Infection control in home-based care for people living with HIV/AIDS/TB in South Africa: An exploratory study

Abstract

The majority of HIV and AIDS patients in sub-Saharan African countries receive health care services at home. Yet research on infection control in home-based care settings is virtually non-existent. This study explored infection control practices in home-based care in a South African province with a high HIV/TB prevalence. We conducted interviews with 10 managers of home-based care organizations and 10 focus group discussions with 80 volunteer caregivers working in high HIV/TB prevalent communities in South Africa. Findings show that volunteers had insufficient training on infection control. Materials necessary for the maintenance of hygiene and protective equipment were in short supply and the protective equipment supplied was of poor quality. Home-based care patients lived in crowded and poor conditions, and family members were negatively disposed to the use of protective devices. Together, these factors put volunteers and family caregivers at risk of infection with HIV and TB. Health policy should address the training of volunteer caregivers and the regular supply of good quality materials to ensure effective infection control. It is also important to educate families on infection control. Finally, there is a need to integrate HIV and TB control at the community level.

Keywords:

• home-based care
• infection control
• tuberculosis
• HIV/AIDS
• South Africa

Acknowledgements

We are grateful to the management of the home-based care organisations and the participants for their time. This work was supported by the National Research Foundation (NRF), South Africa, and the Strategic Grant from the College of Humanities at University of KwaZulu-Natal, Durban, South Africa. We are grateful to the Programme in Policy Decision-making in the Centre for Health Economics and Policy Analysis at McMaster University for hosting Olagoke Akintola during sabbatical time while writing the paper. We are thankful to Melisa Ngwenya who served as editorial assistant on the paper.

Notes

1. We use acronyms as a label for identifying each of the quotes to depict the interview or focus group from which the quote was taken. HBCC stands for home-based care coordinator/manager interview. FG stands for focus group discussion. The number in front of both the interview for managers (HBCC) and the focus group discussion (FG) for volunteer caregivers represent the interview or focus group discussion from which the quote was taken.

2. Department of Health.