The cost of home-based care for HIV/AIDS patients in Zimbabwe

From a study on the cost and quality of community home-based care (CHBC) fo r HIV/AIDS patients in Zimbabwe, programme and household costs were estimat ed. Interviews, using a structured questionnaire, were held with 60 patient s and caregivers sampled from six types of established CHBC schemes. Detail ed cost information was collected from four home care programmes, two urban and two rural. The cost of a home visit in the two urban programmes studie d was estimated to be Z$129 (US$16) in one, and Z$183 (US$23) in the other. In one of the two rural schemes, the cost of a home visit was Z$313 (US$38 ), in the other this was Z$343 (US$42). A large proportion of these costs w ere not Of direct benefit to the patients, as approximately 56-75% of the t otal cost per home visit was spent getting to the patient. The costs of a h ome visit in a rural home-based care programme corresponded to the costs of 2.7 inpatient days in a district hospital. The family cost of caring for a bedridden AIDS patient over a three-month period was estimated to be betwe en Z$556-841. Caregivers spent as much as 2.5-3.5 hours a day on routine pa tient care. The programme costs are high, and schemes do not generally asse ss effectiveness, nor cost-effectiveness. The high cost of home visits lead s to less frequent visits, leaving a larger part of both the burden and the cost of care to the families and the patients.