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  • Title: Battling AIDS through home care in Uganda and Zambia.
    Journal: Caring; 1992 Oct; 11(10):56-70. PubMed ID: 10121240.
    Abstract:
    Innovative home care programs, providing a variety of services to persons with HIV infection and their families and reflecting different health, political, cultural, social, and philosophical concepts, have been developed in Africa, starting in 1987. In 1989 the World Health Organization (WHO) Global Programme on AIDS conducted a descriptive study of some of these programs. It is hoped that these experiences will assist planners and health care providers in their decision making and thereby benefit persons with HIV infection and their families. The lessons learned about the context, backgrounds, structure, process, and outcome of the six selected home care programs can be used and adapted by policymakers and program planners in their own settings when deciding on "their" model of home care. 6 home care, hospice, and pastoral counseling organizations in Uganda and Zambia were compared and contrasted in depth so lessons learned could be applied by similar projects. The programs analyzed were: Chikankata Home Care Program, Mazabuka, Zambia; University Teaching Hospital-Home Care Project, Lusaka, Zambia; TASO-K (The AIDS Service Organization), Kampala, Uganda; Nsambya Mobile Home Care Team, Kampala, Uganda; Kitovu Mobile AIDS Home Care, Education, Pastoral Care, and Counseling Program, Kitovu, Uganda; and TASO-M, Masaka, Uganda. The main sections in this review are: developmental background, human resources, organizational structure, training, financing, and accomplishments. Some of the reasons for the success of these organizations are insufficient hospitals beds for AIDS and other patients, combined with the strong family ties and desire to die at home prevalent in these cultures. All programs incorporated strong elements of psychosocial support in terms of education, counseling, and positive faith or morale for patients, families, and staff. The programs typically have small, close-knit structure with a flexible approach in which "double-people-centered" decision-making is fostered. Mobile units frequently used teams rather than individuals. Extensive and ongoing training is also built in to all of the programs. All have eventually found outside funding. Record keeping is universal, and some operational research has been conducted by Chikankata. Available data show that home care is cost-effective compared to hospital care of AIDS patients, not even considering the intangible benefits of educating the community to accept people with AIDS.
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