Facility fast-track, Zimbabwe
Clients in this Zimbabwean fast-track model are able to collect their ART refills from the health facility in a short amount of time – without having to be seen by clinician, counsellor other health workers. These clients are not required to collect their folder from the registry. Clinical reviews are limited to once or twice a year. In this model, clients go directly to the facility pharmacy or dispensing room, use their client-held patient card, and collect their ART refill from their repeat script at each of their other annual ART refill visits.
A 2019 study of the available DSD models in Zimbabwe found that fast-track was the preferred treatment model of clients who could afford regular visits to their health facility, but were concerned about maintaining the confidentiality of their HIV status and valued shorter waiting times.
Eligibility
On current ART regimen for at least six months, virally suppressed (viral load of less than 1000 or CD4 count above 200, no current opportunistic infections.
Building Blocks
ART refills
What
ART refill
Group adherence support
Brief symptom screen
When
Monthly
2 monthly
3 monthly
Where
HIV clinic/hospital
Primary care clinic
Who
Pharmacy assistant
Lay health care worker
Clinical consultations
What
Laboratory tests
ART rescripting
Clinical monitoring
ART refill
When
6 monthly
Annual
Where
HIV clinic/hospital
Primary care clinic
Who
Nurse
Doctor
Variations
Evening quick pick-up programme, Khayelitsha (South Africa)
In Khayelitsha, South Africa, the quick pick-up programme (QPUP) was piloted at a large ART clinic that was supported both by local government and the . Clients in the QPUP…
Weekend and after-hours treatment collection in Zambia
Zambia’s DSD policy framework makes provision for before/after hours and weekend HIV treatment models that allow for ART collection outside of normal health facility operating hours. These models are designed…
Fast-track ART with family planning integration, Uganda
A facility-based fast-track model is one of the differentiated service delivery for HIV treatment models offered in Uganda. Clients are seen for a clinical visit every six months and receive…
Fast-track with integrated tuberculosis preventative therapy (TPT), Zambia
The Ministry of Health in Zambia, in collaboration with supporting partners, is expanding implementation of aligning six months of TPT with ART refills, as clients enroll in a fast-track ART…
Further information and resources
Published evidence for facility-based individual models
The limited evidence for facility-based individual models suggests increased cost effectiveness for the health system, improved quality of care and improved client outcomes.
