Extended family caring for children orphaned by AIDS: balancing essential work and caregiving in a high HIV prevalence nations

Abstract

While over 90 per cent of the 15 million children who have been orphaned by HIV/AIDS are cared for by family members, there is little information about whether adults can meet orphans' essential caregiving needs while working to economically survive. Using a survey we conducted in Botswana of 1033 working adults, we analyse the experience of adults who are caring for orphans. Over one-third of working adults were caring for orphans and many with few financial resources: 82% were living on household incomes below US$10 purchasing power parity adjusted per person per day. Because of their caregiving responsibilities, they were less able to supplement income with overtime, weekend, evening, or night work. At the same time caregiving responsibilities meant orphan caregivers spent fewer hours caring for their own children and other family members. Nearly half of orphan caregivers had difficulties meeting their children's needs, and nearly 75% weren't able to meet with children's teachers. Pay loss at work compounded the problems: One-quarter of orphan caregivers reported having to take unpaid leave to meet sick childcare needs and nearly half reported being absent from work for children's routine health care. This paper makes clear that if families are to provide adequate care for orphans while economically surviving there needs to be increases in social supports and improvements in working conditions.

Community interventions providing care and support to orphans and vulnerable children: a review of evaluation evidence

“…Resulting changes in children's wellbeing are cumulative, multifaceted and interlinked; including increased risks of school drop-out and poor performance (Ainsworth, Beegle, & Koda, 2005;Case & Ardington, 2006), impaired food security (Nyambedha, Wandibba, & Aagaard-Hansen, 2001), diminished psychosocial wellbeing (Lester et al 2006;No¨stlinger, Bartoli, Gordillo, Roberfroid, & Colebunders, 2006), elevated risks of HIV infection and sexually transmitted infections (STIs) (Gregson et al, 2005;Juma, Askew, & Ferguson, 2007;Thurman, Brown, Richter, Maharaj, & Magnani, 2006a), reduced access to healthcare and other services (Andrews, Skinner, & Zuma, 2006;Miller, Gruskin, Subramanian, Rajaraman, & Heymann, 2006), and other problems associated with poverty (Andrews et al, 2006;Miller et al, 2006) and lacking adult care (Heymann, Earle, Rajaraman, Miller, & Bogen, 2007).…”

A Review of Evidence for Transmission of HIV From Children to Breastfeeding Women and Implications for Prevention

“…Worldwide, an estimated 15 million children have lost one or both parents to HIV/AIDS. [26][27][28] In 2003, approximately 3,000,000 children in sub-Saharan Africa were orphaned before the age of 5. 27,28 It is not known how many of these children were orphaned while they were still breastfeeding, or how many were HIV-infected.…”

Child and young adult-headed households in the context of the AIDS epidemic in Zimbabwe, 1988–2006

“…In most sub-Saharan African countries including Zimbabwe, the extended family has traditionally acted as a safety net for the majority of orphaned children (Monash and Boerma, 2004) but as prevalence rates increase, the capacity of the community to provide care and protection for OVCs is threatened (Heymann et al 2007;Kidman & Heymann, 2008;Madhavan, 2004;Foster, 2000;Unicef 2006;Mtika, 2001;Ntozi & Zirimenya, 1999).…”