Title: The Uncompensated Workforce: A Critical Analysis of the Experiences and Challenges of Informal Caregivers in Zambia

Abstract

Introduction: The growing burden of Alzheimer’s disease and related dementias in low- and middle-income countries (LMICs) has significant implications for health systems, household economies and social protection frameworks. In Zambia, long-term care is largely delivered through community- and home-based models, resulting in a heavy reliance on informal caregivers. Despite their central role in sustaining care provision, informal caregivers remain economically invisible and largely uncompensated in national health and labour systems.

Methodology: This article analyses the experiences and challenges faced by caregivers of individuals living with Alzheimer’s disease in Zambia. Using a qualitative descriptive approach based on secondary data analysis, this study synthesises evidence from peer-reviewed literature, policy documents, and regional caregiving research to situate caregiving within the broader Sub-Saharan African care burden context.

Results: The findings indicate that the caregiver burden is multidimensional. Physically, caregivers often operate under conditions of infrastructural deprivation, including limited access to water, sanitation, and assistive care technology. Economically, caregiving contributes to financial strain through direct medical costs, income loss, and depletion of household assets. Caregivers experience stigma, isolation, and chronic stress.

Conclusion: The study concludes that informal caregiving represents essential but unpaid health labour in Zambia. Greater policy recognition, financial protection mechanisms, and integration of caregivers into health system planning are required to ensure the sustainability of long-term care.