The Economic and Gender Consequences of South Africa's Home‐based Care Policy

Abstract

South Africa's approach to care provision in the era of HIV/AIDS is home-and communitybased care, but in reality care for ill people in the home is provided on an unpaid basis, predominantly by women. But how much do they spend on this care work, in time and money? And what economic consequences does this policy have, particularly for poorer women? This article is based on findings from a study that focuses on unpaid care provision within the home for those in late-stage HIV/AIDS in KwaZulu-Natal, South Africa, and specifically on the costs of such provision. The findings show that female caregivers are bearing the bulk of the costs of care provision for ill people within the home on an unpaid basis. Home-based care is cost-effective for the provincial government but not for unpaid caregivers who are subsidizing the provincial economy. While hospital care for people with HIV/AIDS has been capped, home-based care services have not been increased to a commensurate level. Unpaid caregivers and ill people within the home are largely disconnected from the health system. The analysis clearly shows that the home-based care policy is not resulting in appropriate or sufficient support for these individuals in need and needs to be revised.

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