Home-Based Care for People Living with HIV
For many of the estimated 800,000 HIV-infected individuals living in central Mozambique, simply getting out of bed each day can represent a daunting task. Ravaged by disease and malnutrition, many are hard-pressed to prepare what little food they have or provide even a minimal level of care for their children. For these people, the idea of doing daily chores or traveling to distant clinics to consult with clinicians about health complications or medication side effects can seem unfathomable.
At the same time, regular monitoring of viral loads and adherence to daily antiretroviral treatment are essential to staying healthy for someone living with HIV. In order to reduce the barriers to care and bring health care to those unable to travel to a clinic, we have supported home-based care in central Mozambique since 2001. Through our partnership with 12 community-based organizations operating in 20 of the 23 districts of Sofala and Manica provinces, we provide comprehensive clinical, palliative, psychosocial, and spiritual care to more than 6,000 beneficiaries each month.
Such in-home services can come in a variety of forms. It can mean that a sick mother has help in washing her children's clothes each week or that a newly diagnosed and emotionally distressed HIV patient is provided encouragement from an HIV-positive health worker. In addition to such simple assistance, our home-based care representatives also perform an array of more complex activities. People with symptoms of respiratory illnesses such as tuberculosis are referred to testing and treatment centers and HIV/AIDS patients on antiretroviral therapy are provided psychosocial support to ensure proper adherence to medications.
As with all of our projects, the home-based care program focuses on improved health system and community integrity. With the scale-up of ART in these same communities, HAI and the MOH designed new approaches to linking HBC programs with local HIV care services to ensure that HBC clients were being tested and properly referred for ART. HBC workers were trained in providing ART adherence support, while key health personnel in health facilities were trained to link with local HBC groups to reduce loss-to-follow-up.
Not only do our workers represent an important link between patients and health care providers, but our home-based care programs have also been designed to link easily with other Ministry of Health and HAI-supported health interventions such as the regional food supplement program providing poor patients with monthly food baskets.
Our work with HBC groups is supported by PEPFAR.