Sources of Social Capital for Malawi People Living With HIV.

With one of the highest rates of poverty and HIV in the world, Malawi faith-based organizations (FBOs), non-governmental organizations (NGOs), and community-based organizations (CBOs) are expected to provide tangible and emotional support to people living with HIV (PLWH). Using Lin's social capital theoretical approach, we examine the perspective of PLWH regarding the adequacy of support responses. Forty-six rural Malawi HIV+ adults provided interviews that were recorded digitally, translated, and transcribed by Malawi research assistants. Atlas.ti was used to organize the data and to aid in the analytic process. Participants expressed disappointment in the lack of resources that could be accessed through the FBOs although their expectations may have been unrealistic. Outcomes from accessing and mobilizing the FBO network were negative in terms of stigmatization by FBO leaders and members, whereas outcomes related to CBOs and NGOs were generally positive in terms of empowerment through HIV information and attendance at support groups

A Global Perspective on Intersecting Social and Systemic Barriers Experienced by Grandparent-Caregivers: A Qualitative Systematic Review

Globally, many grandparents are taking on the caregiving role for their grandchildren without public or government interjection of support, particularly financial assistance for basic needs such as housing, health care and living expenses. This paper aimed to broaden understanding of social and systemic barriers experienced by grandparent-caregivers across the globe. Of the 2,828 relevant grandparent caregiving studies identified in the literature, 34 representing eight countries met our inclusion criteria to answer the research question and the focus of this paper: What are the social and systemic barriers experienced by grandparent-caregivers across the globe? We utilized Noblit’s and Hare’s (1988) meta-ethnography method and phases of the eMERGe reporting guidelines (France et al., 2019) to improve the completeness and clarity of the synthesis. Bronfenbrenner\u27s socioecological model informed the qualitative analysis that consisted of three interactive levels that impacted the various aspects of grandparent-caregivers and their grandchildren: the exosystem (physical environment and programs and services), macrosystem (systemic barriers, culture, religion, and spirituality), and chronosystem (time and historic influences). The use of both the meta-ethnography approach and eMERGe guidelines increased transparency, reproducibility and credibility of the synthesis, while the socioecological model enabled us to effectively identify common global and cross-cultural needs among grandparent-caregivers. Our findings have potential to: (1) identify gaps in, and barriers to, available resources for grandparent-caregivers and (2) inform the design of comprehensive intervention models and screening tools needed to address perceived support needs. Further research is needed on comprehensive assessment of support needs and health risks unique to each setting

Ugandan Grandparents as Primary Caregivers for their Grandchildren.

Purpose The purpose of this dissertation grounded theory study is to gain understanding of the experiences and mental health of Ugandan grandparents 50 years of age and older who provide primary care for grandchildren affected by HIV/AIDS. Background Despite the overall global decrease in AIDS-related deaths and HIV infections, sub-Saharan Africa remains the region most affected by the epidemic. In 2015, 23.5 million people were living with HIV in sub-Saharan Africa while an average of 800,000 people have died of AIDS-related causes. Uganda was reported to have had an estimated 28,000 adult deaths due to AIDS by 2015 that rendered approximately 660,000 children orphans to date (UNAIDS, 2016). Despite broad acknowledgement that in this HIV/AIDS era older adult caregivers are the backbone and safety net of the African family, very little research has explored the impact of this grandparental burden on the physical and mental health of this vulnerable population. Methods Using a grounded theory approach, semi-structured qualitative interviews were conducted with 32 grandparents recruited from the general population impacted by the HIV/AIDS epidemic. The one-on-one interviews were audio-recorded, transcribed, and analyzed using open, axial, and selective coding as well as reflexive and analytic memoing congruent with the methodology. FindingsStudy participant narratives described the caregiving burden as being financial, emotional, and physical although a few rewards were reported. In addition, the current study highlighted other experiences such as the described dimensions of loss and characterized the psychosocial distress related the caregiving role and other socio-economic stressors and the associated coping strategies. The mental health implications and explanatory model of this experiences were also described.ImplicationsThe study’s findings provide an extensive insight into the experiences of Ugandan grandparent–caregivers in the context of the HIV/AIDS epidemic. These insights can potentially inform clinicians, researchers, and policy makers who may seek explanatory models upon which to create care plans and design family-centered and community-based interventions such as childcare and respite care for these older grandparent–caregivers

Loss as Experienced by Ugandan Grandparent-Caregivers of Children Affected by HIV/AIDS

Despite increasing numbers of studies investigating grandparent-caregivers of children orphaned by HIV/AIDS in sub-Saharan Africa, research on their mental and physical health remains inadequate. We provide a qualitative account of the nature, extent, and relationships among multiple variations of loss emerging from 32 interviews with Ugandan grandparent-caregivers of grandchildren affected by HIV/AIDS. Regardless the type or nature of the loss, participants expressed physical, emotional, and financial distress as a result. This cumulative loss and subsequent grief could potentially be associated with mental and physical health problems. Research to further explore the concept of loss among this vulnerable population is recommended

Thoughts Can Kill You: Characterization of Mental Health Symptoms by Ugandan Grandparent-Caregivers in the HIV/AIDS Era.

Studies of caregiving provided to HIV/AIDS orphans by sub-Saharan African grandparents have found that it has physical, financial, and emotional consequences. Our study extended this research by identifying and characterizing the symptoms experienced by Ugandan grandparent- caregivers, particularly as related to the caregiving role, loss and grief. Grounded theory methodology was used to conduct and analyze audio-recorded, semi-structured interviews with 32 grandparents. Findings revealed a cluster of biopsychosocial distress symptoms, especially anguish (driven by traumatic anxiety and disbelief), depression, and somatic symptoms that were linked primarily to psychological distress. The impact of cultural practices and beliefs on these symptoms was also identified. Results have implications for public health, research, and policy changes needed to alleviate symptoms of biopsychosocial distress among Uganda grandparent-caregivers

"Thoughts Can Kill You": Characterization of Mental Health Symptoms by Ugandan Grandparent-Caregivers in the HIV/AIDS Era.

Studies of caregiving provided to HIV/AIDS orphans by sub-Saharan African grandparents have found that it has physical, financial, and emotional consequences. Our study extended this research by identifying and characterizing the symptoms experienced by Ugandan grandparent- caregivers, particularly as related to the caregiving role, loss and grief. Grounded theory methodology was used to conduct and analyze audio-recorded, semi-structured interviews with 32 grandparents. Findings revealed a cluster of biopsychosocial distress symptoms, especially anguish (driven by traumatic anxiety and disbelief), depression, and somatic symptoms that were linked primarily to psychological distress. The impact of cultural practices and beliefs on these symptoms was also identified. Results have implications for public health, research, and policy changes needed to alleviate symptoms of biopsychosocial distress among Uganda grandparent-caregivers