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Country Profiles |
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Unprecedented Community and Home-Based Palliative Care Services Being Offered in PNG
With funding from the Australian Agency for International Development (Ausaid), FHI has been leading an initiative to remedy this situation. In partnership with Friends Foundation Inc., FHI is working to establish community and home-based palliative care services that are unprecedented scope and reach. The services are offered in 23 communities in the National Capital District (NCD) and Central Province, and currently engage 115 team leaders and members, including 36 PLHA. |
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An initial needs assessment in NCD and Central Province found high prevalence of pain and other symptoms among PLHA, high levels of stigma and discrimination, and significant emotional suffering among PHLA and their families. To reduce stigma and discrimination at the 23 sites, the project educated, engaged, and built the capacities of PLHA and PLHA support groups; and worked with health providers and community members to dispel myths about HIV and AIDS. Community health workers who have participated in trainings now feel capable of providing care for PLHA and are less likely to discriminate against them. After increasing their knowledge and skills and working with PLHA, the health workers have virtually eliminated discrimination at their facilities.
Team members have formed strong partnerships with healthcare workers, who sometimes ask them to deliver mosquito nets and identify community needs such as clean water and sanitation services. The teams' advocacy of palliative care and positive prevention have sensitized communities and helped to build partnerships. One of the most remote sites where the program is currently implemented is Moreguina. As team leader Mr. Ravu Kapa noted, palliative and home-based care services are integrated with health services that include social and spiritual support; referrals for voluntary counseling and testing, and drug adherence counseling for TB clients and those on antiretroviral therapy. Community support groups made up of community leaders, teachers, social workers, and religious workers have been established to take on healthcare-worker tasks. In addition to working to relieve pain and suffering and improve quality of life, these groups encourage people to change behaviors and to love and respect one another. Community and home-based palliative care has revitalized and complemented valuable cultural traditions in PNG: respecting and caring for the old and young and those sick or dying, as well the inclusion in one supportive household of grandparents, parents, children, aunties, uncles, and cousins. The project demonstrates that major strides can be made within a relatively short time by involving PLHA in community-level service provision and working with dedicated partners. The project has reached out to 900 clients; of these, 322 are HIV-positive and 237 are orphans and other vulnerable children. The initiative will soon be expanded into 10 sites in Madang and Goroka province with People Living with HIV/AIDS as the implementing partner. PHOTOS: (top) A home-based care worker examines a client. (bottom) A team of home-based care workers. (FHI/Papua New Guinea) |
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OCTOBER 2008 — In Papua New Guinea (PNG), HIV care services have been slow to reach all those in need, and on-the-ground services that provide care for people living with HIV/AIDS (PLHA) in their homes have been almost non-existent. 
Social and religious workers and trained healthcare workers form teams who provide community and home-based palliative care services for PLHA and their families. The team members receive supportive supervision as they provide pain and other symptom care; self-care education in the areas of prevention, nutrition, and hygiene; referrals to essential services; adherence counseling; emotional and spiritual support; care for affected children; and end-of-life care.