Socio-economic policies that were introduced in many countries in Africa by international financial institutions, especially the World Bank and the International Monetary Fund (IMF), have had a negative impact on the standard of living of many families and communities across the continent.
Malawi is one of these countries that have not reaped the desired benefits from the policies prescribed by the Bretton Woods institutions.
At worst, the prescriptions from overseas have caused the destruction and dismantling of social services through retrenchment of staff, shortages of suppliers of drugs and other essential medical supplies in health institutions. Compounding the situation is the HIV and Aids pandemic, which has taken centre-stage in the country’s health policy.
Families, in particular women, have had to take over the responsibilities of providing care and support to patients in health institutions, communities and households.
In the country’s healthcare system, as is the case in the majority of African societies, women have been observed to be the main caregivers. The home-based care set-up in the Malawian context is mainly composed of women, even girls.
The duration of care varies, depending on the disease or complications that the patient is suffering from.
In cases of chronic conditions, including HIV and Aids, cancer and stroke, the caregivers bear the burden of care for long periods.
These lengthy periods of providing care for the sick and injured have grave impacts on the caregivers’ physical and mental state of well-being, access to information and attainment of civic rights.
Because women comprise the majority of caregivers, they are the worst affected by these constraints on their agency and opportunities. They already endure a heavy domestic workload.
Nursing patients further constrains their ability to participate in income-generating activities, increasing their financial dependence and decreasing their level of access to social services such as healthcare and education (for their children).
In addition to providing care at home and in hospital, women are generally expected to take on the responsibilities of domestic chores at home.
These run the gamut from house-cleaning and laundry to cooking and fetching firewood.
Very often, they also participate, either formally or informally, in income-generating activities such as agriculture, market trading, tailoring, baking and others.
The income earned from these activities goes towards the purchase of household essentials and children’s school fees.
Despite the heavy burden of care on women, government has not recognised their contribution accordingly.
The work as caregivers often goes uncounted, undervalued and unpaid. No economic value has been attached to this labour contribution.
Their work, especially performed by women, represents a social cost to women, households and communities.
It represents a form of savings for government—as payments are not being made for the care services provided.
All this has implications for national accounting, and thus for economic policies.
From a policy point of view and for the sake of gender equality , there is a need to mobilise policymakers and legislative bodies around the issue of women’s unpaid labour of care in health institution, homes and communities, and for the women giving care. n