Tackling HIV: Improving home-based care in Tanzania

HelpAge's project in Tanzania trains older people as volunteer community carers so they can provide quality home-based care and support to people affected by HIV and AIDS.

The impact of HIV on older people and their families

Fatima, 55, with her grandchild Fatima, 55, is living with HIV. She is visited by a home-based carer once a week. (c) Jeff Williams/HelpAge International It is estimated around half of all children in Tanzania orphaned by AIDS are cared for by a grandparent.

Yet our work in local communities in Tanga province has found older carers have few or no skills in caring for orphans or for people living with HIV.

It means older people are often stressed and have little psychological support.

Due to high rates of poverty and its location on a busy truck route, Tanga province has one of the highest prevalence rates of HIV.

Another issue is that, although our research shows older people are at significant risk of being infected by HIV, they are left out of prevention programmes.

Educating communities about HIV and AIDS

Working with our partner African Women AIDS Working Group (AFRIWAG), we are identifing older carers and training them as volunteer community home-based carers and counsellors.

The training increases carers' understanding of HIV and AIDS-related illnesses and improves their skills to provide care for people living with HIV. They are also trained to provide psychological support to people in households affected by HIV and AIDS and to educate the community (including older people) about HIV prevention.

We are also working with government health staff to improve access to healthcare services for carers and patients.

Mutual support groups have been set up to provide a local forum for older carers to share information and experiences.

The project has been rolled out in three districts in Tanga province following its success in 57 other communities in Tanzania.

Project aims (2008-2013)

  • To train 680 older people to be home-based carers.
  • Each carer will help 15 households headed by an older person per year.
  • Over five years, 25,500 households will receive support.

Aisha: Our training has changed people's attitudes to HIV

Aisha Saidi, a home-based carer Aisha is a volunteer home-based carer in Tanga province (c) Jeff Williams/HelpAge International Aisha Saidi, 62, lives with her husband, son and niece. Aisha became a volunteer home-based carer after losing a younger sister, brother-in-law and a niece to AIDS-related illnesses.

"During my 21-day training, I learned how to give counselling, how to advise people on when to take their antiretroviral (ARVs) drugs, about nutrition and the importance of a good diet when taking ARVs.

"I know how to safely wash patients by wearing gloves. I also advise people about getting tested for HIV and promote safe sex practices in the community through condom use.

"Before the training I didn't know any of these things and if I had I would have been able to help my family more.

"A few days ago a community member came to see me as she had been sick for some time. I advised her to go to the hospital for an HIV test. I accompanied her there and unfortunately she was positive.

"I will now support her with the taking of drugs, and will visit and counsel her whenever she needs my help. She was very comfortable coming to me and asking for advice.

"Raising awareness about the disease is also part of our job and we encourage the use of condoms. There are condoms at the health clinic but some people are still shy about getting them there so come to the home-based carers to get them.

"We often joke with the people who come for condoms and put them at ease so they are not afraid to come back again. We also tell HIV positive people that they should use condoms to help protect their partners from contracting the infection.

"To be a carer you have to be a strong person. You must also be able to love people and you must be able to keep information confidential. Older carers are particularly respected and trusted and the community like to talk to us.

"There are three home-based carers in our village and since our training and work in the local community, people's attitudes about HIV have changed. Before, if a household had an HIV positive member, the neighbours would stop visiting and saying hello. There was a stigma attached to the disease.

"Now people realise that talking about the illness and openness about HIV is very important and neighbours will help each other. For example, if an HIV positive person needs to go to hospital, the community will come together to help pay the costs. People now understand that it is the community's problem, not the individuals."

Read more HIV carers' stories in the gallery


Useful links

Read more on our HIV and AIDS policy work.

What we're doing to alleviate the impact of HIV and AIDS in Ethiopia, Kenya, Uganda and South Africa.

Fact file

  • There are 1.6 million people living with HIV in Tanzania.
  • The country has 1.1 million under 17s who have been orphaned by HIV or AIDS.
  • UNICEF estimates 12.5% of all children in Tanzania in 2005 were orphans with 50% of these living with their grandparents.

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