Differentiated antiretroviral distribution: Implementation in five South African districts

African Journal of Primary Health Care & Family Medicine

 
 
Field Value
 
Title Differentiated antiretroviral distribution: Implementation in five South African districts
 
Creator Engelbrecht, Justin Tajeer, Chandbi O’Connor, Cara Rees, Kate
 
Subject — differentiated service delivery; antiretroviral therapy; differentiated models of care; HIV; CCMDD
Description Background: The National Department of Health introduced Differentiated Service Delivery (DSD) models to improve retention in care and decongest healthcare facilities. Anova Health Institute supported the implementation of DSD guidelines in five districts of South Africa.Aim: The study aimed to describe how the models contained in DSD policies are operationalised.Setting: Five districts of South Africa – two metropolitan, two mixed and one rural.Methods: We used a mixed-methods approach, incorporating a 2-day participatory workshop in 2023 and a retrospective review of routine programmatic data. A mapping exercise was used to understand all models of chronic medication provision in the five study districts and to describe differences in operationalisation. We also report on the number of options per facility and healthcare provider perspectives of benefits and limitations.Results: External and facility pick-up points were the most commonly implemented models. Three key themes were: the trade-off between convenience and additional support, the trade-off between controlling client care and outsourcing tasks and the distribution of work between cadres of staff. Sedibeng District provided the most options per facility, with 57% of facilities having three possible options. Cape Town provided the fewest, with 50% of facilities offering only one option.Conclusion: Health and environmental contexts guide the choice of DSD modalities offered. It is possible to offer clients options in South African settings.Contribution: This study highlights the context-specific nature of DSD model implementation and the importance of client choice. Further research into availability and options from a client perspective would be useful.
 
Publisher AOSIS
 
Contributor PEPFAR USAID
Date 2025-08-27
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/phcfm.v17i1.4974
 
Source African Journal of Primary Health Care & Family Medicine; Vol 17, No 1 (2025); 9 pages 2071-2936 2071-2928
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://phcfm.org/index.php/phcfm/article/view/4974/8540 https://phcfm.org/index.php/phcfm/article/view/4974/8541 https://phcfm.org/index.php/phcfm/article/view/4974/8542 https://phcfm.org/index.php/phcfm/article/view/4974/8543
 
Coverage Five districts in South Africa — —
Rights Copyright (c) 2025 Justin Engelbrecht, Chandbi Tajeer, Cara O’Connor, Kate Rees https://creativecommons.org/licenses/by/4.0
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