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Home Care - 1.3 The Home Care Model in Cambodia
1.3.1 Origins
In early 1997, discussions on establishing home based care for PLHA in Cambodia, were initiated within WHO, and channelled through the HIV/AIDS Co-ordinating Committee (HACC) Sub-Group on Counselling & Care. These discussions sought to bring together local and international NGOs and involve MoH/MHD in developing a pilot project to be implemented initially in Phnom Penh. In bringing together the private and public sectors, it was felt that scarce resources could be shared, and the comparative advantage of different players could be utilised more effectively. (11)
There were a number of challenges to be faced in developing the home care project:
Footnotes
(11) Joint Ministry of Health/NGO Pilot Project on Home and Community Care for People with HIV/AIDS, Cambodia, 1999, op.cit.
In early 1997, discussions on establishing home based care for PLHA in Cambodia, were initiated within WHO, and channelled through the HIV/AIDS Co-ordinating Committee (HACC) Sub-Group on Counselling & Care. These discussions sought to bring together local and international NGOs and involve MoH/MHD in developing a pilot project to be implemented initially in Phnom Penh. In bringing together the private and public sectors, it was felt that scarce resources could be shared, and the comparative advantage of different players could be utilised more effectively. (11)
There were a number of challenges to be faced in developing the home care project:
- the HIV/AIDS epidemic in Cambodia was at a very early stage, and care was not yet on the national agenda. It was therefore difficult to find funding or motivation for anything other than prevention activities
- there was a need to bridge conceptual gaps between NGOs and the public sector, to build trust and to foster understanding of the limitations and potential resources of each of the players
- there were few, if any, hospital outreach services to which homecare activities could be attached
- existing CBO activities were neither strong nor well institutionalised
- there were limited facilities for voluntary testing and counselling
- there was limited commitment from MOH/MHD for home based care for PLHA
- there was little enthusiasm from either management or physicians in the referral hospitals to be part of the continuum of care
- the National AIDS Programme was severely underfunded by the government
- although the NAP had funds for AIDS-related activities, there was no budget line for care and support to PLHA
Footnotes
(11) Joint Ministry of Health/NGO Pilot Project on Home and Community Care for People with HIV/AIDS, Cambodia, 1999, op.cit.