Elderly Grandparents as Caregivers of Children Affected or Infected by HIV and AIDS in Namibia

Introduction

Elderly grandparent caregivers “Omufilishisho” have always played a key role in the lives of their grandchildren, great grandchildren and other vulnerable children. However, in recent years this role has amplified in intensity, as increasing numbers of grandparents, especially grandmothers have become the primary caregivers of orphans and vulnerable (OVC) (AVERT, 2015). Namibia is one of the countries most affected by the HIV epidemic in southern Africa. HIV is acquired primarily through heterosexual transmission (UNAIDS, 2014). Studies show that the country’s HIV prevalence was 12.6% among adults aged 15-64 in 2017(NAMPHIA, 2017).

Recent data shows that 53,000 children aged 0-17 live in grandparent-headed households (UNAIDS, 2014). The United Nations defines an ‘orphan’ as a child who has lost one or both parents (UNAIDS, 2014). Globally, by 2015 it was estimated that 13.4 million children and adolescents between the ages of 0-17 years had lost one or both parents to AIDS. Moreover, well over 80% of these children (10.9 million) disproportionally live in sub-Saharan Africa (UNICEF, 2016). For example, in some AIDS endemic countries such as Zimbabwe (74%) and South Africa (63%), a large proportion of all orphaned children are orphaned due to AIDS (World Health Organization [WHO], 2014). Scholars report remarkable gains in mitigating the economic and social impact of HIV and AIDS on the well-being of children and their caregivers over the past decade (UNICEF, 2016). Studies show that AIDS orphans including those who are themselves HIV-infected, are predominately living to aging elder caregivers (UNAIDS, 2014), Furthermore, the literature is replete pointing to the increased risk of physical, social, and emotional outcomes of children affected by HIV and AIDS compared with other children in sub-Saharan Africa (UNICEF, 2016). In addition, the caregivers of these children, in many instances are kinship caregivers (i.e., elderly grandmothers), although well-intentioned are from economically impoverished backgrounds themselves and suffer inadequacies in similar areas of well-being as the children they are attempting to care and support. Despite the large numbers of elderly women who are primary caregivers of OVC, the current literature in much of southern Africa, including Namibia, has predominately focused on the needs of OVC and paid less attention to the myriad challenges primary caregivers of children affected by HIV and AIDS face on a daily basis. This chapter puts forth a literature review of issues that elderly caregivers of OVC in Namibia might face. The primary objective of this is to provide readers with content to assist in their understanding about elderly caregivers of children affected and/or infected by HIV and AIDS. The chapter highlights who are caregivers of children orphaned by HIV/AIDS in sub-Saharan Africa; what is known about caregivers’ physical and psychological well-being; their ability to care for children in their care. Finally, the chapter offers suggestions for economic empowerment practice approach for social work practitioners and other gerontological professionals working with culturally diverse elderly caregivers. The issues addressed in this chapter, although they may not be new to practitioners working with elderly caregivers, point to the importance of working from a strength-based paradigm.