Community home-based care – a cost-effective model of care: who benefits?

Abstract

Statistics indicate that the HIV and AIDS pandemic is rampant in the province of KwaZulu-Natal (KZN). Increasingly, people with HIV and AIDS rely on voluntary community home-based caregivers for care and support. Drawing on original research conducted in 2005 and a subsequent study in 2009, this article presents the socio-economic context of care and women's perspectives on care giving. The study was conducted in three different communities in KZN. The feminist post-structuralist perspective provided the theoretical framework. Data collection methods included in-depth semi-structured interviews, observations and documentary review. The data were analysed using the grounded theory approach. The study revealed that it is poor, black, unemployed Zulu women who provide community home-based care (CHBC) in the province. The findings further suggested that the CHBC programme overlooks the realities of women, who operate in a context of poverty and unemployment. It is therefore argued that while the National HIV and AIDS Strategic Plan 2007–2011 has made progressive strides, implementation of the set targets remains a formidable challenge. In practice, the Plan remains gender-blind to poor women's social, political and economic imperatives. The article proposes a model of care that takes into cognisance the interests of women caregivers.

Keywords:

• women
• caregivers
• community home-based care
• HIV and AIDS
• poverty

Acknowledgements

I am greatly indebted to Professor Astrid von Kotze who supervised the initial study. My sincere appreciation also goes to the CHBC women voluntary caregivers who participated in the study.

Notes

1. The term was used to define people of colour in the apartheid era. The author does not promote such classifications, but the concept is used throughout the article to facilitate understanding.

2. The names of the organisations are withheld to ensure confidentiality and anonymity of study participants.