Experiences of home-based care organizations in the context of the global financial crisis.

Abstract

Background: The global economic crisis has posed major threats to the fight against HIV and AIDS especially in developing countries. The crisis which originated in well-developed economies such as the US in 2007/2008 (Kin & Penn, 2008) has impacted key drivers of growth in trade, investment, mining and manufacturing at a global level. However, it is unclear how this crisis is affecting small, non-profit organizations providing care and associated services to people living with and affected by HIV/AIDS. Aim: The aim of this study was to explore the experiences of home-based care organizations in the context of the global financial crisis and its implications on the provision of services offered by home-based care organizations through the perspective of the managers. Methods: In-depth qualitative interviews were conducted with 10 managers who work in care organizations that provide care services to people living with HIV/AIDS using an interview schedule containing open-ended questions. Findings: The findings of the study show that the global financial crisis at the macro level has affected government and donors/funders’ grants to non-profit organizations. This has resulted in a reduction of funds allocated to care organizations. Funding cuts have severely affected care organizations at the exo-level. Care organizations were forced to employ different strategies such as organizational restructuring in order to survive in the new funding environment. This led to downscaling of services and the number of communities served, retrenchment of paid staff and reduced incentives for volunteer caregivers. Organizational restructuring had profoundly implications on recruited workers at the meso-level. Paid staff were confronted with retrenchment while volunteer caregivers were confronted with rationalization of incentives. At the micro level, there were severe implications for beneficiaries of care services. People who depended on these services are at a high risk of becoming more vulnerable to diseases and poverty. Recommendations: These findings highlight the need for the government to play a bigger role in the provision of funds and support to home-based care organizations. The government needs to incorporate home-based care into its social and economic policies to create a reliable source of funds for care organizations.