Facility-based individual

Clinical
Specific populations
Context

"I am tired of seeing so many people for so many hours to get my treatment"

Client, Zimbabwe

Individuals who are stable ART clients are assessed and enrolled in the facility fast-track system. These clients are no longer required to draw client folders from the registry or see the counsellor or clinician at each health care visit. Clinical reviews are limited to once or twice a year. In this model, clients go directly to the facility pharmacy or dispensing room, use their client-held card, and collect their ART refill from their repeat script at each of their other annual ART refill visits.

Who is eligible for this model?

On ART for 12 months, 1st or 2nd line ART, undetectable VL or no current evidence of immunological or clinical failure, no active TB, no condition requiring regular clinical follow-up, adult (>18 years)

ART refills

WHAT

ART refill
Group adherence support
Brief symptom screen

WHEN

Monthly
2 monthly
3 monthly

WHERE

HIV clinic/hospital
Primary care clinic

WHO

Pharmacy assistant
Lay health care worker

Clinical consultation

WHAT

Laboratory tests
ART rescripting
Clinical monitoring
ART refill

WHEN

6 monthly
Annual

WHERE

HIV clinic/hospital
Primary care clinic

WHO

Nurse
Physician

Summary of the model (per year)

*ART refill visits 30-60 minutes, clinical visit for ART refill, blood draw and clincal review 180-300 minutes

Summary of evidence

The peer-reviewed evidence has highlighted that facility-based individual fast-track models can reduce visit time for clients, with good levels of retention in care.

More detailed evidence can be found here.

Implementation locations/Model variations

For more information on specific implementation locations/model variations, click on the location name in the list below. 

Facility fast-track 3m ART refill
Swaziland
Fast track 3m ART refill collection
Zimbabwe
Spaced and fast lane appointments
South Africa
3m ART refill
Rwanda
Registered buddy collection and 3m ART refill
Malawi
Fast track 3m ART refill collection
Kenya
Khayelitsha, Western Cape, South Africa
Decentralised PHC care with outreach support for children
Macha, Zambia
Streamlined care for children
Uganda
Streamlined care for children
Kenya
Partner collection and 3m appointment spacing
Ethiopia
Fast track 3m ART collection
Lusaka, Zambia

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More information on how to implement this model.

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