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 a fast-tracked three-monthly ART refill directly from the facility pharmacy in between clinical consultations. In addition to ART, contraceptive options offered include long-acting reversible contraception (LARC), injectables, oral contraceptive pills and condoms. Nearly all the healthcare workers in the ART clinic provide family planning health education. Counselling on family planning is done at every clinical visit and is recorded on the client ART care card. The majority of women use the three-monthly DMPA injectable. Injectable contraceptive users can get their reinjection when they visit the clinic to collect their ART through a family planning fast-track mechanism. For clients taking oral contraceptive pills, refills are aligned with ART refills and can be collected via the fast-track window.
Eligibility
People living with HIV who have been on treatment for at least six months, are virally suppressed (most recent viral load suppressed within the last 12 months), in WHO stage one or two, on first- or second-line ART regimens and have had demonstrated good adherence in the past six months.
Building Blocks for contraceptive methods
Intrauterine device (IUD)
What
IUD information, counselling, insertion/removal, management of side effects
When
At DSD entry by referral
At DSD clinical visits
At facility walk-in services in between visits
Where
Primary care clinics
Hospitals
Who
IUD-trained doctor, midwife or nurse
Contraceptive implant
What
Implant information, counselling, insertion/removal, management of side effects
When
At DSD entry
At DSD clinical visits
At facility walk in services in between visits
Where
Primary care clinics
Hospitals
Who
Implant trained doctor, midwife or nurse
Oral pills
What
Combined and progestin only pills, information, counselling, dispensing of pills, management of side effects
When
At same clinical and refill visit as ART
Every 3 months
Where
Primary care clinics
Hospitals
Who
FP-trained doctor, midwife, nurse, clinical officer, community health worker
Sub-cutaneous 3-monthly injectable
What
ART rescripting
Clinical monitoring
ART refill
When
Annual
Where
Primary care clinic
Who
Nurse
Physician
Intra-muscular 3-monthly injectable
What
Injectable information, counselling, administration, management of side effects
When
At same clinical and refill visit as ART
At walk-in service
Every 3 months
Where
Primary care clinics
Hospitals
Who
FP-trained doctor, clinical officer, midwife, nurse, community health worker
Condoms
What
Male and female
Information, counselling, dispensing of condoms and independent collection by client
When
At same clinical and refill visit as ART
Every 3 months
Where
Primary care clinics
Hospitals
Who
Doctor, clinical officer, midwife, nurse, community health officer
Further reading
Interested in in Leveraging differentiated ART delivery models for stable clients to scale up TB preventive therapy? Read more here. Also available in French and Portuguese
Learn about family planning integration within community ART groups in Kenya here
Learn about family planning integration within postnatal clubs in South Africa here
