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An Evaluation of the MoH/NGO Home Care Programme for People with HIV/AIDS in CambodiaKey Recommendations from the evaluation for improving andexpanding the programme are summarised below:Home Care NetworkIt is recommended that:• MoH includes drugs used in Home CareKits in the Essential Drugs list• The Home Care Network Group becomesan autonomous unit with its ownresources in order to ensure co-ordinationof technical support, improve linkswith other initiatives and facilitate monitoring.• The Municipal Health Department AIDSOffice begins to assume responsibilityfor co-ordinating the Home CareNetwork in Phnom Penh• Central Medical Stores initiates steps toprovide drugs for Home Care Kitsthrough Health Centres• The Home Care Network Group initiatesa discussion on the criteria for homecare provision of prophylactic Bactrim toHIV patients in Cambodia, ensuring thatthere are clear guidelines for selectionand monitoring of patients.• Because of its capacity and presentinvolvement in the programme, KHANAis approached to provide technical andfinancial support to facilitate the expansionand relocation of the Home CareNetwork GroupHome Care ActivitiesIt is recommended that:• The Home Care Network Group initiatesa review process to clarify and agreestrategic priorities for home care activitiesand to rationalise the roles andresponsibilities of the home care teams• The Home Care Network Group reviewswith the HCTs the system of monitoringand reporting patient numbers and teamactivitiesReferrals, Supervision and TrainingIt is recommended that:• The Home Care Network Group strengthensthe hospital referral system by reinstatingthe system of attaching each ofthe HCTs to one of the main referral hospitalsin Phnom Penh.• Referral hospitals provide supportivesupervision to attached HCTs.Supervisors must be resourced andtrained in facilitative supervision• The HCNG implements a schedule ofongoing refresher training and orientationsto deal with emerging issues facingHCTs. KHANA, NGOs, MoH and otherministries could act as resources withfunding and support through the HomeCare Networkpg 6
EXECUTIVESUMMARY• The draft training pack used in initialtraining is updated and developed into atraining resource pack for use when thehome care programme is expanded• The AIDS Care Handbook is translatedinto English and 1000 copies are printedfor distribution to NGOs/IOs• Pictures from the Home Care Stories areincorporated into a flipchart for teachingpurposes by <strong>org</strong>anisations working inthe field of AIDS care.• A module on "Managing ClientExpectations" is included as part of theongoing counselling training provided toHCTsProgramme ExpansionIt is recommended that:• MoH/NCHADS takes the main co-ordinatingrole in expanding the home care programmein Cambodia• NCHADS and partners ensure that keycomponents of the home care modelare incorporated when expanding theprogramme to the Provinces.• NCHADS and partners examine thecost-benefits of different models forexpansion. Adapting the current modelto improve cost-effectiveness in ruralareas should be seriously considered.Volunteer ExpansionIt is recommended that:• MoH/NCHADS and partners supportMoH/NGO Home Care Network Groupsto co-ordinate activity at Provincial level.• The Home Care Teams expand andstrengthen Volunteer involvement in theHome Care programme in Phnom Penhand the Provinces• The maximum number of Volunteers perteam is increased from five to ten andVolunteers are encouraged not to workmore than 10 days per month• Volunteers begin to assume more of thesocial support responsibilities of homecare provision, in addition to many of thenon-patient-related activities• Donors explore the possibility of trialinga sub-sector-wide approach to fundingthe home care programme in Cambodia* The Alliance increases its financialsupport to KHANA for building localNGO capacity, and maintains its presentlevel of technical support• The Alliance considers using theCambodian Home Care Model in otherAIDS care programmes that they support.• The HCTs review and upgrade the skillsof the Volunteers, to enable some toprovide basic counselling to PLHA andto support peer counselling by PLHApg 7
Page 1 and 2: An Evaluation of the MoH/NGOHome Ca
Page 3 and 4: CONTENTSipg 1pg 2Abbreviations and
Page 5 and 6: CONTENTSpg 626 Battambang pilot6.1
Page 7 and 8: ACKNOWLEDGEMENTSThis evaluation cou
Page 9 and 10: EXECUTIVESUMMAR YImpactThe findings
Page 11: EXECUTIVESUMMAR YKey ComponentsThe
Page 15 and 16: BACKGROUNDConcepts of Home-Based Ca
Page 17 and 18: BACKGROUNDavailable, there is a str
Page 19 and 20: BACKGROUNDgiven the opportunity to
Page 21 and 22: EVALUATION DESIGNAND METHODOLOGYDes
Page 23 and 24: EVALUATION DESIGNAND METHODOLOGYBat
Page 25 and 26: EVALUATION DESIGNAND METHODOLOGYtho
Page 27 and 28: EVALUATION DESIGNAND METHODOLOGYwit
Page 29 and 30: IMPACTPeople Living with HIV/AIDS (
Page 31 and 32: IMPACTWhen asked (in an open-ended
Page 33 and 34: IMPACTThe community leaders were un
Page 35 and 36: IMPACTFor the 34% who acknowledge t
Page 37 and 38: IMPACT3.5.1 Access/coverageWithout
Page 39 and 40: COSTANALYSISMethods and Results 4.2
Page 41 and 42: COSTANALYSISCost Implications for H
Page 43 and 44: COSTANALYSISof Health study 37 on t
Page 45 and 46: COSTANALYSISLimitations of the Cost
Page 47 and 48: INPUTSAND PROCESSthe monthly HCT re
Page 49 and 50: INPUTSAND PROCESSIn recommending th
Page 51 and 52: INPUTSAND PROCESSIt is recommended
Page 53 and 54: INPUTSAND PROCESSEach HCT splits in
Page 55 and 56: INPUTSAND PROCESSand the feeling pr
Page 57 and 58: INPUTSAND PROCESSconsiderably, and
Page 59 and 60: INPUTSAND PROCESSEach of the referr
Page 61 and 62: INPUTSAND PROCESSIt is recommended
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INPUTSAND PROCESSto their partner H
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INPUTSAND PROCESSstipend of $20 per
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INPUTSAND PROCESSCaring for the Car
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BATTAMBANGPILOT PROJECTlonger-stand
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BATTAMBANGPILOT PROJECTremaining 88
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EXPANSIONOF THE HOME CARE PROGRAMME
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8 SUMMARY OF KEYCOMPONENTS, LESSONS
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SUMMAR Y OF KEY COMPONENTS,LESSONS
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APPENDICESpg 79
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APPENDIX1a4. a) How often do they v
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APPENDIX1a10. If you didn't have Ho
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APPENDIX1a22. What other material a
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APPENDIX1b9. What difference (if an
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APPENDIX1c• What are your estimat
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An Evaluation of the MoH/NGO Home C
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