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Why Home-Based Care Is Among Kenya’s Big Step in Healthcare

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  • Why Home-Based Care Is Among Kenya’s Big Step in Healthcare

Discover a powerful step-by-step guide to home-based care in Kenya—uncovering its evolution, real-life challenges, and how it’s transforming lives amid a growing need for compassionate, accessible care.
This case study has helped hundreds of people in getting a clear view of home-based care and navigating through the business market of home-based care.

Introduction

Home-based care is providing support and treatment to individuals with chronic or terminal illnesses in their own homes.

This care is an extension of services typically offered in hospitals or health facilities and relies on the active involvement of family members, the local community, and collaboration with healthcare professionals, utilizing the resources available.

Home-based care does not only offer physical but also spiritual and psychological support.

It is an all-encompassing form of care that depends on coordinated efforts between the hospital, the client’s family, and the community.

This collaboration enhances the quality of life of the patient and their family. The home-based care is vital for promoting comfort, dignity and personalized attention in familiar surroundings.
It enhances recovery, reduces hospital readmissions and supports chronic illness management. By involving family members, it strengthens emotional well-being and improves quality of life, making healthcare more compassionate, cost- effective, and accessible for patients of all ages. Home-based care in Kenya has several importance that can be understood through several dimensions.
The importance of home-based care in Kenya can be understood through several dimensions:

• Accessibility:

HBC brings essential health services directly to the patient, particularly benefiting those in remote or underserved areas where health facilities are scarce.

• Affordability:

It reduces the financial burden on both the health system and families by minimizing hospital admissions and transportation costs.

• Continuity of Care:

HBC ensures follow-up care, adherence to treatment, and monitoring of health outcomes in chronic or terminal illnesses.

• Psychosocial Support:

Patients receive care within familiar environments, surrounded by family and community support systems, which enhances emotional well-being and recovery.

• Task-Shifting:

It empowers community health workers and trained caregivers to manage basic health needs, allowing specialized health professionals to focus on more critical cases.
Home-based care is vital for promoting comfort, dignity, and personalized attention in familiar surroundings.
By involving family members, it strengthens emotional well-being and improves quality of life, making healthcare more compassionate, cost-effective, and accessible for patients of all ages.
The concept of home-based care does not just address any disease condition but intended for debilitating diseases that makes patients unable to care for themselves.

Objectives of Home-Based Care

1. To ensure a smooth transition of the client’s care from the healthcare facility to their home and community setting.
2. To increase family and community understanding of how to prevent and manage chronic illnesses.
3. To equip clients, families, and communities with the knowledge and skills needed for providing long-term care and support.
4. To encourage the acceptance of terminally ill individuals within families and communities, helping to reduce stigma related to chronic diseases.
5. To improve the referral process, allowing seamless movement of patients between health institutions, the community, and relevant health or social services.
In order to achieve these goals effectively, it’s important to follow key principles that treat home-based care as a comprehensive and integrated approach to care.

Principles of Home-Based Care

a. Provide accessible, affordable, and high-quality healthcare and support services.
b. Encourage the meaningful involvement of both the client and their family in the care process.
c. Promote engagement from individuals and groups best positioned to support communities at various levels.
d. Direct social support to all affected households, with a special focus on vulnerable groups such as children.
e. Support and protect caregivers to reduce the physical, emotional, and spiritual strain associated with long-term care for terminally ill patients.
f. Support and protect caregivers to reduce the physical, emotional, and spiritual strain associated with long-term care for terminally ill patients.
g. Strengthen the role of home-based care as a crucial link between disease prevention and ongoing treatment and support.

Components of Home-Based Care

Comprehensive home-based care consists of four main components:
1. Clinical care
2. Nursing care
3. Counseling and psycho-spiritual support
4. Social support
Every home-based care program should include these four elements. However, the emphasis placed on each component may differ depending on the specific needs and conditions of the local community.

Key Players and Their Roles

• Patient/Client
• Family Members and Caregivers
• Home Care Team
• Government
• Non-Governmental Organizations (NGOs)
• Community and Community-Based Organizations
• Healthcare Workers

Various individuals and groups are involved in home-based care, each with specific roles and responsibilities that contribute to the overall care and support of the patient.
Role of Family Members and Caregivers in Home-Based Care
Family members, caregivers, and close relatives play a vital role in supporting patients receiving care at home. Their responsibilities include:
a. Learning to adapt to and accept difficult situations, including those involving terminal illness.
b. Working collaboratively with other care providers such as religious organizations, healthcare and social services, and support groups.
c. Offering to help directly or identifying others who can assist with care, promoting shared responsibility for referrals and networking.
d. Encouraging the patient to consider writing a will.
Role of the Patient
The patient is a key participant in the home-based care system. When their illness becomes so severe that they can no longer care for themselves, they need support from others. Their responsibilities include:

a. Choosing an alternative caregiver when necessary.
b. When possible, giving consent regarding who will provide care and deciding on the preferred location for care—such as at home or in a hospital—especially during the final stages of illness.
c. Actively taking part in the care process, particularly in making decisions related to their own well-being, rather than being a passive recipient of care.

Role of the Home Care Team
Home care teams, typically managed by healthcare or social work professionals and often connected to local health centers or community organizations, provide comprehensive support services to patients and their families. Their responsibilities include:
a. Managing health conditions related to the patient’s illness
b. Delivering nursing care in the patient’s home
c. Coordinating access to voluntary counseling and testing services
d. Offering emotional and psychological counseling
e. Referring patients to specialized care such as medical treatment, radiotherapy, emotional/spiritual support, and educating both patients and families about the illness and associated conditions
Role of Health Workers
The health facility is staffed with a variety of trained professionals, such as nurses, clinical officers, physiotherapists, nutritionists, doctors, and others.

a. Provide care for terminally ill patients based on their preferences.
b. Promote and manage the Home-Based Care (HBC) program by enrolling patients/clients, assessing their needs at different levels, and preparing them for discharge.
c. Establish referral and networking systems that may evolve as the patient’s condition and requirements change.
d. Educate and prepare the family and caregivers for their responsibilities in providing home care.
e. Perform initial diagnoses, deliver appropriate nursing and medical care, and address the psychological and social needs of the patient.

Role of the Community

1. Acknowledge the condition of the patient/client and actively cooperate with existing organizations—such as religious, women’s, social, and health groups—to help meet the needs of those infected or affected.
2. Support and encourage the client in drafting a will.
3. Take personal action to help prevent the spread of infections like HIV and hepatitis.
4. Promote and support positive behavior change within the community.
5. Recognize and address one’s own spiritual or pastoral needs.
6. Create a memory book to pass on family history and meaningful memories to children.
7. Be honest and open with caregivers, sharing personal concerns and fears.

Role of the Government

a. Establish a policy framework that supports healthcare initiatives
b. Set and uphold quality standards for services and care
c. Formulate and implement relevant policies and guidelines
d. Ensure the availability of essential medications and supplies
e. Facilitate the creation of support groups that can advocate for patients’ rights
f. Offer and organize training programs to build capacity

Advantage of HBC

• Cost-effective –
Reduces overall healthcare costs for both patients and health systems.
• Comfortable environment –
Patients receive care in the familiarity and comfort of their own homes.
• Reduces hospital congestion –
Frees up hospital beds for more critical cases.
• Promotes faster recovery –
Healing is often quicker in a stress-free, home environment.
• Family support –
Encourages emotional support and participation from family members.
• Personalized care –
Care is tailored to individual patient needs and conditions.

Disadvantages of HBC

1. Emotional and physical strains and stress experienced by caregivers
2. Insufficient empowerment of client and caregivers regarding care/resources and diagnosis
3. Uncertainty about the duration of the situation
4. Inadequate support structures for the caregivers
5. Fear or mistrust of the primary caregivers
6. Focus too often on health services activities only-no common vision
7. Dependency- allows for dependency of the client
8. Social isolation, related to confinement of the person to bed and the home

Importance of HBC

For the patient

1. Encourages patient to accept their status
2. Promote the physical and psychological health of the patient
3. Enables patients to receive care at home
4. Facilitate patients in taking their medication consistently and correctly
5. Facilitate patients to be a contributing member of their community and family

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