Home Based Care
a patient being cared forHome based care has been provided for chronically ill patients over the years. Most people with chronic and debilitating diseases prefer to be cared for in their own homes and by people they know. People who are in the advanced stages of HIV infection and have symptoms of AIDS also need such care.

Home care is any form of assistance given to a sick person, referred to as a patient, in their home. This care is usually provided by family, friends and members of the local community, supported by skilled health care workers. These care-givers should work as a team at all times.

The care given may include physical, psycho-social, spiritual and material support. The care provided depends on the needs of the patient and their immediate support system. The needs of the patient can change from day to day as their illness progresses.

At some point, the opportunistic infections of AIDS progress to a point where treatment is no longer possible and death in inevitable. From this time, the goal of all care is to keep the person as comfortable as possible and integrated in the family and community, so as to die with dignity.

SHAH home based care delivers services via 4 (currently 3) visiting nurses who travel individually to the four regions of Swaziland; Manzini, Hhohho, Lubombo and Shiselweni. The nurses drive to each region daily to provide medical treatment, consultation, counseling, prescribing and dispensing of medication and home based care supplies (disposable napkins, gloves, disinfecting solution (Jik), sunlight (soap) and Vaseline), and bereavement counseling to family members.

The nurses can also provide these services to patients who are able to travel, with the assistance of community care givers to way side clinics, by appointment. For patients who are bed ridden will receive services at their homes. However, at times, the nurses must leave their vehicles parked and walk to the homes of their patients due to poor roads, especially in the rural areas; therefore making home visits and delivery of services very difficult.

Of the four regions in Swaziland, The Manzini region has recorded a high proportion of terminally ill patients as compared to the other three regions of Swaziland with 9922 patients amounting to a proportion of 23.31%. The Manzini region was followed by the Hhohho region with 7106 patients constituting 16.70%, and then the Lubombo region with 5707 patients making up 13.41%. Lastly the Shiselweni region recorded a total number of 4056 patients which constitutes a low of 9.53%. The remaining 37.05% of patients were recorded at the clinic.

The recorded high of terminally ill patients in the Manzini region is due to the influx of people from other regions in Swaziland and from other countries like Mozambique. This influx can be attributed to fact that the Manzini city is a commercial capital situated next to the Matsapha Industrial Town where a lot of people are employed in the factories. The rate at which people flock to the Manzini city has put so much pressure on employment and other services offered in the city and has resulted in poverty taking a toll amongst the people.

The Shiselweni region recorded low of terminally-ill patients is a result of being the least developed region in the country with little or no infrastructure. This region with a lot of impoverished people lacks the basic infrastructure such as roads and health facilities, which makes it difficult for people to access health care. Therefore, making it hard for SHAH nurses on fieldwork in the Shiselweni region to access patients to give them medical attention.