Weighing up the burden of care on caregivers of orphan children: The Amajuba District Child Health and Wellbeing Project, South Africa

Abstract

This paper assesses the burden on orphan caregivers relative to non-orphan caregivers in the context of high HIV/AIDS mortality in South Africa. It presents findings from the third round of a study conducted in the Amajuba District of KwaZulu-Natal between 2003 and 2007. Significant differences were found between orphan and non-orphan caregivers; the former being more likely to care for more children, have poorer health, higher levels of chronic illness, less adult help and they appeared to have more daily responsibilities. Orphan caregivers were also more likely to indicate that children in their care needed help for mental or behavioural problems but overall results showed that only 3.4% of all households had contact with child welfare agencies. The findings question assumptions about the capacity and capability of the extended family to absorb shocks to individuals and families.

Keywords:

• HIV/AIDS
• caregivers
• orphans
• burden
• extended family
• grandmother
• health
• Africa

Acknowledgements

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 program (Grant R29 HD43629). We would like to thank the households and individuals who participated in the study. We also acknowledge contributions of members of the HEARD team and colleagues at Boston University School of Public Health, Centre for International Health and Development, Boston, Massachusetts, USA.

Notes

1. The lack of an adequate comparative group of non-orphan caregivers limits our ability to measure the actual psycho-social and health effects on orphan caregivers.