Date Published: June 21, 2012
Publisher: Hindawi Publishing Corporation
Author(s): Glenn Wagner, Yashodhara Rana, Sebastian Linnemayr, James Balya, Lydia Buzaalirwa.
HIV medical care, including antiretroviral therapy (ART), is often successful in restoring physical health and functioning. But in developing countries, HIV medical care is often insufficient to achieve social and economic health, and hence innovative economic support programs are much needed. We conducted semistructured interviews with 30 adults receiving ART and microcredit loans operated by Uganda Cares. Using content analysis, we explored the impact of the microcredit loans on the economic, social, and psychological well-being of respondents. Most respondents indicated that the microcredit loans played a positive role in their lives, helped them to keep their children in school and sustain their families, and improved their self-esteem and status in the community. In addition, we also found significant positive knowledge spill-over and network effects in the program with regard to business management and support. However, more than half of the participants indicated experiencing repayment problems either personally or with other group members due to unexpected emergencies and sickness. These findings highlight that microcredit programs have the potential of being an economic support system for HIV clients trying to reestablish their livelihoods, especially in resource-constrained settings, though more research is needed to determine the overall economic viability of such programs.
HIV medical care, especially antiretroviral therapy (ART), suppresses the replication of HIV virus, restores some of the body’s ability to fight infections, and consequently helps improve physical health and functioning . But the ultimate goal of HIV care is to enable individuals to achieve social and economic well-being—to work and provide for themselves and their family, keep their children in school, and their households intact [2–4]. In developing countries, where poverty is high and employment opportunities in the formal labor market are few, HIV medical care is often insufficient to achieve this goal, and innovative economic support programs are essential. Microcredit programs have grown tremendously in recent years in Sub-Saharan Africa as they offer the potential to assist individuals in generating income through small enterprises.
These detailed discussions with PLHA on ART who are currently receiving microcredit reveal considerable diversity in the benefits and challenges associated with microcredit in this population. First, we believe that SEEP’s microcredit loan is correcting an important market failure by providing loans to those who need it yet feel shunned by both the formal and informal credit market systems. Similar to previous studies, we found that after being on ART most participants had regained physical strength and were able to resume work . Yet, the consequences of HIV on the socioeconomic well-being of affected individuals render many PLHA in need of economic support even after receiving HIV medical care. Microfinance is one type of such economic support, but only when it is offered through AIDS service organizations do PLHA generally find microcredit loans to be accessible. More than half of the participants in our study were interested in applying for microcredit loans because they wanted to expand their business and/or they desired to work. Yet, roughly two thirds of them had never accessed loans from other formal and informal institutions before enrolling in SEEP. Likewise, at the time of the interviews, the same proportion of participants still felt that they could not access other sources of funding, citing complex bureaucratic systems, requirement for collateral and fear of confiscation of property. Among these reasons, the most frequently cited was the perception that other institutions discriminated against their HIV status.