1. An assessment of impact in care giving by old people in households with people living with HIV/AIDS in rural and urban Zambian communities Presenter(s) Dr. FAD Kaona Prof. S. Siziya Ms. E. Miti

2. Background of the study HIV/AIDS has had devastating social, health, economic and psychological impacts HIV/AIDS has had devastating social, health, economic and psychological impacts Despite International statements, impact of HIV/AIDS on older people remains under reported in Zambia Despite International statements, impact of HIV/AIDS on older people remains under reported in Zambia This study was carried out in 2008 with support from Care Zambia International This study was carried out in 2008 with support from Care Zambia International

3. Main Aim To assess the Impact of Care giving by Old People in Households with PLWHIV/ AIDS in Livingstone and Nakonde, Zambia. (See map of Zambia) To assess the Impact of Care giving by Old People in Households with PLWHIV/ AIDS in Livingstone and Nakonde, Zambia. (See map of Zambia)

4. MAP OF ZAMBIA SHOWING STUDY SITES LIVINGSTONE NAKONDE

5. Methods Both quantitative and qualitative methods were used. Both quantitative and qualitative methods were used. A cross sectional survey of 874 parents who lost an adult child to AIDS in two study sites (Livingstone and Nakonde) A cross sectional survey of 874 parents who lost an adult child to AIDS in two study sites (Livingstone and Nakonde)

6. Table 1: Socio-Demographic Characteristics of Respondents N0 of Cases NAKONDELIVINGSTONE FatherMotherBothFatherMotherBoth 9530239797315412 Age<5050-5960-6970+(%)12.611.635.840.0(%)11.330.833.424.5(%)31.330.6 6.9 6.911.3(%)10.315.535.039.2(%) 14.6 14.6 29.5 29.5 32.4 32.4 23.5 23.5(%)13.925.732.827.6

7. Table 2: Individuals providing personal care in household ProviderLivingstoneNakonde N0 (%) HimselfSpouseSonDaughterMotherFatherBrotherSister 70 (16.5) 70 (16.5) 81 (18.9) 81 (18.9) 9 (2.1) 9 (2.1) 18 (4.2) 18 (4.2) 244 ( 57.0) 176 (41.1) 116 (27.1) 109 (25.5) 101 (23.4) 36 (8.4) 36 (8.4) 4 (0.9) 4 (0.9) 2 (0.5) 2 (0.5) 198 (45.9) 198 (45.9) 136 (31.6) 136 (31.6) 69 (16.0) 69 (16.0) 53 (12.3) 53 (12.3)

8. Gender Differences There were 23.4% in Nakonde and about 17% in Livingstone, who stated that the respondent was responsible for some caregiving. There were 23.4% in Nakonde and about 17% in Livingstone, who stated that the respondent was responsible for some caregiving. Overall, 45.9% of the cases in Nakonde and 57.0% in Livingstone indicated that mothers were main caregivers. Overall, 45.9% of the cases in Nakonde and 57.0% in Livingstone indicated that mothers were main caregivers. There were 43.1% who said that a parent shared the role with brothers other than his or her spouse. There were 43.1% who said that a parent shared the role with brothers other than his or her spouse. Mothers were more likely than fathers to provide personal care. Mothers were more likely than fathers to provide personal care.

9. Table 3: Type of assistance provided by parents Type of activity Instrumental assistance LivingstoneNakonde N (%) Preparing food Bathing and dressing Taking patient to clinic Provide medicine Feeding the patient Consulting with health care providers 378 (86.5) 364 (86.3) 411 (94.9) 372 (85.1) 407 (93.1) 346 (79.4) 405 (92.7) 358 (81.9) 397 (90.8) 382 (87.4) 387 (88.6) 352 (80.5)

10. Table 4 Health Problems reported by caregivers ProblemLivingstoneNakonde CaregiversCaregivers No%No% Strained muscles Headache and stomache Tiredness and fatigue Insomnia Nervousness and anxiety 22623834328823543.553.0 54.2 50.0 60.8 29421129028712756.547.045.849.935.6

11. HEALTH IMPACT The fact that many parents were in older age, made them particularly vulnerable to physical strains associated with caregiving. The fact that many parents were in older age, made them particularly vulnerable to physical strains associated with caregiving. More than 50% of the respondents in Nakonde reported strained muscles and only about 35% presented it as a health problem in Livingstone. More than 50% of the respondents in Nakonde reported strained muscles and only about 35% presented it as a health problem in Livingstone. Insomnia was mentioned by over 40% in each site, while 52.5% in Livingstone and 33.1% in Nakonde indicated nervousness and anxiety. Insomnia was mentioned by over 40% in each site, while 52.5% in Livingstone and 33.1% in Nakonde indicated nervousness and anxiety. Almost half of the respondents (45 and 43%) of parental caregivers reported experiencing tiredness and fatigue. Almost half of the respondents (45 and 43%) of parental caregivers reported experiencing tiredness and fatigue. Headache and stomach were fairly common among respondents and their spouse (43.0 and 41.9%) Headache and stomach were fairly common among respondents and their spouse (43.0 and 41.9%)

12. Table 5: Economic Assessment Financial status Livingstone N= 433 Nakonde N= 432 Sold assets to support caring the sick Sold assets to support caring the sick Lack of resources for dealing with sick adult children Lack of resources for dealing with sick adult children Exhaustion and financial hardship Exhaustion and financial hardship Stressed for failure to provide food and clothes to orphans Stressed for failure to provide food and clothes to orphans Poor accessibility to medicine Poor accessibility to medicine Failure to provide educational needs to orphans Failure to provide educational needs to orphans 5 (1.2) 5 (1.2) 159 (36.7) 228 (52.6) 310 (71.6) 120 (27.7) 164 (37.9) 2 (0.5) 2 (0.5) 217 (50.2) 123 (28.5) 178 (41.2) 145 (33.6) 245 (56.7)

13. Conclusion Older people are rarely visible to government and NGOs agencies. The study further records that caring for AIDS adult children has greater impact on: Older people are rarely visible to government and NGOs agencies. The study further records that caring for AIDS adult children has greater impact on: Health of caregivers Health of caregivers Financial problems and Financial problems and Lack of information on financial accessibility and Medicine Lack of information on financial accessibility and Medicine

14. Acknowledgement The research team is grateful to Care International in Zambia for providing the funds and other material support. The research team is grateful to Care International in Zambia for providing the funds and other material support. To coordinating teams both in Livingstone and Nakonde. To coordinating teams both in Livingstone and Nakonde. Community volunteers Community volunteers Ms. Mweenda and Mr. Zyambo. Ms. Mweenda and Mr. Zyambo. Mr. Synerton C. Sikaona and Mr. Chanda, who conducted key informant interviews. Mr. Synerton C. Sikaona and Mr. Chanda, who conducted key informant interviews. To all our beloved respondents, particularly those who had lost their adult children due to AIDS, we say thanks very much for giving us your time. To all our beloved respondents, particularly those who had lost their adult children due to AIDS, we say thanks very much for giving us your time.

15. THE END THANK YOU THANK YOU MERCI BEAUCOUP MERCI BEAUCOUP GRACIAS GRACIAS DANKE DANKE