Healthcare Service Needs of Orphans and Vulnerable Children in Orphanages and Barriers Caregivers face in meeting their Healthcare Service Needs: A Mixed Method Research.

Poor health and well-being among orphans and vulnerable children (OVC) in orphanages has been documented in literature, and evidence has shown an association between access to healthcare and well-being among this population. This study assessed the healthcare service needs of OVC and explored the barriers their caregivers face in meeting their healthcare service needs using a mixed method research approach. The study utilized a multi-stage sampling technique in selecting 384 OVC and 14 caregivers that participated in the study. Data were collected using pre-tested questionnaire and interview guide. The quantitative data were analyzed using Statistical Product and Service Solutions (SPSS) version 23, while the qualitative data were analyzed using thematic and content analysis. The result of the study shows that regular health assessment while in the orphanage tops the list of health services needed by OVC; this was followed by health assessment before or during admission into orphanages and facility visits for management of common illness by health professionals while health education for the children and caregivers ranked third. Mental healthcare was the least need reported by the children. From the caregivers' perspectives, financial, structural and psychological barriers emerged as major themes for barriers faced in meeting the healthcare service needs of OVC. The study concluded that OVC are mainly in need of regular health assessment and treatment of common ailments during facility visits by health professionals. The study further shows that caregivers face significant barriers in meeting the healthcare service needs of OVC.

Acolhimento institucional na voz de cuidadoras de crianças e adolescentes que vivem em Casa Lar / Acogimiento institucional en la voz de cuidadores de niños y adolescentes que viven en Casa Lar / Institutional foster care in the voice of caregivers of children and adolescents living in Casa Lar

Objetivo: conhecer o acolhimento institucional realizado por profissionais cuidadores que atuam com crianças e adolescentes que residem em Casa Lar. Método: estudo qualitativo, descritivo e exploratório, no qual participaram 11 profissionais que trabalham com crianças e adolescentes acolhidos. A coleta de dados aconteceu de agosto a novembro de 2021, a partir de entrevista semiestruturada, na Plataforma Google Meet®. As enunciações foram submetidas à análise temática de conteúdo. Resultados: os profissionais que atuam na Casa Lar desenvolvem um trabalho desafiador no acolhimento institucional, pautado na interação e relação afetiva, acolhimento humanitário, favorecimento de estratégias para a socialização e desenvolvimento pessoal, por meio do trabalho em equipe, com vistas às vulnerabilidades, demandas dos acolhidos e fortalecimento de vínculos. Conclusão: ao acolher as crianças e adolescentes, é indispensável que os profissionais ofereçam um cuidado que atenda as demandas de saúde desses indivíduos, e que contemple as singularidades presentes no processo de acolhimento institucional.

Objective: to know the institutional care provided by professional caregivers who work with children and adolescents living in Casa Lar. Method: qualitative, descriptive and exploratory study, in which 11 professionals who work with children and adolescents sheltered participated. Data collection took place from August to November 2021, from a semi-structured interview, on the Google Meet® Platform. The enunciations were submitted to thematic content analysis. Results: professionals working at Casa Lar develop a challenging work in institutional care, based on interaction and affective relationship, humanitarian reception, favoring strategies for socialization and personal development, through teamwork, with a view to vulnerabilities, welcoming demands and strengthening bonds. Conclusion: when embracing children and adolescents, it is essential that professionals offer care that meets the health demands of these individuals, and that contemplates the singularities present in the process of institutional care.

Objetivo: conocer la acogida institucional realizada por profesionales cuidadores que actúan con niños y adolescentes que residen en Casa Lar. Método: estudio cualitativo, descriptivo y exploratorio, en el cual participaron 11 profesionales que trabajan con niños y adolescentes acogidos. La recolección de datos tuvo lugar de agosto a noviembre de 2021, a partir de una entrevista semiestructurada, en la Plataforma Google Meet®. Las enunciaciones fueron sometidas al análisis temático de contenido. Resultados: los profesionales que actúan en la Casa Lar desarrollan un trabajo desafiante en la acogida institucional, pautado en la interacción y relación afectiva, acogida humanitaria, favorecimiento de estrategias para la socialización y desarrollo personal, por medio del trabajo en equipo, con vistas a las vulnerabilidades, demandas de los acogidos y fortalecimiento de vínculos. Conclusión: al acoger a los niños y adolescentes, es indispensable que los profesionales ofrezcan un cuidado que atienda las demandas de salud de esos individuos, y que contemple las singularidades presentes en el proceso de acogida institucional.

Supporting Portuguese residential child care staff: An exploratory study with the Incredible Years Basic Parent Programme

Los niños en acogimiento residencial han experimentado grandes dificultades sociales, emocionales y comportamentales a la vez que es fuente de preocupación el control conductual por parte del personal. Este estudio evalúa una intervención paterna, el Incredible Years Basic Parent Programme (IY), desarrollado en centros portugueses de acogimiento residencial de corta duración. En un ensayo no aleatorio de control recibieron el programa IY dos grupos de cuidadores (27). Otros dos grupos (20 cuidadores) no recibieron ningún tipo de intervención. Se utilizaron medidas de autoinforme para evaluar la práctica educativa infantil por parte de los cuidadores, su sentido de competencia y los niveles de depresión. Se administraron las medidas en la línea base y en el seguimiento a los 6 y 12 meses. Los resultados indican que cada centro de acogimiento infantil era un sistema dinámico específico y que las intervenciones no tenían la repercusión esperada en algunas variables. Los grupos que no recibieron ninguna intervención mejoraban en algunas variables. El hallazgo positivo más importante fue la mejora a los 12 meses de las actitudes empáticas en uno de los grupos de intervención y la percepción mejorada de los niños en el otro. La conclusión es que la incorporación de un programa de intervención como el IY en la localización del acogimiento infantil pueden constituir una intervención valiosa y al menos parte de la respuesta para la mejora de los trabajadores

Children in residential care have experienced high levels of social, emotional and behavioural difficulties and behaviour control by staff is an issue of concern. This study evaluated a parenting intervention, Incredible Years Basic Parent Programme (IY), delivered in Portuguese short-term residential child care centres. In a non-randomised control trial, two groups of staff carers (27 carers) received the IY programme. Two other groups of carers (20 carers) didn't receive any form of intervention. Self-report measures were used to assess carers' child rearing practices, sense of competency, and depression levels. Measures were administered at baseline, 6-month and at 12-month follow-up. The findings indicate that each child care centre is a specific dynamic system and that the interventions didn't have the impact expected on some variables. Groups that didn't receive any intervention had some improvements on some variables. The main positive finding was the improvement at 12 months of empathic attitudes in one of the intervention groups and improved perceptions of the children's role in the other. In conclusion, the incorporation of a training programme such as the IY in child care placements can be a valuable intervention and at least part of the answer in enhancing worker development