Home-based care for people living with AIDS in Zimbabwe: voluntary caregivers' motivations and concerns

Similar to the healthcare systems of other resource-constrained countries with a high prevalence of HIV and AIDS, Zimbabwe's healthcare system encourages communities and non-governmental organisations (NGOs) to support the public healthcare sector by initiating home-based care activities and training volunteers to assist households in caring for individuals living with HIV. As part of the response, groups of volunteers were formed to provide basic material, social, nursing, and other kinds of support to members of AIDS-affected households. My research in Bulawayo, Zimbabwe, shows that motives for volunteering included: 1) religious values; 2) desire for prestige; 3) empathy derived from witnessing the suffering caused by AIDS illness; 4) hope of securing caregiving support in the future; 5) hope of enlarging one's network of those with access to political and economic power; and 6) hope of receiving material benefits in the future. This study further documents that volunteers' commitment to caregiving diminished between the early 1990s and 2009 due to: 1) the stigma of HIV and AIDS; 2) lack of funding, preventing volunteers from providing the needed care; 3) the large numbers of sick who are discharged from hospitals and clinics into home care; and 4) volunteers' 'burnout.' Strengthening volunteers' motivations for caregiving and addressing their concerns are crucial for providing effective care for individuals living with HIV or AIDS. In Zimbabwe, improvement of voluntary caregiving programmes requires better integration with the national healthcare system at the clinic level as well as collaboration with NGOs, community leaders and church groups, which have the potential to positively influence volunteers' commitment to caregiving.