Pathways to Resilience III: Beyond Nature vs. Nurture

Health:

Abstract #74
Ugandan Caregiver Grandmothers of HIV/AIDS Orphans: Resilience And Recommendations in Context
Presenters: Caroline Burnley Co-Presenter: Ruth Kirson
Uganda has more than 2 million HIV/AIDS orphans.  The United Nations and many aid organizations, like the Stephen Lewis Foundation, acknowledge the important role that grandmothers play in raising the younger generations to adulthood and contributing to the recovery of the community affected by HIV/AIDS.  This qualitative study consisted of interview data from caregiver grandmothers in Nyakagyezi, Uganda.  A content analysis revealed challenges associated with the caregiver role (poverty, physical limitations of age, lack of financial support) as well as factors associated with the resilience of these grandmothers and their “children” (internal factors such as faith and external supports such as access to education for their children and healthcare for their families).  Recommendations focused on community interventions that would support the resilience of the grandmothers and their children.  Beyond taking a contextual approach to understanding the risk and resilience of these grandmothers, this research also lead to a greater understanding of the importance of taking a contextualized approach to the implementation of the recommendations.  The researchers will discuss the process involved in generating the recommendations and the subsequent actions that were necessary in order to ensure those recommendations were contextually valid.

Abstract #117
The VUKA Family Programme: Promoting Resilience In Perinatally HIV Infected Adolescents In South Africa
Presenter: Arvin Bhana
Abstract:
The VUKA Family programme is targeted to helping perinatally HIV infected early adolescent children and their caregivers thrive in the context of serious challenges associated with a chronic, potentially fatal, sexually transmittable, and highly stigmatising illness. Without intervention youth are likely to face considerable adversity in dealing with the developmental complexities associated with perinatal HIV. The challenge of living with HIV is complicated by a number of environmental factors that include poverty, educational levels of caregivers and safety characteristics associated with the home and neighbourhood.  This paper examines the baseline data from a randomized clinical trial of VUKA taking place in community based clinics in KwaZulu-Natal South Africa. Adolescent adaptation to HIV is examined in relation to how internalised and externalised stigma interacts with protective factors such as self-regulation and self-esteem. In addition, the role of protective factors including parental monitoring, family communication and social support is considered as they directly or indirectly affect mental health outcomes among both children and their caregivers. The examination of the pathways of influence among these variables help shed light on the characteristics important to promoting resilience among HIV+ adolescents in South Africa.

Abstract #155
Planning for Resilient Health System - Advancing Health System Through an Analytical Decision Making Tool
Presenter: Arash Beheshtian Co-presenters: Kieran Donaghy, Asieh Golozar
Abstract:
Due to their multidimensional nature, Health systems represent System of Systems (SOSs). These include sub-systems operated by health sector but might comprise numerous complex systems functioning interdependently. Planning for sustainable health-SOSs (h-SOSs), given the vitality of operable neighboring systems is more intricate while networks’ components are aged, over-capacitated, or under the risk of exogenous shocks such as extreme weather episodes. Consequently, achieving a sustainable h-SOSs requires a set of resilience-enhanced infrastructures robust enough to withstand disruptive events and resilient for resource reallocation to return into nominal performing levels. We investigate resilience planning in the context of h-SOSs.  Our analytic decision-making tool introduces analytic framework that seeks optimum set of resilience-enhanced strategies against potential shocks threatening h-SOSs. We proposed best possible absorptive, adaptive, and restorative capacity-augmentation strategies to enhance the robustness of h-SOSs, given capped budgeting scenarios, logistic capabilities of network’s components, and stochastic extreme events such as superstorms or fast-spreading diseases. Numerical experiments substantiate these models and i) provide potential improvement to day-to-day h-SOSs functioning and create redundancies; ii) keep health-corresponding infrastructures at lower risk of failing catastrophically; and iii) make flexible h-SOSs adaptive for hosting expansion through strategic investment techniques.