A culturally-relevant exemplary model of care for OVC's in Swaziland: Sustainability, caregiver support and child health outcomes

Background: Estimates suggest by 2010 10% of the population in the Kingdom of Swaziland will be orphans from HIV/AIDS related causes. From 2000-2004, twenty-six new residential care homes for orphans and vulnerable children (OVCs) opened. Currently, there are no regulations guiding the expansion of these interventions. This project addresses the gap in information on successful residential care programs for OVCs by evaluating an exemplary model of care. Following the evaluation, a case study resource was developed identifying the program model and outlining the essential components necessary in replication. Methods: Likhaya Lemphilo Lensha is a culturally relevant facility for children left without alternative care, a particularly vulnerable subset of orphans in Swaziland. The evaluation questions were designed to gather both descriptive and specific information on three main areas: (1) the positive health and social outcomes of the children, (2) the caregiver support factors, and (3) the sustainability of the project. Data was collected through key informant interviews and the Child Status Index (CSI). Results: The CSI measures suggest positive outcomes for the children placed at Likhaya Lemphilo Lensha. Qualitative findings suggest central tenants for effective program operation and caregiver support include sense of permanent home and family, ongoing caregiver support, and independent food security. Conclusions: The project offers practical resources for the support of orphan care programming. The social impacts of HIV/AIDS in Swaziland demand innovative approaches to meeting the basic needs of children, including quality residential care as an aspect of orphan care response in prolonged disaster and emergency situations.