Kidman Rachel, Nice Johanna, Taylor Tory, Thurman Tonya R
Program in Public Health and Department of Preventive Medicine, Health Science Center, Level 3, Stony Brook University , Stony Brook , NY , USA ; Department of Health Systems and Development, School of Public Health and Tropical Medicine, Tulane University , New Orleans , LA , USA.
School of Social Work, Tulane University , New Orleans , LA , USA.
Vulnerable Child Youth Stud. 2014 Oct 2;9(4):305-317. doi: 10.1080/17450128.2014.954025. Epub 2014 Sep 2.
Home visiting is a popular component of programs for HIV-affected children in sub-Saharan Africa, but its implementation varies widely. While some home visitors are lay volunteers, other programs invest in more highly trained paraprofessional staff. This paper describes a study investigating whether additional investment in paraprofessional staffing translated into higher quality service delivery in one program context. Beneficiary children and caregivers at sites in KwaZulu-Natal, South Africa were interviewed after 2 years of program enrollment and asked to report about their experiences with home visiting. Analysis focused on intervention exposure, including visit intensity, duration and the kinds of emotional, informational and tangible support provided. Few beneficiaries reported receiving home visits in program models primarily driven by lay volunteers; when visits did occur, they were shorter and more infrequent. Paraprofessional-driven programs not only provided significantly more home visits, but also provided greater interaction with the child, communication on a larger variety of topics, and more tangible support to caregivers. These results suggest that programs that invest in compensation and extensive training for home visitors are better able to serve and retain beneficiaries, and they support a move toward establishing a professional workforce of home visitors to support vulnerable children and families in South Africa.
家访是撒哈拉以南非洲地区针对受艾滋病影响儿童项目的一个常见组成部分，但其实施情况差异很大。有些家访人员是外行人志愿者，而其他项目则投入资源雇佣训练有素的辅助专业人员。本文描述了一项研究，该研究调查了在一个项目背景下，对辅助专业人员的额外投入是否转化为了更高质量的服务提供。在南非夸祖鲁-纳塔尔省各项目点登记入组2年后，对受益儿童及其照料者进行了访谈，询问他们在家访方面的经历。分析重点关注干预接触情况，包括家访强度、时长以及提供的情感、信息和实际支持类型。在主要由外行人志愿者推动的项目模式中，很少有受益者报告接受过家访；即便有家访，次数也较少且间隔时间较长。由辅助专业人员推动的项目不仅家访次数显著更多，而且与儿童的互动更多，交流的话题种类更广，对比照料者的实际支持也更多。这些结果表明，为家访人员提供薪酬和广泛培训的项目更有能力服务并留住受益者，它们支持朝着建立一支专业的家访人员队伍迈进，以支持南非的弱势儿童和家庭。
