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ARVs and other drugs foropportunistic infections, as well asother condition medication.Sustainability of the drug supplyensures that the client will not haveunplanned treatment interruption.Clinical care also helps to promotepositive living and prevent infectionand re-infection. Another importantcomponent of care for people livingwith HIV in the community is instillingawareness of the need to seektreatment in case of any ailments nomatter how minor.3.1.3 Family Care and SupportCare services must extend to thefamily in addition to the individualpatient/client and other caregivers.This element includes psychosocialsupport, reproductive health services,nutrition advice and food security forthe family.3.1.4 Capacity BuildingHCBC capacity building targets thevarious cadres at all levels of serviceand care provision. Training for healthcare professionals varies from shortcourses to diploma and degree levelsin HCBC. Once trained, theseprofessionals in turn train others atthe health facility and community levelusing the NASCOP curriculum. Sincelevel 1 (the community) of KEPH isconsidered to have the largestnumber of service providers, bothformal and on-the-job trainingapproaches should be used toaddress knowledge and skill gaps. Acrucial point here is the necessity forquality training by NASCOPaccredited trainers for all levels andcadres of HCBC personnel.3.1.5 Establishing Linkage, Referraland Networking SystemsKnowing where to go for additionalhelp is key to maintaining acomprehensive continuum of care. Acontinuum of care is a system thatinvolves a network of resources andservices that provide holistic andcomprehensive support for the sickperson, family and caregivers. Thegoal is to provide an affordable rangeof services in various settings, fromhome, community and clinics tohospitals, and vice versa. (See alsoSection 4.5.)3.2 Monitoring and Evaluationof the Minimum HCBCPackageAn effective working M&Esystem will have appropriatestructures in place that includeM&E literate staff, a good networkand linkages, and standard reportingprocedures, formats and tools. M&Econstitutes a system for keepingactivities on track towards achievingthe goals of the HCBC programme.M&E should be carried out for allprogrammes implementing HCBC atall levels, from the centre to thecommunity. The results should beshared among partners and the bestpractices replicated amongimplementing programmes. (Refer toChapter 6 for more details.)12 HOME- AND COMMUNITY-BASED CARE IMPLEMENTATION FRAMEWORK
4 HCBC ImplementationStrategiesStrong support strategies arenecessary to strengthen theimplementation of thenational HCBC model aimedat providing a high quality continuumof care. Among the systems that needstrengthening are administration,supervision, monitoring andevaluation, and quality assurance andaccreditation. Others are leadership,coordination, integration of services,logistics and supplies, referral,linkages, and networking at alladministrative and health care levels.Maintaining the optimal number andquality of staff is essential.Concerted action to strengthenthe administrative and health carelevels from the national, regional,provincial, district and division levels,to the community, will ensure a strongand sustainable system that supportsthe individual and affected family. Thislinks directly with the KEPH, whichfocuses on strengthening systemsright from the lowest level of serviceprovision.The following sections summarizeactions needed to strengthen HCBCsystems.4.1 Systems StrengtheningHealth systems consist of allpeople and actions whoseprimary purpose is to promote,restore or maintain health. Thesesystems may be integrated andcentrally directed, or more looselyconnected. They consist of:• Formal health services.• Traditional medicine.• All use of medication whetherprescribed by a provider or not.• Home care of the sick.• Health enhancing interventionslike disease prevention,environmental sanitation, roadsafety.4.1.1 National Level Actions• Develop and review policyguidelines and training curricula.• Facilitate relevant training for staff.• Formulate and review HCBCstrategy.HCBC Implementation Strategies13
Page 1 and 2: Republic of KenyaMinistry of Health
Page 3 and 4: Republic of KenyaHOME- AND COMMUNIT
Page 5 and 6: ContentsList of Abbreviations and A
Page 7 and 8: Abbreviations and AcronymsACKAIDSAO
Page 9 and 10: ForewordThe preparation of this Hom
Page 11 and 12: Executive SummaryThis document desc
Page 13 and 14: 1 IntroductionServices for the care
Page 15 and 16: All partners implementing HCBCprogr
Page 17 and 18: 2.1.3 Palliative Care, Pain Relief
Page 19 and 20: should therefore take intoconsidera
Page 21 and 22: harmonize a database of servicesava
Page 23: 3 Minimum Package of CareEnsuring t
Page 27 and 28: A healthy community iseverybody’s
Page 29 and 30: 4.5 Linkages, Referral Systemand Ne
Page 31 and 32: administrative levels, the lowest o
Page 33 and 34: • Determine the availability ofre
Page 35 and 36: compile data for onward flow toNASC
Page 37 and 38: Annex B:Additional Reading1. Nation
Page 39 and 40: Annex C: Standard MinimumHCBC Kit C
Page 41 and 42: Notes______________________________
Page 43 and 44: ”-”-”-”-”-”-”--”-

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