The idea for a federation of home-based caregivers arose out of the International Conference on AIDS and STIs in Africa in 2003 in Nairobi, Kenya, when home-based caregivers were challenged by the Global Fund on AIDS, TB and Malaria to federate and organize so that global donors could find them. Grassroots members of GROOTS Kenya took up that challenge and launched the Home-Based Care Alliance in Kenya in 2005.

Some of the major successes of the Alliance in Kenya so far include gaining recognition for caregivers on the National AIDS Control Council (and within the local and district levels of that body), and on other advisory bodies led by UN agencies (UNICEF) and civil society. This collective organizing has allowed the groups at the local level to access and prioritize the distribution of devolved funding. The Alliance in one region has been given and office space by the district government, and has been charged with collecting accurate statistics of HIV prevalence rates and number of orphans in their community. Showing heir contributions and numbers, members of the Alliance are able to negotiate for and claim decision-making space.