Marseille 2007
| Abstract #629 - Vulnerability of orphan caregivers vs. non-orphan caregivers in KwaZulu-Natal | ||||
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Session: 49.4: Late Breakers (Parallel) on Wednesday @ 08.30-10.30 in HC Chaired by Bruno Spire, Kate Hankins Authors: Presenting Author: Dr Busisiwe Nkosi - University of KwaZulu-Natal, South Africa |
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| Additional Authors: Ms Mandisa Cakwe, Dr Busisiwe Nkosi, Prof Tim Quinlan, Ms Sibusisiwe Tshabangu-Soko, Dr Jonathon Simon, | ||||
| Aim: Given the limited empirical evidence to date regarding caregivers of orphans in contexts of high HIV/AIDS mortality, we set out to describe the demographic experience, care burden, health and physical function, and social capital of caregivers of orphans compared to caregivers of non-orphans, in an attempt to identify potential indicators of vulnerability. | ||||
| Method / Issue: Using data from a cohort of school-going children and their households and caregivers in KwaZulu-Natal, South Africa (the Amajuba Child Health and Wellbeing Project, ACHWRP), we compared demographic characteristics, care burden, health and physical function, and social capital of caregivers of orphans with those of non-orphans. The orphan cohort was defined by parental death between March and August 2003. This analysis presents cross-sectional findings from analysis of questions for caregivers that were added for the studys second round, conducted between September 2005 and June 2006. | ||||
| Results / Comments: Caregivers of all children in this cohort were overwhelmingly women (88%). Compared to caregivers of non-orphans, caregivers of orphans were on average older (50.5 vs. 45.8 yrs, p=0.0003), had fewer years of education (6.7 vs. 7.5 yrs, p=0.0383), and were less likely to be married or cohabiting (23% vs. 45%; OR [95% CI]: 0.37 [0.25-0.54]. Caregivers of orphans reported caring for more children than those of non-orphans, with marginal significance (4.6 vs. 4.2 children, p=0.0537). Although there was no difference between groups in the likelihood of caring for an ill adult in the previous year, caregivers of orphans were more likely to have cared for an ill adult biological child in the previous year (OR: 2.28 [1.12-4.63], p=0.0229). There was a high prevalence of self-reported poor health among all caregivers (55% described health as poor). Caregivers of orphans were significantly more likely to report poor general health (OR=1.52 [1.08-2.15]; p=0.0163) and chronic illness (OR=1.45 [1.03, 2.05]; p=0.0328). Although there was a high prevalence of functional impairment (self-reported inability to perform most important activity for an entire day in previous month) among all caregivers (59%), there was no significant difference between caregivers of orphans and those of non-orphans. In terms of social capital, although similar proportions of orphan and non-orphan caregivers reported having friends outside of the household, orphan caregivers were less likely to report having a source of a small loan in case of emergency (enough to pay for food for the household for one week) (51% vs. 63%; OR: 0.59 [0.41-0.84]). | ||||
| Discussion: Caregivers of orphans appeared disadvantaged compared to caregivers of non-orphans in terms of several sociodemographic characteristics, with a somewhat larger care burden, poorer self-reported health, and somewhat lower social capital. Although the situation of orphan caregivers warrants further investigation, our results suggest that these caregivers are indeed more vulnerable, and that their particular limitations and needs must be considered when developing strategies for assisting vulnerable households, to ensure better support for both the caregivers themselves and the children in their care. | ||||
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