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An Evaluation of the MoH/NGO Home Care Programme for People with HIV/AIDS in Cambodiaand impact, and includes appropriate indicators,will be an essential component of an expandedhome care programme. Identifying appropriatetechnical resources will be a necessary first stepin establishing an impact monitoring system.7.1.8 Establishment of a supportivesystem of medical and managementsupervisionGood supervision has been shown to be akey factor in the provision of quality services,and yet is often the missing link in service deliveryprogrammes. The findings of this evaluationdemonstrate the importance of, and demand fora supportive supervisory system to address themanagement and medical needs of theproviders of home-based care.A supportive supervisory structure will beparticularly important in the rural areas wherelong distances between centres and villages arelikely to result in greater isolation of home careproviders from resource centres7.1.9 A well-resourced and supportiveHome Care NetworkThe evaluation notes that the establishmentand maintenance of the Home CareNetwork in Phnom Penh has been critical inhelping to ensure co-ordination of support,improve linkages and assist the programme tobetter meet the increasing demands forimproved care and support at low cost.The establishment of similar Home CareNetworks at Provincial level will be beneficialto help manage and co-ordinate the expansionof home care activities in the provinces.They are likely to play an important part inco-ordinating activities, avoiding duplicationand ensuring co-ordination of technicalsupport and training, establishing andmaintaining links with other initiatives andinstitutions and facilitating monitoring ofprocess, outputs and impact.7.2 Expansion ModelsAlthough the home care model described in thisreport works efficiently and cost-effectively inPhnom Penh, there are dangers in simply transferringthe model wholesale to the Provinces. Theprevious section highlighted the key componentswhich contribute to the success of the model,and which should be replicated in the expansion.However, one major difference betweenPhnom Penh and most of the Provinces, is thelarge distance between villages, health centresand hospitals, and between the villages themselves.As shown by the Battambang pilot,using professional HCTs with the same cadresof staff as in Phnom Penh to visit patients in outlyingvillages is neither efficient nor cost-effective.It is estimated (see section 6.6 of thisreport) that the existing model in Battambang isonly providing between 10-15% coverage inthe district.Furthermore, cost estimates discussed earlierin the report (section 4.4.3) indicate that thecost of providing services in rural areas usingpg 70