Abstract
Situation analysis of home and community based care for people living with HIV/AIDS in southern Thailand The study aims to review and analyse the situation of home and community based care for people living with HIV/AIDS in southern Thailand. Data from three collected and analyzed to examine the way in which people living with HIV/AIDS are managed and taken cared at home and communities. The strategies and factors affected the systems of care were also investigated to present the extent to which care has been changed or modified for sustainability or discontinuity, Results showed the significant findings as follows. 1. The current AIDS situation in Southern Thailand is similar to other parts as the number of new case has been increased particularly in reproductive age. The increasing number of AIDS patients were seen both in and out of hospital. The national case report showed that the proportion of people who were sick with AIDS in a hundred thousand population was higher than the country rate. The report also revealed that the high epidemic areas were from provinces with a large number of fisherman, labor migration, and tourists, Data from fields study were also confirmed. 2. The situation of AIDS care in southern Thailand has been changed since last two years. People were more awareness of HIV/AIDS and perceived it as their own problems particularly when one of their of family members sick with AIDS. However, the level of understanding of HIV/AIDS care at home and community among general population was still low. Stigma and rejection were remained high in community level. Various activities in relation to enhancing care for patients at home and community were then supported by several organizations both government and private sectors. 3. AIDS care management in southern Thailand were mainly individual and family level, partly because of fear and social rejection, Patients and families with AIDS generally conceal their status. They would requires some assistance and support when necessary without disclosing to the public, Although the community was taking the significant role by expressing the value and cultural care, the positive response has currently been low compared to overall projects. 4. The strategies applied for managing care at home and communities wree both active and passive methods. The significant strategies were involved with active community participation, having good leader with scarify or having better knowledge, home visiting, community aceptance, seeking funds to support activities, and using a holistic approach. 5. Several activities were conducted particularly in enhancing the strength of community participation. Training of difference groups was the most common activities, The content was related to AIDS prevention and psychological care for people living with HIV/AIDS and their families. The herbal and tradition medicine had also been promoted and used as the main mode in supplement of lack access to antirrtroviral therapy. 6. The role of individual, family and community are increasing especially in the high epidemic area. The role of temple is one of the community care which represents of active participation. The role of government organization has been less than other in terms of accessing to home visiting and providing psycho-spiritual support. However, people with AIDS who concealed their status would have less assistance. 7. Several models of home and community based care have been found. These were included: model of empowerment of patients and their families, model of strengthening and promoting active community participation, care and support from family and community, development of a temple or religion organization as a center of care. Recommendations Strengthening home and community based care can reduce the impact of HIV/AIDS on individual, families and community. To ensure effective care and support provided for people living with HIV/AIDS, these issues must be stimulated and plan for the future. To apply AIDS home care model, the meaning of care and component of cultural care at home and community must be clearly defined. The findings showed that the best practice model has currently existed, but it required systematic study and further publication.Sharing knowledge and experience about caring for people living with HIV/AIDS at home and community in southern Thailand has been low. The specific skills are required for effective intervention and enhancing care by their family and community. These skills are included community management, effective health and nutrient counseling, and caring of dying at home.Although the role of government, private and community organization continue to increase, the good governor and co-ordination has been necessary to promptly respond and managed. The direction of policy must be clear and focus on sharing resource as much as possible. Development and integrating of the traditional medicine on home and community based care is required. AIDS is a psychosocial and cultural problem related to daily living and survival. To solve the problem effectively, it requires the multidisciplinary knowledge and team.To encourage people living with HIV/AIDS in living longer with less suffering, continuing plan and self care management must be educated. In addition, the alternative therapies and positive thinking strategies should be supported and integrated to their living for better quality of life.Further research on development of a cultural appropriated model for people living with HIV/AIDS is essential. The independently system of care particularly in people who conceal their HIV status should be further explored. Nevertheless, a follow up study on impact of disclosure to patients and their families which affect quality of life and quality of care at home and community level.
