Contexto histórico

An old-age pension program, like those available in a few developing countries, is an intervention scheme that may reduce the vulnerability of elderly people to poverty (HAI, 2003b; Case, 2001; May, 2003). Such programs have had a significant impact on poverty in developing countries such as Brazil, Namibia, Botswana, Lesotho and particularly in South Africa, where it has been used as a tool to re-distribute wealth among the population (Case and Deaton, 1998).

The South African pension grant programme was first introduced in 1928 for the White and Coloured populations and later extended to all South Africans in 1944 (Sagner, 2000; Legido-Quigley, 2003). In the early 1990s, after the abolition of apartheid, the programme was restructured in order to secure equal access and the same quality of service for all South Africans (Legido-Quigley, 2003). Even though the pension grant system is means-tested, it is almost universal for the black population as more than 90 percent of elderly blacks have access to it and only 16 percent of elderly whites receive a pension grant (Ferreira, 2000).

Despite the fact that the pension grant is meant for the elderly, it is usually shared between the recipient and members of his or her family/household (Ferreira, 2000; Sagner, 2000; HAI, 2003b). Considerable research has shown that pensions help alleviate poverty among the elderly and members of family/household (Moller and Sotshongaye, 1996; Case and Deaton, 1998; Sagner and Mtati, 1999; Ferreira, Keikelame and Mosaval, 2001; Duflo, 2003). Moller and Sotshongaye (1996) interviewed 50 grandmothers in urban, peri-urban and rural areas of KwaZulu-Natal in late 1995, and found that they regarded their pension as individual, rather family income; however, pension sharing was the norm. Although the amount of the pension was inadequate for family and personal needs, these grandmothers derived pleasure and self-esteem in pension sharing (Moller and Sostshongaye, 1996). The pension grant could, therefore, be considered as a morale booster for the elderly who would have been dependent on others for survival without it.

Pension sharing was also found to be common among elderly Africans in Khayelitsha in Cape Town. According to Sagner and Mtati (1999), even though pension sharing is partly triggered by poverty and unemployment, it is mostly a future-oriented security strategy. Many of the elderly pensioners in the study believe that they will not be helped in times of need if they do not share their pensions with their kin (Sagner and Mtati, 1999). The implication of this belief among pensioners is that elderly people, particular elderly women who are more likely to be vulnerable, will be compelled to share their pensions to their own detriment. There is, therefore, the need for studies to explore how elderly women can share their pensions with their household members without making their lives more difficult financially. However, this is beyond the scope of this present study.

Data from South Africa show that non-contributory pensioner households are more financially stable and also have ―a lower probability of experiencing a decline in living standards‖ over time, than non-pensioner households (HAI, 2003b). In addition, May (2003) found pension payment to be an important safety net for the elderly and their household members in South Africa. In Agincourt, a rural area in South Africa, Schatz and Ogunmefun (2007) found that elderly women view the pension as a grant to the household, not just to themselves as individuals. Most women in their study, when asked ―who is the pension for?‖ answered, ―For me and my grandchildren‖. Having access to a pension may, therefore, enable the elderly to share their resource(s) with household members, in particular, their grandchildren. It may, however, cause an increase in dependence on the elderly or an increase in household size because of a need to rely on pensions or other government grants, such as the child support grant and the disability grant. These grants are sometimes, the most reliable income a household has.

Elderly women, in particular those that have adult children that are dying or have died of HIV/AIDS, may use their pension in a way that reduces the economic impact of HIV/AIDS. In addition, their pension is used to deal with the economic burden of increased dependency of family members, e.g. orphaned and fostered grandchildren. The pension grant may also help them to recover from this financial strain and the impact of the epidemic. Despite the high prevalence rate of HIV/AIDS in South Africa, not much empirical work has been done to explore how old-age pension reduces the socio-economic impact of HIV/AIDS by helping elderly women to recover after they experience adult mortality in their households. This

study, therefore, examines not only how pensioners use their pensions to cope with the socio- economic impact of adult HIV/AIDS related illness and death in their households, but also how their pensions help them to recover afterward.

One shortcoming of much of the research on HIV/AIDS and the elderly, internationally and in South Africa, is the focus on those aged 60 years and above. This is because most studies focus on the elderly and their pension status and, since people become eligible for pensions as from ages 60/65 or 70 in most countries (HAI, 2004c), there is a tendency for studies to consider only those aged 60 years and above as elderly. In many African societies, however, the title ―older person‖ (or elderly person) is dictated by one‘s role in the community or family/household, for example, a person that has a grandchild is usually regarded as elderly regardless of chronological age (WHO, 2002a; Hunter and May, 2004). As women are more likely than men to attain parenthood at an early age, many are already grandmothers by age 50. Thus, women aged 50-59 years, who are also regarded as elderly in some societies, are likely to face the same challenges, such as caregiving to sick adult children and grandchildren, as their older peers, but they may be more vulnerable since they are non- pensioners. As a result of the limited research conducted on near-old women, this study attempts to fill this gap by focusing on elderly women aged 50-59 years and compares their experiences of adult HIV/AIDS related illness and death to those of their older counterparts who are above the age of 60 years.

Sometimes, the extent of the impact of the epidemic on elderly women may be as a result of the responses of people to the disease. The following section focuses on another impact of

HIV/AIDS which is mostly due to the responses of the people in a community towards those who are infected and affected, that is,HIV/AIDS related stigma.