The Arms Reach Care (ARC) model gives the Family Care Giver a deeper understanding of the components of care for their patient and of the important role in providing that care. By training FCGs and CCAs, the ARC model creates a broad base of trained caregivers in the community, facilitating the management of AIDS-related infections. With the assistance of CCAs, the Project Nurse is able to focus on the more serious cases requiring his/her advanced skills, and to make decisions on referrals to government clinics.
This model offers a solution to both problems: shortage of trained health professionals, and over-burdening of government clinics. Further, this model is different from existing home-based care models as it relocates ownership and responsibility for the care of persons living with HIV/AIDS back into the home. It also significantly reduces the cost of operations and allows for the most care per dollar. With its unique philosophy and structure, the ARC model constitutes a radical shift from present models by engaging more community members in care-giving, significantly increasing the range of care provided at home, and increasing the output and impact of individual caregivers and of the overall system.
At present there are 200 HIV+ children who are direct beneficiaries and an additional 1100 children who benefit indirectly through the caregivers in the program teaching other women in the community about caring for an HIV+ child.
As a result of the care provided:
(i) All children (except two), have either maintained or gained weight since January 2012. A stable or increased weight is an indication of stable health and is remarkable given the HIV+ status of the children and especially so since a majority of the children are on ARV's (antiretrovirals).
(ii) Adherence training and monitoring is provided for older children who are aware of their status. At this time, all children who are aware of their status are adhering well to their ARV regimen.
(iii) As a result of better nutrition and health, all children eligible for school are in school and learning.
(iv) Over 450 Family Care Givers have been trained in caring for an HIV+ child. These women act as role models for other women in the community and teach them the benefits of HIV prevention, proper care of an HIV+ child, the importance of adherence to the medication regimen, the importance of keeping children in school, and the need to go in for voluntary testing and counseling for HIV.
(v) As care givers (grandmothers/grandaunts/mothers) see for themselves the positive effect that quality care has on the children, they themselves have come forward for testing (which, is critical in preventing the further spread of HIV). To date, more than 100 caregivers have come forward for testing for HIV.
Overall, this program has increased survival rates, reduced malnutrition, and lowered the frequency of opportunistic infections for HIV+ children in the community of Matero in Lusaka. Children who were previously unable to attend school due to debilitating chronic diarrhea or serious fungal infections are now able to resume their studies and have dreams of an adult life. Mothers and grandmothers who were previously kept away from work by long waits at the clinic and children in need of intensive care at home, have now returned to earning money to support these children and the rest of their families.