**5.1 Caregiving and support**

The high prevalence of HIV in Africa and Nigeria, coupled with improvements in treatment modalities and life expectancy predict the inevitable loss of autonomy as disease trajectory progressed into AIDS. It has been noted that in spite of prophylaxis for opportunist infection and antiretroviral therapy in preventing AIDS associated illness, PLWHA will still be sick and have disability in functional ability, hence require care [50]. This terminal stage invariable signals the need for either formal or informal caregivers. Studies also revealed that HIV infected individuals return to their homes for physical and psychological support and adequate discharge preparation which incorporate health care team; and family care givers become imperative [50]. However, health care system especially in developing countries do not have the capacity to provide long-term services, they rarely involved family caregivers in the discharge planning, neither are they educated

**105**

*The Exceptional Role of Women as Primary Caregivers for People Living with HIV/AIDS…*

about their roles. Patients are discharged home without contact with family caregivers and most health systems lack structured and effective discharge plans [51, 52]. But effective discharge planning plays a role in continuity of care [53]. Although there are benefits associated with caregiving such as fulfilling normative role and reciprocity when the chips are down [10, 54]. Reducing the cost of institutionalization and receiving care in an environment one is familiar with as well as being in the company of loved ones improved the quality of life of the care recipient. Moreover, during caregiving bonding relationship develops between the caregiver and recipient, but the type of relationship depends on the age of caregiver and recipient [55]. It is however pertinent to note that in spite of family resiliency with care, their experience of physical and emotional strain should never be ignored [56]. Most caregivers are "hidden" patients which health care professional fail to recognize [57]. Besides, while discharging the patient they fail to think about continuity of care to full recovery, based on the implicit assumption that family members would care for them, without educational preparation on how to managed discharged patient. The assumption of caregiving role without preparation might affect the individual coping mechanism resulting in the experiencing of stress or burden. Caregiving has both positive and negative consequences although the two may exist concurrently [57]. Excessive life stressor on the other hand results in negative consequences and without adequate intervention may affect role performance [58]. This informs the need for family caregivers support. Support is conceptualized as what others do to help the individual cope [58]. This conceptualization of involving significant others in the caregivers' capability constitute the principal theme that is

The forms of support have been categorized into three namely: (a) instrumental aid (actions or resources provided to aid caregiving responsibilities), (b) socio-emotional aid (infer demonstrations of love, caring, esteem, sympathy and group belonging) and (c) informational aid (communications of information that makes life challenges easier) [59]. These forms of social support buffer the negative consequences of caregiving. Although men have jobs more than female [30], the female combine caregiving most often with productive and reproductive activities, therefore they need support for adaptation as responsibilities changes or increases, in order to ensure quality care and life of the care recipient. This study therefore seeks to assess the level of burden experienced by all caregivers of PLWHA, identify and compare the gender differences in the degree of perceived burden, ascertain the duration of care, assess the availability of support as well as the willingness of

The study was conducted in Calabar Municipality, a local government in Cross River State (CRS) of Nigeria between June to December 2009. Cross River State is one of the 36 States of the Federal republic of Nigeria situated in the South South

179,392 by the 2006 census. Calabar Municipality otherwise called '*Efik eburutu'* has a rich cultural heritage and very hospitable. Compared with other communities in Nigeria, they operate the patriarchal system with male preference and dominance. Moreover the families take responsibilities for their sick member. CRS operate the three tier health care system which includes primary, secondary and tertiary, however the health facility is skewed to the urban area. The University of Calabar

and a population of

*DOI: http://dx.doi.org/10.5772/intechopen.93670*

exemplified in this study.

**6. Materials and method**

**6.1 Location of the study**

caregivers to continue caregiving in the future.

zone of Nigeria. Calabar Municipality has an area of 142 km<sup>2</sup>

#### *The Exceptional Role of Women as Primary Caregivers for People Living with HIV/AIDS… DOI: http://dx.doi.org/10.5772/intechopen.93670*

about their roles. Patients are discharged home without contact with family caregivers and most health systems lack structured and effective discharge plans [51, 52]. But effective discharge planning plays a role in continuity of care [53]. Although there are benefits associated with caregiving such as fulfilling normative role and reciprocity when the chips are down [10, 54]. Reducing the cost of institutionalization and receiving care in an environment one is familiar with as well as being in the company of loved ones improved the quality of life of the care recipient. Moreover, during caregiving bonding relationship develops between the caregiver and recipient, but the type of relationship depends on the age of caregiver and recipient [55]. It is however pertinent to note that in spite of family resiliency with care, their experience of physical and emotional strain should never be ignored [56]. Most caregivers are "hidden" patients which health care professional fail to recognize [57]. Besides, while discharging the patient they fail to think about continuity of care to full recovery, based on the implicit assumption that family members would care for them, without educational preparation on how to managed discharged patient. The assumption of caregiving role without preparation might affect the individual coping mechanism resulting in the experiencing of stress or burden. Caregiving has both positive and negative consequences although the two may exist concurrently [57]. Excessive life stressor on the other hand results in negative consequences and without adequate intervention may affect role performance [58]. This informs the need for family caregivers support. Support is conceptualized as what others do to help the individual cope [58]. This conceptualization of involving significant others in the caregivers' capability constitute the principal theme that is exemplified in this study.

The forms of support have been categorized into three namely: (a) instrumental aid (actions or resources provided to aid caregiving responsibilities), (b) socio-emotional aid (infer demonstrations of love, caring, esteem, sympathy and group belonging) and (c) informational aid (communications of information that makes life challenges easier) [59]. These forms of social support buffer the negative consequences of caregiving. Although men have jobs more than female [30], the female combine caregiving most often with productive and reproductive activities, therefore they need support for adaptation as responsibilities changes or increases, in order to ensure quality care and life of the care recipient. This study therefore seeks to assess the level of burden experienced by all caregivers of PLWHA, identify and compare the gender differences in the degree of perceived burden, ascertain the duration of care, assess the availability of support as well as the willingness of caregivers to continue caregiving in the future.
