Abstract:
The purpose of this study is to explore the concept of religious health assets
(RHA) and its relevance to HIV/AIDS. This manuscript describes the experiences
of caregivers with a church-run home-based care organisation in Swaziland, site
of the world’s highest HIV prevalence (42%). In light of reduced antiretroviral
treatment rollout in some areas of Africa, strengthening mechanisms of treatment
support with HIV prevention has never been more critical. One modality may be
community home-based care (CHBC), a core feature of the World Bank’s MultiCountry
HIV/AIDS Program for Africa. Yet, these entities, and the frontline
activities of local congregations, remain underexplored. Part of a larger
anthropological study of religion and HIV/AIDS in Swaziland, this manuscript
draws on 20 semi-structured caregiver interviews to discern patterns in motivations;
perceived client needs; care practices; and meanings of religiosity. Thirteen
participants were care coordinators who oversaw approximately 455 caregivers
across nearly half of the 22 communities served. Grounded theory analysis
suggested that caregivers facilitated vital decisions around HIV testing, HIV
disclosure, treatment uptake/adherence, as well as reduced HIV stigma. Also
salient was the importance of a Christian ethos, in the form of ‘talk’ and ‘love’, as
critical culturally situated care practices. Having expanded to an estimated 600
caregivers and 2500 home-based clients between 2006 and 2009, participants’
reports intimated their roles as agents of broader social transformation. This
article contributes to the expanding study of RHA and challenges authoritative
global public health strategies that have largely marginalised local religious
aspects of HIV/AIDS. Future applied research examining how ‘home’ and
‘church’ may be vital public health settings outside of, but integral to, formal
health services and HIV programming is warranted.
