The ‘HOPE’ programme is a major community-based care and support programme for providing care for people living with HIV (PLHIV) in Ghana. This paper explores the challenges confronting the ‘HOPE’ programme and discusses them in the context of wider literature to provide lessons for Ghana and Africa. The study adopted a qualitative approach in which in-depth semi-structured interviews were carried out with 14 stakeholders and 8 focus group discussions were held with the programme beneficiaries. The data was analysed using thematic analysis. It was identified that only a few of the beneficiaries benefited from skills training leading to employment due to inadequate funding, slow cash flow and inadequate inter-sectoral collaborations. To compound these weaknesses, most reported that they preferred petty trading to the skills offered. Also, the long-term sustainability of the food supplementation once funding is discontinued was a major concern. However, the health education component could be sustained due to peer educators trained.
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