Enabling AIDS orphans to think of their future

Project completed

The region of southern Africa holds the sad record of housing the largest number of orphans in the world. Together with armed conflicts and poverty, HIV/AIDS – which can wipe out entire generations –has a major impact on the living conditions and psychological and social wellbeing of children in this part of the world. Deprivation, abuse, early and forced marriages, having to take care of siblings or sick parents, are all part of daily life here. Since 2002, a regional initiative aimed at providing psycho-social support has been trying to provide these children with hope and self-confidence.

Country/region Topic Period Budget
Southern African Development Community (SADC)
Sexually transmitted diseases incl. HIV/AIDS
Primary health care
Basic life skills
01.05.2012 - 31.12.2015
CHF 4'875'000

The Regional Psycho-Social Support Initiative (REPSSI) was launched in 2002 by the SDC in cooperation with the Novartis Foundation for Sustainable Development and the Swedish Agency for International Cooperation and Development. It is currently in its fourth phase of activity, encompassing the period from 2012 until the end of 2015. During this phase the emphasis will be placed on support for the governments of this region to enable them to integrate the psycho-social aspect into their national poverty-reduction programmes, including their health and education policies.

Reversal of support roles

UNAIDS estimates that in 2010 around one-third of minors in sub-Saharan Africa lost at least one of their parents due to AIDS. In millions of families, the support roles have therefore been reversed: it is the children who have to take care of their sick parents and provide for them. In addition, grandparents often have to face the responsibility of bringing up their orphaned grandchildren.

The issue of “AIDS orphans” gives rise to enormous social and psychological difficulties, not only for the people concerned, but also for families and entire communities. While a number of programmes have been implemented in response to the physical and material needs of orphans and vulnerable children, little attention has been paid to their psycho-social needs.

Psycho-social wellbeing: a right and an asset

The REPSSI programme has developed know-how and tools for reducing the social and emotional impacts of HIV/AIDS, poverty and armed conflicts. It is active in 13 countries in eastern and southern Africa (Angola, Botswana, Kenya, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe). REPSSI supports and trains more than 100 organisations focusing on children and adolescents.

The programme is based on the concept that psycho-social wellbeing is the right of every child. Children who have a more positive view of themselves, assert themselves and take action are more willing to help their community. Psycho-social support encompasses all these aspects of children’s wellbeing: not only their immediate surroundings, family and community relations, but also their values, hopes and dreams.

Instruments developed by REPSSI include:

  • Hero Book: a series of autobiographical stories intended to help children identify obstacles and how they can overcome them.
  • Tree of Life: The tree of life uses the various parts of a tree as metaphors to illustrate different aspects of life. It facilitates conversation between children and helps them talk about grief and loss while participating in stories of hope, values and rapport with people who surround them and those who have died.
  • Memory Work: Here the aim is to encourage HIV-positive people to share their memories before they die in order to help children understand their past and face the future with greater confidence.

REPSSI has achieved tangible results since its inception in 2002:

  • 5 million children have been given access to psycho-social care and benefit from professional support; more than 500'000 have been trained;
  • The psychological and social needs of children and vulnerable families affected by HIV are now regarded as priorities by international organisations, as well as by regional and national programmes;
  • To date, 1400 people have received training in how to work and interact with children and vulnerable youths through the Youth and Children Certificate programme that was developed in partnership with UNICEF;
  • Psycho-social support is an integral part of university programmes and training institutes for social workers and teachers in several countries in the region;
  • Various national and regional strategic plans have been developed with the aim of combating HIV/AIDS, reducing poverty and providing psycho-social care.
  • Know-how concerning psycho-social support has been disseminated thanks to tools developed by REPSSI, some of which have also been adapted for use in other regions of the world.
  • An evaluation in South African schools using the pedagogical instrument developed by PEPSSI, Hero Book, shows that teachers are the most vulnerable to the psychosocial problems affecting their pupils;
  • The various tools developed in this programme have succeeded in exposing the stigmatisation of AIDS.

Assessing the impacts of the REPSSI programme

Between 2008 and 2011, the REPSSI programme and the Swiss Academy for Development have been conducting joint studies in the rural areas of Kafue, Zambia, to measure the effectiveness of the psycho-social support programmes

The research has had an impact on REPSSI’s activities with 900 children in four distinct communities.The analysis encompasses not only the instruction manuals that have been developed, but also the actions that have been taken, e.g. the creation of an orphans’ committee and efforts to secure the means of subsistence for communities that take care of children. Thanks to the findings of these studies, it has been possible to improve the methods of intervention.