Table Of Contents:

1) The Impact of Primary Caregiver’s HIV Infection on Caregiving and Child Development: Piloting the Methodology Leslie Swartz, René Brandt, Andy Dawes, Rachel Bray, Lindiwe Mthembu-Salter and Mark Tomlinson

2) Investigating the Impact of the HIV/AIDS Epidemic on Nurses in Primary Health Care Settings in Cape Town Uta Lehmann and Jabu Zulu

3) Poverty Dynamics in HIV/AIDS Affected Households in Soweto, South Africa: A Pilot Study of Income-Earning Households Veni Naidu and Frikkie Booysen

Abstract:
The Impact of Primary Caregiver’s HIV Infection on Caregiving and Child Development: Piloting the Methodology Leslie Swartz, René Brandt, Andy Dawes, Rachel Bray, Lindiwe Mthembu-Salter and Mark Tomlinson

The study’s primary objective is to pilot the methodology for research into the effects of primary caregivers’ HIV infection on child-care and child development in households. Five HIV positive women on antiretroviral therapy, who were each the primary caregiver of an HIV negative child of less than six years old, were administered a questionnaire and semi-structured interview. The children underwent a developmental assessment, and two home observations were conducted in each household. The multi-method approach produced a conceptually rich, dynamic understanding of the impact of caregiver infection that future research can build on by revising the examination of relational aspects of care.

Investigating the Impact of the HIV/AIDS Epidemic on Nurses in Primary Health Care Settings in Cape Town Uta Lehmann and Jabu Zulu

The socio-economic impact of HIV/AIDS combines to create a vicious cycle of poverty and HIV/AIDS. This report focuses on evidence from a longitudinal household impact study conducted in Soweto, South Africa. The impact of HIV/AIDS on households was assessed by means of a cohort study of households affected by the disease compared with a control group of households not affected by the disease. Descriptive analyses, mobility profiling and regression analysis were employed in exploring poverty dynamics in affected households. The evidence shows that affected households experienced relatively greater income mobility over time and were more likely to move into and out of poverty, but recuperated from economic shocks resulting from morbidity and mortality. Poverty alleviation programmes and social assistance can help in smoothing these short-term transitions associated with health crises. In the longer term, efforts aimed at ensuring HIV-infected persons equitable access to the labour market and free access to anti-retroviral treatment in South Africa will remain important, given the importance of employment in explaining poverty and income dynamics in affected households. Methodological limitations however mean that the data cannot be employed as basis for recommendations regarding specific policy interventions, which requires larger, representative surveys of a similar nature to be conducted in communities or countries severely affected by the epidemic.

Poverty Dynamics in HIV/AIDS Affected Households in Soweto, South Africa: A Pilot Study of Income-Earning Households Veni Naidu and Frikkie Booysen

This research report presents the outcomes of an investigation of the impact of the HIV/AIDS epidemic on nurses in four primary health care settings in Cape Town. Based on extensive interviews with nursing staff and health service managers, the authors present findings which illustrate severe strains placed on nurses by the epidemic in a context where health sector transformation is already taxing the health system considerably. There is an indication of a wide range of pressures on nurses, with few initiatives in place to alleviate stress and provide support. Nurses report a widening scope of activities as community resource persons, lack of skills, and vastly increased stress levels because of feelings of helplessness and guilt. Existing support mechanisms and training provision are considered insufficient. The results are worryingly high level of burnout and low morale, which impact on the quality of service delivery and cause nurses to decide to leave public health services. The need for expanded training programmes and systematic, accessible and timely support emerges as a key priority.