PDF File - hivpolicy.org

More documents

Recommendations

Info

An Evaluation of the MoH/NGO Home Care Programme for People with HIV/AIDS in CambodiaIt is believed however, that there is a case forupgrading skills in clinical diagnosis of commonconditions related to HIV/AIDS. It is to thecredit of the home care team staff that theyrecognise the need for better diagnostic skills,especially in a country where the prevailingmedical ethos does not encourage sharingdiagnosis with patients, and where selfprescriptionand treatment without diagnosisis common.It is also felt that HCT staff should continueto receive ongoing refresher training in treatmentregimes to enable them to deal with issuesand answer questions from patients aboutmedication, side effects, etc. A case studyapproach could be used to address individualissues as they arise.It is evident that, with the increase in theAIDS epidemic and the widening profiles ofPLHA, the HCTs will continue to face new issuesand challenges. One issue which emergedduring this evaluation is the increasing numberof pregnant women who are HIV+ and who donot wish to continue the pregnancy. A secondchallenge, which is becoming increasinglyprevalent, is the number of children, many ofwhom are themselves HIV+, who have become,or who will soon become orphaned because ofAIDS-related deaths.It is recommended that the Home CareNetwork assumes responsibility for establishingand implementing a system of ongoing refreshertraining and orientations to deal with theseemerging issues. Some training can beconducted on-the-job, while other issues canbe dealt with during short workshops. It isbelieved that the Home Care Network can drawon existing skills and resources available inCambodia, and it is suggested that KHANA,MoH, NGOs, and other ministries could play amajor role in resourcing this.It is recommended that the Home CareNetwork implements a schedule of ongoingrefresher training and orientations to dealwith emerging issues facing HCTs. KHANA,MoH, NGOs and other ministries could act asresources with funding and support throughthe Home Care Network.5.4 Home Care ActivitiesObservations and interviews conducted duringthis evaluation confirmed findings from a previousreview, that approximately 80% of the HCT'stime is spent in contact with patients and families,including local travel to visit the patients.The remaining 20% of the time of the HCTs isspent on activities which are not directly relatedto patients. These activities include liaison withcommunity leaders, monks, health centres andhospitals, participating in NGO and homecareteam meetings, community-based IEC activities,identifying and establishing links with othercommunity-based initiatives, etc.The majority of the patient contact time takesplace in the patient's own living environment.Sometimes this is a permanent dwelling, but sincethe majority of the home care patients are extremelypoor, the living environment is often a squattersettlement, a temporary shelter or a tarpaulin.Occasionally, patients visit the team at the healthcentre, and sometimes team members accompanypatients to hospitals or testing centres.pg 46
INPUTSAND PROCESSEach HCT splits into two groups of 2 staff,and patients are visited by one of the groups anaverage of 3 times per month. The contact timewith patients and families is devoted to providingthe four main components of home care:• Clinical Management to improve thephysical well-being of patients. Thisincludes taking patients to hospital andtesting centres, providing rational treatmentof HIV-related illnesses using thehome care kit, where appropriate, andproviding follow-up care.• Nursing Care and health education topatients and care-givers to promote andmaintain hygiene, nutrition and infectioncontrol, and providing palliative andterminal care to PLHA• Counselling, including psychosocialsupport to PLHA and their families, toimprove the emotional well being ofpatients and families by reducing stressand anxiety and promoting positiveliving and risk reduction strategies• Social Support, including materialassistance, providing education &information, strengthening links withthe community, and referral to supportgroups and services in order to improvethe social well-being of patients andfamilies.Monthly Visits - Phnom PenhFigure 5pg 47
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 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: INPUTSAND PROCESSIt is recommended
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
Page 93 and 94: 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
Page 103 and 104:
An Evaluation of the MoH/NGO Home C
Page 105 and 106:
An Evaluation of the MoH/NGO Home C
show all

PDF File - hivpolicy.org

Create successful ePaper yourself

Delete template?

Save as template?