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From Children of the Garbage Bins to Citizens: A reflexive ethnographic study on the care of “street children”
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (International Child Health and Nutrition)
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of the study on which this thesis is based was to gain an understanding of the life situation of street children in Kenya and to investigate how caring institutions care for these children.  A reflexive ethnographic approach was used to facilitate entry into the children’s sub-culture and the work contexts of the caregivers to better understand how the children live on the streets and how the caregivers work with the children. A fundamental aim of the research was to develop interventions to care; one of the reasons why we also used the interpretive description approach. Method and data source triangulation was used. Field notes, tape, video, and photography were used to record the data.  Participant observation, group discussions, individual interviews, home visits, key informant interviews, participatory workshops and clinical findings were used for data collection in Studies I and II.  In addition to observation, interviews were conducted with caregivers for study III, while written narratives from learners attending adult education developed and implemented during the research period provided data for study IV.  Study I indicated that food, shelter and education were the main concerns for the children and that they had strong social bonds and used support networks as a survival strategy.  Study II provided a deeper understanding of the street culture, revealing how the boys are organised, patterns of substance use, home spaces in the streets and networks of support. The boys indicated that they wanted to leave the streets but opposed being moved to existing institutions of care. A group home was therefore developed in collaboration with members of the category “begging boys”.  Study III indicated how the caregivers’ interactions with the children were crucial in children’s decisions to leave the streets, to be initiated into residential care, undergo rehabilitation and to be reintegrated into society.  Caregivers who attempted to use participatory approaches and took time to establish rapport were more successful with the children.  Study IV suggested that the composition of learners, course content grounded on research, caregivers’ reflections and discursive role of researchers and facilitators, all contributed to adult learning that transformed the learners’ perspectives and practice.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. , 55 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 790
Keyword [en]
Health care seeking behaviour; Child participation; Re(habilitation); Street children; Caregiver; Reflexive ethnography; Transformative learning; Kenya; Africa; Southeast Asia
National Category
Medical and Health Sciences Health Sciences Learning
Identifiers
URN: urn:nbn:se:uu:diva-178166ISBN: 978-91-554-8410-1 (print)OAI: oai:DiVA.org:uu-178166DiVA: diva2:542215
Public defence
2012-09-14, Sal IX, Universitetshuset, Uppsala, 13:15 (English)
Opponent
Supervisors
Available from: 2012-08-24 Created: 2012-07-30 Last updated: 2013-01-24Bibliographically approved
List of papers
1. Burning "Centre Bolt": Experiences of sexually transmitted infections and health care seeking behaviour described by street boys in Urban Kenya
Open this publication in new window or tab >>Burning "Centre Bolt": Experiences of sexually transmitted infections and health care seeking behaviour described by street boys in Urban Kenya
2007 (English)In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 29, no 5, 600-617 p.Article in journal (Refereed) Published
Abstract [en]

This paper is about how street boys described their experiences of sexually transmitted infections and the care they sought in Nakuru, Kenya. The data were collected over a six-month period at a Soup Kitchen frequented by street children aged 5 to 18 years. Data were generated using participant observation of 115 children; group discussions with 12 boys; interviews with 20 boys; 17 key informant interviews; two home visits; and clinical records of five boys that had sexually transmitted infections. The findings revealed who the boys' sexual partners were, their sexual practices, and their pattern of condom use, their experience of sexually transmitted infections, how they communicate symptoms and when and how they seek care. Lack of money for treatment delayed care seeking. The study also indicated the existence of strong bonds and support networks as a survival strategy on the streets. In conclusion, understanding the ways the street boys experience, reason and communicate their symptoms as well as their support networks is useful in the prevention of sexually transmitted infections and the promotion of their general health and wellbeing. Moreover, eliminating the barrier to health care is imperative for the sustainable provision of care to this vulnerable group of children.

Keyword
Street boys, Sexually transmitted infections, Health care seeking behaviour, Support networks, Kenya
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-121436 (URN)10.1016/j.childyouth.2007.01.005 (DOI)000246254100005 ()
Available from: 2010-03-23 Created: 2010-03-23 Last updated: 2017-12-12Bibliographically approved
2. Are street children beyond rehabilitation?: Understanding the life situation of street boys through ethnographic methods in Nakuru, Kenya
Open this publication in new window or tab >>Are street children beyond rehabilitation?: Understanding the life situation of street boys through ethnographic methods in Nakuru, Kenya
2008 (English)In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 30, no 12, 1345-1354 p.Article in journal (Refereed) Published
Abstract [en]

This paper describes the social organisation of street boys, the complexities and dilemmas of accessing them for interview, and removing the youngest and most vulnerable from the streets. The data were collected from three groups of street boys over a period of eight months: 20 “market boys”; four “plastic bag sellers” and their group leader; and twelve “begging boys” and their group leader. The study employed a reflexive ethnographic approach with participant observation, informal interviews and group discussions as data collection strategies. A participatory workshop was arranged for the highly mobile “begging boys” who could not be interviewed directly on the streets. Key informants helped in gaining access to the three groups of street boys, providing “insider information” about the boys and their contexts as well as in building trust. Through this research process, a deeper understanding of the street culture emerged, showing who the street boys are as well as how they are organised, their hierarchies and socialisation; patterns of substance use, home spaces in the streets, and networks of support.

Keyword
Street boys, Street children, Reflexive ethnography, Research methodology, Child participation, Kenya
National Category
Other Social Sciences not elsewhere specified
Identifiers
urn:nbn:se:uu:diva-86661 (URN)10.1016/j.childyouth.2008.04.003 (DOI)000261256900001 ()
Available from: 2008-11-26 Created: 2008-11-24 Last updated: 2017-12-14Bibliographically approved
3. “With An Open Heart We Receive the Children”: Caregivers’ strategies for reaching and caring for street children in Kenya
Open this publication in new window or tab >>“With An Open Heart We Receive the Children”: Caregivers’ strategies for reaching and caring for street children in Kenya
2016 (English)In: Journal of Social Work, ISSN 1468-0173, E-ISSN 1741-296XArticle in journal (Refereed) Published
Abstract [en]

Summary:

The aim of the study was to explore how caregivers reach out and care for street children and understand their strategies and implication for outreach to the children, removal from the streets, rehabilitation and reintegration into society..  Data was collected over a period of two years using a semi-structured topic guide from seventy caregivers in 35 organisations in Kenya, identified using the snowball sampling strategy. Information generated was discussed with street children to help modify the interview and observation guides. To record interactions between the children and their caregivers, direct observation, video recording and photography were used at the caregivers’ workplaces on the streets and at institutions of care.

Findings:

Two themes were developed from the data, namely, the dedicated caregiver confronting street realities; and making a difference despite the limitations. The way caregivers interacted with the children on the streets and in the institutions greatly influenced the children’s decision to leave the streets, to be initiated into residential care, and attend rehabilitation and reintegration programmes. Children were more positive to caregivers who took time to understand them and were soft in establishing rapport with them.

Application:

The results suggest that caregivers’ strategies are potential contributors to declining trends of the street children phenomenon as they influence the children’s decision to leave the streets and undergo rehabilitation at institutions of care. Thus, we recommend the development of educational efforts focusing on helping caregivers develop healthy relationships and positive interactions with the children.

Keyword
street children, caregiver strategies, (re) habilitation, reflexive ethnography, Kenya
National Category
Medical and Health Sciences
Research subject
Social Medicine; Caring Sciences in Social Sciences
Identifiers
urn:nbn:se:uu:diva-178162 (URN)
Available from: 2012-07-30 Created: 2012-07-30 Last updated: 2017-12-07Bibliographically approved
4. “The training was an eye-opener…”: Transformative Experiences of Caregivers from an Adult Education on Medical and Psychosocial Care of Children in Especially Difficult Circumstances
Open this publication in new window or tab >>“The training was an eye-opener…”: Transformative Experiences of Caregivers from an Adult Education on Medical and Psychosocial Care of Children in Especially Difficult Circumstances
2012 (English)Article in journal (Refereed) Submitted
Abstract [en]

This article describes the transformative experiences observed among social and health care learners in an international training program after they had undergone training focusing on working with children in especially difficult circumstances. Participants were drawn from government departments, non-governmental organizations, community- and faith-based organizations and represented different professional and age groups. The training evolved over time and is built on research conducted among children in especially difficult circumstances and their caregivers. Qualitative methods were used for evaluation and Mezirow’s transformative learning theory served as the framework of reference. Two themes were developed from the process of analysis, namely: Learners’ description of their learning and its impact on their work; and the factors facilitating the transformation. In conclusion, the article indicates that, composition of the learners, course content based on research and the caregivers’ reflections, and discursive role of researchers and facilitators, are critical in adult learning.

Keyword
children; caregivers; education, professional; transformative learning; Africa; Asia, Southeast
National Category
Health Sciences Learning
Identifiers
urn:nbn:se:uu:diva-178165 (URN)
Available from: 2012-07-30 Created: 2012-07-30 Last updated: 2013-01-22Bibliographically approved

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