5.1 PROFILE OF UNPAID CARE PROVISION IN AFRICAN HOUSEHOLDS USING THE 2004 KIDS.90
5.1.2 Characteristics of cared-for
The datasets on the ill and dying who received care were combined for the analysis of the cared- for and caregivers. Of the 358 ill or dying people receiving care, substantially less were male (40 percent) than female (60 percent), which could be explained by the fact that HIV prevalence is higher among females than males in South Africa (Day & Gray, 2007, p. 252). Sienaert (2008, p.
212) also using the 2004 KIDS describes some characteristics of a cohort of individuals, 79 percent of whom were likely to have died of AIDS. Interestingly 44 percent of these individuals are male, very similar to the sex breakdown of the ill or dying people receiving care profiled here.
While an age limit was imposed which influences the findings on age, Table 5.1 shows that two- thirds of males and three-quarters of females cluster between 11 and 39. The average age is 32 years, with very little difference across the sexes. The average age in Sienaert’s (2008, p. 212) cohort was also 32 years. Less of those aged 40 to 59 are male (25.6 percent) than female (35.6 percent).
Table 5.1: Age distribution of cared-for (percentage, n=224)
Age Male Female Male & female
11-19 21.8 23.3 22.8
20-29 24.4 21.9 22.8
30-39 28.2 19.2 22.3
40-49 14.1 19.2 17.4
50-59 11.5 16.4 14.7
Average 31.3 32.7 32.2
With regard to the relationship of the cared-for to the household head, Table 5.2 shows that over half of those receiving care are the son or daughter or the son- or daughter-in-law of the head.
This can be compared to 62 percent of Sienaert’s (2008, p. 212) cohort. In a non-HIV/AIDS context more of the cared-for would be elderly. Over a fifth could be assumed to be of the same generation as the head: either the resident or absent head (the person designated by the
respondent as the household head who does not meet the residency criteria of a minimum of 15 days in the last year) or the wife/husband/partner of the head or a brother or sister of the head or a brother- or sister-in-law of the head, although this is the case for more males (22 percent) than females (19 percent). A further 16 percent are the grandchild of the head, although more are female than male.
Table 5.2: Relationship to household head of cared-for (percentage, n=358)
Relationship to household head
Male Female Male &
female
Resident head 12.0 3.2 6.7
Absent head 4.2 0.0 1.7
Wife/husband/partner of head 0.0 11.1 6.7
Brother/sister of head 3.5 2.8 3.1
Brother-/sister-in-law of head 2.1 1.4 1.7
Son/daughter of head 50.7 51.4 51.1
Son-/daughter-in-law of head 4.2 3.2 3.6
Nephew or niece of head 1.4 0.5 0.8
Grandchild of head 9.9 19.4 15.6
Other relative 4.9 4.6 4.7
Other non-relative 7.0 2.3 4.2
100.0 100.0 100.0
Note: percentages in this and the tables that follow do not always precisely add up to 100 percent due to rounding
Table 5.3 shows that over three-quarters of those receiving care had some primary or secondary education as their highest level of qualification. There are no great sex differences although it is surprising that more males than females have no education or grade 0, and more females than males have a post-school degree or diploma.
Table 5.3: Highest level of education of cared-for (percentage, n=338)
Highest Education Male Female
Male &
female
No education/grade 0 7.5 4.9 5.9
Primary/secondary/failed matric 76.9 80.5 79.0
Matric with/without exemption 13.4 10.8 11.8
Post-school degree/diploma 1.5 2.5 2.1
Other 0.7 1.5 1.2
100.0 100.0 100.0
The main activity of those being cared for was not obtained for those who had died, hence the smaller sample size. Table 5.4 illustrates that the unemployed constitute two-fifths of the cared- for across types of care. This compares with 43 percent of those who are likely to have died of AIDS (Sienaert, 2008, p. 212). Surprisingly, slightly more males than females are unemployed. It is likely that a number of those who are receiving care had to leave their work because they were no longer well enough to work. Further, a quarter of those receiving care were in formal
education (school, university or college) (10 percent of Sienaert’s cohort) while 18 percent were employed in some way (41 percent of Sienaert’s cohort) (ibid). More males than females were employed in regular or casual employment, while more females than males were in self-
employment. Smaller percentages were retired or receiving a pension or undertaking housework or child rearing.
Table 5.4: Main activity of cared-for (percentage, n=224)
Main activity Male Female
Male &
female
Attending formal education 24.4 25.3 25.0
Retired/pensioner 6.4 6.8 6.7
Unemployed 44.9 38.4 40.6
Housework/child rearing 0 8.9 5.8
EMPLOYED 21.9 16.4 18.3
Regular 10.3 4.1 6.3
Casual 10.3 7.5 8.5
Self 1.3 4.8 3.6
Other 2.6 4.1 3.6
Illness periods were stated for those who were cared for. Respondents were asked for how long before dying the cared-for person was too sick or injured to do what he or she usually did. This would seem to be the period over which intensity of care provision would have been the greatest.
Table 5.5 shows that those who died and received care were ill before dying for almost a year on average – remarkably similar to Steinberg et al.’s (2002) finding. This is a considerable length of time. Almost a third (30 percent) were ill for three months or less, while over half (50 percent) were ill for six months or less. It is not possible to tell which of the ill people were household members before they became ill, and therefore it is not possible to know more about illness- associated migration. All that is known is that only nine of the ill people did not live in the household for 15 or more days in the last year.
Table 5.5: Illness periods of cared-for who died (percentage, n=129)
Illness period (months) Male Female Male & female
One 7.9 9.1 8.5
Two 7.9 10.6 9.3
Three 7.9 16.7 12.4
Four 3.2 4.5 3.9
Five 7.9 6.1 7.0
Six 7.9 13.6 10.9
7 to 12 25.5 24.2 24.8
13 to 24 25.5 6.0 15.5
25 + 6.4 9.0 7.8
Mean 13.0 10.4 11.7
As Table 5.6 shows, the average number of months that the cared-for who did not die were not able to perform their normal activities was 12.5. This high number is surprising, and appears to be attributable to a few outliers on the high end. However, in all, two-thirds of ill people
receiving care within homes were ill for a week or under. The remainder were ill for much longer periods of time. Over a tenth were ill for between a month and six months, while a tenth were ill for over six months.
Table 5.6: Illness periods of cared-for who were ill (percentage, n=358)
Illness period Male Female Male & female
0 days 58.5 43.1 49.2
1 – 7 days 17.5 16.2 16.8
8 – 14 days 4.2 7.5 6.1
15 – 30 days 1.4 4.2 3.1
1>6 months 9.8 14.1 12.3
6+ months 8.4 15.2 12.6
Mean (months) 10.1 6.5 12.5
Striking in this section are the similarities between findings from the cohort of individuals likely to have died of AIDS in the KIDS, and the cared-for profiled here, leading to the conclusion that a fair portion of the cared-for were ill were likely to have been ill with HIV/AIDS.