Power of Love's pediatric HIV/AIDS care program, known as the Arm’s Reach Care (ARC) program, was launched in June 2004 in the Matero compound in Lusaka, Zambia. One the largest slum areas in the city, the Matero compound has a population of about 175,000. It is estimated that in this compound alone there are at least 6,000 HIV+ children who need food, medicines, and health care services.
ARC is an innovative community care project focused on strengthening pediatric HIV/AIDS care provided in the home. This program creates a network of family care givers, community health workers, and nurses to provide HIV+ children high quality, lower cost care at home.
The central philosophy of the ARC program, “Everyone A Caregiver,” emphasizes providing maximum care at or as close to home as possible. This approach provides the best model of care for an HIV+ child for several reasons. First, the home environment is best for a child's normal development. Second, many of the health care services needed by a HIV+ child can be provided at home by a trained family member supported by a trained health care assistant/nurse at a much lower cost than in an institution. Finally, training family members in caring for an HIV+ child, leads to a better understanding and prevention of HIV/AIDS in the community. The ripple effect of this approach is huge and long lasting for the community.
Using a tiered structure comprising of Family Care Givers, Community Care Assistants and a mobile Nurse, the ARC program delivers a package of critical health care services to 200 HIV+ infants and children at a low cost/child/year. It consists of three levels of care services that identify children infected with HIV and helps them and their families live with HIV. Each level, from Family Care Givers to Project Nurse, is more skilled medically. Care providers at each level are trained to provide medical care within their capabilities and to quickly recognize situations that require referral to the next level of care providers.
Family Care Givers (FCGs) are members of the patients’ household and they are provided with a 5-day training session on basic home nursing, education in HIV/AIDS, and caring for an HIV+ child. In addition, continued education is provided in bi-monthly daylong refresher sessions. As a part of their training, FCGs are taught simple, yet effective responses to common opportunistic infections such as chronic diarrhea, fever, and cough, and maintenance of good hygiene. They are also taught care-giving specific to patients in the clinical AIDS stage, such as bathing and nurturing. Monthly support meetings for the FCGs provide ongoing opportunities to provide HIV/AIDS education, to promote Voluntary Counseling and Testing, and to reduce the stigma surrounding AIDS.
Community Care Assistants (CCAs) are trained in medical care-giving specific to HIV/AIDS, particularly in the identification and treatment of opportunistic infections, and in counseling an HIV+ child. They undergo an intensive 8-week workshop, followed by monthly daylong refresher sessions. The refresher sessions allow them to reinforce their existing skills, reflect on and address challenges encountered in the community, and acquire knowledge on new areas relevant to their practice. CCAs supervise up to 40 patients each and visit each child at least weekly. During this home visit, they supervise care provided by FCGs, oversee treatment adherence, and counsel the patient as well as the family caregiver.
Project Nurses are fully trained, certified nurses. They meet regularly with CCAs to review patient records and visit each patient monthly. Project Nurses make final diagnoses and referrals, and prescribe treatment courses, as per Zambian regulations for community-based healthcare. The Nurse can dispense medication for common opportunistic infections and transport patients who require immediate urgent medical care to the local clinic/hospital for further treatment.
Cost of this program
At this time, it costs about $55,000 (or about 0.75 cents per day per child) to provide food, medicines and the package of life saving health care services to all 200 HIV+ children. An itemized breakdown of costs can be provided upon request.
Funding Requirements for 2012/2013
Power of Love’s fundraising campaign aims to continue to:
1. Provide food, medicines, and a package of life-saving health care services to all children in the ARC program.
2. Train an additional 100 caregivers/grandmothers in caring for an HIV+ child.
3. Test caregivers of the children in the program for cervical cancer and breast cancer screening.
4. Continue the HIV “testing and prevention” program for caregivers so that the ARC model continues to be comprehensive with elements of prevention, treatment, and care for HIV.
5. Continue to provide school expenses for children whose parents need this support.
6. Continue the “Safe Parks” developmental program.