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An Evaluation of the MoH/NGO Home Care Programme for People with HIV/AIDS in Cambodia3.3.3 Community MobilisationIt was evident that the HCTs had been influentialin encouraging neighbours to provideencouragement and a little food and support toPLHA. However, the community leaders feltthat there was little evidence of systematiccommunity mobilisation to support PLHA beinginitiated by the HCTs, and felt that this shouldbe a future role of the home care programme.They suggested that volunteers, with appropriatesupport from the HCTs, could play a majorrole in identifying and f<strong>org</strong>ing links with existingcommunity resources.3.4ChildrenChildren affected by AIDS are at the extremeend of the spectrum of vulnerability. As thesickness of the parent(s) progresses, the effecton the lives of their children is often drastic.They may have to leave school to care for theirparents, and/or may have to start work. Somemay have to leave home, even before the deathof one or both parents. Discussions with HCTsreveal that dealing with issues related tochildren is becoming an increasing part oftheir workload.Although children were not a major focus ofthis evaluation, a short section of the questionnairefor PLHA was devoted to this issue. Of the100 PLHA interviewed, 67 had children in thefamily. The findings outlined below refer to these67 families.• In 21% of the families, children havehad to start working since the patientbecame sick.• In 30% of the families, the children havehad to provide care, or take up majoradditional household duties.• 40% of the children have had to leaveschool, or take significant periods awayfrom school.• 40% of the families said that since thepatient became sick, the children havehad to go without certain things (food,clothes, books etc).• In 28% of the families, one or more childrenhave had to leave home.The 67 families were asked if participating inthe home care programme had resulted in anychanges for the children in the household. 34%clearly stated that the home care programmehas directly improved the quality of life of childrenin their families. Note that this should notbe interpreted as meaning that 66% feel that theprogramme has had no effect on the quality oflife of the children. It is often difficult (especiallyin an interview situation) to spontaneously makecausal connections, for example linking homecare provision to improved health of parent andimproved capacity of family to provide care, toreduced burden on children, resulting onimproved quality of life of the children.pg 28
IMPACTFor the 34% who acknowledge these causalconnections, the time spent by the HCTs inproviding care and welfare support is felt to beimportant in releasing children from some of theburden of care. The provision of money helps tobuy clothes for the children and pay for schooling,while the provision of medicines helps toimprove health and well-being of the parent,enabling them to devote energy to caring for thechildren. Finally, psychosocial support helpsfoster more positive attitude about the future."The Home Care Team help me continue with mybusiness of selling food; before (they started visiting),I couldn't even get out of bed. Without (the HCT) mychildren would have to leave school to look after me."[widow; age 36; Tonlé Bassac]Health System 3.5Over 2000 families have been visited duringthe 2 years of the project. The total caseload ofthe ten Home Care Teams is now around 800each month.Patient NumbersMarch 1999 - February 2000Figure 1pg 29
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 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: IMPACTThe community leaders were un
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
Page 71 and 72: BATTAMBANGPILOT PROJECTremaining 88
Page 73 and 74: EXPANSIONOF THE HOME CARE PROGRAMME
Page 81 and 82: 8 SUMMARY OF KEYCOMPONENTS, LESSONS
Page 83 and 84: SUMMAR Y OF KEY COMPONENTS,LESSONS
Page 85 and 86:
APPENDICESpg 79
Page 87 and 88:
APPENDIX1a4. a) How often do they v
Page 89 and 90:
APPENDIX1a10. If you didn't have Ho
Page 91 and 92:
APPENDIX1a22. What other material a
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APPENDIX1b9. What difference (if an
Page 95 and 96:
APPENDIX1c• What are your estimat
Page 97 and 98:
An Evaluation of the MoH/NGO Home C
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