Care for AIDS orphans in Uganda: findings from focus group discussions

Abstract

Since 1982 when the first case of AIDS was identified in Rakai district (Serwadda et al. 1985) the disease has moved like a bushfire and killed many people in Uganda. The records of the AIDS Control Programme (ACP) give reports of AIDS cases as 43,825 by December 1993 (ACP 1994). Because this figure is based on official health reports of the disease in a country without a vital registration system and where most people die outside medical units, it is a gross underestimate. Perhaps a close figure is four to five times the ACP report. According to WHO reports, Uganda's number of deaths due to AIDS is second only to that of the United States, a much larger country. In terms of percentages of populations, Uganda is perhaps the worst affected country with an estimate of 8 to 12 per cent HIV positive, although other African countries have not been as open to studies of the disease as Uganda has been. This implies 1.4 to 2.2 million out of a total of 18 million Ugandans may already be infected. The impact of AIDS on the country has been devastating. The disease has killed many highly educated people, businessmen and economically active people, thus depriving the country of the entrepreneurship, technical and professional persons needed for high economic productivity. Both public and private health systems, working under strained budgets, are overburdened by the high cost of medication and care of AIDS patients. Many babies are born with the virus transmitted from their mothers, thus increasing infant mortality. The 1991 census reported an infant mortality rate for Uganda of 128 per 1,000, higher than in the 1969 census, when it was 120 (Republic of Uganda 1993). The adult mortality rate has also increased: life expectancy at birth went down from 47 years in 1969 to 42 in 1991.