Background: Equitable access to health care is a challenge in many low-income countries. The most vulnerable
segments of any population face increased challenges, as their vulnerability amplifies problems of the general
population. This implies a heavy burden on informal care-givers in their immediate and extended households.
However, research falls short of explaining the particular challenges experienced by these individuals and
households. To build an evidence base from the ground, we present a single case study to explore and understand
the individual experience, to honour what is distinctive about the story, but also to use the individual story to raise
questions about the larger context.
Methods: We use a single qualitative case study approach to provide an in-depth, contextual and household
perspective on barriers, facilitators, and consequences of care provided to persons with disability and HIV.
Results: The results from this study emphasise the burden that caring for an HIV positive and disabled family
member places on an already impoverished household, and the need for support, not just for the HIV positive and
disabled person, but for the entire household.
Conclusions: Disability and HIV do not only affect the individual, but the whole household, immediate and
extended. It is crucial to consider the interconnectedness of the challenges faced by an individual and a household.
Issues of health (physical and mental), disability, employment, education, infrastructure (transport/terrain) and
poverty are all related and interconnected, and should be addressed as a whole in order to secure equity in health.
Keywords: Disability, HIV, Care, Household, Malawi