Health care worker-managed groups

Medication adherence clubs (MACs)

Clinical
Specific populations
Context

MSF has implemented a pilot of medication adherence clubs (MACs) in Kibera, Kenya. MACs build on ART adherence clubs by incorporating stable clients with hypertension and diabetes mellitus. MACs meet 4 times per year (every 3 months) for 90-120 minutes and are led by lay health care workers. Pre-packed medication is distributed. Clients have an annual viral load and clinical review that aligns with their MAC visit dates. Those with a high viral load are recalled to visit the facility on a separate date.

Who is eligible for this model?

All: >25 years
HIV: Same ART regimen for 12 months, previously undetectable VL, CD4>200, not WHO stage 3 or 4 active disease
Diabetes mellitus: >6 months on medication, HBA1c<8%
Hypertension: >6 months on medication, BP<150/100

Chronic medication refills

WHAT

Chronic medication refill
Group education and adherence support
Weighed
Referral if unwell
Laboratory tests (ART refill prior to clinical consultation)

WHEN

3 monthly

WHERE

Primary care clinic
 

WHO

Lay health care worker
Group member also selected as group focal point

Clinical consultation

WHAT

Chronic medication rescripting
Clinical monitoring
Blood sugar/BP check

WHEN

Annual

WHERE

Primary care clinic

WHO

Nurse
 

Summary of the model (per year)

*including blood draw visit

Location

Medication adherence clubs
Nairobi, Kenya

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