focus towards strengthening the children and adolescents’ development of psychological protective mechanisms implicates a change in focus from illness to health and has consequences for both treatment and prevention. Psychological health promotion must be systemic and aim at strengthening the family environment, but also to establish peer group support.
Health care professionals’ perspectives on barriers to treatment seeking for formal health services among orphan children and adolescents with HIV/AIDS and mental distress in a rural district in central, Uganda
(Springer Link: Child and Adolescent Psychiatry and Mental Health, 2020-06-03) Mugisha, James; Kinyanda, Eugene; Osafo, Joseph; Nalukeng, Winfred; Knizek, Birthe Loa
Little/no research has been conducted in Uganda in particular and sub-Saharan Africa in general on the health professional’s perspectives on barriers to treatment seeking for formal health services among orphan children and adolescents with a double burden of HIV/AIDS and mental distress. Aim To explore health professionals’ perspectives on barriers to treatment seeking for formal health services among orphan children and adolescents with HIV/AIDS and mental distress in Masaka, Uganda. Method Qualitative research design using key informant interviews with health service managers and staff in agencies working with children and adolescents with HIV/AIDS in Masaka district, Uganda. Results Barriers to treatment seeking reported by health care professionals were quite enormous and are summarized under: family, individual, community and health systems level barriers. The crosscutting finding here is that the societal informal and formal systems of care had been affected by the HIV/AIDs epidemic, and, mental distress aggravates this challenge for the individuals afflicted and families affected by mental distress. Conclusion Children and adolescents with both HIV/AIDS and mental distress are vulnerable due to constraints at family, community and health systems levels. Effective public health interventions to address the double burden of HIV/AIDS and mental distress will be vital in the study communities addressing the constraints at family, community and institutional level. Public health interventions should aim at increased access and effective utilization of services for both HIV/AIDS and mental health services. Stigma reduction strategies at individual, family and community levels are also recommended.