Community Home Based Care Programme

There is currently much interest nationally and internationally in Home Based Carers, recognising again the value and role of community based workers.  Several health systems around the world acknowledge them as the first tier of the health care system upon which the entire healthcare platform is built and depends.  It is widely acknowledged that many development goals such as TB cure rate, ARV access and improved maternal care will only be reached by a renewed focus on community based workers.  This emphasis on community based workers is also reflected in the National Strategic Plan.

A Home Based Care Volunteer visiting a client

The Community Home Based Care Programme provides healthcare education and care training and support to families of people suffering from chronic diseases, such as HIV/AIDS. 140 Community Volunteers, supervised by Tholulwazi Uzivikele, reach into 45 of the 48 tribal areas in the Manguzi Hospital catchment area.     

Why?
The significant hurdles of access to institutional health care (logistically, economically and in terms of knowledge) means that a large number of mostly chronic care patients need to be cared for at home.  The programme aims to empower community volunteers with supervision and training, as well as systems support and care consumables, contributing to improved health care, strengthening the community’s response to HIV/AIDS, TB, Stroke and other diseases.

Home Based Care Volunteer assisting family member to care for patient with a bedsore

HIV/AIDS imposes a significant care burden on communities.  With an increasing number of orphaned and vulnerable children the need for care is escalating.  The volunteers of the Community Home Based Care Programme assist community carers with the care of orphans, providing a second tier of support to this very vulnerable group.

Home Based Care Volunteers take some of the burden off destitute families and give them the resources, skills and emotional support they need to better care of  themselves and their sick or dying loved ones.  Home Based Carers are empowered with valuable skills and confidence to create positive changes in their community.  Through training and their connection to the community, Home Based Carers provide a compassionate, appropriate and culturally acceptable response to the HIV and AIDS crisis within their community.  



How?
Ideally, Home Based Care Volunteers would train caregivers of sick and dying patients on how to care for them. However, due to the destructive effect of the AIDS epidemic, not every patient has someone who can take care of him or her. The twofold role of the Home Based Care Volunteers is therefore; educating those who take care of sick or dying family members and caring for those who have no one taking care of them.

Below is an overview of what a Home Based Care Volunteer teaches caregivers or what she does herself in case of isolation.

What Home Based Carers do: Basic Hygiene Dealing with simple infections Treating pressure sores Caring for basic diseases and infections Giving bed baths Teach nutrition for HIV+ patients Monitoring ARV side effects Washing, cleaning and feeding patient if patient has no family member to provide care Edcucate patients and their families how to keep themselves free from infection Give emotional support on losing a loved one, death and dying Teach families how to best care for thier loved ones Organise hospital visits for severe cases needing doctors intervention Help dying patients find safe child guardians, settle accounts, wills and funeral arrangements

Referral System

The Community Home Based Care programme also forms the foundation of referral to other Tholulwazi Uzivikele programmes.  Community volunteers have been introduced to the orphans in their respective isigodi, providing support to orphans and vulnerable children.  The volunteers have also recently received training in the work done under the Paralegal Assistance programme, enabling them to assist marginalised people in the community through accurate referral. The referral system serves as a basis for continuation and improvement of all the other programmes of Tholulwazi Uzivikele.

Referrals from the Manguzi Hospital are also received and implemented under this programme. This contributes to discharged patients’ chance of successful rehabilitation, supporting the continuum of care.   

Why?
Home Based Care Volunteers are seen as the eyes and ears of the organisation as they know what happens in the communities. The volunteers are exceptionally suited to provide Tholulwazi Uzivikele with feedback on areas of specific need for future programme design and intervention.

How?
The referral system enhances access to healthcare and social support to marginalized community members, many of whom do not have access to this information, skills or resources. Though paper based, we are currently developing an electronic report system to ensure follow-up.