Health care worker-managed groups

Clubs run by community-based organizations in members’ homes or close by

Clinical
Specific populations
Context

Clubs run by community-based organizations (CBOs) in members’ homes or close by locate adherence clubs outside of health facilities and closer to where clients live. This variation is currently implemented by the Department of Health, who funds CBOs in the Khayelitsha area of Cape Town with technical support from MSF. Seven clinics have started these types of clubs alongside facility-based clubs. Each club is made up of 15-30 stable patients, depending on the size of the venue where they meet. CBO-run clubs meet six times per year: four times for ART refills outside the health facility, and two visits to the health care facility (once for routine blood draw and once for ART refill and clinical review).

Who is eligible for this model?

Same ART regimen for 6 months, 1st or 2nd line ART, 1 undetectable VL, no active TB, no CD4 threshold, no condition requiring regular clinical follow up, adult (>18 years)
Patients who have previously had a high viral rebound but re-suppressed are also eligible to join immediately

ART refills

WHAT

ART refill
Group adherence support
Brief symptom screen
Weighed
Referral if unwell

WHEN

5/year
(receive a 4 month refill over year end)

WHERE

Club member’s home
Community venue

WHO

Lay health care worker
CBO lay staff member

Clinical consultation

WHAT

ART rescripting
Clinical monitoring
ART refill

WHEN

Annual
(laboratory tests are drawn separate from club visit date)

WHERE

Primary care clinic

WHO

Nurse

Summary of the model (per year)

Location

Khayelitsha, Western Cape, South Africa

Need more details?

More information on how to implement this model.

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