Linking Clients to Community Support Services
Some examples of community-based support and services for PLHIV and their families
Home-based care (HBC) programs usually involve trained health workers visiting PLHIV in their homes to provide care and support services to clients and families. HBC is needed because:
- Facility-based health services cannot cope with an increasing demand and increased numbers of patients.
- Many people prefer to receive ongoing care in their homes, have too many responsibilities at home to visit the facility (children, getting water, cooking, farming) or live long distances from health facilities.
- It ensures a continuum of care to patients both in the home and within health facilities.
- It can empower PLHIV to take care of each other and themselves when they are trained as HBC providers.
- It provides support and training to caregivers and family members, not just clients.
- It can promote HIV prevention and can reduce stigma and discrimination in the whole community by bringing HIV out into the open.
Types of HBC programs:
- Some HBC programs are extensions of facility-based services. In these types of programs, it is usual trained nurses or nurses’ aides who do home visits on certain days of the week, often focusing visits on the sickest patients or those who cannot come to the facility.
- Other HBC programs are based in the community and run by community-based organizations. These programs often train volunteer community health workers to provide HBC services in homes and mobilization activities in the community.
- The best HBC services help patients learn self-care and train family members/caretakers how to provide basic care.
Support groups are very important for PLHIV and their families. Support groups offer a chance for PLHIV to come together to discuss concerns, share information and provide emotional support to one another. Meetings offer a chance for people to come together in a safe accepting environment.
There are many kinds of support groups for different people and situations, including:
- General support groups for PLHIV
- Adherence support groups
- Mothers support groups
- Women’s support groups
- Caregivers of children living with HIV support groups
- Youth support groups
- Post-test clubs and groups
- Many others
Some support groups may be held at health facilities and others may be held in the community - for example, at schools, community centers, PLHIV association offices or in someone's home.
Self-help and income-generating groups:
Poverty is one of the most common challenges faced by PLHIV and their families. Many communities have organizations and groups to provide self-help and income generation to clients and families in need. These may include:
- Income-generating activities (animal husbandry, gardening and agriculture, handicrafts, etc.)
- Skills-training organizations
- Savings and loan groups, including micro-credit
- Village banking groups
PLHIV associations can offer many other services and support to PLHIV, including:
- Ongoing support through individual or group counseling
- Support groups for PLHIV and their families
- Financial or nutritional support to PLHIV and their families
- Support for children to enroll in or stay in school (formal or non-formal education)
- Income-generating activities or micro-credit schemes for PLHIV and their families
- Advocacy for PLHIV to receive the services they have a right to. This can be at community, regional, national and international levels
- Community sensitization and advocacy to reduce stigma and discrimination
- Sensitization/training for health care providers on providing quality care to PLHIV, drawing on members’ own perspectives and experiences
- Help with legal support when people are discriminated against because of their HIV status (in the home, at work or in the community)
- Linkages to a network of national and local PLHIV associations
- Support for transportation to clinic appointments
Food distribution and nutritional support:
Peer Educators should help clients understand the importance of good nutrition to live positively with HIV. Some types of community-based nutritional support include:
- Food distribution
- Community food donation programs
- Community activities to help families affected by AIDS to care for their crops, gardens and animals
- Community and school gardens
- Community animal rearing
- Agricultural extension and education programs
People living with HIV and their families often have their rights violated and may need legal support services. Some organizations provide these services for free or at reduced cost to PLHIV, often through PLHIV associations. Peer Educators should be aware of what kinds of legal services patients and their families need and who provides these services in the community.
Types of legal support could include:
- Inheritance rights for widows
- Support for women or children who experience violence in the home or community
- Inheritance rights and access to schooling and community services for children affected by HIV (including orphans)
- Fighting discrimination in the workplace, at health facilities or in the community
- Access to HIV testing and other HIV services, especially for children with no legal guardian
- Access to school, especially for orphaned children
- Access to social support and welfare services, regardless of HIV-status