Abstract
IntroductionPredicting the household’s ability to cope with adult illness and death can be complicated in low-income countries with high HIV prevalence and multiple other stressors and shocks. This study explored the link between stage of the household in the life cycle and the household’s capacity to cope with illness and death of adults in rural Uganda.MethodsInterviews focusing on life histories were combined with observations during monthly visits to 22 households throughout 2009, and recorded livelihood activities and responses to illness and death events. For the analysis, households were categorised into three life cycle stages (‘Young’, ‘Middle-aged’ and ‘Old’) and the ability to cope and adapt to recorded events of prolonged illness or death was assessed.ResultsIn 16 of the 26 recorded events, a coping or struggling outcome was found to be related to household life cycle stage. ‘Young’ households usually had many dependants too young to contribute significantly to livelihoods, so were vulnerable to illness or death of the household head specifically. ‘Middle-aged’ households had adult children who participated in activities that contributed to livelihoods at home or sent remittances. More household members meant livelihood diversification, so these households usually coped best. Worst off were ‘Old’ households, where members were unable to work hard and often supported young grandchildren, while their adult children had stopped sending remittances as they had established households of their own.ConclusionsWhile households may adopt diverse coping mechanisms, the stage in the household life cycle when stressful events occur is important for coping outcomes. Households of the elderly and households with many young dependents are clearly vulnerable. These results demonstrate that household life cycle analysis can be useful in assessing ability to respond to stressors and shocks, including AIDS-related illness and death.
Highlights
Predicting the household’s ability to cope with adult illness and death can be complicated in low-income countries with high HIV prevalence and multiple other stressors and shocks
The second stage of the analysis focused on the 16 households that had experienced extended illness or death events of adults in the past 20 years
The processes underlying coping: Illustrative stories from three households The complex processes governing coping and their relation to the household life cycle can be better understood by examining the life histories of individual households
Summary
Predicting the household’s ability to cope with adult illness and death can be complicated in low-income countries with high HIV prevalence and multiple other stressors and shocks. This study explored the link between stage of the household in the life cycle and the household’s capacity to cope with illness and death of adults in rural Uganda. This study makes use of the availability of detailed longitudinal data from a study cohort in rural Uganda to analyse how the severity of the effects of adult illness and death on households can be linked to household life cycle stages. Exploring these links can give valuable insights about household vulnerability to stresses and shocks, including AIDS related challenges. The demarcations are mainly based on the presence and age of dependents, and we characterise these stages further in the analysis
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