Médecins Sans Frontières (MSF) and the KwaZulu-Natal Department of Health offer several ART delivery strategies in Eshowe and Mbongolwane for patients who are stable on treatment:
• Standard Care: Clinical consultation and ART collection at the facility every two months.
• Facility Clubs and community clubs: lay counsellor-led groups of up to 30 patients meeting every second month in locations near the facility or based in the community, for ART collection and yearly for clinical consultation.
• Community ART groups (CAG): patient-led groups of three to eight HIV-positive patients. Patients rotate visiting the facility for three-monthly ART collection for all members and an annual clinical consultation.
• Central Chronic Medicine Dispensing and Distribution: patients receive their medicines on a monthly basis at a DOH-approved “pick-up point” in the community.
By the end of 2015 over 21% of eligible patients were receiving ART refills and adherence support through either a club or CAG in the project catchment area. There was a steady increase in adherence club enrolment over the course of 2015, from 64 clubs in the first quarter to 83 clubs in the last quarter. CAG enrolment remained constant over 2015.
In this video, MSF Eshowe Deputy Field Co-ordinator Musa Ndlovu and Project Medical Referent Dr Vivian Cox explain how CAGs work, we follow Community Caregiver Nonhlanhla Ngema as she provides support to a newly formed CAG, and we hear from patients themselves how this model of care is working for them.