University of Zambia Medical Library
The Impact of HIV/AIDS in Zambia: General Socio-Economic Impact
(AIDS in Zambia Bibliography #174-77)
- (#174) "Social consequences of AIDS in 49 Zambian families - A descriptive study"
Haworth, A., Kalumba, K., Kwapa, P., Van Praag, E., Hamavhwa, C., (1991)
Paper presented to the VIIth International Conference on AIDS, Florence,
1991.
Geographical area: National; Keywords: Mortality, households; Location: unknown
Objectives:
To determine the severity of the impact of AIDS within families.
Methods: Analysis of case histories submitted from counsellors in various parts of
Zambia. The histories are considered to be representative of cases dealt within
counselling/home care.
Results:
Details of the first 49 cases are presented. Results will be illustrated with
brief vignettes. In 12 single-parent (i.e., parent never-married or divorced) families,
AIDS has led to 7 deaths (2 men, 5 women). In the other 37 families both parents had
died in 7, the father only in 15 and the mother only in 12. In only 13 families (27 per
cent) was there a parent described as well. 12 families reported a recent death of a
child, definitely or probably HIV-related. There were 215 dependents, average 4.4 per
family, range 1 to 9 with mean age of the youngest at 4.25 years, of the oldest at 14.5
years and 29 per cent aged 15 years and above. All were affected economically, half
had food shortages (75 per cent where the father had died), family break-up occurred
in 31 per cent, 56 children had left school.
Conclusion:
Adolescents with insufficient schooling, poor employment prospects and
no guardians are becoming an increasing problem to extended families, which cannot
cope. The size of the problem needs to be recognised and community resources
mobilised. -
- (#175) "A study of the effects of AIDS upon the children in 116 Zambian families"
Haworth, A., (1991). Unpublished
Geographical area: National; Keywords: Mortality, households, orphans; Location: UNICEF
Objectives:
To determine the effects of HIV within families on children who are
themselves uninfected.
Methods:
Counsellors and home care workers from all parts of Zambia were asked
to submit details of at least one family, from their routine records; 120 responded.
Since these workers operate in a variety of circumstances, no attempt was made to
insist that they fill in any form, asking for systematic data, but guidance was given on
the type of information which would give a picture of the problems encountered. The
data provided were sufficiently detailed for some statistical analysis while the accounts
sent in provide useful information which could be used to back up the statistics.
Results:
- Data from 116 families were used, 61 per cent living in urban areas and
39 per cent in rural areas. 30 per cent of the families were, or had been before the
death of the only parent, one parent families. The average age of the women in the
study (including age at death of those deceased) was 33.01, and of fathers 40.71; ages
of the oldest children averaged 13.5 and of the youngest 5.1; the overall age of the
children was 10.8. The total number of dependent children was 248 boys and 227 girls
and of the total 475, 118 were aged 15 years and over. 184 children in this sample
were in the age range 7-13 years, and a further 48 were aged 14 to 19, some of whom
would have been expected to complete secondary school.
- Fifty-four of the fathers
and 20 of the mothers had died, both parents having died in 14 (11 per cent) of all
families. Only 13 of the remaining parents were reported as being without symptoms.
One quarter of the children reported that the father had died and the mother was
already sick and unable to carry out her duties. In 90 families where details were
given, 8 boys and 14 girls (total 23.6 per cent) had to care for a parent during their
illness. Consequently, 60 children reported that their school-work had suffered
severely, both from irregular attendance and inability to cope.
- In the group of 90
families were information is available, 14 (15.7 per cent) siblings looked after sick
relatives. When there were orphans a somewhat higher proportion of uncles and aunts
(22.2 per cent of 72 families) took them over. The main burden of caring for orphans
however fell upon children's grandparents (in 52.8 per cent of the families) although
all too frequently they were impoverished and unable to provide sufficient care.
- In
9 families the mother was accused of responsibility for her husband's death. In a much
higher proportion of cases (29.1 per cent) property, often held jointly by husband and
wife was taken by the husband's relatives and the wife left to fend for herself and her
children. Economic problems were reported in 102 families (91.1 per cent of rural and
83 per cent of urban families) and shortages of food in 59.8 per cent (62.2 per cent
rural and 57.5 per cent urban); 46.2 per cent of all families reported a shift to poorer
housing and between 17 per cent and 18 per cent lost electricity or piped water supply.
- Added to the sickness and death of parents was the sickness and death of youngest
brothers or sisters. The last child was frequently also infected and 34 were reported to
have died in the total sample, in 24.1 per cent of the families (6 had lost 2 children
although it was not always clear whether both deaths were HIV-related). In 7 families
knowledge of the presence of AIDS in the family and as a cause of deaths of parents
was translated into actual rejection or other form of stigmatisation. Stigmatisation of
children was reported in some form by members of the community by 24 per cent of
the families.
- 232 children of school age were affected by the death of parent(s) and
98 (42 per cent) were expecting to have to stop school.
Conclusions:
The AIDS epidemic has brought about unimaginable effects on many
aspects of life. The effects of AIDS on the family has brought about breakages in
family life, school problems experienced by children of school age, stigmatisation and
rejection; older children liable to be particularly traumatised. An urgent response to the
plight of children affected as a result of AIDS is needed before the problem becomes
really unmanageable. -
- (#176) "Zambia: The Impact of HIV/AIDS on Productive Labour Force"
Ching'ambo, L.J. (1993), unpublished
Geographical area: National; Keywords: Workplace, private sector, behavioural change, manpower, policy, costs; Location: International Labour Organisation The findings for this study in Zambia which is part of the inter-country (i.e. Tanzania,
Uganda, Rwanda and Zambia) explorative survey put much emphasis on Zambia's
situation analysis on HIV/AIDS, bearing in mind that the current national HIV sero-prevalence rate is estimated at 30 - 40 per cent which is considerably high [Editor's note:
see articles 1-3]. The contributing factors have resulted from poor economic status,
inadequate health care and education. The combined impact of these three factors means
that HIV/AIDS education and awareness campaigns are not fully comprehended and
appreciated by the society. Zambian workers are part of this community, and exposure
to HIV/AIDS risks is unavoidable. To re-enforce the review on the incidence of
HIV/AIDS among various components of the work force in the urban industries of Kitwe,
Ndola and Lusaka, questionnaires and record review were designed to collect information
on the mortality and whether HIV/AIDS has an effect on productive labour force in the
country. Eighteen institutions/firms in Lusaka and Ndola were explored. Supplementary
information was obtained from Monze Mission and Livingstone (Zambia's tourist capital)
hospitals in order to gain a feeling on the situation in rural settings. The findings indicate
that the incidence of HIV/AIDS is evident in some institutions and affected their
economic resources in terms of financial support to families of the employees who died
of HIV/AIDS. Morbidity and mortality are constantly increasing. Results indicate that
96 per cent of recorded deaths were in the age range of 15 - 40 and the trend in mortality
is increasing. A record review on the 1984 and 1992 data on mortality shows the young
people 15-19 years tend to be more affected than those above their age-group. Almost
half (50.7 per cent) of employees who died were below 20 years. Men tend to have a
higher proportion of mortality than women, indicating 84.5 per cent and 15.5 per cent out
of 349 cases. The main causes of death for 1993 indicate HIV/AIDS, related
complications (61.8 per cent) which are AIDS-related complexes (ARC), tuberculosis
and malaria. The most affected groups according to job classification are general and
lower management workers (67.7 per cent) and middle level management (20.6 per cent).
The least affected are the top management (11.8 per cent). High prevalence rates of HIV
infection among nurses, midwives and TBAs were higher (83 per cent) in comparison
with 42 per cent office workers and teachers. The incidence of HIV positivity among
blood donors among the school going pupils and military, indicates that school girls have
a higher seropositivity rate (19.4 per cent) than the military (10.9 per cent). This suggests
the extent to which school girls are at a high risk of HIV/AIDS. A review of the 403
post-test counselling record for Monze and Livingstone showed that 18.1 per cent and 22
per cent of cases had already died. The findings conclude that the magnitude of the
problem is increasing in working places and the community, the compounding factors
being social, cultural and economic conditions. To improve the situation health services,
continued evaluation studies by the Planning and Research Department of the University
of health and community communication skills and policies for behavioural change are
to be established and strengthened. -
- (#177) "A study to Establish the Economic Impact of HIV/AIDS on the Families of People Living with AIDS in Mansa District, Luapula Province "
Kasawa, K.B. (1993), unpublished
Geographical area: Luapula; Keywords: PWA, households, home based care; Location: UNZA Medical Library, WHO
A descriptive survey conducted in Mansa town seeks to determine the economic impact
of AIDS on families of people living with AIDS patients. The study population
comprised families of AIDS clients of Mansa home based care project. A total of 40
households formed part of the study sample and a structured interview schedule was used
to collect data from these families. A focus group discussion with counsellors was
conducted to gain a feeling and views on the economic impact of AIDS on the families
of their clients. The results indicate that AIDS has many economic repercussions on the
families of the affected patients. The notable consequences include risk of malnutrition
in the family (60 per cent), failure to afford children's educational requirement costs (55
per cent) inadequate shelter and reduction in income flow in the family. The need for
adequate resource mobilisation by government and non-governmental organisations to
assist the home based case is recommended.
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Copyright © 1996-2001, The University of Zambia Medical Library and Lenny Rhine
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Last updated February 4, 1999
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