THE IMPACT OF COMMUNITY HOME-BASED CARE ON HIV/AIDSPATIENTS AND THEIR FAMILIES HOPE FOR THE HELPLESS.

The ACTION project has a multi-disciplinary team in the health facilities for provision of comprehensive treatment, care and support to HIV/AIDS patients, One of such is the Home based care.

Home-based care service was introduced into the IHVN ACTION project to complement the efforts of health professionals and strengthen care and support for the infected and affected in their communities.

Home-based care is the provision of health services by formal and informal care givers in clients’ home in order to promote, restore and maintain a person’s maximum level of comfort, function and health.

APPROACH:

Advocacy to policy and community leaders on HIV / AIDS epidemic is paramount to gain their support for a successful program implementation. Community leaders are intimated on the benefits of the program and requested to nominate volunteers who can give in their time to support the program.

Composition of volunteers are drawn from facility, the community and People living with HIV (strong enough to participate in activities), also serve as role models to encourage other PLWHA.

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The health care providers co- opted in the team from the facility serve as a link to register sick clients who wish to be visited at home; they also provide technical assistance on health related issues to the volunteers.

These volunteers undergo six days intensive training to equip them with knowledge and skills in HIV/AIDS care such as basic nursing care, drug adherence, psychosocial counseling, and nutritional support.

Volunteers are trained to conduct various activities such as:

Home visit to the client for:

• Palliative/Basic nursing care

• Psychosocial and spiritual support

• Adherence support

• Assist with activities of daily living

• Use HBC kit for basic care

• Educate relatives and friends on care for PLHA/OVCs

• Identify care giver for OVC

• Counsel and refer relatives / friends for HCT and psychosocial support.

• Link and collaborate with other CBOs/NGOs for other services

• Conduct ongoing community sensitization for HIV/AIDS prevention/stigma reduction and behavior change for positive living

• Follow up clients who missed their appointments (loss to follow up/poor adherence) and refer cases back to care

• Mobilize communities for ongoing mobile HCT in collaboration with Counselors/Lab team.

• HIV/AIDS awareness creation to various groups and referral of persons for counseling / testing

The HBC services had a humble beginning, with only a few clients as many were afraid they’ll be stigmatized by neighbors and other family members. This number has grown tremendously; services have continued to expand as volunteers now identify more patients in need of care through aggressive community mobilization, serve as buddy for community adherence and refer sick persons to hospital.

To enhance their impact the HBC nurses and trained Volunteers conduct HIV counseling and testing in the community and at homes. The linkage between the community and the hospital has been strengthened through the services of the HBC team. The utilization of volunteers has made it possible for smooth transition and effective provision of palliative care from the facility into the community thus enhancing the proverbial adage that “human beings are their brothers’ keepers”. The community involvement and support has been overwhelming to the surprise of both clients and care providers. They have mobilized additional resources e.g. funds and food items to assist clients. They utilize radio programs and other modes of communication to create awareness about HIV and services available for those infected and affected.

The ongoing HIV/ AIDS sensitization to communities and in the media is gradually changing the attitude of individuals. Family and community members are informed on HIV/AIDS to care for their loved ones, which has tremendously reduced stigma, people, can now talk about HIV, and opt for HCT, treatment and care.

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Despite the effort from CHBC volunteers, some challenges abound, like need for increased funding support and transportation assistance especially to hard to reach areas as their client load grows. But the benefits are encouraging and keep them motivated.