| Summary |
In an attempt to deal with impacts, it is now common practice for health care facilities to ration services to people with HIV. Much of the burden of HIV care in developing countries is now falling onto households and communities.
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Any discussion of AIDS care and support thus inevitably turns to a consideration of how to achieve greater community participation, both in minimising impacts on the formal health sector and in meeting the needs of people infected and affected by HIV. Yet decades of experience in implementing primary health care have shown that meaningful community involvement in health services is not easy to develop and sustain, and is especially hard to institutionalise on a wide scale. Similarly, evaluations in various southern African countries have dispelled the idea that home-based care is necessarily a quick-fix and cost-efficient alternative to hospital-based care.
The review methods included a literature review, 68 key informant interviews, and visits to 20 projects across the country. We defined AIDS community-based care and support as being all AIDS activities that are based outside conventional health services. |
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