Unpaid HIV/AIDS Care in Southern Africa: Forms, Context, and Implications

Across southern Africa, policy-makers are promoting home-based care for HIV/AIDS patients as a cheaper alternative to hospital care. However, cost studies have not sufficiently considered the costs and benefits to all stakeholders in home-based care.Footnote1 Drawing on existing literature, this study shows that available data are grossly inadequate for a comprehensive assessment of the cost-effectiveness of home-based care. Previous studies have largely ignored many of the costs associated with home-based care, which is currently borne by unpaid caregivers – predominantly women – as well as the value of their unpaid labor. This study questions the assumption that home-based care is cheaper than hospital care and the wisdom of enacting home-based care policies. This study argues that conclusions about the cheaper form of care can be drawn only by assessing all of the costs, benefits, and utility derived by all stakeholders in home-based care.