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An Evaluation of the MoH/NGO Home Care Programme for People with HIV/AIDS in Cambodia2 EVALUATION DESIGNAND METHODOLOGY2.1Purpose of the evaluationThe International HIV/AIDS Alliance commissionedthe evaluation of the Home Care Modelused by NGO/MoH Partners in Cambodia. Theprimary purpose of the evaluation, which wasagreed in consultation with NCHADS, is toassist Home Care Partners in formulating astrategy to expand and improve care and supportto families affected by HIV/AIDS inCambodia. The evaluation may also be used byother Ministries, NGOs and international donorsto shape national strategy on Home Care. It isintended that the evaluation provides a nationaloverview, which will be supplemented by morelocalised findings from the KHANA Partner NGOParticipatory Reviews in July 2000.The expanded focus on home-based care inthe recent MoH/NCHADS Strategic Plan hasresulted in increased donor interest in this area.The AIDS Care Unit of NCHADS is in theprocess of formulating a strategy for expandingthe Home Care programme to selectedprovinces. It was agreed, in consultation withNCHADS, that the findings of this evaluation willbe used to help guide and shape the expansionstrategy.The evaluation was designed in consultationwith NCHADS, KHANA, Alliance, USAID and theNational Institute of Public Health (NIPH), withinputs from other stakeholders in the programme.The approach of Comprehensive CareAcross the Continuum (outlined earlier in thisreport) provided the theoretical basis for thedesign. Other provisional issues to be evaluatedwere drawn from reviews of other home careprojects and earlier reviews of the Cambodiapilot project, as well as preliminary discussionswith the key stakeholders from government andnon-government agencies.2.2 ObjectivesThe objectives of the evaluation were agreedwith NCHADS and the Alliance, and were verifiedby other key stakeholders. The primaryobjectives are to evaluate:• The impact of the programme in PhnomPenh and Battambang• The cost of the programme and the costsavings to families of people affected byHIV/AIDS who receive Home Care• The key components of the Home CareModel used in Cambodia that need tobe considered in order to successfullyreplicate or scale-up this approach.pg 14
EVALUATION DESIGNAND METHODOLOGYDesign Framework 2.3DATASOURCESIMPACTPROGRAMMECOSTSCOST SAVINGSKEYCOMPONENTS/PROGRAMMESTRENGTHENING& EXPANSIONPatients & familiesCase Studies ofPLHA and families,In-Depth Interviewswith PLHA andcarers, ParticipantObservation ofHome Care visitsCase Studies ofPLHA and families,In-Depth Interviewswith PLHA andfamiliesCase Studies ofPLHA and families,In-Depth Interviewswith PLHA andfamilies, ParticipantObservation ofHome Care visitsCommunityIn-Depth Interviewsand focus groupdiscussionswith communityleaders (PhumLeaders, VillageHeadmen), Monks,Achaa 13In-Depth Interviewsand focus groupdiscussionswith CommunityLeaders (PhumLeaders, VillageHeadmen), Monks,AchaaHome Care TeamsDocument Review,Focus GroupDiscussions withHome Care TeamsDocument ReviewFocus GroupDiscussions,Document reviewDocument Review,Focus GroupDiscussions withHome Care Teams,Attendance atmonthly HomeCare TeamCo-ordinatorsmeetingsVolunteersFocus GroupDiscussionsFocus GroupDiscussionsHealth CentreManagers; HospitalPhysiciansIn-DepthInterviewsIn-DepthInterviewsPartners / OtherStakeholders(NCHADS, MoH, MAO,PAO, PAC, KHANA,Partner NGOs, WOMEN,IDA, KRDA, World Vision,Maryknoll, Servants, FHI,HOPE, MSF, UNAIDS,USAID, WHO, MHD,Key-InformantInterviewsDocumentReviewDocument Review,Key-InformantInterviewsKey-InformantInterviewsKey-InformantInterviewsAttendance atmonthly HomeCare NetworkCo-ordinationmeetings,Document ReviewFrench Co-operation)PLHAnot receivinghomecareIn-Depth Interviewswith PLHA attendinghospital who are notreceiving home careIn-Depth Interviewswith PLHA attendinghospital who are notreceiving home care13 Lay Priestspg 15
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 and 12: EXECUTIVESUMMAR YKey ComponentsThe
Page 13 and 14: EXECUTIVESUMMARY• The draft train
Page 15 and 16: BACKGROUNDConcepts of Home-Based Ca
Page 17 and 18: BACKGROUNDavailable, there is a str
Page 19: BACKGROUNDgiven the opportunity to
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
Page 63 and 64: INPUTSAND PROCESSto their partner H
Page 65 and 66: INPUTSAND PROCESSstipend of $20 per
Page 67 and 68: INPUTSAND PROCESSCaring for the Car
Page 69 and 70: 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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