In Zimbabwe, a family-approach has been taken to align clinical visits and ART refills for all members of a family. Every three months, one family representative collects ART refills for all family members established on treatment and distributes the refills at home. Children between two and five years are required to attend every time (3-monthly) with their family representative for a clinical consultation. When the child is older than five years of age and on adult dosages, they attend only every second visit (i.e., 6 monthly) for their clinical consultation. Where a family member who is already part of this model becomes pregnant, they can remain a member of the family ART refill group and attend maternal and child health care visits separately. The family member ART refill model is an example of a DSD for HIV treatment model that is endorsed by national guidelines and adapted for specific populations.
Eligibility
Same ART regimen for 6 months, 1st or 2nd line ART, recent undetectable VL, no active TB, no condition requiring regular clinical follow up
Building Blocks
ART refills
What
ART and cotrimoxazole refill
When
3 monthly
Where
At home
Who
Family member
Clinical Consultation
What
Comprehensive clinical consultation
Annual viral load
When
Annual for adult family members, 6-monthly for children between 5 years of age and adolescents on adult doses, 3-monthly for children 2-5 years of age
Where
Primary care clinic
Who
Nurse
Psychosocial support
What
Peer support group
When
1-3 monthly*
Where
In community
Who
Lay provider
*Adolescents have access to Community Adolescent Treatment Supports (CATS) providing psychosocial support in the community.
Further reading
Summary of published evidence for health care worker-managed groups
Tools for implementation:
Zimbabwe Operational and Service Delivery Manual (OSDM)
