Challenges faced by caregivers of children on antiretroviral therapy at Mutale Municipality selected healthcare facilities, Vhembe District, Limpopo Province

Abstract

BackgroundChildren depend solely on caregivers who can be either parents or guardians for drug administration to enhance adherence to antiretroviral treatment (ART), which might pose any number of challenges.PurposeThe purpose of this study was to explore and describe the challenges faced by caregivers of children on ART at Mutale Municipality, Vhembe District, Limpopo Province.Research design and methodThe research design was qualitative, explorative, descriptive and contextual in nature. The population consisted of 16 caregivers who were 18 years of age and above, and mentally capable, irrespective of educational qualifications, caring for children aged between 0 and 15 years who were on ART between April 2013 and October 2014. Non-probability, purposive sampling was used to select the 16 caregivers. Required permission, approval and ethical clearance were obtained from the University of Venda Higher Degree Committee, Limpopo Provincial Health Department and relevant institutions. An in-depth, individual, unstructured interview method was used to collect data. One central question was asked: ‘What are the challenges you experience when caring for a child on antiretroviral treatment?’ Subsequent questions were based on the participants’ responses to the central question. Qualitative data were analysed by means of Tesch’s open-coding method.ResultsThe findings of this study revealed that participants, that is, caregivers of children on ART, experienced financial burdens because of transport costs needed to comply with follow-up dates and insufficient of money for food, clothing the child in need of care, pocket money for lunch boxes during school hours and time lost while waiting for consultations. Participants reported some level of stigmatisation against children on ART by family members, especially the husbands or in-laws of the secondary caregivers. Many primary and secondary caregivers seemed to have given up seeking support from government and community structures.ConclusionThe conclusions drawn from this research are that caregivers hardly receive any support from family members or the community. Fear of disclosing the HIV-positive status of children resulted in the delay of financial support from the government, thus leading to serious financial burden on the caregivers.

Burden of caring for children living with human immunodeficiency virus in a semi-rural South African community

“…Females were predominantly the primary caregivers, which is consistent with the results of other African studies, 7,9,10,15,18 where women were seen to assume the primary role of caregiving. The need for men to assume greater responsibility in the caregiving of CLHIV has been emphasised in other studies, 4,19 as it has implications for the emancipation of women and their economic empowerment. 7,19 This concept is particularly pertinent in SA, to challenge the gender-based disparities that cultural beliefs and stereotypes impose on women and young girls in our context.…”

“…The need for men to assume greater responsibility in the caregiving of CLHIV has been emphasised in other studies, 4,19 as it has implications for the emancipation of women and their economic empowerment. 7,19 This concept is particularly pertinent in SA, to challenge the gender-based disparities that cultural beliefs and stereotypes impose on women and young girls in our context.…”

“…Many studies draw attention to the need for enhanced caregiver access to social grants. 7,19,24 The procedural pathways and delayed processing times for grant applications have been found to pose barriers to caregivers. 17 The need for greater mobilisation of social workers in communities may be a possible solution to address this challenge.…”

“…The authors believe that expanding social services for families affected by HIV is essential, so that they are linked to the necessary social protection, and families are protected from imminent social threats. 9 Mafune et al 19 found that caregivers' access to social grants was challenged, considerably straining their ability to adequately provide for the daily sustenance and healthcare needs of CLHIV. Food security and access to healthcare are the most rudimentary requirements for survival for CLHIV, and should at no time be compromised by access to social support, particularly in a resource-poor context.…”

Barriers to the management of children under five exposed to HIV in the rural areas of South Africa

“…This unsatisfactory performance reported in the rural areas is a result of multiple challenges that continue to affect multiple stages of the PMTCT programme. These are clinics being far away from the place of living, lack of transport, shortage of material resources, human resources, poverty, financial constraints, strong cultural beliefs or practices and inaccessible geographical location because of bad untarred roads (Doherty et al 2009 ; Mafune, Lebese & Nemathaga 2017 ; Meehan et al 2015 ).…”