Zimbabwe community ART refill groups (CARGs) were piloted by MSF in partnership with the Zimbabwe MoH. They were endorsed for national implementation as one of the four possible ART delivery models for stable clients included in the minimum package of services to be offered by ART facilities. Stable clients who are willing to disclose their HIV status to each other form groups of 4-15 with support from facility nurses and counsellors. A rotating CARG representative/s attends the facility to collect a 3-month ART refill for each member of the group. The entire group attends the facility either annually (where viral load is available) or 6 monthly for their clinical visit.
Who is eligible for this model?
On ART >6 months, no current OIs, VL <1,000 copies/ml (if no VL available, CD4>200), no other clinical condition requiring more frequent clinical consultations
ART refills
What
ART refill
Group adherence support
When
3 monthly
Where
Community venue
Home
Who
Client
Peer
Clinical consultations
What
Laboratory tests
ART rescripting
Clinical monitoring
ART refill
When
6 months
Annual
Where
Primary care clinic
Who
Nurse
Physician
Summary of the model (per year)
Number of contacts
Number of ART refills
Number of times clinical bloods are completed*
(1-2)
Number of clinical consultations*
(1-2)
*1 if VL, 2 if CD4
