Abstract
Children’s and communities’ quality of life in Malawi has been significantly and negatively impacted by the AIDS syndemic. Up to 10% of Malawian children now live with their grandparents in deeply resource-constrained households, where they face multiple threats to their wellbeing. International development organizations have responded to these threats with projects aimed at supporting vulnerable children’s education. This chapter utilizes decolonial frameworks to describe the key normative assumptions that shape these school projects and limit their utility in improving vulnerable children’s and AIDS-affected communities’ quality of life; and provides two case studies of alternative program efforts that destabilize these assumptions and mobilize new modes of community participation to transform vulnerable children’s individual, familial, and collective wellbeing.
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Notes
- 1.
As Moller, Roberts, Tiliouine, and Lotschky (2017) note, the concepts of quality of life, happiness, and wellbeing are intertwined in Africa in ways that require an understanding of how basic measures of wellbeing interact with constructs such as “global happiness”. Jirojanakul, Skevington, and Hudson (2003) note, Quality of Life (QOL) has been defined as “the individual’s perception of their position in life, in the context of culture and value systems in which they live and in relation to their goals, expectations, standards and concerns” (WHOQOL Group, 1995, p. 1405). Efforts to conceptualize and measure children’s QOL have been more limited than efforts to measure adult QOL, however. In this paper, we utilize the notion of wellbeing instead of quality of life, and more particularly the model of wellbeing developed in Friedson-Ridenour, Kendall, and DiPrete-Brown (2015).
- 2.
Estimated adult (ages 15–49) infection rates of 7.1% (male)/11.2% (female), with youth (ages 15–19) rates climbing rapidly (UNAIDS, 2016). Data accessed at: http://www.unaids.org/en/regionscountries/countries/malawi
- 3.
Singer describes the AIDS syndemic as follows: complex involving interconnected chains of disease causality nested in particular political economic and biosocial environments—what, in the case of southern Africa, might be called a perfect epidemiological storm (p. 9). This understanding of AIDS breaks down traditional medical approaches to understanding diseases in biological isolation from one another, and from the social, economic, political, and cultural environments in which they occur. Singer notes that from a public health perspective, in Southern Africa HIV/AIDS cannot be disentangled from malnutrition and poverty. Examining them instead as one syndemic emphasizes three key issues for understanding and acting to improve wellbeing: disease concentration, interaction, and social context (p. 10).
- 4.
This list of outcomes closely mirrors that developed by Cornish and Ghosh (2007) in their discussion of the complex power dynamics that must be balanced to achieve successful “community-led” health promotion outcomes.
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Kaunda, Z., Kendall, N., Majee, U. (2019). Decolonial Approaches to AIDS, Children’s Wellbeing, and Education in Malawi. In: Eloff, I. (eds) Handbook of Quality of Life in African Societies. International Handbooks of Quality-of-Life. Springer, Cham. https://doi.org/10.1007/978-3-030-15367-0_14
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