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New York, NY. Home-based caregiver and grassroots woman leader Violet Shivutse makes a strong case for why organized groups of grassroots caregivers must be directly involved in the CSW Agreed Conclusions process.

This is the transcript of her presentation at the 57th session of the UN Commission on the Status of Women (CSW57) review theme panel on “The equal sharing of responsibilities between women and men, including caregiving in the context of HIV/AIDS” delivered on Tuesday, March 12, 2013.

Violet_reviewpanelcaregivingIn 2009, caregiving was brought to the forefront in global discussions at the Commission on the Status of Women. After approving the Agreed Conclusions, governments went home and started various processes and plans to scale up caregiving.

In many countries in Africa, our governments with the big global health initiatives supported many plans to address caregiving in the context of HIV. There has been remuneration of caregivers, creation of titles meant to suit the work of caregiving like community health workers, home visitors and health extension workers. Some even have come up with kinds of stipends, very minimal like 20 USD a month, and only given to some caregivers, like 50 out of 2000 women working as caregivers in a given community.

The gap in this is due to the lack of involvement of the caregivers in implementation of the Agreed Conclusions. The work of caregivers has been continued to be an increasing workload as caregivers become fragmented due to these government interventions.

In the last International AIDS Conference in Washington D.C., a lot of emphasis in HIV programming was put on clinical management of the disease where you could tell that caregiving was being dropped or overlooked. Just as women’s care responsibilities are socially ignored as a convenient means to devalue women’s contributions, so too are myths about the feasibility to support caregivers.

In 12 countries in Africa, in Kenya, Uganda, Rwanda, South Africa, Ethiopia, Zambia, Zimbabwe, Malawi, Nigeria, Ghana, Benin, and Cameroon, grassroots women have formed a Home-Based Care Alliance which brings over 30,000 grassroots women working on care work. The Home-Based Care Alliance is countering these myths and is showing the evidence of caregivers’ work. This is being used by likeminded organizations and some local governments to program around care.

One example is the big survey conducted by caregivers that was funded by the government of Japan through the Huairou Commission called “Compensations for Contributions.” In Kenya, we have used this evidence to help in developing the National AIDS Strategic Plan and ensuring a community pillar was formed to direct national level funding to community-based caregiving groups. Caregivers are also working to persuade the African Union to adopt policy on caregivers to facilitate a country level response.

 Recommendations from Grassroots Women

  • Sharing responsibilities in caregiving does not just mean men joining to provide direct care. In the patriarchal society, men are the custodians of resources. Men should recognize caregiving done by women as an important social welfare and provide resources to support care. 
  • Men should acknowledge caregiving is not just about health. Caregivers are working on food security, supporting orphans, water and hygiene, land tenure, and more. This quantifies the caregivers as development agents who need to get space on male dominated decision making tables. 
  • Governments need to set up multi-sectorial policy and programing teams that can look at solutions holistically across sectors like social protection, health systems, and poverty eradication. Caregivers should be a part of this team.
  • Caregiving is a social welfare that promotes social cohesion in families. Most people in need of care do not want to be put in institutions where they are cared for by people they do not know. Grassroots women caregiving is promoting family and reduces expense of care. We can support caregiving by enabling women caregivers to organize more effectively through things like providing offices, access to equipment and grants to caregiving groups. 
  • In Europe and the US, we have seen that government subsidies for care are limited to child care and family leave. Even these have shortcomings. In Africa, caregivers are organized and linked across communities. This actually provides an easier way to governments to commit resources to this collective response to care. It is more cost effective and provides a platform for women’s empowerment. 
  • When we look at the Post 2015 Development Framework, caregiving actually outlines a strategy for women’s empowerment and building sustainable communities.