The Changing Landscape of Home-Based Care in the Era of Art in Zambia

Home-based care has been one of the most effective community care strategies in developing countries for people living with HIV/AIDS in their AIDS stage. This is because the poorly equipped and highly understaffed public health systems are failing to cope with the extra demand of caring for the AIDS patients (in and out of hospital). The HBC programs traditionally have been providing physical, emotional, spiritual and palliative care to the chronically and terminally ill patients. Up to 90% of care for patients in developing countries is done in homes. However, the increased and widespread accessibility of people living with HIV/AIDS to antiretroviral therapy in Zambia through the public health system is changing the type of demands by the PLWHAs on the HBC services. Many formerly bedridden patients are now well and what they need most is support to restart their livelihoods. They also need support and monitoring of their adherence to ART. Some HBC programs have started changing to meet these new and evolving needs, albeit at a slow pace. The consequences of delayed responses to these changing needs is the increased likelihood of PLWHA loosing the gains made.