An evaluation of the implementation of integrated community home-based care services in Vhembe District, South Africa

Abstract

The aim of the study is to evaluate the implementation of integrated community home-based care (CHBC) services in Vhembe District, Limpopo Province, South Africa. Materials and Methods: In all, 393 caregivers responded to a questionnaire on various aspects of home-based care and service provider characteristics. Results indicate that in most areas of the Community Homes-based Care (CHBC) services, caregivers had confidence including wound dressing, health education, bet bathing, giving prescribed medication, and management of diabetes client, and they had sufficient knowledge received through training. Lower knowledge and confidence was noted for the management of hypertensive and asthmatic clients, and lower knowledge (82%) was indicated for counseling. The most common caregiving services included health education (100%), giving medication (98%), management of hypertension (22%), and counseling (15%). Most caregivers rated the implementation of CHBC in their district as excellent or good (70%). The most common problems and barriers in caregiving included (1) structural problems: none or sometimes not available home-based care kits (54%), lack of resources (32%), lack of transport money (30%), and very low stipend (22%); (2) problems with the supervisor such as lack of management skills (40%) and selfishness (38%); and (3) problems with clients and community such as patients not taking prescribed medicines regularly (45%) and not welcomed by patients and family members (35%). Community home-based caregivers are largely able to implement home-based care services but would need more support (training, financial, career structure, and health system) to improve on their services.