[procaare] Background To The Provision Of Home Based Care Kit

[Cornelius Lebeloe <procaare@usa.healthnet.org>]

Background To The Provision Of Home Based Care Kit
- Cornelius Lebeloe, Department of Health, SA
***************************

Dear Colleagues,

Thank you for the wonderful response to the recently held SA CHBC Conference.I have
received several inquiries regarding the Home Care Kits which were launched during the
conference and have therefore decided to provide the background information which led to
this development. The contents of the kits will also be provided in due course.

An assessment on the magnitude of HIV/AIDS and TB care and support including access to
drugs was jointly conducted with World Health Organisation (WHO) in South Africa in 1999.
In preparation for this, sites were jointly selected with provincial officials. Sites
selected included NGOs/CBOs, clinics and hospitals. The sites represented the diverse
nature of the country including levels of programme implementation.

One of the most important recommendations from this assessment exercise was the provision
of home-based care kits. The kits were given to caregivers including those who did not
have formal clinical background.

A consultative process unfolded with the assistance from WHO involving CBO/NGO sector,
provincial care and support focal persons, nurses, caregivers involved in the day to day
provision of home/community based care services. A Home Care Kit list, which served as a
template was provided by WHO.

Process followed in the development of the kits

* Convene a national consultative meeting that included CBO/NGO sector provincial care and
support focal persons, nurses, caregivers involved in the day to day provision of
home/community based care services.
* Circulation of the list provided by WHO
* Developed two separate lists i.e. one for professionals and another for lay caregivers
who did not have any formal health/clinical training. The second list is called `dry
dispenser'. The development of this list considered that the caregivers have to conduct
home visits without hindrances regarding prescribing and dispensing of medication.
* This is national initiative i.e. kick starting a process that has to be taken over by
provinces. The refilling of the bags will be the responsibility of the Provincial
Pharmaceutical Directorate while the Provincial HIV/AIDS Directorate will take the
responsibility of providing financial resources i.e. this is not only an HIV/AIDS
initiative but a collaborative effort between different stakeholders.
* A tender was awarded and a total of 1 439 kits will be distributed country wide in the
next three months.

Home based care kits distribution plan:

Recommended national criteria were developed. Consideration was given to provincial
flexibility and priorities in terms of distribution of the kits. These include:
* Distribute to sites where training on home/community-based care has taken place using
the national minimum standards of HCBC training.
* Distribute in phases to sites that have potential for the development of referral
mechanisms including the development of a patient discharge plan
* Distribute to existing sites so as not to create confusion or duplication. The kits are
meant to strengthen and improve quality of home/community based care services.

Beneficiaries

The South African home/community based care programmes are comprehensive and thus do not
only target PLHA'S. Service beneficiaries also include:

* Asymptomatic HIV positive persons.
* People recovering from illness, who may need specific treatment and assistance after
discharge from hospital.
* Terminally ill persons.
* Persons living with HIV/AIDS or any other debilitating disease and /or conditions
* All categories of caregivers.
* Families.
* Elderly
* Children infected and affected by HIV/AIDS.
* The entire community.

Cornelius Lebeloe
Department of Health
South Africa
Tel:     27 (012) 312-0000
Cell:    082-414-8961
Email: lebelc@health.gov.za

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