The availability of free ARV therapy in the public health sector has brought hope to people
living with HIV/AIDS in Botswana. However, provision of ARV therapy presents challenges
to the health sector and individuals who access them. ARV therapy is a lifelong commitment
that requires from the health service an uninterrupted supply of drugs, close monitoring, the
administration of complicated drug regimens and managing complications. The success of
treatment depends on the ability of the patient to take drugs as prescribed and the caregiver of
a child who is on ARV therapy plays a crucial role in this process. It was against this
background that this study investigated the lived experiences of caregivers and the
implications of their experiences for ARV policy. The study explored challenges in the care
process and the coping strategies devised to address them. It also elicited suggestions on what
could be done to create a supportive environment for provision of care. The argument of this
thesis is that for ARV policy to be successful, it should not only focus on challenges within
the health system but should also address problems faced by the caregivers. These challenges
have a potential to undermine the success of the policy.
The study was conducted in Mahalapye Hospital in Botswana, which started providing ARV
therapy in 2003. The study used a combination of qualitative and quantitative research
methods. A purposive sampling of nine caregivers who varied by age, sex and area of
residence participated in in-depth interviews. Forty-nine caregivers completed the
questionnaire that was used to collect socio-demographic data.
The results showed that most of the caregivers were biological parents, who where living
with HIV/AIDS and as such grappling with their own health problems. It was evident that
caring, which was predominantly done by women, was performed under difficult conditions
of poverty. High levels of income poverty were observed and this was attributed to
unemployment. Food security was an overwhelming challenge faced by caregivers. Transport
costs to access treatment were a major challenge and were cited as the main reason why
patients miss appointments and end up defaulting from treatment. There was an
overwhelming need for financial support to buy food, cater for transport to the treatment
centre and buy other household needs.