The purpose of this study is to explore the concept of religious health assets (RHA) and its relevance to HIV/AIDS. This manuscript describes the experiences of caregivers with a church-run home-based care organisation in Swaziland, site of the world's highest HIV prevalence (42%). In light of reduced antiretroviral treatment rollout in some areas of Africa, strengthening mechanisms of treatment support with HIV prevention has never been more critical. One modality may be community home-based care (CHBC), a core feature of the World Bank's Multi-Country HIV/AIDS Program for Africa. Yet, these entities, and the frontline activities of local congregations, remain underexplored. Part of a larger anthropological study of religion and HIV/AIDS in Swaziland, this manuscript draws on 20 semi-structured caregiver interviews to discern patterns in motivations; perceived client needs; care practices; and meanings of religiosity. Thirteen participants were care coordinators who oversaw approximately 455 caregivers across nearly half of the 22 communities served. Grounded theory analysis suggested that caregivers facilitated vital decisions around HIV testing, HIV disclosure, treatment uptake/adherence, as well as reduced HIV stigma. Also salient was the importance of a Christian ethos, in the form of 'talk' and 'love', as critical culturally situated care practices. Having expanded to an estimated 600 caregivers and 2500 home-based clients between 2006 and 2009, Participants' reports intimated their roles as agents of broader social transformation. This article contributes to the expanding study of RHA and challenges authoritative global public health strategies that have largely marginalised local religious aspects of HIV/AIDS. Future applied research examining how 'home' and 'church' may be vital public health settings outside of, but integral to, formal health services and HIV programming is warranted.
In terms of the social involvement of the Christian church within the community, it would not be an overstatement to say that never before in history has there been a greater challenge facing the church than the present, finding a way to bring hope to those suffering due to the HIV/AIDS pandemic. Yet, in spite of the enormity of this pandemic, it is possible to make a huge difference in people’ s lives, making use of a few willing people and a fairly conservative budget. In this article the author attempts to describe the way in which a very small congregation, where the average weekly attendance at church services is seldom more than fifty people and where nearly all members live close to or under the breadline, started making a noticeable difference in their community. Motivated by God’ s love for them, they decided to share this love in a practical way with all those in the community suffering due to HIV/AIDS and other serious illnesses. This is a story of hope, not only for those who receive help, but even more so, for those who want to give help.
We draw on a study of a church-run community home-based care organization in Swaziland to explore how individuals living with HIV perceived caregivers' impact on well-being. Our primary concern was to examine how religion, as a heuristic practice of Christian-based caregiving, was felt to be consequential in a direly underserved region. Part of a larger medical anthropological project, we conducted semi-structured interviews with 79 community home-based care clients, of whom half (53%) said they would have died, some from suicide, without its services. We utilized a critical phenomenological approach to interpret semantic and latent themes, and explicated these themes within a 'healthworld' framework. Participants were resolute that caregivers be Christian, less for ideological positioning than for perceived ontological sameness and ascribed traits: "telling the truth" about treatment, confidentiality, and an ethos of unconditional love that restored clients' desire to live and adhere to treatment. Findings are intended to help theorize phenomenological meanings of care, morality, health, and sickness, and to interrogate authoritative biomedically based rationalities that underwrite most HIV-related global health policy.
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