THE ECONOMIC AND PSYCHO-SOCIAL EXPERIENCES AND COPING RESOURCES OF FAMILY MEMBERS CARING FOR PWAS IN BHAMBAYI, KWAZULU-NATAL Dr Tanusha Raniga and Siphiwe Motloung School of Applied Human Sciences ranigat@ukzn.ac.za
BACKGROUND TO STUDY In the era of HIV and AIDS, caregivers of PWAs in low income communities bear the brunt of increased medical costs, poor financial resources, inadequate access to health and social services and limited access to basic nutrition which contributes to a disabling environment for those living with AIDS. It is not surprising that the invaluable role played by extended family members as primary support systems in the care of those PWAS is acknowledged by international stakeholders There is little information on the economic and psychosocial challenges experienced by family caregivers caring for PWAs in their homes.
South African Scenario UNAIDS 2010 Global Report reveals that the number of AIDS-related deaths decreased from 2.1 million in 2004 to an estimated 1.8 mil in 2009. The decline reflects the increased availability of ARVs as well as the care and support provided by family members to PWAs in middle and low income countries
AIM OF STUDY Identify the psycho-social stressors of family caregivers caring for PWAs in their homes; Understand the economic stressors associated with caregiving Gain insight into their coping strategies
Map of Bhambayi
Results
The Population Pyramid of Bhambayi based on Quantitative Survey 80-84 70-74 60-64 50-54 40-44 30-34 % Female % Male 20-24 10-14 0-4 -8-6 -4-2 0 2 4 6 8
CONTEXT OF STUDY Bhambayi is a mixed formal/informal settlement about 30km North of Durban November 2007 a 351 household based survey was completed in the community to investigate the effects of poverty and HIV and AIDS on households Preliminary results showed: 67% of the economically active population were unemployed,
QUANTITATIVE DATA The dependency ratio was 1:07 40% of the household heads reported having lost at least one person through AIDS in the past twelve months at the time of the study Purpose of Phase 2: investigate the economic and psycho social impact of Caregivers caring for next of kin living with AIDS.
RESEARCH PROCESS Non-probability, Purposive Sampling was used to select caregivers: Family members who were caring for PWAs in their homes and who were registered clients with the VCT project in Bhambayi Persons living with AIDS who were receiving home-based care services from the VCT project in Bhambayi.
RESEARCH PROCESS Data collection: semi-structured interview schedules were held with 19 participants Challenges: interviews took more than a day to complete Interviews were conducted in isizulu Findings cannot be generalised Reliability and validity of data tape recorded interviews, field notes, weekly meetings with research assistants Kvale s (1996) process of examining, categorising, tabulating and recombining the data
BIOGRAPHICAL PROFILE Four were aged 21-26; 11 were 30-39 and four 40-47. 16 were single; 2 were married and 1 cohabiting with a partner 17 were female and 2 were male; 16 were unemployed and 3 self employed Only 4 completed school while 3 did not attend school at all
Psycho-social stressors Several factors influence psycho-social stressors: length of the caregiving relationship, number and severity of PWA illness, behavioural problems and PWA depression (Darling et al 2009; Vosvick and Amey 2005). In this study PWAs lived an average of 12 years in the caregivers homes 17 caregivers stated that stigma and discrimination was problematic
Harsh Economic Conditions The majority lacked access to basic services such as piped water, electricity, adequate caring space at home and privacy. I have to rise early to fetch water from the communal taps and sometimes pay young children to go fetch during the day On clinic days and when he is sick I have to pay for transport to take him for treatment and to fetch medication.
Continued Many of the caregivers had to give up their employment as a result of their caregiving role but at the same time the economic demands were high Caring for my sick father demands money as I have to buy special foods for him and medication every month and I had to give up my job to look after him I have to buy nappies for my baby and sick brother and the child support grant is not enough
Coping Resources The majority spoke about being grateful for the home-based care workers who visited weekly to assist with care of the PWA Requested more frequent visits 7 received social and emotional support from extended family 12 spoke higher levels of distress and deterioration of their own health
Continued The deep sense of care and affection that the caregivers felt for the PWA was encouraging This impacted the coping levels of the PWA (Darling et al 2011) Many recommended additional training and supportive services from social workers and health professionals to help deal with the demands of caregiving for PWA.
RECOMMENDATIONS AND CONCLUSION Family caregivers perform a significant roe in the care of PWAs The psycho-social stressors and economic demands are extensive Micro level: Department of Social Development and Health need to collaborate to provide counselling, run support groups and increase home-based care services
Continued Such increased infrastructure and networks can serve as a platform to raise public consciousness about the psychosocial and economic burdens of AIDS caregiving Important that policy makers, activists, social and health professions resist the economic, psychological and social disadvantages faced by female caregivers.
REFERENCES Raniga, T and Simpson B. (2010). Grandmothers Bearing the Brunt of HIV/AIDS in Bhambayi. KwaZulu- Natal. The Social Work Practitioner-Researcher. Vol 22(1), 1-18. Simpson B and Raniga T (2010). Who gets and Who Doesn t? Reflections on the Up-take of the Child Support Grant in Bhambayi, South Africa. Loyola Journal of Social Sciences, Vol XXIV, (2), 147-159. Raniga T and Simpson B (2011). Poverty, HIV/AIDS and the Old Age Pension: An Analysis of Older Persons in Bhambayi, KwaZulu-Natal, South Africa. Development Southern Africa Vol 28 (1), 75-85. Raniga T and Mathe B (2011). Private Lives Public Issues: Childbearing Experiences of Adolescent Mothers in Bhambayi, KwaZulu-Natal, South Africa. Social Work/Maatskaplike Werk.