The study was conducted in predominantly rural areas in Manicaland province in eastern Zimbabwe. A multi-method approach was employed with a combination of qualitative and quantitative research methods. Quantitative research methods: The data for the study were taken from a cross-sectional household survey of 4,577 children (2,328 girls and 2249 boys, aged 6-17) conducted between 2009 and 2011 in 12 sites (two small towns, four agricultural estates, two roadside settlements and four subsistence farming areas), spread across three districts in Manicaland province, and linked data on the characteristics of 28 primary and 18 secondary schools from a parallel facility survey in the same districts. These data were used to measure and compare levels of attendance and well-being of HIV-affected children in schools with varying scores on an ‘HIV competence’ index. For these analyses, child wellbeing was calculated as an index using principal components analysis to integrate the variables in each domain (health behaviours, risk and safety, physical health, psychological health, material situation, and social wellbeing) together to obtain a score for each child in that domain. The final score is then a weighted average of the different components that takes into account the variability and dependencies in the data. The HIV-competent school index was calculated based on data collected in the M&E facility survey on a range of HIV-specific and wider characteristics including basic facilities, student-teacher ratio, HIV policies, HIV/AIDS teaching, support for OVC, and links with local community and external organisations. The qualitative component of the study carried out case studies from 3 primary schools, and 3 secondary schools in rural Zimbabwean communities during the period July 2012 to June 2013 using in-depth interviews, focus group discussions, photo voice, participant observation and draw-and-write exercises to explore community perceptions on the role of schools in supporting children affected by HIV. Study participants included HIV-affected children, primary students, secondary students, teachers, head masters and community members. The qualitative study explored: i) community perceptions of possibilities and barriers for schools to play a role in the support and inclusion of children affected by HIV, ii) children’s accounts of their relationships with their schools, and iii) community explanations of factors determining qualities of response. Children affected by HIV (themselves sick/with sick parents/orphaned) are particularly vulnerable to poor nutrition, mental and physical health, sexual abuse and poverty. It is the aim of this study to explore how schools in Africa can help HIV-affected children cope with disease and poverty. Survey data will be used to identify schools with varying levels of success in promoting the inclusion and support of children affected by HIV and poverty, examining links between school enrolment and child health and well-being. Detailed qualitative case studies - using a mix of qualitative research methods - of primary and secondary schools with varying degrees of success in providing a supportive environment for HIV-affected children, will be conducted to generate detailed accounts of 'best and worst practice' in relation to inclusion and support of boys and girls. The study seeks to develop a model of the 'HIV competent school' - which optimises children's inclusion, support and health, even given poverty and political uncertainty. This model will constitute a resource for local, national and international health and educational professionals and policy makers seeking to promote the role of schools in tackling child poverty and disease in Africa.
A multi-method approach was employed with a combination of qualitative and quantitative research methods. Quantitative research methods: The data for the study were taken from a cross-sectional household survey of 4,577 children (2,328 girls and 2249 boys, aged 6-17) conducted between 2009 and 2011 in 12 sites (two small towns, four agricultural estates, two roadside settlements and four subsistence farming areas), spread across three districts in Manicaland province, and linked data on the characteristics of 28 primary and 18 secondary schools from a parallel facility survey in the same districts. These data were used to measure and compare levels of attendance and well-being of HIV-affected children in schools with varying scores on an ‘HIV competence’ index. For these analyses, child wellbeing was calculated as an index using principal components analysis to integrate the variables in each domain (health behaviours, risk and safety, physical health, psychological health, material situation, and social wellbeing) together to obtain a score for each child in that domain. The final score is then a weighted average of the different components that takes into account the variability and dependencies in the data. The HIV-competent school index was calculated based on data collected in the M&E facility survey on a range of HIV-specific and wider characteristics including basic facilities, student-teacher ratio, HIV policies, HIV/AIDS teaching, support for OVC, and links with local community and external organisations. The qualitative component of the study carried out case studies from 3 primary schools, and 3 secondary schools in rural Zimbabwean communities during the period July 2012 to June 2013 using in-depth interviews, focus group discussions, photo voice, participant observation and draw-and-write exercises to explore community perceptions on the role of schools in supporting children affected by HIV. Study participants included HIV-affected children, primary students, secondary students, teachers, head masters and community members.
