Tanzania experiences a high burden of HIV/AIDS, which is the commonest cause of adult morbidity and mortality in some districts. PLHA need intensive care at various stages of their infection and represent a significant additional burden to the grossly under funded public health service delivery system. Currently, patients suffering from HIV/AIDS related conditions occupy >50% of the hospital beds in urban areas. This is one of the justifications for the extension of institutional care of PLHA into their communities and homes.
Tanzania will provide comprehensive services to PLHA at three levels, namely: at facility, community and household levels. The patient receiving care must have access to all the three levels and a strong referral system is necessary to link all the levels with each other. The fulfilment of these conditions constitutes the continuum of care to PLHA. Health care workers should conduct supervisory visits to community and home care providers as part of their role and responsibility to ensure the continuum of care.
PLHA and their affected families and households have a variety of needs beyond the mere provision of clinical care. Such needs include psychological, spiritual, nutritional, educational, economic and legal care and support. The care provided to PLHA in their homes and communities must therefore address these needs of not only the patients but also their carers at home and in the communities. An inventory or directory of service providing organisations in the local community needs to be established to facilitate networking.