Horizons Projects | A Cost Analysis of Models of Home-based Caregiving in South Africa

HORIZONS PROJECT
A Cost Analysis of Models of Home-based Caregiving in South Africa

In 2004, the Horizons program, with partners Family Health International, HOPE worldwide, Hospice Soweto, Medical Care Development International–Ndwedwe, Project Support Association of Southern Africa, and Sinosizo, undertook a study of six different home-based care (HBC) programs in South Africa to examine the cost of HBC services, the best use of resources, and how well programs are able to meet the needs of beneficiaries and their families. Data were collected using quantitative and qualitative methods, including a household survey and focus group discussions with program beneficiaries and outside caregivers. The study offered a profile on household recipients of the HBC services and their needs and a profile of the programs providing the HBC services.

The study found that the needs of HIV-affected households were many and varied, and included counseling, physical care, nursing care, help with chores, and information. Respondents reported that many of these needs were being met by a combination of household and outside caregivers. Each of the six HBC programs had a different historical background, organized its resources in a different manner, provided a different package of HBC services, and served a different mix of clients. As expected, there were large differences in the annual operating costs across programs, including the annual cost per client and cost per visit.

Conclusions from the study include:

Formal caregivers serve more as a complement to household caregivers than as a substitute.
There is a need for HBC programs to work more closely with household members to provide services that meet unmet needs.
HBC programs need to explore ways to assist households with income generation.

Location

South Africa

Duration

May 2004–May 2005

Horizons and Population Council researchers

Eka Esu-Williams, Joseph Motsepe, Catherine Searle

(For more information about this study, please contact horizons@popcouncil.org.)

Non-Council collaborators

Marc Aguirre (HOPE worldwide)

Rick Homan (Family Health International)

Sibongile Mafata (Hospice Soweto)

Farshid Meidany (Medical Care Development International-Ndwedwe)

Corrie Oosthuizen (Project Support Association of Southern Africa)

Liz Towel (Sinosizo)

Nelson Mandela Children’s Fund

Progressus

Provincial Departments of Health

Donor

US Agency for International Development

Publications/Resources
Horizons and Population Council researchers' names appear in boldface type.

2005
Homan, Rick and Catherine Searle. "Exploring the role of family caregivers and home-based care programs in meeting the needs of people living with HIV/AIDS," Horizons Research Update. Washington, DC: Population Council. (PDF)

———. "Programmatic implications of a cost study of home-based care programs in South Africa," Horizons Research Update. Washington, DC: Population Council. (PDF)