Executive summary

The Home Care department, one of the 14 departments of St. Francis Nsambya , , was founded way back in 1987. Sr. Dr. Miriam Duggan, the Medical Superintendent then, had noted with concern that the medical wards were jammed by patients with HIV/AIDS related illnesses. The HIV/AIDS bed occupancy rate was a staggering 95%! This was putting a lot of strain on the inpatient health facilities. The health workers could hardly cope with the workload. In order to ease this load, Sr. Dr. Miriam Duggan started the department with mission.

Almost two decades since then, Nsambya Home Care department has done a lot. There is a wealth of client data that has been generated over the years. However, all this data was still in a raw form on clients' cards. This study was undertaken to computerize the client database, process and analyze the available adult client data from 1987­2003. This report highlights the methods used to carry out this exercise.

According to available data at Nsambya Home Care department, close to 14,000 (13,996) clients have been served from 1987 up to end of2003. Those who were alive at the end of2003 constituted 15% of the total. The proportion of those who were documented as dead was 14%, the majority (70%) is lost to follow up, but most probably they could also be dead.

There were variations in client registration over the years, with peaks in 1993 when the epidemic was maturing, and again in 2003, possibly in anticipation of access to antiretroviral drugs. Client fluctuations could be due to the fact that there were other service providers coming on board during the subsequent years, in response to the raging epidemic. But food provision could have contributed to the rising numbers during 1997­98.

There were twice as many female clients as males accessing service at Nsambya Home Care. Most of these females (47%) were unemployed and few (8%) had skills that would make them employable. This was exacerbated by the fact that they were young with an average age of 31 years. The male clients on the other hand were significantly older, mean age 34 years, and over 50% of them engaged in unskilled or semiskilled labor for survival. The proportion of the clients who indicated the age of their youngest children to be below 15 years was 95%.

Most clients presented with persistent fever, cough, a skin rash or itching and abdominalpains.Tuberculosisis documented as the leading killer(23%), followed by dehydration due to chronicdiarrhea,21%. The majority of those who died spent less than 6 month son the program. Possibly they came very late at an advanced stage of AIDS. More females than males survived up to 2 years and beyond.