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close this bookHIV/AIDS and Communication for Behavioural and Social Change: Programme Experiences, Examples, and the Way Forward (UNAIDS, 2001, 68 p.)
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View the documentCase: Innovative Home-Based Care Programmes for HIV/AIDS in Africa
Open this folder and view contentsCommunicative Challenges for HIV/AIDS

Case: Innovative Home-Based Care Programmes for HIV/AIDS in Africa

As HIV/AIDS takes a heavy toll on the existing medical services in countries of Sub-Saharan Africa, several innovative home-based care programmes have sprung up in South Africa, Zimbabwe, and other countries.

The Tateni Home Care Services was started by a group of retired nurses in Mamelodi, the black “township” of 1.5 million people on the western fringes of Pretoria, the capital of South Africa. In response to the growing needs for care and support among local HIV/AIDS patients, Tateni developed home-based care policy and training materials in cooperation with the local health authorities. Tateni’s credo is based on the values of empathy, acceptance, hope, and the removal of discrimination against those infected or affected by HIV/AIDS.

Tateni’s programme complements existing health care services rather than duplicating or competing with them. The family members of HIV/AIDS patients are trained to enlarge the base of primary care givers, thereby boosting the community’s internal capacity to handle HIVAIDS. Tateni was careful not to copy home-based care models from industrialized countries, where clients usually receive formal home-based health care, mostly in senior citizen homes or nursing home facilities. As African traditions emphasize complex family and community relationships of support, obligation, and consensus, cost-effective family-based home care is provided by Tateni in a way that is respectful of cultural norms and traditions. While Tateni mainly provides enabling palliative care, HIV/AIDS prevention, education, and surveillance are also an integral part of its work. Tateni’s outreach workers teach home care using life-sized dolls made of foam rubber and cast- off clothes. They teach caregivers about how to take care of patients while guarding themselves against HIV infections (for instance, by wearing protective gloves, etc.).

The Chirumhanzu Home-based Care project in the central Midlands province of Zimbabwe, grew out of an initiative of hospital health workers, including senior nurses, Dominican sisters, and expatriate doctors. The home-based care project was launched because of three key reasons: overcrowded hospital wards, high costs of hospital care, and the wish of local AIDS patients to stay at home under the care of their families, up until the time of their death.

The Chirumhanzu project works closely with traditional village leaders, who are first invited to visit the local hospital or clinic to meet with the project staff. A video on home-care and HIV/AIDS is shown during this visit. Then the Chirumhanzu staff visits the village, where a public meeting is called by the local chief. The public meeting begins with a skit created by the Chirumhanzu’s drama troupe to entertain the public while providing relevant information on HIV/AIDS prevention, care, and support. The drama performance is followed by an interactive discussion on the effect of HIV/AIDS on the local community, usually facilitated by a respected nurse practitioner. The meeting usually ends with the chief, his advisors, and the local people showing interest in beginning home care services locally.

Source: UNAIDS (1999a, pp. 54-55).