Integrating Family Planning into Home-Based Care Programs: A Pilot Project in Mpumalanga, South Africa

HIV/AIDS places an increasing burden on health care systems in resource constrained settings. This is particularly true in South Africa, one of the countries hardest hit by the epidemic. Although there is an emerging body of literature on the integration of HIV/AIDS into clinical services, I was not able to find articles on integration into community-based prevention programs. I worked in collaboration with a South African organization dedicated to providing home-based care to people living with HIV/AIDS to explore the possibility of integrating basic communication and counseling skills into its ongoing programs. This paper describes the process I used, including a summary from the literature; site visits and assessments in Mpumalanga, South Africa; and priority-setting with the leadership at Project Support Association (PSA), the local partner organization. The original intent of the program was to provide volunteers with additional information on long- and short-term contraceptive methods, implications of unprotected sexual intercourse, and referrals to appropriate diagnostic, treatment, and care services. However, the findings from the assessment clearly pointed in a different direction. I convinced the leadership at PSA that while accurate information is certainly an essential part of risk reduction, information alone is insufficient to result in behavior change. Basic communication skills could enhance the work of the PSA volunteers. Thus, basic communication skills, rather then a reinforcement of the volunteers' existing knowledge, became the main thrust of the training manual. The training manual I developed is attached as an addendum to this paper.