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Community Models of Care project.

Project Description

Despite the rapid scale up of antiretroviral therapy (ART), patients still encounter barriers accessing treatment, while health systems struggle to provide care to their ever-increasing cohorts. To address these barriers, different models involving the community have been developed, which aim to provide services closer to patients’ homes, and involve separation of medication refills from clinical assessments.  This project consists of:

  • The report “Reaching Closer to Home“, available in both English and Français, describes recent progress in 6 countries on the implementation of community-supported strategies of ART refill such as community ART groups (CAGs), Adherence Clubs, and ART Distribution Points (also known as PODIs).  A short version of this report, published jointly with UNAIDS and called ‘Community-based Antiretroviral Treatment Delivery’, is available by clicking here.
  • Community ART Group (CAG) Toolkit, available in both English and Français, describes how to implement self-forming groups of patients, in which individual group members take turns visiting their health facility for ART refills.
  • An ART Adherence Club report and toolkit, available in English, describes a model that allows patient groups to collect pre-packaged, 2-month supplies of their drugs from lay health workers either at the clinic or elsewhere in the community.
    • A number of tools are available as Adherence Club Annexes to support the implementation of Adherence Clubs.
    • As of June 2015, a new insert/chapter became available that describes Family ART adherence clubs that cater for children stable on ART and their caregivers.  These ‘Family Clubs‘, run by counsellors and supported by nurses, also help to facilitate disclosure of HIV status to the children.
    • A 7-minute video showing practicalities of Adherence Clubs.
  • A report on ART Distribution Points (also known as PODIs), available en Français, which describes progress in implementation of a model whereby patients attend a health facility annually for a clinical check and blood-drawing in the urban setting of Kinshasa.  They then pick up their ARV drugs every 3 months from a community-based ART distribution point (PODI) managed by a local organization that supports PLHIV.

Note that relevant peer-reviewed articles and a presentation on community-supported models of care can be found here in the CMoC Dossier on this website.

Project Details

  • Date December 3, 2013
  • Tags CAG, HIV, Patient education and counseling, TB

Responses (6)

  1. Oniwell Nyekete
    December 27, 2013 at 6:36 am · Reply

    Hi all

    As a Patient Support and Counselling Mentor for Gutu Project, I am more than happy and impressed with this paradigm shift of stable ART patient care and support with the innovation of CAGs which for Gutu I coined a name Community ART Refill in Support Groups (CARSGs). The attention put on this kind of Community ART program satisfies me and even the patients themselves as I had group as well as one-on-one interactions with them during sensitisation in 2012-2013 using the Mozambique CAG videos. This led to the motivation by existing support groups to scale up their group activities into ART refill groups…

    Would like to keep informed and updated on developments related to CARSGs and alternative Community based ART programs in the especially in the Southern African Region and the world in General. please keep me updated on my address above

    Regards

    Oniwell

  2. tom ellman
    April 15, 2014 at 8:21 am · Reply

    Hi
    This is Tom from SAMU. Am in Dar es Salaam, at a workshop on models of care for People Who Inject Drugs in Africa. A lot of interest shown by programme managers and patient groups in the possibility of using a CAG model for delivery of methadone substitution therapy and needle exchange at community level.

    We will follow up from SAMU but if anyone out there has ideas on this or other applications for the CAG model outside of HIV treatment let us know…..

    cheers
    tom

  3. […] pertenece al Grupo Comunitario de Tratamiento Antirretroviral de Arnon, un modelo creado por Médicos Sin Fronteras que fue introducido en el distrito de Gutu de Zimbabue hace un año. En estos grupos solo un […]

  4. […] facility-based fast-track through to adherence clubs, community ART groups (CAGS), and, finally, some examples of community-based pharmacies are appearing. These strategies have been variously named alternative-refill strategies, community […]

  5. Munya
    August 12, 2015 at 11:57 am · Reply

    HIV care simplification, slowly we’re getting there. We need to continuously remind ourselves of the need to embrace opportunities being presented by various alternative refill models being tried. the biggest battle is to convince oursleves as health care wokers to trust that patients can self care, they have always been

  6. Munya
    August 12, 2015 at 11:57 am · Reply

    HIV care simplification, slowly we’re getting there. We need to continuously remind ourselves of the need to embrace opportunities being presented by various alternative refill models being tried. the biggest battle is to convince ourselves as health care workers to trust that patients can self care, they have always been

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