Mama Jaja: the stresses and strengths of HIV-affected Ugandan grandmothers.

This paper reports an exploratory qualitative project in the Entebbe-Kampala area of Uganda with 11 grandmothers who are raising orphans because of a parent's death from HIV infection. In Sub-Saharan Africa, the highest HIV infection and mortality rates are among women, especially in their childbearing years, leading to a tremendous number of orphaned HIV-infected and -affected children. Uganda has the world's highest rate of HIV-affected orphans. In Uganda, extended family members, especially grandmothers, provide general orphan care, AIDS care, and care for HIV-affected orphans. If orphans have places to stay, they are most often with grandparents and other elderly relatives in rudimentary village dwellings. Many of these elders are in poor health, recovering from nursing their adult children as they died of AIDS, and suffering from an extreme lack of financial resources. The burden of HIV-affected orphan care is enormously heavy. Services are not being provided adequately to custodial grandparents who are enormously challenged spiritually, socially, emotionally, financially, physically, and mentally. The following themes emerged from the interviews: experiencing extreme economic deprivation; feeling physically challenged with caregiving; being concerned for the children under their care; and struggling to cope through action, resilience, and relationships. Recommendations for research, practice, and policy are offered.