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An Evaluation of the MoH/NGO Home Care Programme for People with HIV/AIDS in Cambodia• Achieving the right balance of skills,experience and gender within a team andfostering team support and collaborationare important inputs in setting up thehome care programme• Comprehensive training for the HCTs, usingparticipatory approaches where appropriate,is essential preparation for initiatinga home care programme• Supportive supervision is a key componentof the home care programme and is highlyvalued by the home care teams• Volunteers play a number of important rolesin the home care programme and are likelyto be a key component in the expansionprogramme• Strong NGO/government partnerships haveenabled scarce resources to be shared, andhave ensured that the comparative advantagesof each of the players have beeneffectively utilised• Support from community leaders is animportant factor contributing to thesuccessful implementation of the workof the HCTs• Participatory reviews and responsivemanagement have played an importantrole in helping to shape and guide thehome care programme.8.3 Recommendationspg 76Home Care NetworkIt is recommended that:• The Home Care Network group becomesan autonomous unit with its own resourcesand financial support in order to ensureco-ordination of technical support, improvelinks with other initiatives and facilitatemonitoring.• The Municipal Health Department AIDSOffice begins to assume responsibility forco-ordinating the Home Care Network inPhnom Penh• 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 Group• The HCNG seeks technical support tofacilitate the process of establishing animpact monitoring system for the homecare programme, including developingappropriate indicators• The Home Care Network Group addressesthe concerns of HCTs related to health andsafety at work• <strong>org</strong>anisations wishing to provide homebasedcare are federated to the HomeCare Network• CENAT is included in the list of collaboratinginstitutions of the Home Care Network• a representative from the Home CareNetwork Group is invited to be on theHIV/TB working group chaired by NCHADS• HCNG identifies and supports CommunityLiaison Officers to improve and expandlinks between HCTs and community-basedwelfare and support activities
SUMMAR Y OF KEY COMPONENTS,LESSONS LEARNED AND RECOMMENDATIONSHome Care ActivitiesIt is recommended that:• The Home Care Network Group initiates areview process to clarify and agree strategicpriorities for home care activities and torationalise the roles and responsibilities ofthe home care teams• Home Care Teams (HCTs) should onlyprovide money to PLHA against specificcriteria which are agreed in consultationwith the Home Care Network• The Home Care Network Group reviewswith the HCTs the system of monitoringand reporting patient numbers and teamactivities• MoH includes drugs used in Home CareKits in the Essential Drugs list• Central Medical Stores initiates steps toprovide drugs for Home Care Kits throughHealth Centres• Home Care Network Group reviews the criteriaand rationalises the process of prescribingmedicines to patients.• The Home Care Network Group reviews thecriteria for home care provision of prophylacticBactrim to HIV patients in Cambodia,ensuring that there are clear guidelines forselection and monitoring of patients.Referrals, Supervision and TrainingIt is recommended that:• The HCNG strengthens the hospital referralsystem by reinstating the system of attachingeach of the HCTs to one of the main referralhospitals in Phnom Penh. The designatedhospital would then assume responsibilityfor medical supervision and facilitate referralsfor their partner HCTs• Home-based Care activities are further integratedinto the programme of work of HealthCentres in Phnom Penh and ReferralHospitals in the Provinces• Referral hospitals provide supportivesupervision to attached HCTs. Supervisorsmust be resourced and trained in facilitativesupervision• The Home Care Network identifies andresources a pool of supervisors fromgovernment and NGOs to provide facilitativesupervision to the HCTs• The Home Care Network Group reviews andstrengthens the system of record keeping,planning and prioritising visits to patients• The Home Care Network implements aschedule of ongoing refresher training andorientations to deal with emerging issuesfacing HCTs. KHANA, NGOs, MoH andother ministries could act as resourceswith funding and support through theHome Care Network• The draft training pack used in initial trainingis updated and developed into a trainingresource pack for use when the home careprogramme 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 in thefield of AIDS care.• Module on "Managing Client Expectations" isincluded as part of the ongoing counsellingtraining provided to HCTsVolunteer ExpansionIt is recommended that:• The Home Care Teams expand andstrengthen Volunteer involvement in thehome care programme in Phnom Penhand the Provincespg 77
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An Evaluation of the MoH/NGOHome Ca
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CONTENTSipg 1pg 2Abbreviations and
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CONTENTSpg 626 Battambang pilot6.1
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ACKNOWLEDGEMENTSThis evaluation cou
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EXECUTIVESUMMAR YImpactThe findings
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EXECUTIVESUMMAR YKey ComponentsThe
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EXECUTIVESUMMARY• The draft train
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BACKGROUNDConcepts of Home-Based Ca
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BACKGROUNDavailable, there is a str
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BACKGROUNDgiven the opportunity to
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EVALUATION DESIGNAND METHODOLOGYDes
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EVALUATION DESIGNAND METHODOLOGYBat
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EVALUATION DESIGNAND METHODOLOGYtho
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EVALUATION DESIGNAND METHODOLOGYwit
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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
Page 71 and 72: BATTAMBANGPILOT PROJECTremaining 88
Page 73 and 74: EXPANSIONOF THE HOME CARE PROGRAMME
Page 81: 8 SUMMARY OF KEYCOMPONENTS, 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
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