Abstract:
In response to the negative impact of HI VI AIDS pandemic on health care services in
the developing world, governments have adopted the Home Based Care strategy for
People living with HIVI AIDS (PL WHA). However, little is known about the quality
of care given to AIDS patients in the terminal stages. This study descriptive study
used a mixed method of both quantitative and qualitative designs to determine
factors affecting the quality of palliative care given to AIDS patients by caregivers
within communities in Dar es Salaam region in Julyl August 2008. The aim of the
study was to determine patient's satisfaction with palliative care services, related
factors and described the palliative care given to AIDS patients within communities.
The study has shown that majority of the caregivers 74% (n=37) were female.
Majority of the care givers (52%, n=26) had primary education, and fourteen
individuals (28%) had formal employment as nurses. Among the eighty eight
patients that received care, 59(67.1 %) were female; most of the patients had attained
primary education 70(79.6%). General physical care provided as the main home
based care and a third (30%) of care givers provided nutritional and general
counselling. Patients with a longer duration of illness (19-24 weeks) were ten times
more likely to report unsatisfactory provision of care (OR, 10.4: 1.6 - 68.6); p-value
0.01. The main problems found included inadequate supplies of essential materials,
inadequate training among caregivers and informal care givers (volunteers) and
unsatisfied care given to patients. From the findings care givers providing palliative
care services to HIV/AIDS patients face challenges most of which is beyond their
abilities to solve. Given the importance of palliative care, the study recommends the
government to workout a policy stating clearly the duration of training course for all caregivers. Streamline HBC, PC services provided by community volunteers and
caregivers into the comprehensive health plans may provide needed solutions to
problems like salaries, transport, supplies and training, which address their needs.
Access to uniform package for community volunteers regardless of where they are
geographically or under which organization they are, Will motivate them and
increase the quality of care to their clients.
