Background
Namibia is one of the country most affected by HIV/AIDS epidemic in the world and in SubSahara
Africa with an adult prevalence of 19,7 %, and 210.000 people estimated to be living
with HIV/AIDS at the end of 2003. The Caprivi region adult prevalence in adult pregnant
women is estimated at 43%.
The health care services are overstrained with patients and home-based care (HBC) is seen a
possible solution. The scale up of HBC and expansion of coverage to patients has lessened
the burden of public hospitals to deal with all these chronically ill patients. The challenges
that volunteers are facing impact in the quality of care people living with HIV/AIDS receive.
Objectives
This study assessed the utilization of home-based care service, knowledge and perception of
People living with HIV and AIDS (PLWHA) toward home-based care services. The views of
volunteers towards home-based care service are also reported.
Methods
This is a qualitative study that utilized Focus Group Discussions (FGDs) for the home-based
care-givers and in-depth interview with the clients accessing antiretroviral treatment at
Katima State Hospital. A total of four focus group discussions were organized with caregivers
comprising 31 adult participants (15 males and 16 females) and 18 in-depth interviews
were conducted with the people living with HIV and AIDS accessing antiretroviral treatment
(ART) at Katima State Hospital. All FGDs were tape recorded and one-to-one interview was
hand written.
Result
The study demonstrates that most of the participants have positive attitudes toward utilization
of HBC service. However, few people are still afraid to disclose their health status. In
general, the community participation has tremendously reduced stigmatization.
v
The self-reported health status by the HBC givers in order to have access to nutrition support
may have played a role in reducing the stigma associated with HIV and thus increased the
number of people utilizing the HBC service.
The HIV-positive participants valued the assistance received from the volunteers and
volunteers appreciate the training received to enable them to undertake their duties with more
confidence. The dress code of volunteers when visiting patients was perceived to disclose
HIV status but did not influence patient attitude to access the service.
Conclusion
The improvement in community knowledge about HIV and HBC service has enhanced the
positive attitude toward utilization of home-based care service which has consequently
reduced the stigma associated with HIV. Advocacy is required to improve the working
condition of volunteer care-givers home-based care by policy markers. The collaboration
between different stakeholders will advance and sustain the HBC service in focusing on
prevention of HIV infection.