Community Health Services
Since 1997, Lighthouse has been implementing a community health service program previously known as Home Based Care (HBC) in Lilongwe city with the aim of improving the lives of chronically and terminally ill patients through provision of quality health care services. To achieve this aim, Lighthouse works in partnership with 19 Community Based Organizations (CBOs) in its catchment area that have over 500 active community volunteers.
The Lighthouse approach to HBC has historically been distinctively medical. In addition to volunteer support, the fieldwork is operated by 4 nurses who care for an average of 215 severely ill patients in their homes, providing weekly nurse visits and clinical backup. Over 80% of patients who receive HBC services know their HIV status and over 70% of those that know their HIV sero status are HIV+. The HBC program focuses on traditional ‘palliative care’ and looks after chronically ill patients including cancer patients towards their end of life when the only alternative is inpatient care. Patient within the program are categorized on a simple 4 point disability scale: no significant disability, slight disability (unable to perform full day’s work), disabled (unable to contribute to household work), and bedridden. Around 80% of our patients are in the latter two categories.
Patients are visited by volunteers three times a week and once by a qualified nurse. These volunteers are recruited through the community health structures (CBOs) and receive 6-monthly refresher training following an initial Home Based Care training.
Annually, all CBOs working with the Lighthouse meet to report on progress over the year. This gives volunteers a forum for recognition by various stakeholders apart from evaluating their progress. Lighthouse also provides volunteers with non-monetary motivational items, including ID cards, “Lighthouse HBC volunteer” T-shirts, insecticide-treated bed nets, and ‘long-service’ umbrellas.
Between 1997 and 2005, the volunteers relied on Lighthouse for support on almost everything. With support from Centres for Disease Control and Prevention (CDC), Lighthouse has been able to sponsor volunteers’ exchange visits to other districts in the country to learn how community organizations mobilize resources on their own for the sustenance of program activities. As a result, the CBOs have established stable resource mobilization initiatives at their level, without any seed money from Lighthouse. CBOs now have established village savings and loan schemes for group members’ household economic empowerment. They are now able to address some patient needs on their own.
Lighthouse CHS has a great reputation for providing high quality services in its target areas in Lilongwe city.