PROGRAM FOCUS: HIV/AIDS

COMMUNITY AND HOME-BASED CARE

In 2010 Vietnam is home to an estimated 254,000 people living with HIV. The disease is present in every province of the country, although concentrated in particular groups and geographic areas. Improved access to life-saving antiretroviral therapy has the potential to help people living with HIV (PLHIV) live much longer, higher-quality lives, but treatment alone cannot address all the challenges confronting PLHIV and their families.

Filling the gaps

Despite Vietnam's progressive legal protections of PLHIV, widespread effects of stigma and discrimination persist, limiting access to available treatment and compromising adherence. Economic hardships add to physical and emotional burdens, and the growing proportion of newly infected woman and children bear the brunt of HIV's effects on families. Such wide-ranging needs require wide-ranging services such as medical care, psychological and spiritual support, livelihoods strengthening and basic self-care including pain and symptom management.

As a complement to the formal healthcare system, community and home-based care (CHBC) can fill gaps in the service landscape by drawing on community resources and ensuring effective two-way relationships with HIV/AIDS care and treatment facilities. Many CHBC providers are living with HIV themselves and work in teams with medical and social service professionals who can support their response. Pact and its civil society partners have become leaders in expanding the reach, scope and quality of CHBC in Vietnam: With funding from USAID under PEPFAR, Pact provides direct support to 14 organizations that bring comprehensive care to the homes of PLHIV.

Deepening skills and knowledge

Because consistent delivery of quality services depends on strong monitoring systems, Pact has developed an innovative client tracking system that helps CHBC providers accurately assess and follow client needs. To create the system Pact solicited input from each of its CHBC partners, resulting in a streamlined yet flexible paper-based system that helps generate information for reporting and program improvement.

Pact's quest for ongoing improvement in service delivery also led us to develop the Cue Card. This practical tool helps CHBC providers with reminders on key areas of assessment and care during all interactions with clients. To fit continuous skills-building into our partners' busy work schedules, we developed a unique Topic Talk training program based on short, high-impact peer discussion and themed work sessions. With Pact support and capacity building tools, CHBC partners are broadening their scope to forge linkages with other essential services, advocating for the rights of the most vulnerable and developing their capacity for self-care.

For more on our Program Focus areas in Vietnam, see Building local capacity and Children affected by HIV.