Bwafwano TB Corner

 

Bwafwano Community School

 

Bwafwano Feeding Program

BWAFWANO COMMUNITY HOME BASED CARE ORGANIZATION

The Bwafawno (“Helping One Another”) Community Home-based Care Organization was established in 1996 in response to the increasing numbers of HIV/AIDS and TB patients and OVC in Chipata catchment area. Chipata is densely populated, with 250,000 people living in squatter settlements on the outskirts of Lusaka.  There is only one government clinic in the entire catchment area.   The high HIV prevalence rate, combined with high rates of poverty and unemployment, limited public services and rapid population growth, make the need for care and support services in the compound particularly severe.

Bwafwano established a community health center in this area in 1998 to supplement the government clinic efforts to provide medical care to People Living with HIV/AIDS (PLHA), TB patients, and OVC and to provide preventive and curative health services to the community in general. Through its network of community volunteers, Bwafwano also provides home based care and other support services for PLHA and chronically ill patients, manages a community-based TB treatment program, and provides nutritional support, skills training, and educational support to OVC. At inception, Bwafwano was caring for 180 HIV/AIDS and TB patients. By August 2003, the project had registered a cumulative total of 1,574 PLHA (918 females and 656 males) and 219 TB patients (127 females and 92 males).

Bwafwano has acquired a great deal of experience in the design and implementation of HIV/AIDS care and support programs, and is considered a leader in the field of home based care and OVC support in Zambia. Through its dedicated cadre of volunteer caregivers, the program has managed to bring care and support services to chronically ill HIV/AIDS patients to as close to their homes as possible. The caregivers identify, register, and conduct home visits to provide counseling for the patients and their families, provide basic medical care to the patients, identify cases that need additional attention to refer to clinic, conduct food demonstrations, and assist families with household chores. TB treatment supporters also visit TB patients on a daily basis to oversee treatment as part of a community-based DOTS strategy, and to collect samples for sputum smear miscroscopy at the Chipata government clinic.

In 1998, Bwafwano initiated an OVC program to provide care and support services to children who were left as orphans after their parents registered in the Bwafwano HBC program died. The number of OVC has increased from 125 in 1998 to 1341 currently (791 females and 567 males). Services provided include education, medical care, nutritional support, psychosocial counseling, skills training, home care and recreational activities. OVC registered in the program continue to live in their own homes or those of other families or community members and receive support through the Bwafwano community center or through home visits. OVC caregivers conduct regular home visits to provide care and refer OVC to relevant support services. The caregivers have also received skills in business training and use proceeds of income-generating activities (over $4,000 has been raised since July 2002, for example) to support OVC with school fees, educational materials, food and clothing.

In July 2002, USAID through Pact International supported the initiative by Project Concern International, Bwafwano and JHPIEGO to scale up this successful community and home based care program in Zambia. PCI has been implementing USAID HIV/AIDS capacity building programs in Zambia since 1997 and has enjoyed a successful capacity building partnership with Bwafwano since 1997. JHPIEGO brings to the partnership its wide experience in establishing and improving the quality of integrated health professional education services systems in low-resource settings.

The first year of this three year program has seen Bwafwano expand coverage in its current catchment area and has seen the organization expand its services to Ngwerere, a community on the outskirts of Lusaka, which was hitherto underserved in the area of home based care for PLHA, TB patients and OVC. Currently 162 PLHA and 30 TB patients are registered in Ngwerere. With technical assistance from JHPIEGO, 100 HBC caregivers have been extensively trained in home- based care techniques. The project has also developed national standardized home-based care training and reference manuals.

Bwafwano also receives support from the Central Board of Health through the Lusaka District Health Management Team, World Food Program, UNICEF, the Cecily Fund (United Kingdom), TB Alert (United Kingdom), Catholic Relief Services and the Zambia HIV/AIDS TB Related Program (ZAMBART). Bwafwano has also since 2000 been participating in a PCI capacity building program funded by USAID Washington.