Since its inception in 2008, the Clinical Psychology Department has made significant contribution to the care of children, youths and their families by addressing their mental, emotional and behavioral needs. Patients are referred to the Clinical Psychologist by other clinicians at the COE or by Community Health Workers. Through observation, interviews and tests, the psychologist makes a diagnosis of any existing or potential disorders. Then, formulate a program of treatment according to the client’s needs, and continue monitoring the client’s progress on a regular basis to ensure that a desired behavior is met, e.g. good adherence.
Over the reporting period, the Clinical Psychologist Onkemetse Phoi broadened her scope of work to include children, adolescents and young adults referred by Community Health Workers through the Advancing Partners and Communities and the Orphans and Vulnerable Children Care and Support Projects. The clients referred from the community present with a host of psychological issues, such as depression, sexual and physical abuse, education difficulties, and others. Unsurprisingly, adherence to medication continues to be the biggest challenge stemming from other psychological factors, with depression being the highest cause.
The social work department continued to provide social welfare counselling services to Botswana-Baylor patients and their caregivers. Supportive counselling and adherence counselling were the main services offered by our social worker, Ms. Tapiwa Tembwe. Supportive counselling was offered mostly to families during home visits. Home visits were done on a monthly basis targeting mainly patients who were not returning regularly for treatment and those with poor adherence to medication.
Botswana has a growing population of orphans, estimated at 6.28% of its entire population, according to the 2011 National Population Census. Children who are categorized as vulnerable in Botswana include those who are orphaned, living in abusive environments, living with a sick parent or guardian, living with HIV, living with disability, or living outside of family care. These cumulative risk factors may result in illness; withdrawal from services, including schooling and healthcare; emotional distress; trauma; abuse; neglect; and exploitation. Other challenges facing orphans and vulnerable children with HIV infection include adherence to medication and a lack of emotional support.
The Botswana Comprehensive Care and Support project is implemented by various partners in seven PEPFAR priority districts (Kweneng East, Gaborone, South East, Mahalapye, Kgatleng, Southern and Kanye) with the health organization PCI serving as the main implementer. The project aims to improve the health, wellbeing, and safety of these children and their families through direct service delivery, referral and networking, and through capacity building for OVC service providers. Botswana-Baylor’s role in this project is to provide care and support services to OVC living with HIV, from birth to 17 years old, and their families.
Thirty community health workers travel to these children’s homes to deliver a range services that support them in almost every aspect of their lives. They link them to HIV and social protection programs and provide counseling and psychosocial support. They assess the children’s nutrition and help parents learn effective communication skills. The heath workers even monitor their school attendance and progress, while preparing them for the workforce with vocation training support and referral. Each client receives a household visit every three months.