Considerations for Home and Community-Based Care for COVID-19

This review presents considerations for care and infection prevention and control (IPC) for COVID-19 in home and community-based care settings.

Overarching considerations
Many guidelines from LMICS recognise the necessity to support home and community-based care for COVID-19 (as deemed clinically appropriate, usually recommended only for ‘mild’ disease) for reasons such as to protect capacity in formal health care settings and to reduce the risk of infection spread in health facilities.
Not all people will be able to access services due to factors such as cost or availability, and in such instances will rely heavily on a broader range of services such as from informal providers or drug sellers. Local health system realities and resources will require consideration to assure relevance to context and to address gaps and provide support as far as is possible. Responses to COVID-19 should not undermine health care for other prevalent conditions.
Some people may prefer home care for a variety of reasons, including mistrust of formal health services borne of historic exclusions and bad experiences. Efforts to create dialogue with people in local settings and to build trust is crucial.
Guidance for home care should avoid assumptions about people’s resources, capacities and preferences and take into account their diverse social, economic and health system settings. Practicable guidance tailored to context and easily available materials and support is urgently needed.