Abstract
Home based care (HBC) is a key component of care and support for people infected with human immunodeficiency virus (HIV). Understanding the pattern of HBC needs in a population is beneficial in planning and providing optimal HBC services for the people. This retrospective study assessed the pattern of home based care needs and services in patients of the adult antiretroviral therapy (ART) clinic of Jos University Teaching Hospital (JUTH), Jos, Nigeria. All documented home based care visits to patients of the clinic from September 2008 to December 2013 were reviewed. Relevant information was obtained from the patients’ clinical and home visit records. Data was analysed using Epi info version 7 statistical software. A total of 152 patients with 542 home visits were reviewed. There were 112 (73.7%) females and 40 (26.3%) males, with a mean age of 34±8.9 years at the time of initial home visits. The three commonest primary reasons for home visits were psychological counselling (22.7%), adherence counselling (15.5%) and ill-health (12.4%), while follow up visits accounted for 32.5% of the home visits. The 3 most frequent services provided during home visits were counselling on clients medication for adherence (77.5%), basic nursing care (61.6%), and psychological counselling (41.5%). By December 2013, out of 152 patients reviewed, 61.8% were alive, 15.1% had died and 23.1% were lost to follow up. The services provided during home visits extended beyond the patients’ perceived needs (primary reasons for visit). Home based care brings to light some patient needs that may not be evident or catered for at the facility level of care. This supports the endorsement of home based care as a useful strategy to complement facility care towards achieving an overall patient well-being. Key words: Home based care, human immunodeficiency virus (HIV), adult, Nigeria.
Highlights
The scourge of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) continue to be a weighty public health concern especially in underdeveloped countries
In 2010, it was estimated that worldwide, over 34 million people were HIV-positive and approximately 68% of them lived in subSaharan Africa (UNAIDS, 2010)
The HIV pandemic, which is greatest in subSaharan Africa, contributes immensely to the health burden, and this further overstretches the already overburdened health systems (UNAIDS, 2014; WHO, 2008)
Summary
The scourge of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) continue to be a weighty public health concern especially in underdeveloped countries. In 2010, it was estimated that worldwide, over 34 million people were HIV-positive and approximately 68% of them lived in subSaharan Africa (UNAIDS, 2010). In this geographical region of the world, the typical pattern of healthcare is a combination of overburdened healthcare services with insufficient financial resources, inadequate infrastructure, few hospital beds and fewer health workers to cope with the health burdens faced (WHO, 2008; Tillekeratne et al, 2009). In 2012, Nigeria, not left out of the scourge, was reported to have an estimated 3.7% of its population living with HIV and ranked second place among the countries with the highest burden of HIV (NACA, 2012). Home based care (HBC) is defined as any form of care given to ill people in their homes (WHO, 2002). HBC has long been part of HIV care, even before the era of ART and the availability of ART has not decreased the need for HBC (Bowie et al, 2010)
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