HomeBased Care Volunteers

1
Home-Based Care Volunteers

• Results from A Study of Home-Based Care
  Volunteers in the SUCCESS Program Zambia.

Shannon Senefeld Catholic Relief Services
2

• Home-based care is taking us back to the root of
  human coexistence. It reminds us that we all have
  the responsibility to one another. If we hold
  hands through this tragedy ... we will be able to
  retain our humanity and will come out of this
  epidemic as a stronger community. Joy Phumaphi,
  Minister of Health, Botswana (as quoted in WHO,
  2002)

3
Introduction

• HBC Volunteer (HBCV) Survey was initially
  presented to SUCCESS HBC Diocesan Coordinators at
  an annual planning workshop.
• Coordinators expressed interest in implementing
  the surveys in their Dioceses, so the survey was
  revised with partner input in order to make it
  appropriate to the Zambian context.
• Each Diocese agreed to randomly survey at least
  50 HBCV.

4
Methodology

• In all four dioceses, the following steps were
  followed
• Survey translated into local language(s) by HBC
  volunteers or diocesan staff
• Survey back-translated with different
  participants or with a group of translators in
  collaboration with Survey Coordinator
• Survey presented to HBC site coordinators as a
  volunteer activity. The Survey Coordinator
  discusses the objectives of the survey, how
  coordinators can randomize those they select, and
  the timeframe for implementation and submission.

5
Methodology Continued.

• 4. Site coordinators were given the option to
  participate. Numbers of survey per site were
  decided upon with consideration to
• Total number of participating sites
• How many volunteers each site has
• Whether or not some sites have been supported by
  SUCCESS for a significantly longer period of time
  than others
• 5. Surveys printed and distributed, when
  possible with specific requests by site
  coordinators as to which translations are most
  appropriate for them and how many
• 6. A timeframe for submission to the diocese is
  decided upon, normally 2-4 weeks

6
Respondents

• 270 Respondents
• Representing HBCV in Mpika, Mansa, Mongu, and
  Solwezi Dioceses
• 58 female
• 67 married, 10 widowed, 19 single
• 88 of male respondents were married only 53 of
  female HBCV were married.

7
HIV in the lives of the carers

• 95 of HBCV cared for at least one child, and 65
  cared for more than 4 children
• 78 cared for at least one orphan in their
  household (HH).
• Women HBCV were more likely to report caring for
  orphans (plt.01).
• 9 of HBCV reporting that someone in their HH is
  living with HIV 39 reported not knowing.
• Women HBCV were more likely to report the
  presence of someone with HIV in their HH (plt.05).
  

8
Income and Incentives

• 75 of HBCV reporting income levels in the lowest
  quartile in the area.
• Nearly all (93) were unemployed.
• 44 reported receiving some sort of incentive for
  volunteering.
• No HBCV reported receiving cash incentives.
• More than half (58) reported sharing their food
  with their clients.
• HBCV who received incentives were more likely to
  share their food with their clients.

9
Client load and retention

• Most HBCV (35) reported supporting only 1-3
  clients, but 23 reported assisting more than 9
  clients.
• The majority (62) spend 1-4 hours a week
  volunteering, but some (15) volunteer more than
  8 hours a week.
• The majority of volunteers (55) had volunteered
  for more than 3 years, and 85 planned to remain
  volunteers for more than 4 more years.
• Women had been volunteers longer than men,
  although this may be because men HBCV are only
  being actively recruited recently.

10
Psychosocial Correlations

• HBCV who were unemployed were more likely to
  exhibit increased depression, anxiety and stress
  scores as well as lower quality of life scores.
• HBCV who reported more frequent caregiver
  meetings have lower depression, anxiety and
  stress scores.
• The number of clients reported by the HBCV is
  linked with decreased psychosocial scores.

11
Using the results

• Our HBCV are the poorest of the poor in their
  areas. Theyre unemployed, yet they share their
  food with their clients. The lack of employment
  is linked with decreasing psychosocial scores.
• How can we improve their livelihoods while
  improving the livelihoods of the clients?
• Access to SILC, Self-help groups, etc.

12
HBC volunteers VCT

• Our HBCV arent being tested themselves for HIV,
  nor are their families. 39 dont know if
  someone in their HH is infected, yet they promote
  VCT to the communities regularly.
• Why HBCV are not being tested?
• Increased training to HBCV on importance of
  testing, increased referrals, home testing
  rollout.

13
Psychosocial

• The caregiver meetings are clearly helping the
  majority of the HBCV. The HBCV who attend these
  meetings regularly have reported less depression,
  anxiety and stress.
• Intervention Replicated the meetings and
  increased frequency of meetings.

14
Conclusions

• Retention appears to be strong, with dedicated
  HBCV. In fact, theres a significant relationship
  between time already spent as an HBCV and time
  planned to remain an HBCV. However, the data
  clearly demonstrates that support for HBCV is
  necessary.
• The results presented here can in no way be
  generalized to HBCV as a population, as our
  sample was relatively small and only included
  HBCV from four Dioceses in Zambia.
• However, this work does demonstrate that HBCV
  also need specific support. So many HIV programs
  rely on the work of the volunteers that many of
  our programs would crumble without their
  continued vital effort and contribution.
• Special focus should be paid to the stress that
  is inherent with volunteering and caregiving with
  often terminal clients.

15
Next Steps

• Repeat the survey to the volunteers again over
  the coming years to make additional corrections
  as needed.
• Share these results with others who are
  implementing HBC programming.

16
Thank you!