“Unseen” Caregivers: The disproportionate gender balance and role of females in the home-based care of lymphatic filariasis patients in Malawi.

Objective: This study examines the gender of home-based caregivers for people affected by lymphatic filariasis (LF) lymphoedema.

Methods: In total, 69 LF lymphoedema cases in Malawi were questioned about the assistance they received with a focus on the gender of the caregiver and the type of support provided.

Results: Of the 35 cases who required daily assistance, 27 indicated the gender of the caregiver, of which 20 were female (74.1%), and most commonly daughters, sisters or school-aged girls. This care was usually only provided during episodes of painful disabling acute-dermatolymphangioadenitis (ADLA) attacks. The males who provided care were most commonly husbands.

Conclusion: The role of female caregivers is ‘unseen’ and this has considerable domestic, educational and economic implications. This gender imbalance also poses barriers to Goal 5 of the Sustainable Development Goals, specifically Target 5.4 that aims to recognize and value unpaid care and domestic work.