An exploratory study of the resources used by, and the coping strategies of poor urban households affected by HIV/AIDS in Harare City.

Master Thesis


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University of Cape Town

Zimbabwe like many other countries in Sub-Saharan Africa is being ravaged by the effects of HIV/AIDS. Prevalence levels currently stand at between 15-35% (for women aged between 25-29), and are expected to grow to 50% by the year 2010. The economy is suffering from the loss of productive labour, the health sector is over-burdened and unable to cope with the increased demand for health services due to ADS related illnesses. Many households have lost their principal breadwinners to the disease and have become impoverished as a result. Despite a myriad of interventions aimed at preventing the spread of the infection, and mitigating its effects on the health system, the economy, and households, the infection still presents a problem for the country. Poor urban households in particular, are susceptible to poverty induced by the effects of this illness. It is therefore important to not only assess the costs of the disease on these households, but also to understand the strategies which .they employ to cope with the impact of the illness. The main aim of this study was to assess the costs (direct and indirect) incurred by poor households as a result of HIV /AIDS, and to explore the strategies which they make use of in dealing with the effects of the disease. Social capital was examined as a resource which households utilize in order to mitigate the impact of HIV/AIDS related ill health on the household. Data was collected from interviews of people living with HIV/AIDS (using a structured questionnaire), focus group discussions and key informant interviews. The sample of 110 people living with HIV/AIDS was drawn from two poor urban communities with different wealth profiles. The questionnaire was structured in order to obtain information on the costs incurred by households as a result of the disease and about the strategies employed to cope with the disease. The results indicate that HIV/AIDS places a heavy economic burden on affected households, many of whom already struggle to meet their basic needs. The results show that that most households (72%) enter into debt, and few make use of household savings and Medical Insurance as mechanisms for coping with the high costs of ill health. Both communities exhibited high levels of certain types of social capital resources, with the lower income community exhibiting higher levels of social capital resources in general. A pattern in the results reveals that the resources and forms of assistance (financial and non-financial) that households in the two communities had available to them for coping with the disease differed according to the type of social capital held by the respondents in the each community. An analysis of these results suggests that introducing structures to assist affected households in meeting their basic needs such as food and education would improve the ability of households to cope with the economic impact of the disease. The institution of means tested exemption systems for health care services for these people would greatly improve the ability of their households to cope with the high illness costs. The results also suggest that organisations and actors involved in HIV/AIDS interventions should co- ordinate their efforts so as to be effective in mitigating the effects of the disease on these households. It is also suggested that policy makers develop capacity in the area of social capital and HIV/AIDS so that interventions targeted at assisting communities affected by AIDS are informed by an understanding of the complete resource set (including differing social capital endowments) that households have at their disposal.

Bibliography: leaves 121-130.