Volume 8, Issue 1, January – 2023 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

Perspectives and Experiences of Caregivers

of Pediatric Patients on Effects of Reduced
HIV Care Funding
Mary Mokeira Nyagisera RN, BScN*, Angeline C. Kirui RN, PhD, Lilian A Omondi RN, PhD, Lucy W Kivuti-Bitok RN, PhD

Corresponding Author: Mary Mogeira,

School of Nursing Sciences, University of Nairobi Nairobi, Kenya

Abstract:- Key words:- Funding, HIV/AIDS, Pediatrics, Caregivers,

Background: The Human Immunodeficiency Virus Perspectives, Program.
(HIV) infection remains as the most significant public
health issue in the world today. Most treatment I. INTRODUCTION
programs are sponsored through grants and donations
since the cost of care is extremely high. The support HIV is still a dominant global public health disease
programs too have changed with more focus on in affecting most people including children. Globally, roughly,
country home grown interventions. The experiences and 2.8 million children are HIV positive with 90% of these
perspectives of caregivers of the children living with population coming from the Sub-Saharan Africa and those
HIV/AIDS shades light on the possible challenges who are orphaned are estimated to be 13.4 million (Short &
resulting from the loss of traditional sources of funding Goldberg, 2015a); (UNICEF, 2015).
for treatment and social support. The researchers sought HIV treatment needs long-term plans in terms of the
to outline the experiences and opinions of those who cost of therapy being a long enduring condition (Volberding
cared for juvenile patients living with HIV/AIDS at Kisii & Deeks, 2010). It also requires a well-supported
Teaching and Referral Hospital (KTRH). specialized system for it to be successfully managed (World
Methods: A cross-sectional qualitative design with a Health Organization, 2020).Notwithstanding, some
phenomenological approach was used. In-depth noncommunicable diseases like diabetes and cancers related
interviews (IDI) were conducted on participants who to HIV infection and adverse effects of some of the
treatment regime emerge (Adeyemi et al., 2021). With
provided consent and met the inclusion criteria.
Potential participants were selected using purposive ageing the disease progression become significant and
sampling approach method from in-patient and proper approach in terms of treatment and care is important
Comprehensive Care Centers (CCC). The IDI audio files (Kasaie et al., 2020)
were converted into a Microsoft text document, and then In Sub-Saharan countries, approximately 1/3 of the
the text file was imported into the R version 4.0.2 income per household earned yearly is spent on HIV and
program for thematic analysis. Tuberculosis associated morbidities(Teweldemedhin et al.,
Findings: Eight respondents that included both men and 2018). A comprehensive approach that is inclusive of both
women were interviewed and all had attained high a non-medical and medical approaches like socio-economic
minimum of high school education. The move from a sustenance and poverty reduction is key when it comes to
robust donor supported HIV care to decreased funding, eradication of these diseases (Assebe et al., 2020). Material
according to all respondents, is marked by great Hardship which is an indicator of poverty has been linked
difficulty. The lack of adequate funding has resulted in with deterioration of socio-economic and health inequalities
the suspension of nutritional supplementation programs with impacts of food insecurity and irregular access to
and a drop in the interval of drug distribution from six health services(Masa & Chowa, 2019). House hold members
months to two weeks and negatively affects adherence of HIV affected families with material hardship have been
for clients who face challenges with repeated travels to found to be heavily taxed in terms of health care costs(Short
hospital to refill doses of treatment. & Goldberg, 2015b). Financial resources will help in
improvement of health infrastructure for care integration,
Conclusion: It was observed that a significant financial promotion of ART adherence and retention in care,
and social disruption was encountered due to the overcoming stigma inhibiting access to care among other
reduction in HIV care funding as evidenced by the logistics geared towards HIV prevention and treatment
caregivers taking up the role to fill gaps in care that (Nachega et al., 2021)
includes out-of-pocket payments for drugs, supplements,
consultation and laboratory services. Most of these Primary caregivers of children living with HIV are
services initially were supported 100 percent through frequently exhausted and short on funds to fulfill their
donor programs. The inadequate donor support for responsibilities(Kidman & Heymann, 2016). The social
HIV/AIDS programs hindered the comprehensive care (Lentoor, 2017), economic (Katana et al., 2020), and
of children living with HIV and raised caregiver costs psychological strain can sabotage continuity of care and
thus putting a strain on the family support system. treatment to children infected with HIV as well as those

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Volume 8, Issue 1, January – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
who are critically sick leading to poor outcomes (Oyeyimika a bed capacity of 700. The hospital offers both outpatient
et al., 2021).The high incidence of HIV infection in Sub- and inpatient services for people from South Nyanza and
Saharan Africa has been linked to historical, political, the surrounding Counties.
economic, and cultural factors and so the coping strategies  Study Population: The target were caregivers of pediatric
like education, voluntary counseling and testing, community patients on treatment for HIV infection in pediatric wards
involvement, care, treatment and support of the affected and the Comprehensive Care Centre in (KTRH). We
persons are employed (Lau & Muula, 2004). Consequently, included all caregivers of pediatric patients living with
external support is needed as the countries in Sub-Saharan HIV/AIDS who agreed to take part in the study; those
Africa are unable to effectively produce adequate resources who had been taking care of the patient for over 6 months
to efficiently improve on revenues from the government continuously; those identified as the next of kin in the
(Remme et al., 2016). In Ethiopia, spending cuts led to files of patients and have consistently been taking care of
elimination of numerous HIV prevention and care programs them. Caregivers who had mental challenges and not
as well as those that support orphans and vulnerable concerned with to time, place, and person; those with
children(OVC)(Kates et al., 2016). According to a recent symptoms of Covid 19, those who could not express
study, compared with no disruption, a 6-month interruption themselves in either English or Swahili and those who had
in the supply of antiretroviral therapy (ART) medications for not attained the age of 18 years were excluded from the
HIV-infected individuals receiving treatment would be study.
projected to result in a 1.63 times greater spike in HIV-  Sampling: The participants were selected using a non-
related mortality over a 1-year period (Jewell et al., 2020). probability purposive sampling technique from inpatient
and comprehensive care facilities in (KTRH). Using the
The health system in Kenya has a concerted donor participant information and consent form, the researcher
landscape. It has been reported that 4 donors fund almost enlightened the possible volunteers who met the
90% of all aids that come from the external sources (K. requirements about the study. Informed consent was
McDade et al., 2021). Reduced funding led to inability to obtained and a consent form was signed by each
maintain programs that considerably increased the participant after they expressed their awareness of all the
introduction of HIV+ treatment of children from 43% to study's information and participation requirements.
93% with a surge in a number of new infections (UNAIDS-  Ethical Considerations: The Joint Kenyatta National
KENYA, 2018). In 2020, hit with a scarcity of Hospital and University of Nairobi Ethics and Review
cotrimoxazole and resulted to anxiety amid patients who had Committee gave approval for the study. The recorded data
lost their incomes as well and depended on well-wishers for was secured by keeping under lock and key to maintain
food aids (Osweta, B, 2021),. confidentiality and protect Participants’ personal
Sub-Saharan countries have economic constraints identifiers. The designated Counseling rooms at the
however, some have tried domestic and innovative financing pediatric wards and Comprehensive care center were used
to manage HIV and related complications(Atun et al., as interview spaces. There was no monetary or any form
2016).Coping strategies used by caregivers depend on both of direct benefits given to participants.
internal and external strengths(Mujjuzi et al.,  Data management: Data collection tools were validated
2021).Consequently, acceptance, positive reframing , through pretesting and interviewers were trained to ensure
emotional support in religion, substance use and quality data capture. Professional transcription of data was
venting(Oyeyimika et al., 2021), borrowing with friends, done. Data was analyzed using R version 4.0.2 software.
reduction of meals and borrowing with institutions(Lopera Qualitative data was run and the resultant outputs were
et al., 2011) avoidance and self-distraction(Ahmed et al., examined.
2021) have been utilized by caregivers to cope with
III. RESULTS
caregiving burdens. Regarding, children living with HIV
infection, it is crucial that the opinions and experiences of A. Socio-Demographic characteristics of participants
caregivers in the African context are adequately documented The researchers recorded perspectives and experiences
(E. Asuquo et al., 2017). to saturation levels from participants. Majority of the
participants were mothers and fathers who formed the most
II. METHODS
direct linkage to children with HIV/AIDS and thus
 Design: The researchers adopted a cross-sectional understood more deeply how reduction of funding affected
qualitative design to describe the perspectives and them. Participants had varied occupation levels of which
experiences of caregivers of pediatric patients on reduced farmers composed of 50%, teachers 37.5% and community
funding of HIV/AIDS care programs obtained through in- service 12.5%.
depth interviews. A descriptive phenomenological B. Perspectives of participants on HIV/AIDS funding
strategy was adopted aiming at gaining a deeper To effectively access the theme that touched on
understanding and describe thoughts, emotions, and perspectives of caregivers and reduced funding, certain
actions of caregivers in the wake of reduced funding of specific codes were used. Some of the notable codes
HIV Care. included ‘worries,’ ‘views,’ ‘concerns,’ ‘transition
 Study Site: The study was carried out at Kisii Teaching problems,’ and ‘opinions.’ From these codes, the following
and Referral Hospital (KTRH). This facility is the main themes related to caregivers’ perspectives on reduced
teaching and referral hospital in Kisii County, Kenya with funding for HIV/AIDS programs were identified.

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Volume 8, Issue 1, January – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Categories Frequency Percentage
Gender
Male 2 25%
Female 6 75%
Age
30-35 years 4 50%
36-40 years 0 0%
41-45 years 3 37.5%
46-50 years 1 12.5%
Level of education
High school certificate 3 37.5%
College Education 5 62.5%
Occupation
Farmer 4 50%
Teacher 3 37.5%
Community health worker 1 12.5%
Family role
Mother 6 75%
Father 2 25%
Table 1: Demographic Information of participants

 Theme 1- Transition Problems The same respondent offers a succinct elaboration of

The first theme that related to perspectives of caregivers the lack of preparedness when she observes that:
was transition problems or issues that emanated from the
reduced funding regime and the consequent taking over by …like now they're now implementing "partners
the government agencies. All the respondents asserted in are changing hands." Yet, the new incoming
one form or the other that the transition from a robust donor partner has not stepped on the ground but the
funding of HIV/AIDS regime to a reduced one had outgoing partner has already left. And the gap
significant challenges. has been left there between offering the
services like there's a continuation but some of
 Sub-theme 1. Lack of preparedness by the Kenyan the services are not being done” (respondent
Government 007, 2021)
One of the respondents with a HIV/AIDs child who had
previously benefited from donor funds for instance  Sub-theme 2. Comparison of before and after
asserted that: reduced funding
The respondents identified and contrasted issues before
“I see there is still a challenge for the Kenyan and after funding. The responders provided a more
government to oversee this project. I don't see comparative account of what had previously occurred prior
it being as successful as when the donor to the funding drop and what has since taken place. For
agencies were in charge of the HIV/AIDS example, a caregiver who also serves as the mother of an
projects. If I compare the government only infected child recounted what she saw, saying:
without any outside support, it's still a
challenge” (respondent 002, 2021). “Before when we'd been offered support by
other NGOs, you'd be given drugs for two
The respondent is here comparing the donor funded months then you come back and get a month
regime against the present government control and sees a supply but nowadays, according to this
significant gap. Part of the reason for the gap is attributed to transition, drugs nowadays are issued that
lack of preparedness by government agencies to deal with only lasts for two weeks supply and you are
the issues that the HIV/AIDS program sought to address. asked to come again. The problem is, if the
child’s school is far away, one has to come
This is best elucidated by another respondent speaking many times to the hospital to access the
on the transition problems noted that: drugs” (respondent 002, 2021).
“Most county governments are not prepared She continues saying that:
for the transitioning in case there's a
changeover. This means that maybe we will be “With my firstborn, we'd be given food
affected in such a way that we will not get all supplements to help add weight if you see the
the services that we used to get when the donor child has a deficiency, the child would be
funding was there” (respondent 007, 2021). given and they'd take it. Nowadays those
things are no longer available. Now they affect
the child that when you give them drugs, they
see them as something bitter. If you don't give

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Volume 8, Issue 1, January – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
them something sweet afterwards, they view  Theme 4. Unavailability of nutritional supplements
taking them as a challenge” (respondent 002, On the issue of absence of nutritional supplements due
2021). to less funding, respondents noted that;
“We'd be given food supplements to help add
 Theme 2. Frequency of drugs disbursement weight if you see the child has a deficiency….
Reduced funding had reduced the regularity of Nowadays those things, the food supplements, are no
disbursement of drugs from six months to just 2 weeks longer available” (respondent 002)
supply while others asserted that it reduced from 3-month “We used to be given food and given drugs.
supply to a month supply depending on availability, stability But these days we're only given drugs. We
of the patient and distance they were from the facility. don't even have fare to go to the clinic”
(Interview 005, 2021)
“Sometimes I go to the hospital to get the “If you watch the kids, they've missed out on
drugs. I find that I don't get a three months’ things like nutritional support. They lack
supply of drugs as before and I'm issued a two supplies, thus they don't have access to healthy
weeks supply” (respondent 004, 2021). food. “(respondent 001)
“We used to be given three months’ supply of C. Experiences of caregivers as a result of reduced funding
drugs, but now we get only a month’s supply. for HIV/AIDS programs
(respondent 008, 2021). To effectively access the theme that touched on
A caregiver who is also a teacher and a mother remarked experiences of caregivers on reduced funding, certain
that the two-week supply and in some cases a one-month specific codes were used. Some of the notable codes
supply instead of a six-month supply is difficult for included ‘experience,’ ‘happening,’ ‘what you do.’
caregivers especially because it raises the traveling  Theme 1. Joblessness and homelessness
expenditures necessary to get those drugs. She said that: The respondents responded on what the reduction of
“It becomes a challenge to us, doctor, because funds has meant for parents and the child alike. One of the
we used to go to the health center to pick the respondents offered an elaborate response on this when she
drugs for three months’ supply, it'd be long said:
before we go back to pick more. In the process “Yes, well, for example we had pediatric
we'd have saved fare if we were coming from mothers who used to be attached to the clinic
far. So, this one-month supply of drugs and they were being given a stipend every
becomes a challenge because of the short month. However, they were laid off because of
interval and therefore we are unable to afford the transitions, because of the reduction of
fare to travel to pick the drugs because they funds. Now, they don't have another source of
get used up fast” (respondent 008, 2021). income. Before someone gets to build
themselves up again and get to the place they
 Theme 3. Lack of support for continuity of care were before becomes tough. Life becomes very
The 49-year-old mother asserted to reinforce the point difficult than bearable. In fact, some of them
about the lack of blood tests, that: have gone to the streets. They're now street
children; street parents because they cannot
“… there was this thing about the transition afford to pay rent (respondent 007, 2021).
where you'd be issued with drugs. A child was :” ...like now without funds, the people who
supposed to have a blood test every six months were employed as counsellors tracing drug
but it's no longer available nowadays. Since defaulters lost their jobs and so difficult
the onset of the Covid-19 pandemic, they say reaching this group” respondent 001
that there'll be no more blood tests. Now it's
almost one year. …If the child's health has According to the respondent, reduced funding has led
deteriorated, and you want them to do a check to loss of jobs for caregivers as well as taking them to street
up to find out what's up; if they test let's say life with experiences of tight budget concerns as reported by
like the kidney, you'll be forced again to pay” one of the caregivers who indicated that:
(respondent 001, 2021).
“To get here in Kisii to access drugs, I use Ksh
“...They used to follow up on how we live and 150; to and from I use Ksh. 300. Ksh 300 to
how we take our food, and our drugs when our and from, when you're with the child, you must
food was exhausted, they'd give us more use and additional Ksh 300. My income is low,
supplies. But these days they don't follow up. so I see it's difficult to visit the clinic as
“(respondent 007, 2021). required” (respondent 002, 2021).

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Volume 8, Issue 1, January – 2023 International Journal of Innovative Science and Research Technology
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 Theme 2. Child health care deterioration “There are things the children were used to
Others who responded discussed the impact of the cut in begin given like refreshments when they come
funding on child care. One of the caregivers who has been to the clinic, they can cannot get them
working with a child with HIV/AIDS for more than 5 years anymore like some used to be given even
observes that: money as transport reimbursement for them to
come to the clinic which is not there anymore”
“…when a child fails to take his drugs respondent 007,2021.
properly his viral load doesn't decrease, you
find he has a high viral load because he  Theme 3. Reduced HIV funding and access to education
doesn't get drugs” (respondent 005, 2021). According to one of the fathers who participated in the
interview, he was more worried about school fees and how
“We used to be given food supplements, the transition had affected them by saying:
especially for children who are malnourished, “In the past we'd be supported even in paying
that used to boost with immunity, but now school fees. However, since the changes
there are no supplies. Many of these children occurred, I've never gotten that support in
are so weak as they cannot eat well too” payment of school fees. I have two children
(respondent 008) whose school fees has not been paid so I'm
affected” (respondent 005, father, 2021).
Essentially, the child’s health has worsened as a result
of the less funding and has aggravated the negative practices “The government should reinstate the earlier
on post funding reduction among caregivers. program which would serve us food wise and
some school fees and few school items. When
 Sub theme 1- Out- of pocket cost expense I could get some money, I could contribute to
The respondents spoke of refreshments, fare withdrawal clearing school fees and in buying some food
and blood test subsidy prompting them to create a at home. But now that is not provided. Some of
budget for them. my children are not going to school because
am not able to afford all these things”
“Like earlier on, we would have all the tests
(respondent 008,2021)
for free but now we pay for all the tests but in
the past the donor would cover it” (respondent It is clear that financial assistance given to parents in
001, 2021). some way lessened the financial burden of the children's
school expenses. Lack of these assistance prevented them
The caregiver keeps saying that:
from receiving HIV care and accessing educational
“In the past we'd do tests including kidney opportunities.
function to gauge if the drugs are causing the
 Theme 4. Reduced funding and Nutrition
kidneys any harm. But since the transition, it
Others who responded to the survey discussed their
has been now on the parents. And when they
experiences with the food they consume. The care-giver
go to the lab and are asked to pay say Ksh
aged 35 years indicated that:
1000 for the tests, yet some even Ksh 200, they
can't afford it. They used to be free of charge.” “We used to be given plump nuts, weighed and
(respondent 001, 2021). height measured and if they got your child's
weight was amiss from the graph they used at
It was said by another respondent that:
the clinic, they would inform you that you
“For example, my child here has had lots of needed nutritional intervention. You'd be given
"missed appointments. Sometimes it's time to plump nuts and flour. But these days all these
pick drugs, and we don't have a fare to come are gone. We don't know how it happened. So,
to pick the drugs. Earlier on, Nuru ya Watoto, these days we fend for ourselves, we're only
a funded program for children, would give us recommended what to get. The nutritionist gives
fare to the clinic. But now it's not available. us a list, only tells us to buy omena, buy that
We have to budget for it” (respondent 005, and that and they don't want to know if we
2021). reside in town or in the upcountry. It's difficult.
It's true; they don't care if you have the money”
“I must use the fare to go from my home to the (respondent 005, 2021)
hospital. A two weeks interval! You see I use a
lot of money unlike when I'd get a two or For instance, a different respondent who was
three...months’ supply of drugs. And now that I questioned made a forceful observation about the problem of
am a low-income earner!” respondent the victims' lack of nutritional support and their experience
008,2021 of hunger. In this regard, she pointed out:

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“Many deaths have resulted, especially among “I'd wish that these programs had counselling
children, because they lack the support that for children of the adolescent age like before.
they'd get from the donor, regarding drugs, They talk to them, teach them and organize
nutrition and much more. And for these drugs, things like fun activities” (respondent
ARVs, you cannot take them on an empty 004,2021)
stomach! These drugs need one to eat properly
for them to work effectively. Taking these drugs IV. DISCUSSION
on an empty stomach contributes to affected
children dying. And now, many deaths have Caretakers who are closely related to children living
resulted but we are quick to attribute all deaths with HIV/AIDS and a deeper understanding of how the
to Covid-19. But you may find that the child reduction in funding affects them were polled about their
could have been infected with HIV but failed to perspectives and experiences. The results above indicate that
get proper nutrition, and as soon as they took the study was able to access qualitative data from a cross-
the drugs, the immunity got further section of respondents based on the gender, age, occupation,
compromised” (respondent 001, 2021). level of education, and family roles of the respondents. This
improves the results' reliability, dependability, and
“About the food, we can't tell how the children confirmability.
are doing. We used to be given some food but
nowadays is not provided. We just eat what's Caregiver stress is exacerbated by the constraints
available, not proper nutrition (bora chakula brought on by reduced funding, burdens characterized by
tu si chakula bora) the children suffer...and medicine shortages, the withdrawal of nutritional
sometimes we sleep hungry and the drugs don't supplements, and high associated costs. This agrees with the
go well with someone who doesn't feed literature asserting that a child's psychological, mental, and
properly” (respondent 008,2021). physical wellbeing are strongly influenced by the mental
health of caregivers(Murray et al., 2017) and those of
 Theme 5. Loss of training opportunities for HIV positive studies on the mental health of caregivers of critically ill
children and their caregivers patients that are restricted to population in English-speaking
The training that was available prior to funding high-resource countries.
reductions and the lack thereof are two crucial
experiences that are contrastively portrayed. A systematic analysis of the effects of pediatric critical
According to one caregiver who has had AIDS for 22 illnesses on caregivers and families revealed that the family
years had this to say: had unmet demands and pressures, therefore health
professionals should be aware of this to make sure they are
“...I thank God because I have children. I included in the treatment of the sick child(Shudy et al.,
have 1 out of 6 who is affected by HIV. For us 2006). Further, the outcomes agree with (E. F. Asuquo et al.,
we were able to get the teachings earlier on 2017) who conducted a study on the encounters of informal
and know how to handle the children. Back caring of PLWHIV by women. It was established that care
then when the organizations were powerful. giving strains mostly in women due to poverty, joblessness,
They'd even pay us a visit in the rural areas, in singlehood coupled and being sole family breadwinners. In
our homes and offer us advice. But now we addition, the study found that they had a greater risk of
don't have an organization that does that contracting HIV in addition to physical stress and mental
anymore” (respondent 001, 2021). health issues. The literature demonstrates that Kenya's health
system has a concentrated donor landscape, with four donors
Actually, another caregiver supported the issue of training funding nearly 90% of all external aid (the United States, the
and said that: Global Fund to Fight AIDS, Tuberculosis and Malaria, the
“Another challenge we've experienced in United Kingdom, and Gavi, the Vaccine Alliance). The
taking care of children is "health education". transition challenges identified by the caregivers are
You know in the past, we used to be grouped consistent with this literature (K. K. McDade et al., 2021).
according to the age of the child and then
we're taught. Through education, the child According to analysis of the viewpoints and
knows the importance of taking his drugs, and experiences of the caregivers, they have considered the
what the drugs do to reduce the viral load. severity, action cues, susceptibility, and benefits related to
Nowadays we don't have health education; we the wellbeing of their children in the wake of the drop in
don't have those programs where we'd meet donor financing. This suggests that the results are consistent
up, now we are troubled.” (respondent 005, with the Health Belief Model, which aims to clarify and
2021). anticipate wellbeing practices and provides the basis for
interventions to increase awareness of health risks, improve
perceptions of individual risk, encourage actions to reduce
or eliminate the risk, and increase confidence in one's ability
to make the necessary changes (Green et al., 2020) (Chin &
Mansori, 2019)

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V. CONCLUSION [5.] Asuquo, E. F., Etowa, J. B., & Akpan, M. I. (2017).
Assessing Women Caregiving Role to People
The study outcome indicated a substantial transition Living With HIV/AIDS in Nigeria, West Africa.
challenge evidenced by the caregivers taking up the role to SAGE Open, 7(1), 215824401769201.
fill gaps in care due to “reduced funding” that includes out- https://doi.org/10.1177/2158244017692013
of-pocket payments to pick drugs, buy supplements, [6.] Atun, R., Chang, A. Y., Ogbuoji, O., Silva, S.,
consultation, and laboratory services. Most of these services Resch, S., Hontelez, J., & Bärnighausen, T. (2016).
initially were supported 100 percent by donors. The lack of Long-term financing needs for HIV control in sub-
donor support for HIV/AIDS programs hindered the care of Saharan Africa in 2015–2050: A modelling study.
HIV positive children and raised caregiver costs, which BMJ Open, 6(3), Article 3.
exacerbated the bad experiences caregivers had with https://doi.org/10.1136/bmjopen-2015-009656
children after financing. But because it is a reality for them, [7.] Chin, J. H., & Mansori, S. (2019). Theory of
others have turned to other means of survival, albeit with Planned Behaviour and Health Belief Model:
difficulty. Females’ intention on breast cancer screening.
Cogent Psychology, 6(1), 1647927.
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A multi-sectoral partnership of community-based [8.] Green, E. C., Murphy, E. M., & Gryboski, K.
organizations, non-governmental organizations, and county (2020). The Health Belief Model. In R. H. Paul, L.
health facilities should develop guidelines for resource E. Salminen, J. Heaps, & L. M. Cohen (Eds.), The
mobilizations to support funding HIV programs. In addition Wiley Encyclopedia of Health Psychology (1st ed.,
to reducing and managing HIV/AIDS cases, particularly in pp. 211–214). Wiley.
youngsters, this will also make it easier for caregivers to https://doi.org/10.1002/9781119057840.ch68
handle the crisis. The government, through its non- [9.] Jewell, B. L., Mudimu, E., Stover, J., ten Brink, D.,
governmental organization, would prioritize empowerment Phillips, A. N., Smith, J. A., Martin-Hughes, R.,
initiatives that would aid parents of children with HIV/AIDS Teng, Y., Glaubius, R., Mahiane, S. G., Bansi-
in becoming self-sufficient. To analyze the same constructs Matharu, L., Taramusi, I., Chagoma, N., Morrison,
as the current study, a quantitative study should have M., Doherty, M., Marsh, K., Bershteyn, A., Hallett,
components like questionnaires, observation schedules, and T. B., & Kelly, S. L. (2020). Potential effects of
document analysis. disruption to HIV programmes in sub-Saharan
Africa caused by COVID-19: Results from multiple
 Study limitation: Single site study findings cannot be mathematical models. The Lancet HIV, 7(9), e629–
generalized e640. https://doi.org/10.1016/S2352-
 Declaration of interest: There was no conflict of interest 3018(20)30211-3
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