Alternative care giving in the context of HIV/AIDS in southern Africa: complex strategies for care

Abstract

This paper examines the various mechanisms by which alternative care giving occurs in the context of the HIV/AIDS pandemic in southern Africa. High infection rates and the clustering of illness and death among families and communities, has resulted in large numbers of orphans coupled with an extended family support system which is already over-burdened and in some cases disintegrating. Drawing on a series of case studies from qualitative research carried out with young people, aged between 10 and 17 years, and their guardians in urban and rural communities in Malawi and Lesotho the changing nature and increasing complexity of family, household and community relationships around care giving are discussed.

The concept of inter-generational contracts as a mechanism through which extended families operate is used to explore the diverse arrangements for the care of young people, and their increased their involvement as carers for family and surrogate family members. The paper identifies three ways contracts are changing in relation to orphan care. For many there is a reduction in the time frame within which contracts take place, the contracts have become more explicit and there is an emerging inequality in the provision of resources related both to the stigmatisation of orphans and the greater impoverishment of care givers.