Vulnerability of orphan caregivers vs. non-orphan caregivers in KwaZulu-Natal

Abstract

Using data from a cohort of schoolgoing children, their households and caregivers (the Amajuba Child Health and Wellbeing Project, ACHWRP) in KwaZulu-Natal, South Africa, we compared demographic characteristics, care burden, health, physical function and social capital of caregivers of orphans (n = 300) with those of non-orphans (n = 298). This analysis presents cross-sectional findings from questions for caregivers that were added for the study's second round, conducted between September 2005 and June 2006. Caregivers of all children were overwhelmingly women (87%). Compared to non-orphan caregivers, caregivers of orphans were on average older (49.5 vs. 45.2 years, p = 0.0002), had fewer years of education (6.7 vs. 7.8 years, p = 0.0042) and were less likely to be married or cohabiting (29% vs. 46%; p < 0.0001). Caregivers of orphans reported caring for more children than those of non-orphans (4.8 vs. 3.8 children, p < 0.0001). A larger proportion of orphan caregivers reported having cared for an ill adult in the previous year (28% vs. 19%), and for that adult to have been a biological child (p = 0.0531). There was a high prevalence (55%) of self-reported poor health among all caregivers; caregivers of orphans were more likely to report poor general health and chronic illness. Although there was a high prevalence of functional impairment (self-reported inability to perform primary activity) among all caregivers (59%), there was no difference between groups. In terms of social capital, although similar proportions of orphan and non-orphan caregivers reported having friends outside the household, orphan caregivers were less likely to have a source of a small emergency loan [51% vs. 63%; adjusted odds ratio: 0.60 (0.41–0.88)]. Our results suggest that orphan 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 caregivers and the children in their care.

Keywords:

• Orphans
• HIV
• children
• caregivers
• households
• poverty
• South Africa

Acknowledgements

We thank the households and individuals who participated in the study. This project was funded by the National Institute of Child Health and Development (NICHD) of the United States National Institutes of Health (NIH) under its African Partnerships programme (grant R29 HD43629).