This project is now successfully being implemented at seven regional offices (Anamulenge, Rehoboth, Gobabis, Rundu, Oshikuku, and Katima Mulilo and Keetmanshoop) or 96 service sites (volunteer groups) throughout Namibia.  1,202 from a target of 875 volunteers have been trained with this added curriculum from October 2008 to 30 September 2009.

APCA has provided direct technical assistance and support visits to pilot sites, as well as the staff at the national office.  The supervision and support address program quality issues, gathering of MER data for impact evaluation and the plans for continued expansion of this intervention. During September, a specific new monitoring tool for CAA palliative care nurses was developed and this will be implemented during the coming quarter.  This tool will assist CAA in more effective and efficient use of the nurses.

Integrating palliative care within CAA's existing home based care service delivery has dramatically increased the quality of care.  There have been increased referrals to and from facility-based services (hospitals and clinics), more timely and efficient identification and treatment of opportunistic infections, including tuberculosis, improved pain assessment and pain management, improved integration of family and caregivers into the care and support of the identified patient, and improved psychosocial support provided by the volunteers, particularly with discussing issues of death and dying.

CAA has now received a draft MOU with the Ministry of Health and Social Services.  This will work to formalize the relationship and facilitate the referrals and services between community based and facility based programs.

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