The Better Future International’s family care model in Tanzania: Creating social capital as a means to empowerment in social work practice

Abstract

This article describes the impact on social services of an innovative model of family care in Moshi, Tanzania, aimed at orphaned children and youth who are affected by HIV/AIDS and their caregivers. We explore three questions: Is social capital created during the provision of social work services? If so, what aspects of the model are responsible for it? How does this social capital influence the participants’ educational/occupational aspirations and vision of the future? This qualitative study is based on a case analysis of eight adolescents and their caregivers. Data were collected from in-depth interviews. The unique aspects of a family-oriented, holistic, social service model focused on empowerment and future orientation-generated bridging, bonding, and linking social capital. Youth with more social capital appeared to have clearer visions of their future path. Implications for community-based social work practice serving marginalized and impoverished groups are presented.

Keywords

Family care model HIV/AIDS orphaned and vulnerable youth social capital Tanzania

Introduction

Non-governmental organizations (NGOs) based in developing countries face many challenges in their efforts to deliver assistance to orphans and vulnerable children, including the efficient delivery of concrete services and the empowerment of the communities and individuals they serve. Approximately 19.6 million individuals are living with HIV in Eastern and Southern Africa, vast regions comprising countries such as Botswana, Kenya, Lesotho, Malawi, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe (Averting HIV and AIDS [AVERT], 2019a). With the highest HIV prevalence rates in the world, wide disparities in income and a lack of adequate infrastructure negatively affect access to care and social services in this region (AVERT, 2019a). In 2016, AVERT estimated that there were 1.4 million individuals living with HIV in Tanzania. UNAIDS reported that HIV prevalence for women was 5.8 percent compared with 3.6 percent for men in Tanzania (AVERT, 2019b). Approximately 898,000 adolescents (aged 10–19), or 4.7 percent of this age cohort live with HIV (UNICEF Tanzania, 2017).

In addition, each year, over 50,000 individuals are newly infected with HIV, and over 30,000 individuals die from AIDS-related illnesses (AVERT, 2019b). The burden of the AIDS epidemic in Tanzania falls disproportionately on women, adolescents, and children. Women remain primarily responsible for the care of the sick and those left behind after the death of their parents. The stigma attached to those associated with the disease compounds the difficulties encountered by both caregivers and children (Arnab and Serumaga-Zake, 2006; Lugalla, 2003; Roby and Shaw, 2006).

Stigma and HIV/AIDS in Africa

Stigma has long been associated with the experience of living with HIV/AIDS around the world, often linked to society’s perceptions of how the disease is transmitted, as well as the fears about contracting it from those infected (Pardasani, 2005). The idea that this disease is mainly transmitted through sexual activity (both heterosexual and homosexual) creates a moral bias toward those living with HIV. Finally, the discrimination that people living with HIV face in terms of housing, access to care, education, and employment leads them to hide their health status or reduce their network of support. Yassin et al. (2018) found that HIV-related stigma negatively affected the psychosocial well-being of children orphaned by AIDS. Gamerel et al. (2017) found that the mental health of children and their caregivers and HIV-related stigma were intrinsically linked. Williams (2014) and Chan et al. (2015) found that HIV-related stigma negatively affected health and social service utilization in many African countries. Ogunmefun et al. (2011) found that older female caregivers for adults and children living with HIV experienced significant secondary stigma such as social isolation, voyeurism, and being gossiped about (p. 86). Thus, stigma acts as a roadblock to vulnerable individuals seeking assistance, preventing them from adequately accessing resources, support, and social capital.

The role of NGOs in HIV/AIDS-related services in Tanzania

AVERT (2019b) reports that the government of Tanzania has supported several initiatives that aim to reduce the transmission of HIV, such as post-natal health care, condom promotion, voluntary male circumcision, and harm-reduction programs for substance abusers. There is a vast network of NGOs that provides social services and educational, employment, and financial support programs to those affected by HIV/ADS (Nyangara and Lema, 2009; Seckinelgin, 2005). According to the International Labor Organization (2005), Nyangara and Lema (2009), and Seckinelgin (2005), NGOs play a critical role in providing psychosocial, social welfare, educational, and healthcare support for people affected by this disease.

The Better Future International model

Better Future International (BFI) has developed an innovative model of family care that is implemented by the Salaama Center, a program site in Moshi, Tanzania. The BFI model of family care is a departure from the more typical institutional orphanage model in several ways. First, youth are cared for by their family, typically grandparents. Many of the youth and children were reconnected with caregivers by the program, and the Center offers services to these families as a unit. Concrete services such as food, medical care, and education are provided to the family as a whole. Family visits and parenting workshops also provide support to the family. The goal is to strengthen, empower, and sustain these families providing care to HIV orphans.

A second innovation is their holistic approach, placing the family and services received within the community. Youth (children and adolescents) attend local schools in the community and occasionally boarding schools. Health care is provided by a local clinic in the community. The participatory and empowering nature of this social service model is a third innovative aspect. The Center empowers families in a number of ways; for example, caregivers are offered vocational workshops and microloans to begin small businesses. An advisory group representing all the caregivers helps direct the Center’s activities. Youth are also offered supplemental tutoring and computer instruction, and sports, traditional dances, and crafts. These opportunities allow the adolescent to feel a sense of growth and empowerment.

Purpose of the study

This article builds on recent publications describing the implementation of direct services at BFI’s Salaama Center and its effect on the families and children (Chazin et al., 2015; Pardasani et al., 2010). Here, we focus on less tangible aspects of the model – the creation of social capital and the role it plays in the youth’s sense of empowerment and the future. Our research questions were as follows:

Is social capital created during the provision of social work services?

If so, what aspects of this model are responsible for it?

How does this social capital contribute to educational/occupational aspirations and vision of the future?

Literature review

Family care models

The advent of family-centered treatment models could be traced back to Carl Rogers’ work in psychotherapy (Wexler and Rice, 1974). Rogers (cited in Wexler and Rice, 1974) believed that family dynamics and level of support directly affected client functioning and outcomes. Briar-Lawson et al. (2001) highlighted the centeredness of family in all positive interactions with individual clients. They viewed the family as collaborators and advocates in treatment. Bamm and Rosenbaum (2008) highlight the philosophical principles of family-centered service that include recognizing parents as experts on their child’s needs, promoting partnerships between parents and service providers, and empowering the family’s role in decision-making.

Previous studies on BFI have noted the fragmented nature of social service delivery in this region (Chazin et al., 2015; Pardasani et al., 2010). Many programs focus on vulnerable children and youth, as well as their families, but the scope of social work is narrow. While some NGOs focus on income generation for impoverished families, others focus on education and life skills for children and youth or on healthcare services (Chazin et al., 2015; Pardasani et al., 2010). BFI embodies the social work perspective of ‘person-in-environment’ by focusing on physical, emotional, and social health. By providing a comprehensive array of services for both the children/youth and their caregivers, the program emphasizes the centrality of family support and decision-making in the core model. We consider this program model to be unique, holistic, and comprehensive as it focuses on multiple dimensions of well-being and empowerment and is therefore worthy of study for its effect on social capital development.

Social capital: What is it and how is it created?

There is no one universal definition for the term ‘social capital’. We define it drawing on a model based upon the work of Coleman (1988) and Putnam (1995): networks of relationships that generate feelings of trust, common norms, and a history of reciprocity. These networks are created through participation in civic associations and other more informal group activities.

The literature speaks generally of three types of social capital. Bonding social capital comprises social networks between homogeneous groups of individuals. This term refers to the links between like-minded people who share a history, a common purpose, and experience (Schuller et al., 2000). Bonding can be valuable for oppressed and marginalized members of the society, such as the youth and their caregivers at the Salaama Center, as a means of accessing information and resources. Just being together in various programs (both youth and caregivers), the participants have developed a sense of common identity and positive self-esteem.

Bridging social capital refers to the building of connections between socially heterogeneous groups. This form promotes the exchange of information, ideas, and innovation and builds consensus among groups representing diverse interests. These networks are likely to be more fragile than those created among homogeneous groups, but are more likely to foster social inclusion – one of the explicit goals of the Salaama Center (Schuller et al., 2000). One example of this fostering of community connectedness is that the Salaama Center allows community members (youth and adults) to take part in some programs even if they are not clients or care recipients. This kind of community-building allows for the development of bridging social capital, which in turn leads to coalition building, causes advocacy, and leads to collective bargaining capabilities.

Linking social capital is the building of relationships between individuals and more powerful institutions in order to access resources (Szreter and Woolcock, 2004; Woolcock, 2001). This allows for clients of the Salaama Center to receive entitlements and resources from the government and financial institutions. These links can also be crucial to the development of BFI as it enhances its own capacity for resources and services that can be made available to their clients.

Aldrich and Meyer (2015) examined the critical role that networks and social capital play in building community resilience after a natural disaster. They posited that individual and group access to networks is essential for building all three types of social capital (bonding, bridging, and linking). White and Gager (2007) demonstrated that a family’s economic status and ethnic/racial background were correlated to participation in social networks and activities. In other words, minority youth and their caregivers who hailed from low-income and/or rural neighborhoods were less likely to engage with the community, thereby reducing their ability to develop social capital (p. 105). BFI’s clients are among the poorest of families who live with very few resources and are affected by HIV/AIDS, a stigmatized disease. These factors limit their ability to engage productively with the community and service networks, thus lowering their efficacy with building social capital on their own.

A number of studies suggest that NGOs in less developed countries create social capital, which has been an important justification for their existence. Jamil and Muriisa (2004) describe the creation of bridging social capital through drama that brings performances to communities, bridging the gap between those infected with AIDS and those not infected. Islam (2014) describes the creation of social capital through engaging the community in the NGOs’ efforts to prevent the spread of AIDS.

Studies suggest that participation in NGOs creates bonding social capital at the individual level. Previous studies have demonstrated how the BFI program helped engender a sense of belonging, self-respect, and positive identity among the recipients of services (Chazin et al., 2015; Pardasani et al., 2010). Larance (2001), Anderson et al. (2002), and Jamil and Muriisa (2004) describe the creation of bridging and linking social capital generated by meetings and interactions tied to microloans. These authors also describe the generation of bridging and linking social capital through participation in other NGO activities such as education, community partnerships, and political advocacy that address the challenges of HIV/AIDS.

Social capital and social work practice

Most theoretical conceptualizations in social work draw a distinction between macro-level and micro-level practice. Sesane and Geyer (2017) surveyed community residents in two municipal regions in South Africa that were disproportionately affected by HIV/AIDS. Their study found that the community regarded social workers as assets who helped build social capital and capacity through individual, group, and community empowerment (p. 16). Thus, they viewed the work of the social worker as occurring simultaneously at the individual (micro) and community (macro) levels. Researchers argue that a concept like social capital is particularly well suited to be employed at individual, family, community, and societal levels simultaneously (Aguilar and Sen, 2009; Hawkins and Maurer, 2012; Loeffler et al., 2004). In doing so, health and well-being outcomes for clients are enhanced several-fold. Proponents of integrating social capital in social work practice highlight its congruence with the social work perspective of person-in-environment (Aguilar and Sen, 2009; Torronen, 2015). Developing social capital among consumers of social work services and the community at large is a social workers’ critical and dual-focused task (Cheung and Kam, 2010; Torronen, 2015). It is, in essence, the mission of social work, which is not only to help individuals and families but also to create an equitable and well-resourced community.

This article focuses on a community-based social work model that serves individuals, families, and the larger community simultaneously. Okpych and Courtney (2017) posited that increased agency within the social/institutional network of foster children helps to build social capital, and that it acts as a positive predictor of college enrollment. With respect to community, the linkages formed with other service providers like schools, healthcare facilities, vocational training programs, lenders, and local businesses enhance the capacity of the community to utilize their resources more effectively.

In terms of community-based social work practice, the three most popular models of community organizing that social workers engage in are community development, social planning, and social action (Aguilar and Sen, 2009; Wakefield and Poland, 2005). These three models differ along several dimensions, including goals and pathways to action. However, their effect on building bonding and bridging social capital is critical (Aguilar and Sen, 2009). Cheung and Kam (2010) argue that an effective social worker helps the clients and the community where they reside build social capital as a means to personal and group empowerment.

Social capital and adolescent empowerment

A review of the literature in 2002 found consistent relationships between greater social capital and higher educational attainment and achievement (Dika and Singh, 2002). Clark (2011) found that positive peer relationships with friends and teachers led to the development of social capital that, in turn, had a positive effect on academic achievement. Coleman and Hoffer (1987) pointed to a parent’s social capital as important to their children’s educational development. Other studies have also documented the positive influence of social capital on academic achievement and educational attainment (Crosnoe, 2004; Israel et al., 2001; Kim and Schneider, 2005; Sun, 1999).

The effect of social capital on educational aspirations has been studied less extensively. However, Dika and Singh (2002) found a consistent relationship between educational aspirations and social capital. Social capital, in particular bridging social capital, is very important in exposing adolescents to broader views of the world and its opportunities, especially for those with limited access to visions of the future and informational sources within their close networks (Ellison et al., 2014).

This study fills several gaps in the literature. While there is some indication that NGOs are capable of creating social capital, there is little research on how that happens or what components are most important. There is also limited research on how adolescents in Africa create and use social capital, particularly those whose future may be limited because of a lack of resources, opportunities, and social stigma. Understanding more about both these processes can enable NGOs to leverage the services they provide and empower those they serve, and learning about how social workers can aid in the development of social capital is critical to their effectiveness.

Method

Design

This is a qualitative case study of eight caregivers and their adolescent youth served by BFI’s Salaama Center. We address our research questions by considering the contrasting stories of five of these eight adolescents and their caregivers. Case vignettes are presented below. Our goal is to understand the complexities of each case, beginning with concentrated study of the individual (Patton, 2014). They are all nested within the Salaama Center, a critical service component of BFI’s family model.

Sampling and recruitment

After an initial informational meeting to introduce the project, the researchers approached all caregivers with adolescent children in the program requesting their participation. Caregivers of the participating adolescents provided informed consent and the adolescents all provided assent as well. Eight caregivers and their respective adolescent children (ages ranging from 14 to 17) participated. The length of time the caregivers and the youth have been involved with the Salaama Center is 10 years, as the program was formally launched in 2008. All the participants in this study were the original clients of the program.

All personnel, including administrators, teachers, and staff, were personally invited by one of the co-investigators to participate. Two co-directors, one case manager, and four teachers were interviewed for this study. All provided informed consent. These procedures were approved by the investigators’ home institution.

Data collection

Interviews were conducted in Kiswahili and lasted approximately half an hour. Most were conducted either at the caregiver’s home or at the Salaama Center in a separate space, ensuring as much privacy as possible. Interviews were conducted by a local social worker who had no personal or professional relationship with BFI or the Salaama Center (Table 1). He was trained and supervised by the researchers. Another member of the local community later translated the recorded interviews into English.

Table 1.

Interview Questions for Stakeholders.

Interview questions for caregiver

What services do you receive from the Center?

How has your life changed as a result of the program?

What changes have you seen in the child who is enrolled in the Center?

What grade would you like your child to finish before leaving school?

How likely do you think it is that your child will finish this grade?

Is there anything you would like to change about the Salaama Center?

Interview questions for staff

How long have you worked at the Salaama Center and what do you do here?

How has the Salaama Center changed since you have been working here?

In your opinion what has helped you most in carrying out your work here?

What has been the greatest challenge to carrying out your work here?

What do you see as the Salaama Center’s biggest success?

What is the Salaama Center’s biggest need?

What is your vision for the Salaama Center’s future?

Interview questions for adolescents

What would you like to be when you grow up?

How possible do you think that is (place sticker on the scale below)?

1 2 3 4 5 6 7 8 9 10

Not possible Will happen?

Who are you closest to at home?

How would you describe your relationship with your guardian?

How has the Salaama Center affected your life?

What would you like to change about the Center?

Adolescent participants were asked questions such as what they would like to be when they grow up and how likely they thought it was that they could accomplish their goals. They were also asked about their relationship with their caregiver and how the Salaama Center had affected their lives. Caregivers were questioned about services they received and changes they perceived in their own and in their children’s lives. They were also asked what grade they would like to see their children complete and how realistic they felt their goal was. Information was also gathered from the Salaama Center’s records about attendance, how the child was doing in school, and notes on home visits to the family. Staff provided information on the youth’s involvement in the program and their perceptions of changes they had witnessed in them (the youth).

Data analysis

Analysis of the interview data was conducted in several stages. Translated audiotapes were transcribed; we used transcripts as they were recorded rather than improving the English. We coded all transcripts using Atlas.ti to help organize the transcripts, and the investigators and two graduate students reviewed the transcripts and developed codes. Using these codes, the transcripts were then independently coded by three coders each, and the need for new codes and discrepancies in coding were discussed and resolved. The first set of codes was developed to capture information in two areas – services utilized by the youth, and their future professional/academic goals. We developed a second set of codes related to the adolescent’s development of bonding social capital, including support from the Center, peers, and family. A third set of codes was related to the creation of bridging/linking social capital available to the family, including parental and adolescent connections with school, role models, connections with other community institutions, and linkages to resources. Table 2 describes the operationalization of the three types of social capital for this study and related examples from Salaama Center. These examples served as guides in our analysis of the interviews and the assigning of types of social capital to the families’ experiences.

Table 2.

Operationalization of social capital in case study.

Type of social capital	Operationalization	Examples from case study (BFI)
Bonding	Resources such as trust, social support, and assistance provided by members of the group sharing common characteristics.	Development of an informal support group among the youth and caregivers of BFI. Creation of an advisory group comprised clients to support program design.
Bridging	Resources such as new knowledge, educational or employment opportunities, and financial assistance through engagement in networks comprised heterogeneous groups. This could comprise involvement in civic, political, and religious groups/alliances and allow for building consensus, increasing group bargaining power, exchange of ideas, and resources.	Linking the youth and caregivers of BFI with the Parent–Teacher Association of the local school, faith-based institutions, volunteer tutors, health care, local businesses, and other NGOs in the region.
Linking	Resources such as concrete services and assistance provided by formal authorities and institutions in society. This comprises building relationships with individuals and institutions with power and control over vital resources.	Linking the youth and caregivers with government-funded benefits and entitlements, as well as financial institutions that offer microloans.
Social capital (overall)	Ability to develop a future orientation toward professional and/or educational goals	Identify a career path and learn about how to realize that goal.

BFI: Better Future International; NGOs: non-governmental organizations.

We addressed issues of validity of the codes in several ways. First, we triangulated data from the interviews and Salaama Center records. We also had information from the staff concerning changes in the adolescents, the effect of the Salaama Center, and the social capital accrued. We also were able to verify our findings with several individuals intimately involved with the Center, although we were not able to member check.

Results

Models of social capital generated

With reference to our first research question (Is social capital created during the provision of social work services?), we found that the family-centered approach helps create bonding social capital. Placing the adolescent within the family opens access to the social capital of other family members (bonding social capital). This is very evident in the case of P, described below, who has a role model she can draw on to create a vision of the future for herself as a nurse. D, another of the adolescents described below, has access to the social capital his caregiver acquired by working for the government and a saleable skill passed on by his father.

The holistic approach, which views the family as a unit within the larger community, creates both bonding and bridging social capital. Because the youth go to different schools of varying quality within the community, the adolescents pool materials and assist each other with their school work. One adolescent stated, ‘We also look for study materials from other schools and to study together with those who attend good schools and have good teachers’.

During this process, they create bonding social capital. When families are viewed holistically as being as a vital component of the larger community, the services offered are especially likely to create bridging social capital. Both health care and schooling in this case are in Moshi. Bridging social capital is created when caregivers, joined by Salaama Center staff, visit local providers. Caregivers also take the skills learned in vocational workshops into the community, developing bridging social capital. Indeed, one caregiver, after attending a workshop in tailoring, was able to rent a sewing machine through the Salaama Center’s connections and start a small business offering tailoring services to the community. She made use of the bridging social capital the Salaama Center made available and accrued additional bridging social capital while running her business in the community.

With reference to our second research question, we found that the participatory, empowering approach to programming creates both bonding and bridging social capital. An obvious example is the Center’s advisory group. Bonding social capital was created through their working together, successfully addressing serious difficulties with the Center leadership. The vocational workshops offered by the Center are meant to economically empower caregivers, who also accrue bonding social capital while participating. The caregivers also share similar challenges and struggles, and this social support network has helped alleviate some of their stressors. Activities offered to provide youth with opportunities to excel create bonding social capital through participation. Both adolescents and caregivers describe a process through which the adolescent moves from a street-based peer group to one based at the Center:

After Salaama Center it’s good because before he was a child who just after school goes in streets till late . . . at the center he goes for tuition, so he has changed. And even when they have closed school he is there at the center and not around streets. (Caregiver)

The future orientation of this model creates bridging as well as linking social capital. The Center reaches out to the community in the hope of addressing the stigma and creating a place for these vulnerable families in the larger society. Opening the Salaama Center activities such as computer classes, after-school activities, and vocational workshops to the community at large introduces client families to new individuals, promoting bridging social capital. At an organizational level, Salaama Center staff also engage with the local community, as well as the national and international community, by approaching other NGOs with information and collaborative projects. These efforts create bridging social capital for the Center itself. Training programs and workshops attended by staff bring skills and ties to other NGOs. One Center teacher was invited to a workshop on participatory theater, advocacy, and community development in one of the larger towns. He brought his newly acquired skills to the Salaama Center, which utilized them to create theater for the community in Moshi. The Salaama Center has also established ties to other governmental entities and national/international NGOs, creating linking social capital. Working with government and nongovernmental programs, the Salaama Center has been able to access free condoms, microloans, and employment incentives, which constitute a core component of linking social capital.

The effects of generating social capital on the youth

This study’s third question asks, ‘How does this social capital contribute to the youth’s vision of his or her future?’. Perhaps the simplest way is to contrast adolescents with different levels of social capital and at different life stages. Here, we focus on five of the adolescents to demonstrate the process of building social capital. We selected five out of the eight adolescents due to constraints of space in this article. We selected the five cases that offer the most diversity in terms of age, gender, and experience. Although we focus mainly on the narratives provided by the youth in this section, we used the information provided by the staff as verification of the services provided to the families and their (client) level of involvement in center activities.

D

D is a 17-year-old boy who is nearing the end of his secondary school studies. He wants to be a journalist. This began as a desire to be a ‘TV presenter or radio presenter’ because of what he saw and heard in the media. He later clarified his future goals by stating he wants to be a journalist with a clear idea of what journalists do and knowing that specific journalism training is available. He is bright and artistic and has always been interested in expanding his mind beyond the academic. He has a very strong sense of self-efficacy.

His family has accrued much social capital. He has a close relationship with his caregiver, who supports his studies and dreams. She encourages him not to give up hope. His caregiver also works for the local government 6 days a week as a gardener, which means she walks into the city of Moshi every day and meets others outside of her immediate circle of peers. D has also learned an artistic skill from his late father (making small figures out of straw) that he uses to keep himself out of trouble.

D and his family are very involved in the Center. D has moved from a street-based network of peers to one that is Center-based:

He had bad company in the street. He didn’t have a place like to spend time, like learning computer and everything. So after joining Salaama Center its better because he goes there to participate in activities and seminars. He has changed a lot, I really thank God. (D’s caregiver)

D’s caregiver is also a member of the advisory group at the Center, despite her limited time, and often offers ideas for the Center’s improvement.

D has used Center connections both to develop an outlet for the figures he makes, which provides a small income for the family, and to pursue his studies by accessing materials from other students who go to better schools. He seeks out Center staff to discuss his goals and visions. Not only does D have a clear sense of his future as a journalist and the route to pursue it, he also has an unusually strong vision of the Center’s future. D has expressed a desire to specifically learn about how other centers operate and bring that knowledge back to Salaama and the community. He sums up the potential of the Salaama Center here and adds a number of recommendations:

Like the whole process of Salaama Center trying to remove youth from bad companies in the streets, maybe a youth needs to have a different activity, like to have footballs, to have maybe a team for Salaama Center . . . . now we from secondary school we can’t attend the Center, it’s only for primary school, so they also need an addition of classes. And also to have study trips . . . at least twice a year.

This is a relatively far-reaching vision of a future in which he not only becomes a journalist but gives back to the Center. It also reflects a desire to continue an affiliation with the Center.

P

P is a 16-year-old girl who lives with her aunt, uncle, and grandmother. They would not have been able to care for P in their home if it were not for the financial, educational, health, and social support the Center provides to the family. She has a very clear vision of the future (to become a nurse) that is based upon her grandmother as a role model. She knows what it takes to accomplish this goal and is optimistic about her future. Through ties to the Center and a solid base in her family, P has substantial social capital available to her. She has a strong role model who is supportive of her goal. Her family is somewhat supportive, although her aunt expected her to stay home and care for a newborn baby. Her caregiver participated in a project to raise chickens and sell them, as well as in a garden project. She also attends fundraisers at Salaama Center and explores governmental programs of assistance.

Center staff visit the family regularly. They worked with her aunt to alleviate P’s childcare responsibilities, enabling her to return to school and the Center’s after-school programming. Her inconsistent performance at school improved, leading to her successful completion of primary school and her passing an entrance exam for higher education at a boarding school. The Center pays the fees for her boarding school:

I’m very much in desire of becoming a nurse. My grandmother is a nurse and she has a good life. I’m very much eager to become a nurse and I hope that will happen . . . If you want to succeed you have to have a wish. (P)

S

Sixteen-year-old S has a very limited vision of the future. He has had a career goal since age 15, but does not know how to achieve it. He would like to be a policeman to ‘save and help the citizens’ but lacks a specific plan. S states he knows a policeman but does not know his name. When asked about a policeman’s life, S replies, ‘The way he works really satisfies me. He goes for his work on time and comes back on time’. He later elaborates upon this, adding that he would like ‘to guide the right of the country, for the safety of the country and the safety of all citizens in my country’. However, he remains unclear of how to achieve his goal and has very little confidence in succeeding.

The social capital available to S is very limited. His living situation has changed several times over recent years. After his father committed suicide, his mother left him to live with his aunt. His mother suffers the implied stigma of her husband’s death, which was due to complications associated with HIV. S has a checkered history with local schools. Although he attended primary school regularly, he was a very poor student and received little support from his teachers, who beat him because his school fees were not paid on time. His ties to secondary school were tenuous; he altered his uniform in a fit of anger, which meant he could not attend until the Center provided another. He no longer attends any school.

S has only fragile ties to the Center. The Center’s concrete services to the family did enable S’s mother’s return to care for him as he entered secondary school. However, S dropped out of school. He attends the Center inconsistently, and when he is there, he keeps to himself, sometimes playing soccer but rarely engaging with Center staff.

When asked what he would like to change about his life, S answered ‘school, home, everything’. His vision of the future seems very limited and short term.

J

J is one of the younger adolescents interviewed at 14 years old. She is HIV positive. She states she wants to be a doctor, lawyer, or accountant because she ‘loves those subjects’. However, she lacks a good sense of the path leading to these occupations.

J’s social capital is relatively modest. Her grandmother had a business and connections in Moshi, which allowed her to accumulate some money. She used these funds to build a house farther out of town, and in doing so, lost her business and social connections. J’s involvement with the Center has become limited because she lives far away.

She has been able to overcome some of the stigma attached to her HIV-positive status with the help of the Center staff who visit the school with her grandmother regularly. This has led to a reduction in bullying and being less isolated from her peers. The staff at the school she attends look out for her and give her extra food to alleviate the side effects of her medication and ensure that she takes her medicine on time. She does well in classes and has asked the Center to send her to a better boarding school. Limited funds have prevented the Salaama Center from providing this support at this time.

J and her caregiver express only a very immediate, concrete, and relatively short-term view of J’s future. J’s grandmother states,

I don’t know what will be happening, because God is the one who plans everything. Because education has no end she can study as much as she can. I’m old so they . . . don’t have to depend on me anymore. So I wish for them to have the better future later. The only thing that I can help them is just to encourage them and remind them to work hard.

M

M is the oldest of our adolescents at 19 years old. He has at least initially achieved one component of the future as he planned it. M began with two visions of the future for himself. One was that of a performer, specifically a comedian. The second was that of an electrician, a particularly viable vocational option in his locality because of the availability of training and the employment opportunities locally. He had a clear idea of what that would mean for his future. He had repeated his first and second years of secondary school, was older than the majority of his classmates, and realized that the traditional educational route was not the best path for him.

M has a number of sources of social capital. His caregiver was supportive and his uncle was financially supportive of his educational activities. His caregiver was also a very active participant in Center activities and a member of the advisory board.

Relying on his ties to the Center, M approached staff seeking their help in finding a strong technical school. Both his caregiver and his uncle believed that completing traditional secondary school was his only option. The Center staff helped M convey his wishes and the soundness of his decision to them, ultimately gaining their support. With the joint financial support of his uncle and the Center, M was able to attend the technical school and graduate.

M has achieved his vision of the future as an electrician, living and working in the community. He regularly visits the Salaama Center to keep them apprised of his progress and he has given demonstrations of his electrical skills. He has also talked to the children about his experience, the importance of developing a personal vision for the future, and how to use the available resources such as the Salaama Center to achieve that vision.

Discussion

Our reading of these cases suggests several themes.

Bonding social capital

The Center provides financial support and a host of social work services (case management, counseling, advocacy, etc.) to the family as long as the children and youth remain in their care. As a result, all five adolescents (D, P, S, M, and to a limited extent J) have developed bonding social capital through close ties with their caregivers and other relatives. These caregivers have provided invaluable stability, love, support, and nurturing. D, P, and M have maintained close ties to the Salaama Center, providing a safety network of peers and serving as a source of social support. Their interviews demonstrate the development of bonding social capital, which they have perceived as valuable to them. M has continued to visit the Center and interact with the staff and youth even though he is now an adult. This demonstrates his commitment to help maintain the bonding social capital he has developed. S and J have limited bonding social capital as a result of their lack of interaction with the Center. J could not participate due to the distance between the Center and her new home, while S has dropped out of school and does not want to interact with the Center youth or staff. Neither of them seem happy and both lack the peer support they could use.

Bridging social capital

D has developed a skill to make artistic figures out of everyday items like straw, twine, and bark. He was helped by the Center in developing his ability to market these figures and raise additional income for the family, an example of developing bridging social capital. Similar examples of bridging social capital can be found in instances of the Center paying for P’s boarding school expenses, Center staff working with J’s school teachers and administrators to reduce the bullying and isolating behavior of her peers, school staff providing food to J, and the Center staff’s assistance in helping M realize his dream of finishing technical school in order to become an electrician.

Linking social capital

Linking social capital involves connecting clients to resources (material and fiscal) from formal institutions like government and private providers. All the caregivers have been connected with programs such as microloans (to rent a sewing machine for M’s caregiver) or access to a business opportunity like raising chickens (P’s caregiver). This linking social capital has raised the capacity of the caregivers and their families to sustain themselves. The Center has also helped M connect with businesses in the community to obtain employment as an electrician. All families receive monthly food rations, paid health care for the caregivers and the youth, school fees and related expenses for the youth, and access to tutoring and vocational guidance (caregivers). Not just the Center, but the schools, local businesses, and other service providers have benefited from this program. This is an example of linking and bridging social capital.

Realizing goals

We operationalized a clear vision or goal for the future as a reflection of social capital for this study. Through that lens, we believe M realized his goal of becoming an electrician, while D is learning more about how he can become a journalist. P is clear about wanting to become a nurse although she has struggled academically. J is probably limited in her ability to identify future goals as she is the youngest in this cohort and has limited interactions with the staff and her peers at the Center. Similarly, S has had a tumultuous childhood and seemed lost at the time of this study with regard to his future aspirations.

Implications

The empowerment and future orientation of this model also suggests some future directions. The empowerment aspect suggests that families be helped to understand and leverage their own social capital. The future orientation suggests that creating ties to the community so as to integrate these youth and diminish the stigma they face is important. The Salaama Center might bring community members engaged in various occupations and professions to the Center to expose the youth to different career possibilities and different visions of possible futures. Community members might not only be invited to attend the workshops offered, but perhaps collaborate with staff and participants in developing and running these workshops. A program’s focus on creating all forms of social capital can constitute a valuable addition to its services, thereby enhancing relevance to the community. Social workers could also help in building sustainable linkages with other service providers, which is directly connected with social capital development.

The findings of this study can inform social work efforts in this field. Social workers are tasked with enhancing the micro- and macro-level functioning of individuals, families, and communities. While they have frequently focused on addressing personal needs, social justice, inequities, and disparities, social workers could enhance clients’ lives by helping build social capital. This makes the change not only meaningful but also sustainable. Social workers need to be trained to include social capital in their assessment and intervention processes, and all outcome measures should include development of social capital as a benchmark for effectiveness.

Limitations

As in any qualitative study, one of the limitations of our study is that our conclusions are based on self-reported narratives. While we attempted to verify information with Center staff, we focused on the perceptions and personal experiences of the youth. A second limitation could be the potential analytical bias based on the lens employed by the authors of this study. In other words, our own subjective experiences, expectations, and cultural biases may have influenced our interpretation of the findings. Finally, although the transcripts or recordings of the participant interviews were not shared with Center staff, some participants may have withheld information or criticism due to their personal concerns about service disruption.

Conclusion

The BFI model is an effective model for providing vital services for the benefit and welfare of a marginalized community. Impoverished and under-resourced communities exist worldwide. This model can help social workers identify barriers and gaps in services, help build networks through the development of social capital, and realize the larger vision of social work – to transform individuals and communities.

Footnotes

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article

ORCID iD

Manoj Pardasani

Author biographies

Barbara Kail’s research has focused on female substance abuse, the family care model, and domestic violence. She teaches policy and research. She has taught and conducted research in Tanzania and Spain.

Manoj Pardasani’s expertise is in gerontology and HIV/AIDS. He has taught social work and conducted research internationally in India, China, Chile, Germany, Rwanda, South Korea, Tanzania, Taiwan, and the UK.

Robert Chazin’s expertise is in international social work. His teaching is focused on mental health and clinical practice. His research has been conducted in Ukraine, Belarus, Georgia, Vietnam, Tanzania, and Rwanda.

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