It is estimated that over 6 million South Africans live with HIV. The provision of Antiretroviral drugs in public health facilities has substantially increased the lifespan of patients diagnosed with HIV however, the demand for HIV treatment has put significant strain on clinic pharmacies resulting in longer waiting periods for ARTs. Due to this, patients default on treatment because of work or family commitments.
The ART Adherence Clubs were initiated by Medecins Sans Frontieres in 2007 with the support of the Western Cape Department of Health and the Treatment Action Campaign in Khayelitsha at the Ubuntu Clinic to address this challenge. The ART clubs decentralize the provision of treatment to patients' local communities with an added incentive of social support as stigma is still a challenge faced by many people infected with HIV in South Africa.
The ART clubs are a long term retention model of care catering for stable ART patients where 30 stable patients meet and are facilitated by lay healthcare workers who provide a quick clinical assessment, referral where necessary, peer support and distribution of pre-packed ART every 2 months.
What are the key components of this program? :
The success of the models relies in all components working together to deliver treatment. The following actors each contribute towards improving patient outcomes.
Club Managers:
- Ensuring that the Standard Operating Procedures are adhered to.
- Scheduling annual return dates for club visits.
- Six monthly scripting of club patients.
- Monitor outcomes.
- Clinical oversight of clubs.
Clubs facilitator
- Prepares club sessions including pre-packed ART.
- Running the sessions.
- Administrative tasks of group (registers, conducts screening including taking down weight)
- Distribute ART.
- Return uncollected ART pre-packs to pharmacy and follow up on patients who missed sessions.
Club professional nurse
- Not present at the club session but is responsible for seeing patients who are symptomatic and conducts annual clinical consultation.
Pharmacist
Ensures scripts are submitted and pre-packs are received and correct.
Data Capturer
- Captures data on club patients from register into facility electronic register.
Expansion History: