AIDS home care: a baseline survey in Zimbabwe

The research was undertaken during the first half of 1992; and data sought on 150 organisations throughout Zimbabwe. Of these; 25 organisations nationwide were visited by the research team and the rest were sent questionnaires. At least 24 are providing AIDS home care services; and a further 30 or more have investigated developing home care; have trained nursing and other staff in home care; and/or are just beginning to implement a programme. Organisations with AIDS home care programmes included AIDS service organistions and NGOs; mission hospitals and clinics and district hospitals. By the end of 1992 over 50 AIDS home care programmes should operational in Zimbabwe. In addition to visiting agencies; the researchers made 21 home visits with various home care teams; and were able to interview relatives or patients in 15 homes. This provided valuable opportunities for seeing the teams in action; and gaining first hand insights from the families themselves about their needs and how the services had assisted them. The organisational base and structure of the programmes varies considerably. Some programmes are community based and others are institution (hospital) based outreach programmes; and programmes exist in rural and urban areas. Some are staffed entirely by professional health workers; and others utilise volunteers with varying levels of training. Home care for AIDS; usually part of a wider home care programme for the chronically sick and others; but there are also vertical programmes only catering for patients with AIDS. [abstract terminated]

A study to provide baseline data for a home based care programme to recommend strategies which meet the needs of people with HIV (PWHIV) and their care givers

The study was conducted in Umzingwane District; in the urban; rural; farming; and mining communities from January to May 1993. HIV/AIDS and the caring of people with HIV (PWHIV) is of great concern in the country. However not much is known about home based care; in particular the needs of PWHIV and their care givers. Home visits to PWHIV in Umzingwane District were initiatedwhen it became clear that numbers of PWHIV were rising and that in future their care would prove to be difficult in health institutions. There were no well defined objectives nor targets for these home visits. It was in this context that itwas found necessary to redefine the objectives to focus on baseline information;which will help to formulate strategies for home based care system that will meet the needs of PWHIV and their care givers. The study is explanatory qualitative in nature. The variables study were; needs of PWHIV; knowledge needs and skills to cope in home based care. Study population comprising for PWHIV who are in the district AIDS register and have agreed to home visits. Care givers were identified by the PWHIV as their care giver. Health workers were those who had a basic input on home based care. Members of the community were chosen for focus groupdiscussion and consisted of traditional healers; traditional midwives; church women and Ward Development Committee. Structured interviews were held with PWHIV care givers. Health Workers were sent self administered questionnaires. Focus group discussions were held with community members

A study to provide baseline data for a home based care programme to recommend strategies which meet the needs of people with HIV (PWHIV) and their care givers

The study was conducted in Umzingwane District; in the urban; rural; farming; and mining communities from January to May 1993. HIV/AIDS and the caring of people with HIV (PWHIV) is of great concern in the country. However not much is known about home based care; in particular the needs of PWHIV and their care givers. Home visits to PWHIV in Umzingwane District were initiated when it became clear that numbers of PWHIV were rising and that in future their care would prove to be difficult in health institutions. There were no well defined objectives nor targets for these home visits. It was in this context that it was found necessary to redefine the objectives to focus on baseline information; which will help to formulate strategies for home based care system that will meet the needs of PWHIV and their care givers. The study is explanatory qualitative in nature. The variables studied were; needs of PWHIV; knowledge needs and skills to cope in home based care. Study population comprised PWHIV who are in the district AIDS register and have agreed to home visits. Care givers were identified by the PWHIV as their care giver. Health workers were those who had a basic input on home based care. Members of the community were chosen for focus group discussion and consisted of traditional healers; traditional midwives; church women and Ward Development Committee. Structured interviews were held with PWHIV care givers. Health Workers were sent self administered questionnaires. Focus group discussions were held with community members

Condicoes de enquadramento familiar da crianca deficiente mental

Condicoes de Enquadramento Familiar da Crianca Deficiente Mental e um trabalho que aborda as praticas socio-culturais ligadas a Saude Mental; a partir de um levantamento dos problemas de adaptacao social das criancas com deficiencia mental em alguns bairros suburbanos da cidade de Maputo. O estudo faz uma analise do conceito de deficiencia mental segundo os praticantes de medicina tradicional (PMT); pais e familiares de criancas deficientes mentais e analisa o papel da medicina tradicional no diagnostico e no tratamento de deficiencias mentais bem como as condicoes de integracao familiar da crianca deficiente mental. Na tentativa de uma analise comparativa do papel desempemhando pelos sectores moderno e tradicional da medicina; o presente trabalho aborda aspectos da cultura local que influem no comportamento das pessoas quanto as doencas e aos meios de as curar. Assim fez a constatacao de que entre os PMT; pais e familiares de criancas deficientes mentais; existe um conceito comum da doenca quanto as suas causas e tratamento. Segundo eles; as deficiencias mentais tem causas sobrenaturais e; consequentemente; devem ser tratadas pela medicina tradicional; chegando mesmo a ser contraindicado o tratamento pela medicina moderna/formal. Constatou ainda que existe uma concepcao segundo a qual a crianca deficiente mental e um ser do outro mundo podendo representar; perante a familia; o simbolo do seu castigo; uma dadiva dos espiritos dos ancestrais ou simplesmente a maldade de outras pessoas; nas comunidades estudadas. Por tudo isto; a medicina tradicional ocupa um lugar mais importante do que a medicina moderna/formal; no diagnostico e tratamento das deficiencias mentais; dado o facto de se crer que elas tem origem sobrenatural e que o seu tratamento passa pela invocacao dos espiritos. Em suma; a presente investigacao demonstra que as atitudes da familia em relacao a crianca deficiente mental variam com a idade da crianca; com as causas e com o modo como a familia as encara. O fim ultimo deste trabalho e contribuir no aconselhamento das familias no que diz respeito ao enquadramento e socializacao das referidas criancas; na educacao popular no tocante saude a mental da crianca e as atitudes da familia em relacao a sua educacao

AIDS home care : a baseline survey in Zimbabwe

The research was undertaken during the first half of 1992; and data sought from 150 organisations throughout Zimbabwe. Of these; 125 nationwide were visited by the research team and the rest were sent questionnaires. 24 are providing AIDS home care services; and a further 30 or more have investigated developing home care; have trained nursing and other staff in home care; and/or are just beginning to implement a programme. Organisations with AIDS home care programmes included AIDS service organisations and NGOs; mission hospitals and clinics and district hospitals. By the end of 1992 over 50 AIDS home care programmes should be operational in Zimbabwe. In addition to visiting agencies; the researchers made 21 home visits with various home care teams; and were able to interview relatives or patients in 15 homes. This provided valuable opportunities for seeing the teams in action; and gaining first hand insights from the families themselves about their needs and how the services had assisted them. The organisational base and structure of the programmes vary considerably. Some programmes are community based and others are institution (hospital) based outreach programmes; and programmes exist in rural and urban areas. Some are staffed entirely by professional health workers; and others utilise volunteers with varying levels of training. Home care for AIDS; usually part of a wider home care programme for the chronically sick and others; but there are also vertical programmes only catering for patients with AIDS. A common finding on most schemes was that poverty is often the primary concern of the patient and family; and that home care must involve the provision of basic food; medication and; perhaps; money for essentials. Large amounts of money have been spent on training workshops for home care staff; but in most cases little finance is available for these basic welfare needs of patients and their families; and in some cases the training does not appear to be utilised. This raised the question of whether too much has been spent on training staff; and too little on programme implementation and follow up; and meeting basic welfare needs. The types of care provided through home care services include: medical care; the provision of food and other material goods; counselling and spiritual care; and training for care-givers in the family. The frequency of visits varies considerably; with some schemes normally making only one; or at most two; visits per family; and one or two providing an intensive service with daily (or more frequent) visits and needs demand to a small number of patients and families. Occasionally the service includes transporting patients home from hospital but in most cases this in so offered and a follow up may only be made weeks; or even months later when the patient may already be dead. The schemes that are operating most effectively tend to be ones in which the home care providers were involved in the planning and establishment of the service itself. Those that appear to have most difficulty are those in which existing staff; such as hospital nurses; have been coopted into counselling and home care on top of their other duties; and fell unable to make time for home care; or hold equivocal views about its value. Interestingly; certain rural home care services; operating under greater constraints than their urban counterparts; are among the most well developed. A particular problem observed with several schemes is that of coordination and communication between the various agencies involved; including problems to do with patient referral where the home care service is not provided by the hospital itself. Confidentially was cited as a problem in many programmes; with staff ensure how to work with patients' demands for strict confidentiality; and their own uncertainty about criteria for passing the information to others