Community-home based care and support services

1
Community-home based care and support services

• Presentation to the Social Development Portfolio
  Committee
• 23/5/2001

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Introduction

• The purpose of this report is to provide the
  Portfolio Committee with updated information on
  the progress made in the implementation of the
  Strategy for Home Community Based Care and
  Support Services
• The presentation includes the National Integrated
  Plan for Children Infected and Affected by HIV /
  AIDS, the home community based care model options
  and interventions.

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The main challenges regarding HIV/AIDS include

• Increased number of hospitalization
• Increased health budget
• Increasing number of children in distress.
• Inability of traditional models of surrogate
  support care to accommodate the number of
  children in distress

• Inability of poor communities to absorb children
  in distress into informal care facilities without
  the introduction of outside support
• The stigma associated with HIV/AIDS i
• HIV/AIDS will have a profound impact on social
  assistance in South Africa.

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Definition of home/community based care and
support

• Home care is defined as the provision of
  comprehensive services, which includehealth and
  social services by formal and informal caregivers
  in the home in order to promote, restore and
  maintain a person's maximal level of comfort,
  function and health including care towards a
  dignified death.

• Community based care and support is the
  care/services that the consumer can access
  nearest to home, which encourages participation
  by people, respond to the needs of people,
  encourages traditional community life and creates
  responsibilities

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Objectives of home/community based care and
support

• To shift the emphasis of care to the
  beneficiaries - the community
• To ensure access to care and follow-up through a
  functional referral system
• To integrate a comprehensive care plan into the
  informal, non-formal and formal health and social
  development system
• To empower the family / community to take care of
  their own health and welfare
• To reduce unnecessary visits and admissions to
  health facilities
• To ensure that children and families who are
  affected by HIV/AIDS access social development
  services in the community

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Beneficiaries of the service

• Asymptomatic HIV positive persons.
• People recovering from illness and who might be
  in need for specific treatment and assistance
  after being discharged from hospital.
• Terminally ill persons.
• Persons living with HIV/AIDS or any other
  debilitating disease and /or conditions
• All categories of caregivers.
• Families.
• Children infected and affected by HIV/AIDS.
• The entire community

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SERVICE PROVIDERS

• The providers of home/community based care and
  support services could include the following
• Professionals doctors, nurses, social workers
• Non-professionals family members, community /
  care givers, volunteers, traditional healers /
  leaders,
• Community and faith-based organisations.

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Sectoral responsibilities -Health

• Provide basic home care supplies and conduct home
  visits.
• Assess care needs (nutrition, physical care, and
  emotional support).
• Train and support care givers.
• Counselling clients and caregivers.
• Develop care plans and provide care.
• Provide IEC materials
• DOTS supervision
• Liaison with health services
• Referrals to health providers

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Sectoral responsibilities -social Dev.

• Community mobilisation
• Establish childcare committees
• Train volunteers
• Identifying vulnerable children and families
  through home visits
• Identify community needs and resources
• Provision of material assistance (food, clothing,
  shelter)
• Identify and provide
• Alternative care for orphans.
• Residential care
• Foster care
• Adoption
• Counselling and support
• Monitoring and supervision adoption

• Social security
• Identify eligible persons and assist access to
  benefits
• Networking
• Referrals
• Poverty alleviation
• Capacity building
• training family members
• training professionals
• training volunteers
• Monitoring

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CORE COMMON FUNCTIONS

• Identifying community needs and resources and
  mobilisation
• Networking
• Referrals to or from other services
• Identifying eligibility and help access benefits

• Material assistance
• Nutrition, clothing, shelter, financial
• Poverty alleviation
• Training and emotional support of families and
  care givers
• Including counselling such as bereavement, HIV.
• Identifying affected and vulnerable families and
  individuals.
• Monitoring and supervision.

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Special allocation

• The Cabinet approved that an amount of R450
  million be made available for the implementation
  of the National Integrated Plan over a period of
  three years.
• An amount of R 13 million was allocated for the
  financial year 2000 / 2001 for the joint
  implementation of the home community based care
  component.
• Of this amount R 6.8 million was allocated to the
  Department of Social Development
• Dept of Health was allocated R6.2million

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GOALS FOR FUNDING COMMUNITY AND HOME-BASED CARE
PROGRAMME

• 1 TO DEVELOP AND IMPLEMENT EFFECTIVE AND
  AFFORDABLE COMMUNITY-BASED CARE AND SUPPORT
  MODELS
• 2 TO INTEGRATE POVERTY ALLEVIATION PROGRAMMES IN
  THE SIX SELECTED SITES IN ORDER TO MEET THE
  OVERALL BASIC NEEDS OF FAMILIES OF HIV INFECTED
  AND AFFECTED CHILDREN
• 3. BUILD CAPACITY ON DIFFERENT LEVELS OF SERVICE
  RENDERING
• 4. STRENGTHEN EXISTING INTEGRATED PROGRAMMES
• BUDGET R13M FOR 2000/1, R20M FOR 2001/2,, AND
  R32M FOR 2002/3

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Progress

• SITES SELECTED
  
• Tonga in Mpumalanga
• Tsolo in Eastern Cape,
• De Aar in Northern Cape,
• Jouberton in North West,
• Welkom in Free State
• Pietersburg (Polokwane, Maraba and Mashahane) in
  Northern Province.

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National Support to Provinces

• Several capacity building workshops were held
  jointly with the provinces to
• Ensure that the business plans were integrated,
• Ensure that funds are utilized specifically for
  the integrated Plan for Children infected and
  affected by HIV/AIDS.
• Enable provinces to assume responsibility for the
  planning, implementation, monitoring, evaluation
  and sustainability of the programme
• Ensure that both national and provincial offices
  monitor the initial implementation process.

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Progress national Support

• Appointment of provincial home community based
  care co-ordinators is in progress in consultation
  with provinces.
• Situational analyses in the above mentioned six
  sites have been outsourced. The adjudication
  process is presently ongoing
• The national departments will conduct an interim
  nation wide audit of home community based care
  programmes together with the provinces due for
  completion by end of June 2001.

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Training and capacity building

• A 12 module-training manual including a
  curriculum and learners handbook has been
  developed.
• 90 trainers, that is 10 trainers per province
  have been trained at to date.
• 1305 persons trained within provinces already

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Progress

• Provincial personnel including HIV / AIDS
  co-ordinators were trained on the Public Finance
  Management Act.
• Provincial staff development Exposure to
  international models of home/community based
  care and support.
• Provincial officials from both Health and social
  Development Departments were exposed to different
  international models of home/community based
  care.
• Home / community based care fact finding mission
  to Botswana
• Visit to alternate models of care in Uganda
• Attended 1st regional home / community based care
  conference in Botswana in March 2001

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Material assistance

• Provision of home-based care supplies
• Distribution protocols have been developed.
• Five provinces currently providing these basic
  supplies
• Gauteng preparing for official launch in June
  2001.
• WHO has donated 24 empty home based care bags
• LSP is donating second hand gloves
• Current service beneficiaries stands at 21463
• Poverty Relief
• R6 million was made available to faith based
  organisations and NGOs by the Dept of Social
  Development to provide material assistance to
  infected and affected persons

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