Research into Social Support for Health of Caregivers
How important is informal family and community support for the health of caregivers of children in southern Africa? And what would it mean for caregiver and child wellbeing if these support networks broke down in the face of HIV and the many other social stressors?
These were some of the central questions driving recent HEARD research led by Dr Marisa Casale on the role of instrumental and emotional social support for the health of caregivers of children in HIV-endemic communities.
Studies in various parts of the world among ill and healthy adult populations have shown more social support to be associated with better mental and physical health. However, there is very little work in this area of research in Africa.
This collaborative HEARD research represents the first mixed methods study of this nature and dimension on social support and health conducted with HIV-affected caregivers in the southern African region.
Overall, the findings highlight the importance of social networks and psychosocial support for caregivers living in resource-deprived HIV-endemic southern African communities, especially for female caregivers living with chronic illness.
The findings also suggest that social support may be protecting caregivers from mental health problems in various ways such as: providing an opportunity to communicate problems and receive advice; boosting self-esteem, confidence and hope; and encouraging caregivers to cope with problems differently by tackling them more proactively and spending less time thinking negatively about their poor health and other problems.
These findings are particularly salient considering the high mental health risks among similar vulnerable populations, the low uptake of mental health services in South Africa, and evidence that better mental health may be linked to better physical health and slower disease progression. In the case of caregivers of children, research from other parts of the world has also shown better caregiver mental health to be related to greater wellbeing of children cared for.
There are several important messages for policy and practice deriving from this work. One is that psychosocial support should be a key element of mental health interventions working with caregivers and/or AIDS-affected individuals, whether implemented by NGOs or through the public health system. Examples could include support groups, group-based interventions and community home-based care linked to health facilities or programmes. These may be valuable means of combining health care, psycho-educational interventions and health information exchange with longer-term social interaction and emotional support.
Another message from the work is that existing social networks need to be protected and, where possible, strengthened and mobilised as potential channels to provide health education and information, as well as encourage health service uptake.
- Shela McCullough