Protective Processes and Resilience in Rwandan Children and Families Affected by HIV/AIDS

BACKGROUND: The healthy development of children is threatened by menaces such as war and HIV/AIDS, and greater knowledge is needed about protective processes that contribute to positive development despite risk (resilience). Rwanda presents an important example of compounded adversity where many families are simultaneously affected by the legacy of the genocide, severe poverty, and HIV/AIDS. The aims of this research were to identify and examine strengths and sources of resilience in individuals and families at risk for psychosocial difficulties due to HIV/AIDS. METHODS: We used maximum variation sampling to complete free-listing exercises (N=21), key informant interviews (N=68) and focus groups (N=9) among adults and children (ages 10-17) in Southern Kayonza District, Rwanda. We identified local Kinyarwanda terms for protective resources, their indicators, and local perceptions of how to foster these strengths in children, families and communities. These data were compared to existing theory on resilience and protective resources in other cultures. CONCLUSIONS: We identified five forms of resources comprising individual, family and collective/community strengths: Kwihangana (perseverance/coping); Kwigirira ikizere (self-esteem/self-confidence); Kwizerana (family connectedness); Uburere bwiza (good parenting) and Kubaba hafi / kubitaho (social support). There is evidence of important protective resources among children and families affected by HIV/AIDS in Rwanda that can be leveraged by intervention programs. These findings are being used to develop measures of protective resources and to design preventative interventions that build on local strengths.