156 CHAPTER 9


they departed from the pay point (Devereux et al. 2007, 9–10). In general, beneficiaries’ impressions of the sensitization campaign were largely posi- tive. The use of local musicians and actors, as well as the dancing that often accompanied the music, mitigated the boredom of waiting in line for the cash transfer. And beneficiaries often found the teachers and facilitators effective and funny (Devereux et al. 2007, 11). Information campaigns alone may not be sufficient to significantly affect health outcomes, however, particularly with respect to HIV transmission. Accord- ing to Malawi’s 2004 Demographic and Health Survey, despite overall advanced knowledge about HIV transmission and infection vectors, HIV prevalence remains high. This suggests that Malawians may understand the causes of HIV/AIDS but have not adapted their behavior. Information campaigns, then, are unlikely to be successful without other services that help overcome key constraints to behavior change, such as the provision of free condoms, VCT, or ARVs (McCord 2005). (See the “Psychosocial Support” section.)


Psychosocial Support Children living in households affected by HIV and AIDS can experience a range of hardships, from poverty and ill health to social instability and grief, all of which affect their physical, cognitive, and psychological development. Psychosocial needs—“to be happy, creative, to belong in social groups, and to have hope for the future”—can be addressed at home by strengthening children’s daily routines and seeking opportunities for normal childhood be- havior (for example, playing) or through programs or activities beyond what children receive in their home environment (Richter, Foster, and Sherr 2006, 9, 16–17). Richter, Foster, and Sherr (2006) argue that psychosocial support, care,


and rehabilitation are best provided by the family or the community because children who experience lasting supportive, stimulating, and affectionate relationships are more likely to feel hope for the future as well as to develop resources for coping with the challenges of HIV and AIDS. The authors recom- mend involving local CBOs and prioritize placing and keeping children in set- tings with supportive family or other caregivers before looking to outside interventions. For children who suffer from extreme mental or behavioral dis- orders, the support of trained professionals may be necessary (Richter, Foster, and Sherr 2006, 11). Cash transfers could be linked to psychosocial support services. One such


example is Mozambique’s National Institute for Social Action program, which itself provides psychosocial support (Devereux et al. 2005). In Malawi’s SCTS, CBOs, extension workers, and child protection workers collaborate to link cash transfer beneficiaries to psychosocial support services (UNICEF 2007).


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