Social Workers Association of Zambia

Health needs of older people as carers in urban communities of Kafue District, Zambia

A presentation of study findings to the PSS Forum 2015 held in Victoria Falls, Zimbabwe 1-3/09/2015 By Sebastian M. Chikuta

IntroductionMotivation for welfare of elders & this study: Many years of work in health & social development sectors

with vulnerable groups (Children, Youth & families). 2003 attended a HelpAge organized regional conference in

Kenya & listened to the voices of the elderly (at this conference the fact that aging is real dawned on me).

2010 decided to study Social Gerontology with the University of Southampton – UK which raised my interest in research & advocacy on the wellbeing of the seniors.

2012 undertook this research titled: An exploratory descriptive study of the health needs of older people as carers in urban communities of Kafue District in Zambia.

Research Question & TheoryThe Question: What are the health needs of older

people who are carers of orphaned children, sick sons and daughters, and other family members in urban communities of Kafue District in Zambia?

Theoretical basis of the study: Social Exchange Theory - a micro-level theory focusing on individuals and the way they interact with others & perceive their own world.

Research Design & Methodology Study type – Exploratory & descriptive using a qualitative

approach to capture the views & experiences of older carers. Study Areas – Four communities of Kafue town, 55 Km south of

Lusaka. Kafue experienced closures of industries in 2nd republic; multi-ethic town; intersection town of 3 major roads; fishing town; all these factors posing risks of HIV & AIDS with its impact of vulnerable children.

Sampling method – Convenience & Purposive sampling methods.

Ethical clearance – from three Ethics Committees (University of Southampton-UK, MoH & ERES Converge in Zambia); consent from respondents in the field; compensation after data collection.

Data collection & analysis - In-depth interviews using an interview guide. Interviews were recorded and data transcribed. Transcripts were coded and thematic analysis used to identify emerging themes.

Findings Findings are presented in 5 main sections:

Demographic attributes of the sampleOlder carers’ understanding of health

and illnessHealth needs of older carers and the

impact on their caring roleOlder carers’ coping mechanismsSupport mechanisms for older carers

and the role of government

Demographic attributes of the respondents More older women (12) interviewed

compared to older men (4), Majority of women were widowed (7) while

all the men except one were married (supporting the view that men tend to easily re-marry when widowed than women).

12 carers were looking after 5 to 7 dependants; 3 carers had 11 to 15 dependants; 1 had 2 dependants.

Older women shoulder the greatest burden of care.

Older carers’ understanding of health and illness Three themes define health and illness from the

perspective of the older carers: Basic needs; Disease; and Daily physical activities.

Basic Needs – “That person who is ill--- is chronically ill---- he has no food-------has no clothes----and every time they are begging so that they can have some life.” (70 yr old man)

Disease - “That means that person does not usually fall ill--ee, he/she does not lack anything, they are not troubled by anything.” (65 yr old woman)

Daily physical activities - “An older person who is healthy manages to get up, you see them manage to cook Nshima and can sweep around-----able to walk around.” (65 yr old woman)

Health needs of older carers and the impact on their caring role14 carers described their health status as

poor or fair. Only 2 carers said their health status was

good. Older carers whose health was poor or fair

gave reasons which included physical disease (14), mental health problems because of worries (9) and socio-economic health issues (11).

Interesting to note that mental and socio-economic challenges formed part of their health problems.

Health needs (cont’d) Physical health problems – High Blood Pressure, general

& leg pains, diabetes , eye problems, HIV & AIDS, asthma & heart problem. E.g. A 66 yr old woman narrated, “My health is not good for I have diabetes and B.P I stayed for about 3 years not knowing as to what was happening to my body-----------.

Socio-economic health needs – difficulties in meeting their basic needs and those of their families (food, shelter, education and healthcare). E.g. A 63 yr old man said “The main challenge is school fees---------even now I have a debt with the schools were they go to. The other problem is space in the house-----the house is too small for this number of children.

Health needs (cont’d)Mental health problems - too many

thoughts and worries about the future of their grand children and how to support them, & their own impending death. E.g. 62 yr old woman explained:

“It affects me mentally especially, when I think of how my grandchildren will live when I die. Yes, just on thinking---how will the young ones grow without me in their life?

Older carers’ coping mechanisms

Five ways older carers deal with their health needs:

health seeking behaviour (14), income generation (9), spiritual methods (5), informal support (5) and

pensions (3). “----I take medicine, and when it does not work they

take me to the Clinic. For the problem of thinking, I just pray.” (66 yr old widow).

“I retired and the monthly pension I get is very minimal----ha, ha---(Respondent laughs)-- which does not cater for my needs, for I have to pay for electricity, water and land rates.” (60 yr old widow).

Support mechanisms for older carers

Carers described support mechanisms in terms of source and form.

Received more of informal (relatives, community & Church) than formal support (Government & NGOs).

“----people within the community I live do help. There is no support that comes from Government, NGO, and Churches.” (66 yr old woman).

“----the grade eleven grandchild is being helped by Social welfare-----when they noticed that I no longer have the energies to work and raise money for fees” (60 yr old widow).

Conclusion & Recommendations Limitations related to delayed ethical clearance in Zambia, limited data on

health needs of older people in Zambia (ZDHS does not capture people aged 65 & above but ends at 50).

Utilization of results - Research report was given to MoH & MCDMCH in Zambia for utilization. Past 2 years has seen the roll-out of cash transfer prog for seniors & other vulnerable h/hs.

Recommendations to this Forum: mainstream issues of older carers into prog/s & respond to their health needs; advocate to Govts for social protection prog/s for the seniors.

Care of children & youth at h/h level can only be effective when needs of the carers are met.

Future research – Need for country surveys to establish exact Nos of seniors & capture their needs; Story-telling by seniors from a therapeutic perspective; Social policy issues

God bless you all!