THE ZIMBABWE COMMUNITY AND HOME BASED CARE STRATEGY AND GOALS

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Community based care

This is care that consumers can access nearest to home, which encourages active participation by the community, responds to the needs of people, encourages traditional community life and creates responsibilities (Zimbabwe MoHCW & NAC 2009b:7). This definition provides a basis for this research. Since the care of the sick often takes place in the home environment, this type of care takes place with support from community structures, and is therefore referred to as community and home based care. This brings out the aspect of complimentarity between the home and the community systems.

Health need/s

These are essential requirements for a client receiving health care at home as a result of a chronic illness and may include health education, food, shelter, water and sanitation, psychosocial support, and basic nursing care. Client-care-preference and needs for people with chronic illnesses are diverse and complex, and consequently, this study aims to explore those complexities. The issue of health needs is complicated by its correlation with social needs, as these two areas are interlinked. This study addresses all needs (social and health needs) in general, since these needs are interrelated; and it then differentiates between health needs and social needs.

Health need/s

These are essential requirements for a client receiving health care at home as a result of a chronic illness and may include health education, food, shelter, water and sanitation, psychosocial support, and basic nursing care. Client-care-preference and needs for people with chronic illnesses are diverse and complex, and consequently, this study aims to explore those complexities. The issue of health needs is complicated by its correlation with social needs, as these two areas are interlinked. This study addresses all needs (social and health needs) in general, since these needs are interrelated; and it then differentiates between health needs and social needs.

RESEARCH DESIGN AND METHODS

This is a cross sectional explorative and descriptive study of the C&HBC service using a combination of qualitative and quantitative methods (David & Sutton 2007:38). The use of multiple mixed methods is known to provide an examination of both process and outcome (Tucker, Van, Teijlingen, Phillip, Shucksmith & Penney 2006:185-186). According to David and Sutton (2007:44), there is no significant distinction between qualitative and quantitative methods, as the two provide synergy and added benefit to 20 social research. Each method has its own limitations, and therefore mixed methods ensure robust results, due to the possibility of triangulation, to confirm findings from the various sources of information (Issel 2009:480-481). By triangulating information from multiple sources, it will be possible to increase understanding of the dynamics between attainment of service users’ needs and goals and the prescribed health service delivery.

Sampling

The researcher will use purposive selection of clients within the identified communities. Purposive sampling is recommended for qualitative studies, as it allows for flexibility in determining the appropriate participants for the phenomenon under investigation (David & Sutton 2007:152; Issel 2009:482; Usherwood 1996:29). Furthermore, purposive sampling of organisations implementing C&HBC programmes to facilitate access to clients will be undertaken. Sampling will be made in collaboration with the selected C&HBC programmes’ implementers working in selected districts and villages. Primary participants (chronically ill clients) who are eligibile and willing to participate in the study will be identified through community health workers residing within the communities.

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Table of contents :

  • CHAPTER 1 ORIENTATION OF THE STUDY
    • 1.1 INTRODUCTION AND BACKGROUND
      • 1.1.1 The health system in Zimbabwe
        • 1.1.1.1 National Health Strategy:
        • 1.1.1.2 Zimbabwe National HIV and AIDS Strategic Plan 11 (ZNASP) 2011−
        • 1.1.1.3 Community and Home Based Care programmes for chronic illnesses
      • 1.1.2 The socio-economic situation
        • 1.1.2.1 Economic situation in Zimbabwe
        • 1.1.2.2 Food security and nutrition
        • 1.1.2.3 Sustainable livelihoods of vulnerable communities
  • 1.2 BACKGROUND INFORMATION ABOUT THE RESEARCH PROBLEM
    • 1.2.1 The source of the research problem
    • 1.2.2 Background to the research problem
  • 1.3 RESEARCH PROBLEM
  • 1.4 PURPOSE OF THE STUDY
    • 1.4.1 Research purpose
    • 1.4.2 Research questions
    • 1.4.3 Research objectives
  • 1.5 SIGNIFICANCE OF THE STUDY
  • 1.6 DEFINITION OF KEY TERMS
    • 1.6.1 Community
    • 1.6.2 Community based care
    • 1.6.3 Home based care
    • 1.6.4 Health need/s
    • 1.6.5 Community participation
    • 1.6.6 Service users
    • 1.6.7 Quality of life
    • 1.6.8 Home based care kit
    • 1.6.9 Experience
    • 1.6.10 Perceptions
    • 1.6.11 Primary care giver
    • 1.6.12 Secondary care giver
    • 1.6.13 Words used interchangeably in the study
  • CHAPTER 2 LITERATURE REVIEW
    • 2.1 INTRODUCTION
      • 2.1.1 Chronic illness
      • 2.1.2 HIV and AIDS as a widespread chronic illness in Zimbabwe
      • 2.1.3 Other issues associated with chronic long-term conditions
    • 2.2 COMMUNITY AND HOME BASED CARE
      • 2.2.1 Evolution of Community and Home Based Care
      • 2.2.2 The role of community and home based care in service delivery
      • 2.2.3 Services offered in Community and Home Based Care
    • 2.3 THE ZIMBABWE COMMUNITY AND HOME BASED CARE STRATEGY AND GOALS
      • 2.3.1 Community and Home Based Care models
    • 2.4 PUBLIC HEALTH, DEVELOPMENT AND COMMUNITY AND HOME BASED CARE
      • 2.4.1 Primary health care
      • 2.4.2 Community and Home Based Care as a development issue
      • 2.4.3 Community capacity, empowerment and participation in Community and Home Based Care
      • 2.4.3.1 Challenges of Community and Home Based Care
  • CHAPTER 3 RESEARCH DESIGN AND METHOD
    • 3.1 INTRODUCTION
    • 3.2 RESEARCH DESIGN
      • 3.2.1 Evaluative research
      • 3.2.2 Qualitative research
      • 3.2.2.1 Sampling for the qualitative approach
      • 3.2.3 Quantitative research
      • 3.2.3.1 Sampling for the quantitative approach
    • 3.3 RESEARCH METHOD
    • 3.3.1 Sampling
      • 3.3.1.1 The population
      • 3.3.1.2 Sampling and sampling procedure
      • 3.3.1.2.1 Inclusion criteria
      • 3.3.1.2.2 Exclusion criteria
    • 3.3.2 Data collection
      • 3.3.2.1 Data collection approach and method
      • 3.3.2.2 Development and testing of data collection instruments
      • 3.3.2.2.1 Validity and reliability
  • CHAPTER 4 DATA ANALYSIS AND PRESENTATION OF FINDINGS
    • 4.1 INTRODUCTION
    • 4.2 DATA MANAGEMENT AND ANALYSIS
    • 4.3 RESEARCH RESULTS
    • 4.3.1 Demographic characteristics
      • 4.3.1.1 Age and gender
      • 4.3.1.2 Education background
      • 4.3.1.3 Socio-economic status
      • 4.3.1.4 Occupational status
      • 4.3.1.5 Income levels
    • 4.3.2 Health experiences and needs of service users
    • 4.3.2.1 Service users’ overall needs
    • 4.3.2.2 Meeting service users’ health needs
    • 4.3.2.3 Community and family coping strategies
  • CHAPTER 5 STUDY DISCUSSION
  • CHAPTER 6 PROPOSED GUIDELINES FOR AN INTEGRATED APPROACH TO THE MITIGATION OF CHRONIC ILLNESSES
  • CHAPTER 7 CONCLUSIONS AND RECOMMENDATIONS

GET THE COMPLETE PROJECT
AN INVESTIGATION INTO HOME AND COMMUNITY BASED HEALTH CARE PROGRAMMES IN ZIMBABWE: AN ANALYSIS OF THE CONGRUENCY OF SERVICE USERS’ NEEDS AND THE PROGRAMME GOALS

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