196929 Alleviating the burden of responsibility: Men as providers of HIV/AIDS care and support in Lesotho

Monday, November 9, 2009: 4:30 PM

Constance Newman, MSW, MPH , IntraHealth International, Chapel Hill, NC
Nthabiseng Makoae, PhD , University of Lesotho, Maseru, Lesotho
Erik Reavely, PhD , IntraHealth International, Chapel Hill, NC
Linda Fogarty, PhD , IntraHealth International, Chapel Hill, NC
Purpose: Gender segregation in health occupations, which typically assigns caring/nurturing jobs to women and technical/managerial jobs to men, creates barriers to the fullest possible pool of formal and non-formal health workers. Gender segregation of community-based HIV/AIDS care and support is a form of health inequity that results in an unsustainable burden of care on women and girls in Africa.

Data/Information Used: The Lesotho Ministry of Health and Social Welfare sponsored a study, conducted by USAID's Capacity Project, to strengthen its capacity to address the HIV/AIDS pandemic by increasing the active engagement of men as providers of community home-based health care.

Methods Used: The study determined the need and feasibility of bringing men into community-based HIV/AIDS caregiving and identified the gender-related and cultural factors that need to be addressed to increase the number of men while supporting the women already heavily engaged in this work. Twenty-five key informant interviews and 31 focus group discussions were conducted with 264 participants in villages, health clinics and hospitals drawn from three districts purposively sampled to include ecological zones, rural and urban sites and public and private sector facilities at various levels.

Major Results and Recommendations: The study found that HIV/AIDS caregiving is sustained by stereotypes about essential “male” and “female” traits, beliefs and perceptions of men that kept women in voluntary HIV/AIDS caregiving and kept men out of it. Engaging men as care providers is feasible with financial incentives, training and support. National health, HIV/AIDS and community home-based care (CHBC) and human resources policies should explicitly promote a more equal division of responsibilities between women and men and be promulgated through training curricula, job descriptions and protocols. Training should include critical reflection on masculine and feminine gender roles. CHBC programs should promote the equal sharing of responsibilities between women and men in training and supervision and in the recruitment of men. Standardized working conditions are essential to respond to community-based HIV/AIDS care and support needs.

Learning Objectives:
1. Explain gender segregation of health occupations as a significant barrier to health workforce participation and contributor to health disparities 2. Describe the methodology and results of a study conducted for the Lesotho Ministry of Health and Social Welfare to address gender segregation in community –based HIV/AIDS care and support. 3. Identify at least 3 policy and practice recommendations to reduce gender segregation in community –based HIV/AIDS care and support.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Senior Technical Advisor in charge of Gender and Human Resources for Health on the Capacity Project, a USAID-funded global project that strengthens HRH systems to implement quality health programs in developing countries by planning, developing and supporting the health workforce. I am the Principal Investigator on the study, responsible for the conceptualization of the study, the final writing and dissemination of the report.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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