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Can households cope?
Informal fostering among extended family members is a vital coping mechanism in nations with growing orphan populations, yet the enormity of the AIDS epidemic is challenging the viability of extended family care as the epidemic decreases the number of available caregivers, increases economic vulnerability, and causes households to dissolve.
In many nations, orphans who are informally fostered are living in poorer households with fewer assets and worse dependency ratios than other children.1 On average, the head of orphan households in sub-Saharan Africa are female, have low levels of education, are unemployed, and are older than caregivers in non-orphan homes.2
Although grandparents often provide nurturing care, 80% of older people who live in developing countries do not have a regular income, and are among the poorest in society.3 While older headed households may scrape by, these households are economically vulnerable to shocks caused by illness, weather, or changes in the economy. In many older person homes, children must work in order for families to meet their basic needs. In these conditions, social welfare assistance must be created or expanded to provide assistance to destitute families. Moreover, even in income earning households, families struggle to meet their basic needs, particularly when they do not receive assistance.4
2. UNESCO: Education For All. vol 2005. Paris: UNESCO, 2005.
3. Help Age International. London, 2005.
4. Miller, C., Gruskin, S., Rajaraman, D., Subramanian, S.V. and Heymann, J. “Orphan care in Botswana’s working households: Growing responsibilities in the absence of adequate support.” Accepted by the American Journal of Public Health November 2005.
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