Home- and Community-Based Care

Friday, May 06, 2005

Men in demand for home-based care in Zimbabwe

Varaidzo Dongozi
Zimbabwe Red Cross, Harare

While home-based care is viewed as one of the more successful ways of fighting stigma against people living with HIV and AIDS, it would have more impact if men took a more active role.

The community-based approach has proven to be a cost effective way of caring for people living with HIV and AIDS, with its strength deriving from the fact it is a community driven activity.

Many countries in Sub-Saharan Africa are scaling up home-based care services to people living with HIV and AIDS. Research has shown that community-driven initiatives increase community acceptance and reduce stigma.

Infected people have the opportunity to be looked after by their families and they continue to live in a family environment while they are being cared for.

The major challenge of the home-based care approach however was that it increased the burden on women, whom society viewed as the traditional caregivers.

“Most programmes in Zimbabwe include women as caregivers. This means that women at some point are forced to neglect some of their routine activities, in order to give this care”, said Emma Kundishora, Secretary General of the Zimbabwe Red Cross Society.

Phillipa Zengeya, a woman working with people living with HIV and AIDS in the Zvishavane project, one of the Zimbabwe Red Cross Society home-based care projects, in the Southern part of Zimbabwe, agreed that more women than men were willing to engage in care giving work.

“The problem that we are facing is that women are involved in care-giving work but they don’t make most of the decisions which promote the acceptance of HIV and AIDS and people living with HIV and AIDS in their community,” she said.

She also mentioned that because care-giving was viewed as the responsibility of women, it was not being given the prominence and respect it deserved considering its impact in the community.

Kindman Dimbo, a supervisor of the Zvimba home based care project, explained that care-giving was not an easy task for men. “For a man care giving is mostly associated with raising income for the family so it certainly is not a natural thing for man to do,” he said.

If men participate more in home-based care, it may reduce the stigma that is often faced by people living with HIV and AIDS. Their involvement would send positive signals since many people take more notice of what a man says than a woman.

“So men should use this to influence people’s response to HIV and AIDS,” said Dimbo said.

In recognition of this, the Zimbabwe Red Cross Society is making efforts to increase the number of male care facilitators in its 27 established home-based care projects. To date only 10 per cent of the Zimbabwe Red Cross Society’s 1,042 home-based care facilitators are men.

Dimbo explained that men could play a significant role in promoting community ownership of HIV and AIDS projects as a way of ensuring sustainability of the projects.

“As the opinion leaders in most communities, men can instil a sense of ownership because in their communities men are identified with a lot of importance. Therefore people will also view HIV and AIDS as an important issue for the community,” he said.

Acceptance of caregivers among both men and women has already proved to be high in areas where men have participated in giving care. One of the strengths of male involvement was that communication among men on HIV an AIDS had increased.

David Mukasa, a Uganda Red Cross volunteer and a man living with HIV, has experienced at first hand how significant of the involvement of other men can be.

“During the time when I was trying to accept my HIV-positive status, there were moments when only another man was able to understand my feelings of hopelessness and to console me,” he said.

This was because when he was too sick to provide for his family, it was difficult for him to view himself as an adequate head of the household.

“When I could no longer provide for the family, I felt useless to my family and it was only when other men who had gone through the same experience counselled me, that I realized that it was a phase that would probably pass when I became well again,” he said.

Although greater participation of men in giving care is vital, ensuring it happens will be a huge challenge.

“The obvious feeling within our culture is that men do not need to give care because women are there to do it. It is difficult to ask men to engage in ‘soft’ roles that are usually reserved for women as this is seen as a sign of weakness,” Dimbo points out.

[Published on 3 May 2005; Source file here]

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