Impact of AIDS on older people in Africa: Zimbabwe case study
Executive summary
The project “Impact of AIDS on older people in Africa”, was designed to develop a methodology to examine the impact of HIV/AIDS on older caregivers preliminary in four countries in Africa, Zimbabwe, Ghana, South Africa and Tanzania. Starting with a pilot project in Zimbabwe, a mix of qualitative and quantitative research methods was designed, tested and applied to provide statistical and qualitative information on the role of older people in HIV/AIDS-related care, and on the burden they bear. This pilot study was carried out in six provinces selected to represent the diversity of the Zimbabwean population.
Working in close collaboration with governmental departments, non-governmental organizations (NGOs), and academic institutions, the WHO Ageing and Life Course team (ALC) aimed to provide baseline data which would facilitate efforts to improve institutional and community understanding of the plight of older people in the context of the AIDS epidemic in Africa. It is expected that the data will be useful for policy and programme initiatives that can potentially strengthen the capacity of older people to act as care providers to their HIV/AIDS-affected families.
This report of the Zimbabwean pilot study is presented in four sections. Section one provides background information to the study, sets out its objectives and describes its methodology (sampling and definition of subjects; site selection; data collection; brief discussion on the study’s strengths and limitations).
Section two presents the composition and characteristics of the sample, such as (living arrangements, religion, occupation and sources of income) and provides an analyses and discussion of the key findings of the study to include (the main roles of those caring for persons with HIV/AIDS: providing food, medical care, psychological support and daily physical care).
The findings indicate that barriers to care for person(s) with AIDS (PWA) and orphans include:
- financial constraints;
- lack of basic necessities such as food;
- burn-out;
- stigma;
- violence;
- fear of contracting the disease and;
- frustrations inherent in performing daily chores (e.g. cleansing, feeding and washing).
As the findings indicate, older caregivers are under serious financial, physical and emotional stress due to their care-giving responsibilities. The study also documented a high prevalence of abuse related to care-giving – in particular verbal abuse; accusations of witchcraft (sometimes leading to physical violence) as well as stigma. Older people stated that their motivation for providing care to people with HIV/AIDS and orphans was a demonstration of love and a desire to make those ill and the children left behind as comfortable as possible. They also indicated that they were caring for orphans either simply because they were the only people in the family who could take on the responsibility or because the patient had asked them before they died to take care of the soon-to-be orphans.
Section three of the report suggests strategies and recommendations for a concerted effort by the government, NGOs, community based groups and organisations to strengthen the capacity of the older persons to perform their duties.
The fourth section summarises the key points of the pilot study and points the way forward. Additional information is presented in the appendices on background to Zimbabwe, national health profile, situation of older people, profiles of the study sites and the study questionnaire.
