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Periodical article Periodical article Leiden University catalogue Leiden University catalogue WorldCat catalogue WorldCat
Title:Reckoning HIV/AIDS care: a longitudinal study of community home-based caregivers and clients in Swaziland
Authors:Root, RobinISNI
Van Wyngaard, Arnau
Whiteside, AlanISNI
Year:2015
Periodical:African Journal of AIDS Research (ISSN 1727-9445)
Volume:14
Issue:3
Pages:265-274
Language:English
Geographic term:Swaziland - Eswatini
Subjects:AIDS
health care
community participation
Link:https://doi.org/10.2989/16085906.2015.1059864
Abstract:The article is a descriptive case study of a community home-based care (CHBC) organisation in Swaziland that depicts the convergence of CHBC expansion with substantially improved health outcomes. Comprised of 993 care supporters who tend to 3,839 clients in 37 communities across southern Swaziland, Shiselweni Home-based Care (SHBC) is illustrative of many resource-limited communities throughout Africa that have mobilised, at varying degrees of formality, to address the individual and household suffering associated with HIV/AIDS. To better understand the potential significance of global and national health policy/programming reliance on community health workers (task shifting), the authors analysed longitudinal data on both care supporter and client cohorts from 2008 to 2013. Most CHBC studies report data from only one cohort. Foremost, their analysis demonstrated a dramatic decline (71.4%) among SHBC clients in overall mortality from 32.2% to 9.2% between 2008 and 2013. Although the study was not designed to establish statistical significance or causality between SHBC expansion and health impact, the findings detail a compelling convergence among CHBC, improved HIV health practices, and declines in client mortality. The analysis indicated (1) the potential contributions of community health workers to individual and community wellbeing, (2) the challenges of task-shifting agendas, above all comprehensive support of community health workers/care supporters, and (3) the importance of data collection to monitor and strengthen the critical health services assigned to CHBC. Detailed study of CHBC operations and practices is helpful also for advancing government and donor HIV/AIDS strategies, especially with respect to health services decentralisation, in Swaziland and similarly profiled settings. Bibliogr., notes, sum. [Journal abstract]
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