What AIDS Leaves Behind: A Heavy Burden on African Women


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Unlike other diseases in Africa (malaria, tuberculosis, intestinal worms, etc.), which mainly affect the young and the old, HIV/AIDS takes its toll on prime-age adults during the most productive years of their lives. The death of an adult family member can have large consequences for the surviving family. Given prevailing social norms in many African societies, the burden may likely be heaviest for women.

Most studies focus on the consequences for orphaned children – their schooling and health. We know less about how older adults are impacted.  In our study, we track individuals and their households in northwest Tanzania, an area of high HIV prevalence in the 1990s, over a 13-year period.

We find that, when a family member dies, women (even old women) end up working more on the farm; men do too, but not as much.  Having an asset such as goats enables them to work less. 

But elderly individuals’ health is generally no worse off after the deaths of their prime-age relatives. Surprisingly, if an adult child living outside the home dies, his/her parents’ health or workload do not suffer . It appears then that support from adult children is either replaced by other family members or the support is much lower than is currently speculated.


These findings suggest that policies like old-age assistance programs should take into account the long-term effects of losing an adult family member, particularly for elderly women, who seem to be compensating for much of the lost income in the household.


Kathleen Beegle

Lead Economist with the World Bank Gender Group

Join the Conversation

September 29, 2009

This is a very interesting find. The empowerment of women is so essential to development, and here we find an example involving the prevalence of HIV/AIDS. It is not often that I read about the effects that such deaths have on other members of the family. Apparently, older women are most affected, which makes me wonder how to compensate for that. Women should receive as much equal opportunity as men, no matter their age. If they are the ones picking up the slack, is that cultural, economic or something else? I would be interested to see if these results change over time.

Ibrahim Kai-Samba
September 29, 2009

In the latter half of the 1980s, I lived around one of the renowned fishing grounds in Freetown- Sierra Leone.
From Lumley to Goderich, a near 2+ km stretch, one could sense whether there had been a good catch or not. When there was good catch, the whole area would appear stinky of excess fish thrown about the beach, left to rot. Yet there were times when demand (far) exceeded supply, and we could see fish sellers returning to town with empty baskets; what an irony.
Here is what I think govt may do for the good of all. I know local taxes are collected any time deemed, but don’t know if the fishermen, apart from licenses to fish, do pay taxes on their catch. If not, then govt may start levying taxes on them. But as I have always believed, TAX IS PROTECTION MONEY, govt should in turn help to curb the fish crisis. Here is how.
At times when there is excess catch, and the fishermen can’t sell out all their catch, instead of dumping them on the beach (as was usual practice), govt. can buy the excess fish at a lower price, say Le (x-2.00). The fishermen then stand to make money from all their catch. Govt in its turn can store this fish as reserve for times of shortages (bad catch), during which govt resells them say, for Le (x-1.00). In the end all three parties; govt., fishermen, and fish sellers reap benefit, and the masses too, are assured of fish all the time.
A second option is for govt to build a cold storage around the fishing areas. Excess fish can be stored here on rentals. People employed to man the storage facility; more employment opportunities. This can be done in the event that govt doesn’t want to be in fish selling.
In addition, govt, can get involved in the importation of fishing materials, and giving them out as loans to these fishermen who have never boarded a flight to go abroad, let alone to go and buy fishing materials. Videos/lectures on good fishing habits can even be provided for these people. The community can be encouraged to construct a community centre where they can periodically meet to exchange ideas.
If govt can provide this group of people with these basic necessities, in my opinion all will be more than willing to pay whatever (reasonable) tax is deemed, and govt will also stand to further expand its revenue source, while at the same time improving its citizens’ quality of life.

November 02, 2009

I'm a teacher by proffession and currently working with HOCOSEN a CBO helping children with special needs.
I'm happy to learn about your article 'HIV/AIDS is a burden to women'I would be grateful to see policies changing towards helping women and children as they are part of the most affected group of people as far as AIDS perdemic is concerned.whether they are directly affected or not(our survey of march 2009 reveals)