HIV/AIDS, intra-family resources capacity and home care in Maun, Botswana

Abstract

Home care involves the transfer of a patient’s medical supervision from a formal institution to a family setting in the context of a community. The aim of this paper is to assess the resource capacity of families to provide immediate home care to HIV/AIDS related chronically or terminally ill member/s in Maun in Ngamiland District. Data for the study was obtained through cross-sectional interviews with 61 care-givers. Ethnographic methods were also used: these included informal interviews with key informants, unobtrusive participant observation, and narratives of individual and family life experiences. Data collection focused on assessing family resource capacity to access three forms of capital, namely social, productive and produced. Issue focus analysis on qualitative data, and descriptive frequencies and cross-tabulations on quantitative data were carried out. Generally, care-givers reported receiving non-material support from multiple sources. These included moral support from close family members, especially their own children, siblings, parents and spouses, and less from parents’ in-law and their extended family. The threshold of care-giving resource demands could either fragment the family unit, on precipitate ‘enclave-like’ or ‘disengaged’ co-existence or passive aggression. On the other hand, caregiving resource demands may enhance mutual obligation and shared responsibility among family members. A high level of tolerability tends to reduce vulnerability and facilitate pooling limited resources in ways that enhance family capacity. Conversely, adversarial intra-family relations compromise the ability of a family to mobilize its resources. About 70% of care-givers were dependent on non-farming activities as their source of livelihood. Care-giving depletes family resources, including the abandonment of income generating activities. About 81% of care-givers said that they could not do anything to recover or reverse the loss. Access to produced capital such as telecommunication infrastructure is important in terms of the dissemination of public education information aimed at helping reduce risks and the prevention of infection. A significant proportion of care-givers had access to a radio (60%) and cell-phone (48%). The paper ends with some policy recommendations.