Community home based care for people living with HIV-AIDS in the Goodhope sub-district : Botswana : policy planning and implementation.

Abstract

Botswana occupies an unenviable position of having the highest HIV / AIDS infection rate in the world, and this has generated pressures on health facilities as they are over stretched beyond their coping capacities to attend to the ever-increasing numbers of people who are infected. To relieve the health care system, the Botswana government has adopted the CHBC programme as an instrument for taking care of the infected and affected people. The CHBC programme, which is care given to long term and terminally ill people adopts the approach that, the family and the community assisted by the health professionals are the primary source of support and care. CHBC has always been in existence, though it was not given the attention it deserves until the realities of HIV / AIDS pandemic striked and doubted the ability of the health facilities to accommodate the ever increasing HIV / AIDS cases. CHBC gained more support as a result of the HIV / AIDS pandemic. This is the case because of the programmes' rationale that, the home is the best place to care for many of the people with terminal illness. The programme gives patients chance to be looked after in a familiar environment and by their relatives. The aim of this study is to establish the existence of a CHBC Policy in the Good hope Sub-district in Botswana, and if it exists to find out whether implementation is congruent to the Policy guidelines, whether its implementation is done in the most effective way, and if not, to identify obstacles to effective implementation of the Policy in the Goodhope Subdistrict. The hypothesis of this study is that, CHBC for people living with HIV / AIDS is ineffective in the Good hope Sub-district of Botswana because of shortage of resources, the unexpected (low) support the Programme gets from the community and the incorrect understanding of HIV / AIDS issues especially the modes of transmission by the community. The sample used consisted of 57 research participants (10 HIV / AIDS patients, 10 care-givers, 10 Policy makers, 10 health professionals, 5 traditional doctors, 5 spiritual healers, 5 village headmen, 1 village chief and 1 NGO representative). The literate respondents were given structured questionnaires to complete while those who are illiterate were helped by the researcher to fill in the questionnaires. The focus group discussion and participant observation methods of data collection were engaged. The study's findings were that, the CHBC Policy does exist in the Good hope Sub-district of Botswana. The study further discovered that, implementation of the Policy is not as effective as expected, and this has been attributed to the following problems; shortage of resources (manpower, transport, food etc) and the community's reluctance to give it support. The study recommends that, the government should provide resources to train more professionals who would address the problem of manpower inadequacies. There is need for communities to be mobilised so that they join hands in the fight against HIV / AIDS. The Government has to see to it that enough resources are allocated to the CHBC Programme. There is need for HIV / AIDS education in order to equip the community with the necessary information on HIV / AIDS issues. All caregivers need to be given relevant training on HIV / AIDS issues. Lastly there is need for further research in this field in order to find better ways of improving CHBC Programme.