203214 A human rights framework for rehabilitative care with street children: A mixed-method comparison study

Tuesday, November 10, 2009: 12:50 PM

Priya G. Nalkur, MPH, EdD , Adolescent Risk, University of Pennsylvania, Philadelphia, PA
Purpose: Applying a human rights framework to rehabilitative care for homeless street children may encourage positive shifts in children's health priorities. This study used mixed-methods to compare Tanzanian street children in rehabilitative care with street children not in rehabilitation and school-going children living with their families.

Methods: Quantitative data were responses to the “Importance Scale.” Children rated the importance of 29 experiences encompassing two sub-scales: Current Well-being and Future Preparations. ANOVAs and contingency-tables determined group-level differences; post-hoc Bonferroni tests determined pair-wise differences. Qualitative data were narrative responses to the Thematic Apperception Test. Thematic analysis with inductive coding was used for the narratives.

Results: Groups differed on 14 of 29 experiences, with children in rehabilitation showing more similarities to school children. Street children prioritized current well-being by emphasizing relationships with adults and finding safe sleeping places, while children in rehabilitation and in school prioritized preparing for the future, highlighting education-related ambitions. After one year of rehabilitation, children prioritized their health by emphasizing learning how to protect themselves from violence and STIs. Qualitative analysis indicated that rehabilitation encourages a sense of “positive transformation” regarding feeling safe at night, curbing drug use, doing well in school, and protecting oneself from HIV/AIDS. Importantly, children in rehabilitative care emphasized personal agency concerning their health and educational outcomes. Street children expressed fear and doubt about their health, especially in regards to glue-sniffing, sexual abuse, and suicide.

Conclusions: Human rights-oriented rehabilitation may encourage children to have more agency concerning their health, allowing for more hopeful future orientations.

Learning Objectives:
1. Compare the health priorities of street children undergoing human rights rehabilitation with street children who are not in rehabilitation. 2. Describe the main components of human rights rehabilitative care for street children. 3. Discuss how an understanding of human rights may empower children to take responsibility for their health. 4. Explain how qualitative narrative data can enhance findings from quantitative survey data.

Keywords: Adolescents, International, Human Rights

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed the study, and collected and analyzed all data. This study is part of my dissertation project at Harvard University in Human Development and Psychology (I received my doctoral degree in June, 2008). I am currently writing up results as individual journal articles.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.