Medication adherence clubs with non-communicable disease (NCD) integration, Kenya

In Kibera, Kenya, there was a high volume of people living with HIV, as well as clients with hypertension and diabetes. Building on the experience of group models for clients who are established on ART, medication adherence clubs (MACs) were established. MACs are a group model for ART established clients who may have comorbid NCDs of hypertension (HPT) and/or diabetes (DM), or NCDs alone.  

Started in 2013, by August 2014, a total of 1,432 clients had been enrolled into 47 clubs. Clients were predominantly on ART (71%) and 29% had diabetes or hypertension. A total of 2,208 consultations were offloaded from the routine outpatient clinic and loss to follow up from the MACs was 3.5%(a). A qualitative study found the model acceptable to both patients and healthcare workers, saving patients time and reducing queues at the clinic.  MACs are an example of health care worker-managed groups with integration of healthcare for NCDs.

Eligibility

HIV related: 25 years or older, 12 months on ART, virally suppressed.  

NCD related: 25 years or older, 6 months on HPT/DM medication, blood pressure less than 150/100 and/or blood glucose less than 8% 

Building Blocks

ART refills

Clinical consultation

Psychosocial support