Home-Based Care

This article evaluates the cost effectiveness of facility-and home-based voluntary counseling and testing (VCT) utilizing community health workers with the primary outcome measure of extra cost per HIV sero-positive case identified to help for health service managers at primary care level in making decisions on suitable alternatives for VCT provision in rural communities in Uganda based on operational efficiency. [adapted from author]

This report is the result of research undertaken in South Africa to review community and home-based care, especially in regards to HIV prevention, treatment, care and support. The research highlights the important roles played by caregivers in health promotion programs, counselling and testing, client advocacy, stigma mitigation and community mobilization. [adapted from author]

This study investigated the acceptance of home-based counselling and testing by lay counselors, its equity in uptake and the effect of negative life events with a cluster-randomized trial. [adapted from abstract]

This study piloted home-based counseling and testing with point-of-care CD4 count testing and follow-up visits from lay counselors to facilitate linkage of HIV-infected persons to local HIV clinics and uptake of antiretroviral treatment in rural KwaZulu-Natal, South Africa. [adapted from abstract]

Because programming for home-based HIV testing and counselling (HBHTC) services poses a series of practical challenges with design, cost, human resource, and logistical implications, the purpose of this handbook is to provide practical guidance on ways to address these challenges and to outline some of the key considerations when planning, implementing, and monitoring HBHTC. [from author]

There is growing interest in expanding testing coverage through the implementation of innovative models such as home-based HIV counselling and testing (HBHCT) by trained lay counsellors. With the aim of informing scale up, this paper discusses client characteristics and acceptability of an HBHCT intervention implemented in rural South Africa. [from abstract]

HIV/AIDS is fast becoming a chronic disease with the advent of antiretroviral drugs, therefore making home based care key in the management of chronically ill HIV/AIDS patient. The objective of this study was to determine the perception and practice of health care workers on HIV/AIDS related home based care in the health facilities in Ogun state, Nigeria. [from abstract]

This paper is a synthesis of research on recruitment and retention challenges for home support workers in Canada. [from author]

The aim of this paper is to show that present provider-centred models of chronic care are not adequate and to propose full self-management as an alternative for low-income countries, facilitated by expert patient networks and smart phone technology. [from abstract]

Low uptake of voluntary HIV counselling and testing (VCT) in sub-Saharan Africa is raising acceptability concerns which might be associated with ways by which it is offered. This study investigated the acceptability of home-based delivery of counselling and HIV testing in urban and rural populations in Zambia where VCT has been offered mostly from local clinics. [from abstract]

Identification of new ways to increase access to antiretroviral therapy in Africa is an urgent priority. We assessed whether home-based HIV care was as effective as facility-based care. [from summary]

A program to create a cadre of skilled birth attendants for home births was launched by the Government of Bangladesh Bangladesh in 2004. This article suggests that the task-shifting program can only serve as an interim measure rather than a long-term solution as more women decide to seek institutional delivery and professional midwifery care. [adapted from abstract]

This paper discusses the role and impact of community health workers in Nyanza Province, Kenya, in response to the growing demands the HIV epidemic has placed on the people and communities in this region. [adapted from abstract]

This paper aims to discuss the challenges influencing the state of caregiving in the Kanye community home-based care programme in Botswana. [from abstract]

In Zimbabwe, as in many parts of sub-Saharan Africa, home-based care (HBC) plays a vital role in the response to HIV as overwhelmed public health and welfare systems fail to cope with the demands of the epidemic. This document details a project designed to contribute to better understanding and evidence-based decision-making in the implementation of HBC interventions in Zimbabwe and beyond. [adapted from executive summary]

Tanzania’s government has developed various policies and guidelines to address the HIV/AIDS pandemic, including a five-year commitment to provide anti-retroviral therapy to 500,000 Tanzanians. This program faces many HRH-related challenges and constraints. This report discusses the implementation of a home-based care model to support older caregivers for Tanzanians living with HIV/AIDS. [adapted from report]

Demand for home care services has increased considerably, along with the growing complexity of cases and variability among resources and providers. Designing services that guarantee co-ordination and integration for providers and levels of care is of paramount importance. The aim of this study is to determine the effectiveness of a new case-management based, home care delivery model which has been implemented in Andalusia (Spain). [from abstract]

All long-term care agencies struggle to find and keep sufficient, reliable, and skilled staff capable of meeting client needs and providing great quality care. This workbook offers 12 concrete steps to guide agencies in developing excellent recruitment, selection and retention practices

Neonatal mortality accounts for a high proportion of deaths in children under the age of 5 years in Bangladesh. This article describes a project for advancing the health of newborns and mothers implementing a community-based intervention package through government and non-government organisation infrastructures to reduce neonatal mortality. [from abstract]

This study was implemented to develop and evaluate the effectiveness of a home based intervention in reducing caregiver burden, promoting caregiver mental health and reducing behavioural problems in elderly persons with dementia. [from abstract]

The overall objective of this study was to analyse the challenges which family caregivers encountered in home-based care when they tried to access medical treatment for home-based AIDS patients in the context of confidentiality and limited medical care. [from abstract]

The emphasis of the COPHIA program is the provision of home-based care and support services by multi-purpose community-based health workers to vulnerable households in the geographic focus areas that are coping with the burden of caring for seriously ill family members or caring for orphans and vulnerable children. The COPHIA community-based health workers, with the support of clinical and non-clinical supervisors, provide the direct physical and emotional care and support services to PLWHA and orphans and vulnerable children in the project catchment area with the support of trained primary caregivers.

The objective of this research is to explore inequities in utilization of skilled attendance at birth, delivery by caesarean sections and use of postnatal care services, by key socioeconomic factors in two home-based SBA areas of Bangladesh to provide insights for future programming. [from introduction]

Given the limited availability of formal, inpatient programs, households rely upon informal caregivers (e.g. household or family members, friends, community members, or voluntary organizations) and homebased care (HBC) programs for assistance. This summary documents the roles played by household and HBC program caregivers in meeting the needs of the chronically ill.

Many Nigerian children with malaria are treated at home. Treatments are mostly incorrect, due to caregivers’ poor knowledge of appropriate and correct dose of drugs. A comparative study was carried out in two rural health districts in southwest Nigeria to determine the effectiveness of a guideline targeted at caregivers, in the treatment of febrile children using chloroquine. [from abstract]

The general aim of this paper is to add to the limited research on family caregivers, and specifically to enable a better understanding of the actual experience of providing care for ill adults within the home in the context of HIV/AIDS, using qualitative research findings from a KwaZulu-Natal study. [from author]

This case study was conducted to impart a thorough understanding of the Tumaini Home-Based Care Program model and to document lessons learned that could be applied to other initiatives. While the Tumaini program addresses the needs of both people living with HIV and AIDS (PLHA) as well as OVC, the case study focuses particular attention on specific services and program impact for OVC. The program goals were to provide care and support to OVC; to provide care and support to PLHA; Tumaini: Home-Based Care and to build the capacity of local organizations to provide sustainable HBC services. [from

This document provides a systematic framework for establishing and maintaining community home-based care (CHBC) in resource-limited settings for people with HIV/AIDS and those with other chronic or disabling conditions.

Given the very limited health infrastructure and resources and the need to provide a palliative care service to about one percent of the population each year, community and home-based care is viewed as the key to responding to these needs. Some countries have already developed strong home-based care networks in coordination with the PHC system to respond to the HIV/AIDS epidemic. Palliative care, as part of the continuum of care of HIV/AIDS, cancer and other chronic conditions can be integrated into this existing network. [author’s description]

This report outlines information from a literature review and field research pertaining to the key differences and similarities between the hospice ICHC model and other home-based care models used in South Africa; reviews the core elements of the ICHC model; and highlights best practices of the model. [adapted from introduction]