Reckoning HIV/AIDS care : a longitudinal study of community home-based caregivers and clients in Swaziland

Show simple item record Root, Robin Van Wyngaard, Arnau Whiteside, Alan 2015-09-15T08:44:54Z 2015-09-15T08:44:54Z 2015-08
dc.description.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), we analysed longitudinal data on both care supporter and client cohorts from 2008 to 2013. Most CHBC studies report data from only one cohort. Foremost, our 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, our findings detail a compelling convergence among CHBC, improved HIV health practices, and declines in client mortality. Our 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. en_ZA
dc.description.embargo 2016-08-20 en_ZA
dc.description.librarian hb2015 en_ZA
dc.description.uri en_ZA
dc.identifier.citation Robin Root, Arnau Van Wyngaard & Alan Whiteside (2015) Reckoning HIV/ AIDS care: A longitudinal study of community home-based caregivers and clients in Swaziland, African Journal of AIDS Research, 14:3, 265-274, DOI: 10.2989/16085906.2015.1059864. en_ZA
dc.identifier.issn 1608-5906 (print)
dc.identifier.issn 1727-9445 (online)
dc.identifier.other 10.2989/16085906.2015.1059864
dc.language.iso en en_ZA
dc.publisher Routledge en_ZA
dc.rights © NISC (Pty) Ltd. This is an electronic version of an article published in African Journal of AIDS Research, vol. 14, no. 3, pp. 265-274, 2015, doi : 10.2989/16085906.2015.1059864. African Journal of AIDS Research is available online at : en_ZA
dc.subject Africa en_ZA
dc.subject HIV testing en_ZA
dc.subject HIV/AIDS policy en_ZA
dc.subject Adherence en_ZA
dc.subject Care supporter/caregiver en_ZA
dc.subject Gender en_ZA
dc.subject Religion en_ZA
dc.subject Task shifting en_ZA
dc.subject Community home-based care (CHBC) en_ZA
dc.subject Human immunodeficiency virus (HIV) en_ZA
dc.subject Acquired immune deficiency syndrome (AIDS) en_ZA
dc.subject Antiretrovirals (ARVs) en_ZA
dc.title Reckoning HIV/AIDS care : a longitudinal study of community home-based caregivers and clients in Swaziland en_ZA
dc.type Postprint Article en_ZA

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