The Ghana national DSD operational manual has endorsed a model for primary health centres, community sites and key population drop-in centres to function as ART refill sites. Drop-in centre refill sites have a defined agreement with a specific ART site where the client’s care booklet is held, ART is supplied and clinical follow-up is provided. A nominated healthcare worker or client collects ART from the ART sites. The host ART site performs the 6-monthly clinical review and scripts two 3-month ART refills, which can be distributed by lay cadres, including peers.
The International Healthcare Centre (IHCC) has utilized the policy to differentiate HIV treatment for gay men and other men who have sex with men, who are established on ART. IHCC operates a private community clinic with outreach services to gay men and other men who have sex with men. ART established men from this key population receive an abbreviated clinical check-up by a nurse and ART refills of 4-6 months (depending on drug supply availability) during extended hours. When gay men and other men who have sex with men express concern at being seen by other community and network members, they are also given the option for lay healthcare workers (peers) to deliver their ART refills to an agreed community pickup point or for pickup from the mobile outreach service.
Eligibility
12 months on 1st or 2nd line ART and virally suppressed
Building Blocks
ART refills
What
ART refill
Referral check
Adherence check
Condom and lubricant distribution
When
4-6 monthly
Extended hours (8am-8pm on weekdays and
8am-1pm on Saturdays)
Where
IHCC community clinic or delivered at home by peer or picked up from mobile outreach
Who
Peer/nurse
Clinical consultation
What
Clinical consultation
Laboratory tests
Rescript
When
4-6 monthly
Extended hours (8am-8pm on weekdays and 8am-1pm on Saturdays)
Where
IHCC community clinic
Who
Nurse
Further reading
Interested in prioritizing differentiated ART delivery for clinically stable clients in West and Central Africa? Read more here (English) or here (French).
Access our policy brief for differentiated ART delivery for clinically stable clients in West and Central Africa here (English) or here (French).
Learn more about another West and Central African DSD intervention: “Community-based points of ART distribution (PODI) in the DRC” here.
Learn more about another West and Central African DSD intervention: “ART refills through clubs in Côte d’Ivoire” here.
Learn more about another West and Central African DSD intervention: “Community pharmacies for ART refills in Nigeria” here.
For more information on DSD with key populations, access “A Decision Framework for Differentiated Antiretroviral Delivery for Key Populations” in English, French or Portuguese.
