Browse by Subject

Low uptake of voluntary HIV counselling and testing (VCT) in sub-Saharan Africa is raising acceptability concerns which might be associated with ways by which it is offered. This study investigated the acceptability of home-based delivery of counselling and HIV testing in urban and rural populations in Zambia where VCT has been offered mostly from local clinics. [from abstract]

Identification of new ways to increase access to antiretroviral therapy in Africa is an urgent priority. We assessed whether home-based HIV care was as effective as facility-based care. [from summary]

A program to create a cadre of skilled birth attendants for home births was launched by the Government of Bangladesh Bangladesh in 2004. This article suggests that the task-shifting program can only serve as an interim measure rather than a long-term solution as more women decide to seek institutional delivery and professional midwifery care. [adapted from abstract]

This paper discusses the role and impact of community health workers in Nyanza Province, Kenya, in response to the growing demands the HIV epidemic has placed on the people and communities in this region. [adapted from abstract]

This paper aims to discuss the challenges influencing the state of caregiving in the Kanye community home-based care programme in Botswana. [from abstract]

In Zimbabwe, as in many parts of sub-Saharan Africa, home-based care (HBC) plays a vital role in the response to HIV as overwhelmed public health and welfare systems fail to cope with the demands of the epidemic. This document details a project designed to contribute to better understanding and evidence-based decision-making in the implementation of HBC interventions in Zimbabwe and beyond. [adapted from executive summary]

Tanzania’s government has developed various policies and guidelines to address the HIV/AIDS pandemic, including a five-year commitment to provide anti-retroviral therapy to 500,000 Tanzanians. This program faces many HRH-related challenges and constraints. This report discusses the implementation of a home-based care model to support older caregivers for Tanzanians living with HIV/AIDS. [adapted from report]

Demand for home care services has increased considerably, along with the growing complexity of cases and variability among resources and providers. Designing services that guarantee co-ordination and integration for providers and levels of care is of paramount importance. The aim of this study is to determine the effectiveness of a new case-management based, home care delivery model which has been implemented in Andalusia (Spain). [from abstract]

All long-term care agencies struggle to find and keep sufficient, reliable, and skilled staff capable of meeting client needs and providing great quality care. This workbook offers 12 concrete steps to guide agencies in developing excellent recruitment, selection and retention practices

Neonatal mortality accounts for a high proportion of deaths in children under the age of 5 years in Bangladesh. This article describes a project for advancing the health of newborns and mothers implementing a community-based intervention package through government and non-government organisation infrastructures to reduce neonatal mortality. [from abstract]

This study was implemented to develop and evaluate the effectiveness of a home based intervention in reducing caregiver burden, promoting caregiver mental health and reducing behavioural problems in elderly persons with dementia. [from abstract]

The overall objective of this study was to analyse the challenges which family caregivers encountered in home-based care when they tried to access medical treatment for home-based AIDS patients in the context of confidentiality and limited medical care. [from abstract]

The emphasis of the COPHIA program is the provision of home-based care and support services by multi-purpose community-based health workers to vulnerable households in the geographic focus areas that are coping with the burden of caring for seriously ill family members or caring for orphans and vulnerable children. The COPHIA community-based health workers, with the support of clinical and non-clinical supervisors, provide the direct physical and emotional care and support services to PLWHA and orphans and vulnerable children in the project catchment area with the support of trained primary caregivers.

The objective of this research is to explore inequities in utilization of skilled attendance at birth, delivery by caesarean sections and use of postnatal care services, by key socioeconomic factors in two home-based SBA areas of Bangladesh to provide insights for future programming. [from introduction]

Given the limited availability of formal, inpatient programs, households rely upon informal caregivers (e.g. household or family members, friends, community members, or voluntary organizations) and homebased care (HBC) programs for assistance. This summary documents the roles played by household and HBC program caregivers in meeting the needs of the chronically ill.

Many Nigerian children with malaria are treated at home. Treatments are mostly incorrect, due to caregivers’ poor knowledge of appropriate and correct dose of drugs. A comparative study was carried out in two rural health districts in southwest Nigeria to determine the effectiveness of a guideline targeted at caregivers, in the treatment of febrile children using chloroquine. [from abstract]

The general aim of this paper is to add to the limited research on family caregivers, and specifically to enable a better understanding of the actual experience of providing care for ill adults within the home in the context of HIV/AIDS, using qualitative research findings from a KwaZulu-Natal study. [from author]

This case study was conducted to impart a thorough understanding of the Tumaini Home-Based Care Program model and to document lessons learned that could be applied to other initiatives. While the Tumaini program addresses the needs of both people living with HIV and AIDS (PLHA) as well as OVC, the case study focuses particular attention on specific services and program impact for OVC. The program goals were to provide care and support to OVC; to provide care and support to PLHA; Tumaini: Home-Based Care and to build the capacity of local organizations to provide sustainable HBC services. [from

This document provides a systematic framework for establishing and maintaining community home-based care (CHBC) in resource-limited settings for people with HIV/AIDS and those with other chronic or disabling conditions.

Given the very limited health infrastructure and resources and the need to provide a palliative care service to about one percent of the population each year, community and home-based care is viewed as the key to responding to these needs. Some countries have already developed strong home-based care networks in coordination with the PHC system to respond to the HIV/AIDS epidemic. Palliative care, as part of the continuum of care of HIV/AIDS, cancer and other chronic conditions can be integrated into this existing network. [author’s description]

This report outlines information from a literature review and field research pertaining to the key differences and similarities between the hospice ICHC model and other home-based care models used in South Africa; reviews the core elements of the ICHC model; and highlights best practices of the model. [adapted from introduction]

Recent efforts to improve maternal health have focused on skilled attendants and emergency care at health facilities. Skilled birth attendants and access to emergency obstetric care are essential to saving mothers lives. In developing countries, 60 million women give birth at home without skilled care and with high maternal and neonatal mortality. Nearly all essential newborn care can be provided safely, effectively, and at a low cost at the household level. The same is true for care of the mother, and many effective interventions can be implemented at the household and community level that will save mothers’ lives.

It is imperative that we use our limited health care resources as optimally as possible. One of the best ways of doing this is through home-based care and community-based care. These guidelines are intended to assist in the development and implementation of nationwide home-based and community-based care programmes. [from foreword]

This pre-tested and peer-reviewed curriculum focuses on the knowledge and skills necessary for providing holistic CHBC for people living with HIV/AIDS, transferring knowledge and skills to caregivers and CHBC clients, and mobilizing communities around HIV/AIDS prevention, care, treatment, and support. The trainer’s guide includes comprehensive units that cover topics from HIV basics, communication skills, nursing care, nutrition, positive living, family planning, HIV prevention, ART, to community mobilization.

Home-based care (HBC) for HIV/AIDS is increasingly looked to as a more accessible and affordable alternative to more costly inpatient care, both for patients who are unable to travel to or pay for inpatient care as well as for governments that must fund inpatient facilities. Partners for Health Reformplus estimated the cost of HBC for HIV in Rwanda, based on a sample of eight programs offering care in early 2004. The sample comprised facility- and community-based programs. Both types of program implement the medical care recommended in the Ministry of Health guidelines for HBC. [from abstract]

There is a growing acknowledgment of the importance of the continuum of care and support services to people living with HIV/AIDS outside of health facilities. Greater reliance on communities to provide care and support to people living with HIV/AIDS as well as non-complex maintenance and adherence support for treatment of those who are under antiretroviral treatment is seen as a way to alleviate the burden placed on traditional health systems in countries highly affected by HIV/AIDS. This report presents findings from the field-test of the Partners for Health Reformplus guidelines developed for costing home-based care (HBC) programs, with cases drawn from nine HBC programs in Uganda.

The integration of HIV-prevention activities into care has received little attention within or outside formal healthcare settings. The contribution of community home-based care services in facilitating disclosure of HIV status and reducing stigma have also not been described. This study examines the community impact of an integrated community home-based care (ICHC) programme on HIV-prevention efforts and disclosure of status. Quantitative data was collected from 363 people living with HIV (PLHIV) and 1 028 members of their micro-communities. [from abstract]

This study investigates the experiences of informal caregivers of people living with HIV in two semi-rural communities in South Africa. It is argued that a thorough understanding of how home-based care undermines the physical health and psychological wellbeing of already vulnerable women is crucial for informing policies on home-based care. Thus, there is a need to incorporate gender perspectives when planning and implementing home-based care programs. [from abstract]

In order to identify potentially effective models of home-based care (HBC) within which paediatric palliative care could be integrated, and to identify critical aspects requiring strengthening, the NMCF commissioned an in-depth evaluation of three NGOs that have been supported through the Goelama Program. The objectives of the evaluation were: to evaluate the current capacity of the three HBC projects to provide paediatric palliative care as a component of overall HBC - this focused on the overall management of the projects, as well as the competencies of carers to provide both general HBC and palliative care to children; To explore the possibilities for strengthening the provision of paediatric palliative care as an integrated component of HBC; and to explore the role of home-based carers and HBC projects in the provision of ART to children. [author’s description]

Poverty and limited health services in rural Africa present barriers to adherence to antiretroviral therapy that necessitate innovative options other than facility-based methods for delivery and monitoring of such therapy. We assessed adherence to antiretroviral therapy in a cohort of HIV-infected people in a home-based AIDS care programme that provides the therapy and other AIDS care, prevention, and support services in rural Uganda. [author’s description]