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The Contribution of Counselling in Hospital and Home-Based Care in a Small Town and Surrounding Rural Area in Zambia

1995; SAGE Publishing; Volume: 25; Issue: 1 Linguagem: Inglês

10.1177/004947559502500107

1758-1133

Irene-Brigitte Jordan, Alan Haworth,

Family Caregiving in Mental Illness

In early 1991 in Zambia, Mansa General Hospital hosted Luapula Province's first training course for counselors of patients with AIDS and their families. Physicians and nurses soon saw that counseling made their work easier. Counseling helped the clients and their families and affected the behavior of the providers. The counselors have made it easier for hospital providers to discuss AIDS. Several months passed after counseling was implemented before a specific room for counseling was established to preserve privacy. The counselors provide pre- and post-test counseling. They meet weekly to share problems and concerns and to review counseling content so they can learn from each other. Since some patients live too far from the hospital, four counselors have joined the home-based care team (nurse, clinical officer, laboratory assistant, and physician). Home-based teams help HIV-positive spouses, widows about to lose all their property to the late husband's relatives, and family members providing for orphaned children. Community counseling or community education for transformation eventually replaced the hospital-centered home-based care model that ignored the community and its resources. The local health educator facilitated this transition. This model provided information to chiefs and headmen and helped them to learn how HIV/AIDS affects individuals. Teachers, social workers, and church workers were later also targeted as community leaders. The second training course in Mansa was established to train counselors who would then be resource persons to local institutions or within their own communities. Training of social workers and teachers relieves the home-based care team of the counseling burden. Thus, the counseling program evolved into a multi-nodal network made of resources from the hospital, health center, and community.