Aim: To report the outcome of a comparative study among people living with HIV/AIDS (PLWHAs) served by an integrated community/home‐based care (ICHC) programme and those who are not in any ...home‐based care programme in terms of acceptance and disclosure of the HIV status.
Background: One of the major challenges in HIV/AIDS care in developing countries is acceptance and disclosure of a positive HIV status by PLWHAs. Denial and non‐disclosure of HIV status hinders prevention efforts as well as access to treatment, care and support for PLWHAs.
Methods: Quantitative data were collected in 2004 from a group of PLWHAs served by the ICHC programme and a group that was not receiving any community/home‐based care. Data were compared between the two groups in terms of acceptance and disclosure of HIV status.
Findings: The ICHC was effective in improving acceptance and disclosure of the HIV‐positive status by PLWHAs in the programme. PLWHAs in the ICHC programme did not find disclosure of their status difficult, and had disclosed their positive HIV status to more people than those who are not in any programme. PLWHAs in the ICHC programme not only disclosed their positive HIV status within their family network and households, but also disclosed to the community in general, sports group, religious groups and other social networks.
Conclusions: Community/home‐based care programmes can serve as catalysts for acceptance and disclosure of a positive HIV status by PLWHAs.
The factors influencing the quality of community home-based care (CHBC) were explored from the perspective of volunteer caregivers, their clients and key informants in a South African Eastern Cape ...district. Focus group discussions and semi-structured interviews were used to collect data on the perceptions of quality of care from 32 volunteer caregivers, 32 clients and 12 other key informants. The survey data were descriptively analyzed and the qualitative data thematically coded. The results showed that supervisor support, peer support, community support and family support of the volunteer caregivers influenced their ability to provide quality CHBC to their clients.
This case study investigates access to potable water in HIV/AIDS related home-based care households in five rural communities in Ngamiland, Botswana. Primary data collected from five villages ...consisted of two parts. The first survey collected household data on demographic and rural livelihood features and impacts of HIV/AIDS. A total of 129 households were selected using a two-stage stratified random sampling method. In the second survey, a total of 39 family primary and community care givers of continuously ill, bed-ridden or non-bed-ridden HIV/AIDS patients were interviewed. A detailed questionnaire, with closed and open-ended questions, was used to collect household data. In addition to using the questionnaire, data were also collected through participant observation, informal interviews and secondary sources.
The study revealed that there are several sources of water for communities in Ngamiland such as off-plot, outdoor (communal) and on-plot outdoor and/or indoor (private) water connections, as well as other sources such as bowsed water, well-points, boreholes and open perennial/ephemeral water from river channels and pans. There was a serious problem of unreliable water supply caused by, among other things, the breakdown of diesel-powered water pumps, high frequency of HIV/AIDS related absenteeism, and the failure of timely delivery of diesel fuel. Some villages experienced chronic supply disruptions while others experienced seasonal or occasional water shortages. Strategies for coping with unreliability of water supply included economizing on water, reserve storage, buying water, and collection from river/dug wells or other alternative sources such as rain harvesting tanks in government institutions. The unreliability of water supply resulted in an increase in the use of water of poor quality and other practices of poor hygiene as well as a high opportunity cost of water collection. In such instances, bathing of patients was cut from twice daily to once or not at all. Depending on the severity of HIV/AIDS related symptoms, e.g. diarrhoea, 20–80 additional litres of water could be required daily. The case study demonstrates that, at individual level, access to water is an integral element of the patient’s holistic healing process and psychosocial well being. At household and community levels, access to sufficient supplies of potable water when and where it is needed is central to mitigation of HIV/AIDS impacts. Access to water should therefore not be treated strictly as an economic good due to its importance as a basic human need, a social good and indeed a human right.
The article is a descriptive case study of a community home-based care (CHBC) organisation in Swaziland that depicts the convergence of CHBC expansion with substantially improved health outcomes. ...Comprised of 993 care supporters who tend to 3 839 clients in 37 communities across southern Swaziland, Shiselweni Home-based Care (SHBC) is illustrative of many resource-limited communities throughout Africa that have mobilised, at varying degrees of formality, to address the individual and household suffering associated with HIV/AIDS. To better understand the potential significance of global and national health policy/programming reliance on community health workers (task shifting), we analysed longitudinal data on both care supporter and client cohorts from 2008 to 2013. Most CHBC studies report data from only one cohort. Foremost, our analysis demonstrated a dramatic decline (71.4%) among SHBC clients in overall mortality from 32.2% to 9.2% between 2008 and 2013. Although the study was not designed to establish statistical significance or causality between SHBC expansion and health impact, our findings detail a compelling convergence among CHBC, improved HIV health practices, and declines in client mortality. Our analysis indicated (1) the potential contributions of community health workers to individual and community wellbeing, (2) the challenges of task-shifting agendas, above all comprehensive support of community health workers/care supporters, and (3) the importance of data collection to monitor and strengthen the critical health services assigned to CHBC. Detailed study of CHBC operations and practices is helpful also for advancing government and donor HIV/AIDS strategies, especially with respect to health services decentralisation, in Swaziland and similarly profiled settings.
As we enter more and more into a super-aging society, the requirement for home healthcare will increase. Pharmacists must work along with doctors and nurses in the field of home healthcare. Within ...the 6-year pharmacy curriculum, we must educate students as medicinal professionals who will join a medical team to serve the community. The Good Practice (GP) program, which has been supported by the Ministry of Education, Culture, Sports, Science & Technology, continues to be offered in our university. As a part of this program, students learn home healthcare in the community in cooperation with Yubari Medical Center. In addition, our students (pharmacy) can study community medicine together with students from Tenshi College (nursing and nutrition) in an optional class made available in Yubari during their summer vacation. According to the results of our survey after these programs, students have achieved a deep recognition of the importance of community medicine and cooperation with other medical staff in contributing to community home healthcare. We carry out these programs under agreements of collaboration with Yubari Medical Center and Tenshi College. We will talk today about training for pharmaceutical care in the community and the effect of training through this class on pharmacy education.
In sub-Saharan Africa, the model of care for people who are living with HIV/AIDS has changed from hospital care to home-based care. In this paper, a mathematical model describing the dynamics of HIV ...transmission, hospitalization, and home-based care is constructed and analysed. The model reproduction number
R
e
is determined and discussed. The equilibria are determined and analysed in terms of
R
e
. It is shown that if
R
e
<1, the disease free equilibrium is both locally and globally asymptotically stable. The model has a unique endemic equilibrium and is locally asymptotically stable whenever
R
e
>1. Five cases arise in the discussion of
R
e
pertaining to intervention strategies. Numerical simulations are done to compare the impact of each strategy on the dynamics of HIV/AIDS. The model is fitted to the prevalence data estimates from UNAIDS on Zimbabwe. The implications of some key epidemiological parameters are investigated numerically. Projections are made to determine the possible long term trends of the prevalence of HIV in Zimbabwe.
Statistics indicate that the HIV and AIDS pandemic is rampant in the province of KwaZulu-Natal (KZN). Increasingly, people with HIV and AIDS rely on voluntary community home-based caregivers for care ...and support. Drawing on original research conducted in 2005 and a subsequent study in 2009, this article presents the socio-economic context of care and women's perspectives on care giving. The study was conducted in three different communities in KZN. The feminist post-structuralist perspective provided the theoretical framework. Data collection methods included in-depth semi-structured interviews, observations and documentary review. The data were analysed using the grounded theory approach. The study revealed that it is poor, black, unemployed Zulu women who provide community home-based care (CHBC) in the province. The findings further suggested that the CHBC programme overlooks the realities of women, who operate in a context of poverty and unemployment. It is therefore argued that while the National HIV and AIDS Strategic Plan 2007-2011 has made progressive strides, implementation of the set targets remains a formidable challenge. In practice, the Plan remains gender-blind to poor women's social, political and economic imperatives. The article proposes a model of care that takes into cognisance the interests of women caregivers.
The Politics of Homeschooling Cooper, Bruce S.; Sureau, John
Educational policy (Los Altos, Calif.),
01/2007, Letnik:
21, Številka:
1
Journal Article
Recenzirano
Homeschooling has developed from a small, isolated, parent-led effort to a vibrant national movement to lobby for and legalize K-12 education at home in all 50 states. Although a majority of ...homeschool families are Evangelical Christians, the others come from a variety of religious and nonreligious backgrounds, giving homeschooling a broad national political and social base. Homeschool families have organized regional and national associations, gained children’s access to after-school and even during-school classes and activities in local public schools, and increasingly gained entry to college. About 1.35 million children in the country are being officially home-schooled, making it a vital and expanding form of private education and political force in U.S. society.
The aim of the study is to evaluate the implementation of integrated community home-based care (CHBC) services in Vhembe District, Limpopo Province, South Africa.
In all, 393 caregivers responded to ...a questionnaire on various aspects of home-based care and service provider characteristics.
Results indicate that in most areas of the Community Homes-based Care (CHBC) services, caregivers had confidence including wound dressing, health education, bet bathing, giving prescribed medication, and management of diabetes client, and they had sufficient knowledge received through training. Lower knowledge and confidence was noted for the management of hypertensive and asthmatic clients, and lower knowledge (82%) was indicated for counseling. The most common caregiving services included health education (100%), giving medication (98%), management of hypertension (22%), and counseling (15%). Most caregivers rated the implementation of CHBC in their district as excellent or good (70%). The most common problems and barriers in caregiving included (1) structural problems: none or sometimes not available home-based care kits (54%), lack of resources (32%), lack of transport money (30%), and very low stipend (22%); (2) problems with the supervisor such as "lack of management skills" (40%) and "selfishness" (38%); and (3) problems with clients and community such as "patients not taking prescribed medicines regularly" (45%) and "not welcomed by patients and family members" (35%).
Community home-based caregivers are largely able to implement home-based care services but would need more support (training, financial, career structure, and health system) to improve on their services.
This study explored the perceptions of the quality of community home-based care (CHBC) as provided by volunteer caregivers in a South African Eastern Cape district. Data on perceptions regarding ...quality of care were collected from 76 community informants (32 volunteer caregivers, 32 clients and 12 key informants) using focus group discussions and semi-structured interviews. The quantitative data from the survey were descriptively analyzed and the qualitative data thematically coded. The results showed that poverty, inclusive of substandard living conditions, unemployment and a lack of food security influenced the perceived quality of the CHBC.
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