Kasedde Susan, Doyle Aoife M, Seeley Janet A, Ross David A
MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda; London School of Hygiene & Tropical Medicine, Keppel St, London WC1E7HT, UK; UNICEF House, 3 United Nations Plaza, Office #1016, New York, NY 10017, USA.
London School of Hygiene & Tropical Medicine, Keppel St, London WC1E7HT, UK.
Soc Sci Med. 2014 Jul;113(100):161-8. doi: 10.1016/j.socscimed.2014.05.002. Epub 2014 May 10.
This qualitative study examines the role of older people (60 years and above) in fostering decisions for orphans and non-orphans within extended families in a rural Ugandan community heavily affected by HIV. Fieldwork conducted in 2006 provided information on the influence of HIV on fostering decisions through 48 individual in-depth interviews and two group interviews with foster-children and family members to develop detailed case studies related to 13 fostered adolescents. The adolescents included five non-orphans and eight orphans (five were double orphans because they had lost both parents). Older people play a very important role in fostering decisions as potential foster-parents, advisers, mediators and gatekeepers. They have a high level of authority over the foster-children, who are regarded as important resources within the extended family. With fewer potential caregivers available because of HIV-related deaths, the responsibility for fostering orphans has often fallen to surviving older people. Fostering is used by older people and the child's extended family as a strategy to ensure the welfare of the foster-child. When the foster-parent is an older person, it is also used to ensure physical and emotional support for the older person themselves. Support from the extended family towards foster households is widely reported to have been reduced by HIV by diminishing resources that would otherwise have been made available to support foster care. New initiatives and investment are required to complement community and family resources within well-managed social protection and welfare programmes. To be effective, such programmes will require adequate investment in administrative capacity and monitoring. They must aim to strengthen families and, recognizing that resources are limited, should prioritize the community's poorest households, rather than specifically targeting households with orphans or other foster-children.
这项定性研究考察了乌干达一个受艾滋病毒严重影响的农村社区中老年人（60岁及以上）在大家庭中促成孤儿和非孤儿寄养决策方面所起的作用。2006年开展的实地调查通过对48名寄养儿童和家庭成员进行的个人深度访谈以及两次小组访谈，获取了关于艾滋病毒对寄养决策影响的信息，以形成与13名寄养青少年相关的详细案例研究。这些青少年包括5名非孤儿和8名孤儿（其中5名是双亲孤儿，因为他们的父母都已去世）。老年人作为潜在的寄养父母、顾问、调解人和把关人，在寄养决策中发挥着非常重要的作用。他们对寄养儿童拥有很高的权威，而寄养儿童被视为大家庭中的重要资源。由于与艾滋病毒相关的死亡导致潜在照料者减少，寄养孤儿的责任往往落到了幸存的老年人身上。老年人和孩子的大家庭将寄养作为确保寄养儿童福利的一种策略。当寄养父母是老年人时，寄养也被用来确保老年人自身获得身体和情感上的支持。据广泛报道，艾滋病毒通过减少原本可用于支持寄养照料的资源，降低了大家庭对寄养家庭的支持。需要新的举措和投资来补充管理完善的社会保护和福利项目中的社区和家庭资源。要想取得成效，此类项目需要在行政能力和监测方面进行充分投资。它们必须旨在加强家庭，并且认识到资源有限，应优先考虑社区中最贫困的家庭，而不是专门针对有孤儿或其他寄养儿童的家庭。
