oa South African Health Review - AIDS in the household : priority programmes

Volume 2002 Number 1
  • ISSN : 1025-1715



The HIV epidemic that has swept through South Africa has now developed into a maturing AIDS epidemic. In many communities around the country, households are battling to cope with caring for a severely ill household member, while dealing with the economic consequences of the person's illness. There is no doubt that health services are feeling the impact of this epidemic, and this is likely to get worse in the next 5 to 10 years. <br>A study was undertaken to understand the impact that AIDS is having at a household level in 4 provinces in South Africa, and also to explore the perception of household members of the care that they had received. Data were collected through structured interviews with the heads of 728 AIDS affected households. These households were sampled randomly from lists of households provided by organisations that work with people with AIDS and their households. While data were collected on a range of issues, only the household experience of illness, and the utilisation and rating of health services are presented in this chapter. <br>Almost half of the respondents interviewed needed assistance with walking, while 10%-20% required assistance with other daily tasks like dressing and washing. the most common symptoms reported by households were weight loss and pain, but chronic diarrhoea was the symptom that the households found most difficult to deal with. <br>Most of the households reported that there was someone to provide full time care for the ill person, but in 32% of households there was either no care or only part time care. the main caregiver was usually a woman, and 73% of the caregivers were women over 60 years old. In a significant 7% of households the caregiver was under the age of 18 years. <br>Utilisation of public clinics was high, and satisfaction with these services was also high. This is in contrast to the use of public hospitals, which was much lower than clinics. There was also a greater level of dissatisfaction with the treatment provided at public hospitals. Surprisingly there was a high level of dissatisfaction with traditional healers. <br>The households in this study spent an average of 34% of their monthly income on health care. This is much higher than the amount spent on health care by non-AIDS households. <br>The study highlights the needs for policy makers and planners to address the health needs of people with AIDS, and find ways to assist their households. Without a clear and comprehensive approach to this problem existing poverty will be deepened, and the dignity of poor families and communities threatened.

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