Evaluation of Home Based Care Project in MoH Central Zone from February 12-14, 2008
Background: AIDS like many other conditions such as cancer, Tuberculoses, hypertension and congestive heart diseases is along term illness which requires a long term maintenance plan to meet the medical, social and psychological needs.One of the exceptional characteristics of AIDS is that it is inevitably fatal and many societies relate it with stigma anddiscrimination. As result there are a relatively big numbers of people who are deprived of care and support from their family, friends and /or professionals. To be able to reach PLWHA who need care and support, MoH, Maekel zone has been coordinating a home based careproject since long. In 2007, with the support of Norwegian Church Aid, the CDC program of Maekel zone implemented an effective home based care project which covered 10 villages of Maekel zone. This project was implemented by involving the four faith based organizations (Orthodox, Catholic, Evangelical and Mufti) plus BIDHO Association (PLWHA), Ministry of Labor and Human Welfare and NUEW. MoH, Maekel Zone jointly with NCA-Eritrea evaluated the 2007 project. Purpose/ Objective: The main purpose of this Evaluation was to find out to what extent the NCA supported Home Based Care Project carried out in 2007 complied with its set objectives and to identify what challenges were faced during this period and to come up with recommendations with regard to strategies and methodologies for the next phase of the project in 2008. Specific objective: • To assess the relevance of the Home Based Care project with the priorities and needs of the target group, andimplementing agency.• To assess immediate impact of the home based care project in the lives of PLWHA.• To evaluate the sustainability of the NCA supported Home Based Care project Methodology: The methodologies of the Evaluation were an open ended form questionnaire, using guiding structured questions. Interviews were held with 44 key informants. These included, Coordinators and Care Providers from the four faith based organizations, plus BIDHO Association (PLWHA), Ministry of Labor and Human Welfare and NUEW and the beneficiaries (PLWHA) and it was carried out in Asmara and surrounding: Aba Shaul, Hadish Adi, Geza Birhanu, Vilago, Edaga Hamus, Merhano and Addi Sogdo. Key Findings: The project accomplished most of the listed objectives through the active involvement of volunteers and the community. The awareness among PLHIV about the importance of home-based care improved significantly and this project enabled PLHIV to develop a positive attitude towards themselves and people around them. The health education provided played an important role in informing about the access to and follow-up of taking the prescribed drugs. The home based care providers are dedicated and highly respected by the care receivers. Their understanding about the project and its aims is good; however they lack skills in nursing and in counselling, in particular spiritual counselling. The food distributed to the families, however, had little impact because the amount distributed was too little compared to the need of calorie intake for HIV infected. There is a need to work in a more holistic way in order that the various aspects of the life of PLHIV are taken care of. The various aspects of the home-based care should be included in a balanced way, that is, provision of food and hygiene items, nursing, psychological support and spiritual counselling. It is also noted that family members of the HIV infected, who are the primary care and support providers, in most cases do not know the HIV status of their family members. In addition tobeing a very difficult situation for the HIV positive, this condition may increase the risk of the spread of HIV. Taking the scale of the project into consideration, partnership and coordination among the partners is strong. All the partner organizations, even though there are differences in implementation, have a common understanding of the aims of the project. Still there is a need to establish a technical working group for improved coordination, joint planning and sharing of experience. Recommendations: • A holistic approach should be developed in order that all aspects of home-based care are included in the activities.• The amount of food should be increased, also with the view to the general situation with lack of food in the country.• The care givers need further training in spiritual counseling and psychosocial assistance, and they themselves needpsychosocial care and assistance.• To further develop the coordination and partnership, the project needs to develop the information exchange and flow among the partners in a consistent way. As recommended by the partners, there is a need to form a regional technical working group for improved coordination, joint planning and sharing of experience. Comments from Norwegian Church Aid (if any):• At the start of the new project period for 2008?, a workshop on the evaluation report was conducted for allstakeholders. This was to learn from experiences and in order to improve on implementation of the new project.• NCA is following up with the faith communities looking for possibilities for further training of care takers and takingcare of care-takers.• The increase of food commodities for distribution is being looked into. However, this is costly and a substantialincrease may not be covered under the present budget.• A technical working group for the Home-based Care project has been established.