[procaare] HCC: Please Restart The Discussion.

[ProCAARE Moderation Team <procaare@healthnet.org>]

HCC: Please Restart The Discussion.
- ProCAARE Moderation Team.
********************

Dear forum members,

It is now eight months to the Dakar Home & Community Care Conference in December 2003.

Below, we repost some messages, which have recently been published on a Yahoo group,
initiated by the Dakar organisers to facilitate discussions leading to the conference. The
Yahoo group members have since been invited to join ProCAARE.

ProCAARE Moderation Team

********************


1. Francisco Rosas, Mexico

I would like to refresh the memories of us all: this EForum is the first step to know each
other, exchange ideas about relevant topics and more...

By the way, I would like to know if anyone knows how to submit an abstract, apply for
scholarship opportunities to attend the event, request the registration form and for late:
how to become a  member of a committee, etc.

Many thanks,

Francisco Rosas
HIV Technical Specialist
Calle 22, No. 100, Col. Maravillas
Ciudad Nezahualcoyótl
CP 57410, Estado de México. México.
Tel. & Fax: (55) 57 35 26 54 & (55) 57 35 94 32
E mail: frosas22@prodigy.net.mx

***

2. Nenet Ortega, Philippines

I agree with Francisco that we need to start the discussion around issues which are
important to PLHA's and which may be touched in the forthcoming HCC in Senegal. This will
help set the tone for the said conference eventually highlighting the most pressing
concerns and issues which need immediate response locally, regionally and globally.

At the same time this will give everyone some form of guidance on advocacy planning.

Nenet L. Ortega
Manila
Philippines
Email: nenetgem@yahoo.com

***

3. Francisco Rosas, Mexico

Thanks Nenet for the reply to my message posted in this EForum. I think there are areas of
home and community care that need to be strengthened and other that need to be launched.
For example:

- I was wondering in which places with a HCC programs exist a deep understanding of the
needs of PLHA's and what are the responses to their needs.

- Is there an available framework of home and community care, which can be used in all
places or regions?

- Guidelines and recommendations for home and community care are useful, but those need to
be adapted to the culture of each region. Please pass lessons learned about this topic.

- Lessons from community caregivers are from CBO's (Community Based Organisations)
basically and there is so little attention to register these efforts. HCC Conference is an
excellent effort to bring the local, regional and global attention to this matter.

- Is there communication among different models of home care in the world for example
those from CBO's, religious groups, PLHA's networks and government (hospitals and other
health settings)?

- Is there a REAL connection among different approaches:
*A comprehensive health approach
*A person-centred approach and
*Goals centred on access to treatment?

- Is there competence between care for PLHA's and other sick people or terminally ill
people in each health setting?

- Is the Home and Community Care for PLHA's issue influencing local, regional and global
public policy? Is urgent to summarize the efforts from advocates and fighters for caring
of the PLHA's around the world.

- Is the HCC for PLHA's a matter of human rights?

- Are the governments passing from the rhetoric to the real action in each country?

I think the forthcoming Home and Community Care to be held in Dakar, Senegal is a
wonderful opportunity to discuss relevant topics, exchange ideas and to share practical
information about the questions above.

Francisco Rosas
HIV Technical Specialist
Mexico
E Mail: frosas22@prodigy.net.mx

***

4. Dr. Hedwig Goede, WHO, Geneva

Dear Francisco and others,

You have raised important issues. I agree totally with you that it is time to improve the
documentation of lessons learned from CBO's and answer the important questions that you
raised. This may directly help similar groups involved and in addition provide the
evidence that policy makers at national and international level need to shape policy. Some
policymakers have a good understanding of the contribution and activities of CBO's in HCC,
others not. I think that the Dakar conference can help to make the step towards increasing
the impact of the work of CBO's, advocate for the necessary attention and support and
build orchestration and synergies between HCC from CBO's and other available health
services in communities and districts.

WHO has developed a framework for home and community care directed towards planners under
the title: Community and Home-based Care in resource-limiting settings. It would be good
to discuss if this framework is useful and if it needs adaptation or supplementary
guidelines to be of assistance to the people in the field.

It can be downloaded from the website: www.who.int/hiv/pub/prev_care/pub14

Lets keep the discussion going.

Best regards,

Hedwig

Hedwig Goede
HIV/AIDS Department,
Care Unit Cluster of Family and Community Health
World Health Organization
20 Avenue Appia, 1211 Geneva
phone: (+41) 22 7913252
fax: (+41) 22 791 4834
email: goedeh@who.int

***

5. Francisco Rosas, Mexico

Dear Hedwig and others:

Thank you for your for your enthusiasm to contribute with this dialogue.

First of all, I like to make an explanation: I rather use the term "dialogue" instead of
"discussion", because many other people could feel encouraged to give their opinions about
these important matters. I like to remember that all could contribute with our own
expertise, knowledge, experience and skills in the performance of caring the quality of
life of PLHA's. Caring the quality of life of PLHA's is a wide issue that lies in the
human solidarity, respect, understanding, support and a source of ongoing messages of hope
for all people affected.

I said in my last e-mail: "In which places with a HCC programs exist a deep understanding
of the needs of PLHA's and what are the responses to their needs".

In my opinion a need assessment is a technical tool that could contribute with a good
understanding of the situation of PLHA's and their real needs. In this sense a study of
indicators of quality of life could be conducted. In my own understanding caring the well
being of PLHA's is a continuum process of improvement of the physical, psychological and
socio economic conditions.

This is my own definition of well being of PLHA's:

The well being of PLHA's is not only a biological condition, but also very much a social
and psychological conditions. Physical well-being means to be free of sickness and
disability, to experience no physical suffering or pain, and to be able to maintain a
healthy lifestyle. Psychological well being means to have good mental health that
demonstrates confidence, hope, and relative freedom from pressures and anxieties.
Socioeconomic well being means to be an accepted member of society, to have access to
societal rights, to feel free of discrimination, and to have the economic means available
to lead a decent life.  In this sense, a person's quality of life is about not only the
proper maintenance of one's health but also control of the changing factors that affect
one's healthy life and permits the strengthening of a healthy environment.

The questions that should be responsed before planning an intervention are:

- What is the physical, psychological and socio economic condition of PLHA's?

- Which are the barriers that should be overcome to conduct a needs assessment to shape
these conditions?

- Do HCC programs give response to these levels of welfare -physical, psychological and
socio economic in your country?

- Is this a comprehensive approach to the quality of life of PLHA's?

Francisco Rosas
HIV Technical Specialist
EMail: frosas22@prodigy.net.mx

Source: dakar2003hcc :Yahoo! Groups

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