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Developing low-cost highly sustainable home-based care in rural Kenya

By the start of the 21st century it was estimated that over two million people in Kenya had been infected with HIV/AIDS. In one small area alone, with a population of 90 000, over 2000 people die every year. Since 1999 the death rate has been approximately seven people per day; this, together with other illnesses and diseases such as TB and cancer, has become an unsupportable burden for all concerned. There was an urgent need to find away to help the local communities to cope. The approach selected involved working in partnership with the women elders of the local villages. The women participated in a series of intensive workshops designed to give them the knowledge and skills to provide homebased terminal care for all members of their community regardless of their HIV status. The women were supported and monitored, both individually and in groups, by the public health officer who had organised the training. This paper presents an account of one strategy used to evaluate the approach. Detailed interviews were undertaken with 17 nurses, nine clinical medical officers and 17 of the women elders. The outcomes showed that both families and healthcare professionals accepted the women’s role. There were clear examples of much improved terminal care; AIDS, cancer and TB were the most frequently cited terminal conditions. The women themselves were knowledgeable, committed, enthusiastic and determined to continue their work supporting and educating their communities. In consequence, the programme is now being disseminated in other areas of Kenya.

Author(s): Joy Notter, Monica Ogutto, Khama Rogo, Chris Brannigan, John Odera

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