Eight years since the founding of the Home-Based Care Alliance (HBCA) in Kenya, HCBA groups across twelve countries are thriving and experiencing high levels of success. As of the summer of 2011, there are approximately a total of 24, 648 registered caregivers. A recent exercise base-lining the current state of organizing in the Alliance reveals that most of the groups have a strong foundation of close to or over 1000 caregivers, who are actively involved in their communities and working tirelessly in improving the lives of people living with HIV/AIDS and advocating for their well-being.  Each community, mostly in rural settings, has been diligent in taking steps to build the Alliance from the bottom up.  They start by creating and implementing a mapping process in order to identify all caregivers in their community, and have set up a database of all the caregivers. .  This ensures transparency and gives way to a comprehensive system in which all caregivers are accounted for.

Organizational formation varies based on local context, but generally groups are structured from the ground up, starting with the home-based care group/caregiver cluster (usually of about 20 people). Each of these groups nominate 1-3 representatives for a district or divisional Alliance, and moving up to the national level. In Uganda, a strong grassroots board of caregivers representing the various regions serves as the decision making and planning body for the Alliance.  In Malawi, current structure consists of a taskforce, which oversees three districts committees.  They in turn manage and coordinate the Alliance.  Benin, on the other hand, has at least 25 leaders of various types.  These include, local authorities, health center managers, and NGOs, which organize women providing home-based care.  Thus, in order for Lambassa ICA (the support NGO in Benin) to facilitate their work, a network of people living with HIV/AIDS has been created, which allows all members to participate in organized activities and engage in peer exchanges.

Solid networking and linkages are the strongholds and foundations for the Alliances, which allows for access to national and international information about health initiatives that is vital for Alliances to make an impact on advocacy.  GROOTS Kenya has made significant gains in advancing the position of home-based caregivers and has proven to be an effective model for other countries.  The International Women’s Communication Center (IWCC) in Nigeria serves as a connection between the international network of women’s rights and development organizations to the Nigerian women at the grassroots level.  They have established homecare, and organize annual women institute training centers in twelve local authorities in the country.  In Rwanda, the Rwandan Women’s Network (RWN) facilitates activities and provides capacity building workshops for people who are already working as caregivers.  Moreover, RWN’s partnership with the Department of International Development in the UK includes working with caregivers who provide care and support for genocide survivors who contracted HIV/AIDS as a result of sexual violence.  RWN’s caregivers also partner and collaborate with local NGOs and with local government, which helps caregivers to be regarded as advocates and allies within their respective communities.

HCBA’s all across are engaging in vital and ongoing activities that respond to the needs of the communities.  In Ethiopia, for example, a consultative workshop was held by SHAFON in February 2011 in Hawassa.  Additionally, communities on both a regional and international level participate in peer exchanges, which strengthens the Alliances and fosters advocacy by allowing for sharing of achievements and challenges.  Rwanda’s group has been active in working with local clinics and doctors to provide referrals and clinical trainings for caregivers.  Moreover, their partnership with USAID runs the Community HIV and AIDS Mobilization Project (CHAMP).  This project also collaborates with the Rwandan Ministry of Health to train community health workers.  Other groups, such as the Grassroots Sisterhood Foundation in Ghana, besides being committed in HIV/AIDS awareness advocacy and the Home-Based Care Alliance, activities also revolve around issues of domestic violence, early marriages, land, and property and inheritance rights.