2.1 Introduction
In Zimbabwe, HIV/AIDS is associated with sex outside marriage; and due to its fatal nature, it is widely regarded as a cause for shame, fear, stigmatisation and denial. Most people in Zimbabwe who know they are infected with HIV/AIDS try to conceal their status because they are afraid of rejection by their friends, family, neighbours and co-workers and of discrimination or dismissal by their employers.
Despite the stigma associated with HIV/AIDS, much of society continues to place itself at risk by engaging in multiple sexual relations. According to Ray and Williams (1993), the breakdown of pre-colonial family and village life in Zimbabwe has led to the erosion of traditional values and norms of sexual behaviour. Sexual relations usually with several partners and without protection are now common in Zimbabwe.
Many still deny the existence of AIDS itself, claiming it is simply another name for a disease known as rakao or runyoka, which has been around for decades and can be cured by traditional African medicine. Others jestingly refer to AIDS as “American Ideas for Discouraging Sex” (Ray and Williams 1993). These feelings and attitudes are common in all sections of the society.
Although there is a considerable amount of data on the impact of HIV/AIDS in the workplace especially the formal sector, there is little qualitative and quantitative literature on the impact of HIV/AIDS on the MSE sector. There is even less evidence on how the pandemic affects women in this sector. In the recent past, several studies have analysed the macroeconomic effects of HIV/AIDS in sub-Saharan Africa. The studies examined the overall impact of HIV/AIDS on productivity and the labour force using a macroeconomic framework such as computable general equilibrium (CGE) model.
The general approach in using a macroeconomic framework is to project what GDP and GDP per capita would be like in an HIV/AIDS scenario versus a no HIV/AIDS scenario. Studies using this approach include Cuddington (1993), Kambo, Devarajan and Overu. (1992) and Cuddington and Hancock (1995), which analyse the macro implications of HIV/AIDS in Tanzania, Cameroon and Malawi, respectively. Without exception, the studies conclude that there will be substantially lower levels of GDP and GDP per capita in the future because of the pandemic.
Ray and Williams (1993) show that the formal sector in Zimbabwe is being negatively affected by the pandemic. According to the study, there was an increase in the number of employees taking sick leave because of HIV/AIDS related illnesses. Even as early as 1993, some companies were beginning to observe sharp increases in the mortality rates of their employees. Loewenson (1998) found in a study on the impact of HIV/AIDS on companies that lost work time due to HIV/AIDS related illnesses increased from 3-4 days per year to over 20 days in those with more serious illnesses. She further states that these periods of illnesses are interspersed with periods of health and ability to work, making it difficult to predict specific periods of lost work time. At the time of her study, she found out HIV to be responsible for forty percent of lost work time.
According to UNAIDS (2000), a sugar estate in Kenya lost 8000 days of labour due to HIV/AIDS related absenteeism. This resulted in a 50 percent drop in production during the same period. The company also had to pay higher overtime wages for workers obliged to work longer hours to fill in for sick colleagues.
In order to formulate mitigation policies aimed at the labour force, it is important to examine how the pandemic affects different sectors including the MSE and informal sectors. Unfortunately, most sectoral studies have tended to focus only on well-established companies in the formal sector, where it is easier to measure the impact of HIV/AIDS because of the sector’s structured environment. For example, Young (2000) examines the perceptions of employers about HIV/AIDS in South Africa’s formal sector. The study employed a questionnaire to assess how South African employers perceive the HIV/AIDS problem in the formal sector. Accordingly, over 70 percent of the respondents were of the opinion that HIV/AIDS did not affect productivity in their enterprises.
2.2 HIV/AIDS and the MSE Sector
Despite the bias towards the formal sector, minimal work has been done on the impact of HIV/AIDS on the informal/MSE sector; however, there is now an increased realisation of the importance of assessing this problem. According to Robert (1999), although little published information exists on the relationship between HIV/AIDS and small businesses, this interaction may be one of the key factors contributing to the slowing down of Africa’s development.
African countries are realising that it is important for them to consider the effects of HIV/AIDS on the MSE sector. For example, the DFID (2000) study of Malawi’s MSE sector shows that more than 37 percent of MSEs indicated that they were likely to be affected by HIV/AIDS. This has important implications for the country as a whole and for the kinds of programmes that could be developed to help the MSE sector.
Chingambo (1999) reports the findings of a study looking at the effects of HIV/AIDS on small businesses in Zambia. The study was based on 25 randomly selected small businesses in Lusaka and Kabwe. Data were collected using a semi-structured questionnaire containing closed and open-ended questions. The questionnaire was administered to the owners of the small businesses and to qualify for inclusion in the sampling frame, the small business was required to have between 5 and 50 employees. Interestingly, 64 percent of the operators indicated that the operations, production and profitability of their businesses had not been affected by HIV/AIDS. However, 84 percent of those interviewed felt that HIV/AIDS would be a problem in the future mainly as a result of lost skilled labour.
Ballard and King (2000) report findings of a survey of large and small companies in South Africa. The inclusion of small companies is an indication that the impact of HIV/AIDS in these companies is becoming an increasingly important issue to assess. Survey participants estimated that 11.3 percent of all employee deaths in 1998 were AIDS-related compared to 8.2 percent in 1997 and 6.5 percent in the previous year. AIDS was also responsible for 3.4 percent of the number of staff lost to long-term disability, up from 2.5 percent in 1997 and 1.7 percent in 1996. Respondents stated that 10.2 percent of employee sick leave in 1998 was HIV/AIDS-related, compared to 6.3 percent in 1997 and 5.2 percent in 1996. Similarly, the incidence of AIDS-related compassionate leave increased from 4.8 percent in 1996 to 11.1 percent in 1998 with employees staying away from work to attend funerals of relatives or to care for ill family members.
Although the gender considerations of HIV/AIDS are important, little effort has been made to so incorporate them in studies. None of the studies mentioned above take into account the gender aspect of HIV/AIDS in the MSE sector. It is however necessary to examine this aspect closely because women are a very important part of the labour force. This is especially the case within the MSE sector, which according to Donahue (1995) provides almost all the entrepreneurial opportunities available to women.
Even though the literature is very limited, there is some indication that small businesses employing women are likely to suffer more as a result of HIV/AIDS than those employing men. According to the ILO (1995), because of their traditional caregiver roles, women are more likely to reduce time spent at work to look after sick relatives and friends. Extended periods away from work disrupt the operations of the small businesses, negatively affecting productivity. The extent of this disruption is extremely profound in small businesses where the absence of even one employee may mean that half the labour force is not at work. Furthermore, not only are the small businesses affected by the absence of these women employees, their employment and/or earnings are also placed at risk.
The same ILO publication reports the findings of a case study of female traders in Owino market in Uganda. The results show that their work is easily interrupted, their perishable stocks suffer spoilage rapidly, and their meagre resources are quickly wiped out as they try to cope with their own illness or that of a close friend or relative. Clearly, HIV/AIDS has a devastating effect on small businesses employing women.
An important factor to consider is that the nature of some small businesses exacerbates the prevalence of HIV/AIDS among women employees. Msiska (1990), for example, reports that women in the fishing industry in Zambia may feel compelled to participate in multiple sexual relations as a way of securing the continued success of their businesses. Due to their weaker position in sexual relations, their possible coercion by men, and their desire to succeed as entrepreneurs, women working in small businesses can very easily be affected by HIV/AIDS.
The review of literature shows that the amount of literature on the impact of HIV/AIDS on the MSE sector is minimal. This is particularly the case with literature that examines the gender implications of this impact. However, there are indications that in the future this is likely to change as more research is being carried out on the relationship between HIV/AIDS and the MSE sector. This is a positive development that will benefit the MSE sector. Hopefully, the research will also take into account the gender considerations of HIV/AIDS in the MSE sector. The ILO (2000) states that in response to the growing crisis of HIV/AIDS, the ILO will launch focused activities for the mitigation of the impact of HIV/AIDS for micro and small enterprises. The ILO (2002) also states that during 2002-2003, the organization will pay due attention to the effects of HIV/AIDS on the workforce and in the workplace.
Furthermore, as stakeholders become more aware of the potentially devastating effects of HIV/AIDS on the MSE sector, more nationally based studies will also likely be done soon. For example, the Department of Health (2002) in South Africa has commissioned a study into HIV and AIDS in the hospitality sector. The study will involve sampling more than 5 000 employees working in hotels, bed and breakfasts, guesthouses, game lodges, resorts, restaurants, fast food outlets, pubs and catering companies to find out their current knowledge, attitudes, perceptions and behaviour towards HIV/AIDS. The study will also include an assessment of how hospitality organisations are currently dealing with the pandemic and the current and projected future impact of HIV/AIDS on individual organisations and the sector as a whole. A management toolkit will emanate from the study, which will guide large and small enterprises throughout the hospitality sector in managing HIV/AIDS in the workplace.
2.3 Level of Awareness of HIV/AIDS
In Zimbabwe, there is a relatively high level of awareness of HIV/AIDS. The media has played a big role in raising awareness regarding the pandemic. The relatively high level of education in the country is also a contributing factor to the level of awareness. According to Mbizvo et al. (1997), as the level of education increases, knowledge of HIV/AIDS also increases.
In order to effectively curb the spread of HIV/AIDS in the MSE sector, it is important that awareness programmes be introduced. Unless the findings of research and the high level of information dissemination are translated into practical programmes that can be implemented, there will be little impact from studies that examine the impact of HIV/AIDS on this sector.
In Zimbabwe, the main policy tool guiding the implementation of awareness programmes in the workplace is Statutory Instrument 202 of 1998 contained in the National HIV/AIDS Policy (Government of Zimbabwe 1999). Under this instrument, employers are expected to provide information on infection and transmission of HIV, prevention of HIV/AIDS, and counselling facilities for HIV/AIDS patients.
However, one limitation of this policy tool is that it is targeted mainly at large companies as opposed to MSEs. This is evidenced by the fact that education programmes are to be designed in accordance with guidelines approved by the relevant employer and employee organisations. In Zimbabwe, it is mainly large companies and government agencies that have such structures, which are used mainly for negotiating salaries. The policy tool is now being used to include the MSE sector as well, given its growing importance in the national economy and the increasing incidence of the pandemic within the sector.
The National Aids Council of Zimbabwe (NAC) has come up with the Workplace Programme (NAC 2002). The programme uses mainly the Peer Education Model. Accessories to this are leaflets, pamphlets, books, posters, stickers, handouts, condoms and videos. Yet again the design of the Workplace Programme, like the National HIV/AIDS Policy, is biased towards larger companies. However, in the recent past, companies in the MSE sector have also adopted the programme.
It is not only the government that can make an impact on raising awareness on HIV/AIDS. The church can also play an important role. Hartwig (in Berer and Ray 1993) carried out a study in Tanzania and found out that the church was very vocal as far as the HIV/AIDS scourge was concerned. The church was becoming more and more open about the disease so that its congregation are aware of its effects. Mbizvo et al. (1997) also comments that Christian men and women generally are more knowledgeable of the pandemic, how it is transmitted and ways to avoid contracting it, than individuals from other religions.
In Malawi, USAID sponsored a project that encouraged religious leaders to introduce HIV/AIDS prevention themes into their ministries and pastoral messages by emphasizing the importance of monogamy and sexual abstinence outside of marriage (USAID 1992). HIV/AIDS prevention presentations were made to more than 25,000 church members and more than 20,000 AIDS information booklets were distributed. The project was so successful in Malawi that its success prompted planners to design a similar strategy for Brazil.
Although women in the MSE sector in Zimbabwe may have a high level of awareness of HIV/AIDS, there are cultural barriers especially as far as married women are concerned which place them at high risk of infection. UNIFEM-SARO (2001) carried out a study in Zimbabwe and found that women complained of the difficulty of suggesting the use of condoms or of discussing HIV/AIDS with their spouses even when the man appeared ill. Reasons given were that it was taboo to discuss sex even in a marriage setting. According to SAFAIDS (1993), in as much as everyone seems aware of the pandemic, African women have very little control over their own bodies, thus reducing their participation in negotiating sexual activities with their partners. Therefore, due to these socio-cultural factors, women in the MSE sector are vulnerable to HIV/AIDS despite having knowledge of the pandemic and efforts they might take to protect themselves.
2.4 Summary
Perhaps the most obvious conclusion that can be drawn from the review of the related literature is that very little work has been done on the impact of HIV/AIDS on the MSE sector as a whole, and with reference to women employees in particular. This in itself would indicate that the current study would be of value in terms of added knowledge and in terms of assisting stakeholders in their decision making processes. It does appear that this issue is gaining some prominence as a socio-economic problem requiring more attention from researchers and policymakers.
Even though related literature is scarce, the little that is there seems to point out quite clearly that MSEs with women workers are particularly vulnerable to the devastating effects of HIV/AIDS. The current study can be expected to make an important contribution to understanding how HIV/AIDS affects MSEs employing women.
It is encouraging to note that more interest on the impact of HIV/AIDS on the MSE sector is being generated. As a result, we expect more studies to be done on the area that will be useful for policy makers and companies in dealing with HIV/AIDS in the workplace. We also expect some of the research will be directed at addressing issues pertaining to gender as those considered in the current study.
Another important issue that arises from the literature review is that of data collection. The issue of HIV/AIDS is a very sensitive one. Efforts to study the topic can very easily be frustrated if the research instruments are not well designed. From the literature review, it seems that questionnaires soliciting for employers’ opinions, understanding and perceptions are the safest and most effective way of obtaining data on the issue. Though this leaves studies such as the current one open to subjectivity, the approach still provides some important and useful information.
Finally, HIV/AIDS policy and awareness programmes are not very well suited for the MSE sector. The inclusion of the MSE sector within the framework of these tools was not a priority at their onset, rather it was necessitated over time as it became apparent that this sector is important to consider when assessing the effects of HIV/AIDS on the economy.
