|Community Home-Based Care in Resource-Limited Settings - A Framework for Action (WHO - OMS, 2002, 100 p.)|
|Essential elements of CHBC|
|Financing and sustainability|
Poverty cannot become a barrier to accessing CHBC. A waiver system or some form of free care that can be equitably applied to destitute families must therefore be developed. In some countries, funds for financial support come from some form of community taxation. In addition, CHBC programmes run by NGOs and faith-based organizations usually have a source of funding from the donor agency. The CHBC team is unlikely to be responsible for developing this free service. This will probably fall to government officials or administrators of NGOs, faith-based organizations or community-based organizations. However, CHBC team members may be asked to assess the needs of the ill person and family for free services and to provide the necessary resources. These resources might include transport, medicines, CHBC supplies and sometimes food, blankets, clothing and money.
CASE STUDY 13
Kapit Kamay Sa Bagong Pag-Asa: promoting financial independence for people with HIV/AIDS in the Philippines
The Philippine National AIDS Council in partnership with the Centre for Community Transformation and the Pinoy Plus Association, Inc. have established a livelihood assistance project through microfinance for people with HIV/AIDS and their family members. The overall aims of the project are: to assist people with HIV/AIDS in achieving financial stability by helping them to generate savings and to manage or own microenterprises; to assist them in regaining their self-worth and dignity by becoming productive and augmenting family income; and to reintegrate isolated people with HIV/AIDS back into their respective families and communities.
Qualifying for microfinance. Applicants for microfinancial assistance must first participate in an orientation and training session. Included in this session are discussions on loan policies, the responsibilities for programme partners, the development of business proposals and business management strategies. The applicant's proposal must include information on the project to be undertaken together with a short feasibility study including a statement on the return on investment. A budget must be prepared that includes the items to be purchased and the income expected to be derived from the business. In addition, applicants are expected to begin saving for 4 weeks during their training and orientation period to demonstrate their responsibility in financial management. Based on the project proposal and on the applicant's ability to demonstrate financial responsibility, microfinance funds are provided to the applicant with a clearly agreed repayment schedule.
Projects funded. Nineteen projects were funded throughout the Philippines. These projects included variety and general merchandise stores, a piggery, tricycle and motorcycle hire, a video rental shop, a vegetable market stall, an eatery and a bar. Nine of the project managers were men and ten women. Five people with HIV/AIDS died during the project, but family members took over their businesses.
Problems encountered. The microfinancing project was housed in the same location as the social welfare office. As a result, there was some confusion as to the difference between a business loan and a welfare grant. Thus, some borrowers did not understand the importance of repaying their loans. In addition, despite the orientation and training sessions, many participants experienced difficulty in managing their businesses. Problems were also encountered when participants used their loans for family expenditure. Finally, great distances between project locations resulted in poor monitoring. Only in Metro Manila was it possible to visit the business locations, whereas other projects were monitored by telephone.
Lessons learned. Based on the problems encountered by the project, the following lessons and recommendations were made. The organization responsible for managing the project should have had previous experience working with people with HIV/AIDS and family members. Such families pose unique problems related to illness, family disintegration and profound poverty. Rigorous standards must be established for reviewing proposals and disbursing and monitoring funds, and criteria must be established for loan defaults. Microfinance and social development programmes should not be attempted within the same organization.
Beneficial outcomes. Despite the challenges experienced in this microfinancing project, the programme monitors also found considerable benefits to people with HIV/AIDS and their families. This livelihood opportunity enhanced the self-worth of people with HIV/AIDS by restoring their confidence and dignity. They were able to help in supporting their family and to be productive members of the community.
The Kapit Kamay Sa Bagong Pag-Asa project provides one example of the challenges and benefits of supporting people with HIV/AIDS and family members to become financially independent and productive members of the community. The lessons learned from this project can help future programmes in developing more effective orientation and training sessions and setting clearer policies, guidelines and standards for granting microcredit while also monitoring and supporting project participants. Programmes that are well organized, managed and monitored will contribute to alleviating poverty among people with HIV/AIDS and family members while also increasing their sense of self-worth and self-efficacy. Such strategies help in contributing to an improved quality of life for the people with HIV/AIDS and their family members.
Source: Philippines National AIDS Council, Centre for Community Transformation and Pinoy Plus Association, Inc., Manila, the Philippines.