Home Based Care (HBC) is a concept of providing the health service at the door of the COVID-19 patient. The concept arisen by the public health experts to serve the COVID-19 patient perfectly&timely even when hospital facility is not available for the COVID-19 patients as more than 75% of the beds of SARI ITC (Severe acute Respiratory illness; Isolation treatment center) will be occupied by the COVID patients & rest of the beds will be preserved for the very critical patients who need the hospital treatment badly to save their lives. Since the mild & moderate cases without any co morbidity like HTN, DM, Chronic kidney disease, Cancer, immune compromised patient, patient on chemotherapy, Asthma, COPD or patient of any type of lung disease have more chances to recovery , they can be treated at their own home with skilled medical personals.
HBC Will be initiated during high community transmission of COVID-19, when there is not sufficient capacity in the isolation facilities and when the numbers of ill individuals exceed the numbers of available medical personnel. This will help to treat all the patients with limited resources. Though the HBC project did not get approval from civil surgeon office yet but recently COVID-19 transmission in the camps are increasing day by day. So anytime Partners those who are working on COVID 19 will get approval from Civil surgeon office. From
Linkage & Networking:
Without liaison & coordination no project will be successful & fruitful. For that reason since from the Very beginning, we shared our activities & roles &responsibilities of this project to health sector, CIC office ( CIC sir of Camp-19 attended in our HBC training session) , CHFP & RRRC. We also maintain collaboration with RIRT team of camp-19 & others sector of Camp-19 as HBC & COVID-19 response is a multidisciplinary approach.
Key Programs of the Project:
As decision of initiation of HBC for the FDMN community is still under consideration of Civil surgeon office of Cox’s Bazar , the HBC team of DAM besides these theory of care , initiatives some programs in COVID-19 response in camp -19 covering both Health center oriented &Outreach services.
## Dedicated care for all patients who come to health center with flue like symptoms (Fever, cough, rhinitis, breathless, anorexia, anosmia (absences of smell sensation),weakness,diarrhea& soon)
## A dedicate medical professionals team consisting of Medical Doctor, Nurse, Midwife do the whole procedure to separate the COVID suspected cases from others & give them full course of treatment including Screening from the entry point of suspected cases having fever or other symptoms, Consultation by a dedicated medical officer &they are given medicine separately by our skilled COVID dedicated HBC team in our health post in Camp-19.
## Suspected cases are referred to nearby Sentinel sites for their Corona test through our DRU ambulance &thus we maintain COVID screening & Referral pathway.
## The suspected &quarantined cases will be underour regular follow up thorough our CHWs. As a result we can ensure our after testfollow up. If anything goes wrong, we again refer the patient to nearby SARI ITC.
## Through CHWs the team raise awareness among the both FDMN & Hostcommunity by organizing regular courtyard session, awareness session& so on.
## We also arrange training session to train up our own staffs along with trained up the Rohingya leadersincluding the host community leaders & elite persons so that we can spread the news of how to fight against COVID-19, How to maintain hand &Respiratory hygiene to prevent COVID-19 & what will do if symptoms arises among the people. Thus we can break down social false belief & taboo & make people more aware.
## All our activities are recorded & documented regularly &accurately & we also maintain register & regularly submitted our records to the concerned authority.
Donor, Project Duration, Population & Area:
Integrated COVID-19 Response Programme for the Rohingya and Surrounding Host Communities (Home Based Care) project phase Iof the DAM providing key services in camp-19, Ukhiya, Cox’s Bazar among the5600 Rohingya &2400 Hostpopulation in respective camps areawithin project duration is 1stSeptember 2020 to 31th January 2021 which is funded by Christian Aid
**Manage community cases and ensure fast referral of cases& prevent further deterioration of COVID-19 patients.
** Isolate patients and household members during the infectious period to reduce further transmission in the community
** Ensure standard health care facility for all COVID -19 patients.
** Take the health facility services to the door step of FDMN community.
** Ensure Proper utilization of resources &man power.
** Stop massive community transmission.
** Reduce the socioeconomic damages &make a team to fight together against corona virus
How to carry on:The HBC team is mainly responsible to take care of mild to moderate cases of COVID -19 at their own home. In case of low grade fever, mild cough, Body ache, anorexia, nausea, weakness (mild case), the patient is given medication like Paracetamol & ORS by the CHWs & regularly visit the patient at home. In case of patient with symptoms of high fever, cough, Breathlessness without distress or any type of anoxia, vomiting, severe weakness, these patients will be visited by HCWs &necessary antibiotics& symptomatic medications are advised. If patient has high fever, cough with severe respiratory distress, nothing to eat or drink, altered consciousness, reduced urination, bed ridden &having comorbidity like HTN, DM, Bronchial asthma, cancer, immune compromised drug therapy then the patient will be immediately referred by the physician to SARI ITC for hospital management. In case of children, elderly people & pregnant mother special attention will be given as they are very prone to be infected by the virus&critical condition may arise very soon in these groups.
Home based care concept is now the burning question of health sector to fight against thepublic health emergency COVID-19 crisis. It will be able to provide health care faculty to a large number of people even where hospital facilities are not adequate & the patient will be categorized according the severity of their disease condition for hospital facility. This concept is very effective for a large community with inadequatehospital support. We hope thatthis concept will make our way smoother to victory over COVID -19 pandemic
To improve health status; to reduce vulnerability of communicable and non-communicable diseases, Health awareness on COVID-19 management and to enhance the quality of life of Rohingya and Host Communities DAM Health Sector providing general consultation (CD & NCD), laboratory test, ambulance & referrals services, door to door surveillance, health awareness & community mobilization, Hand washing session & training through Physician, Midwife, Nurse,CHW Supervisors for the Rohingya & Host community in camp level in collaboration with the Camp-in-Charge, Site Management, UNHCR, Health Sector, WHO, UNO Office, Civil Surgeon Office, DC Office, RRRC Office& other stakeholders in Cox’s Bazar district.