Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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New review sets out evidence on effective home-based care

1
MAR
2010

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Delivering comprehensive home-based care programmes for HIV

A new peer-reviewed publication led by the Alliance/Evidence for Action Research Consortium has concluded that most effective home-based care (HBC) programmes incorporate ongoing support, training and remuneration for their workers, are integrated into existing health systems, and involve local communities from the outset in programme planning and delivery. 

Delivering comprehensive home-based care programmes for HIV is a review of lessons learned and challenges ahead in the era of antiretroviral therapy (ART). It constitutes an important synthesis of the evidence around community led HBC programmes. It has been published in the journal of Health Policy and Planning, in association with the London School of Hygiene and Tropical Medicine, and is available to read now.

HBC programmes in low and middle-income countries have evolved over the course of the past two decades in response to the HIV epidemic. This review uses lessons learnt to assess whether the necessary conditions are in place to effectively expand sustainable HBC programmes in the context of greater access to ART.

Although considerable commitment has so far been demonstrated to delivering comprehensive HBC programmes, their effectiveness is often hindered by weak linkages with other HIV services. Top-down donor policies and a lack of sustainable and consistent funding strategies represent a formidable threat to these programmes in the long-term.

The benefits of HBC programmes that incorporate ART care are unlikely to be replicated on a larger scale unless donors and policymakers address issues related to human resources, health service linkages and community preparedness. Innovative and sustainable funding policies are needed to support HBC programmes if they are to effectively complement national ART programmes in the long-term.

You can read the review in full here.

    Top-down donor policies and a lack of sustainable and consistent funding strategies represent a formidable threat to these programmes in the long-term