Facility-based individual models

Standardized paediatric expedited encounters for ART drugs initiative (SPEEDI)

Clinical
Specific populations
Context

Children and adolescent clients who are stable on ART are assessed by any clinician at the specialized paediatric facility and enrolled in the standardized paediatric expedited encounters for ART drugs initiative (SPEEDI) programme. These clients are no longer required to see a clinician at each health care visit. During a SPEEDI visit, the client’s file is marked at reception to reflect a potential SPEEDI visit. The client/caregiver proceeds to the triage room, where the triage team takes their vital signs and anthropometrics, conducts a pill count and enquires if they wish to see a clinician. If they do not wish to see a clinician, the client goes directly to the pharmacy to collect a 2-3-month ART refill. While waiting at the pharmacy, a clinician quickly reviews the file to ensure that the patient is indeed eligible for SPEEDI. The clinician writes the appropriate script and lab requisition forms (when needed). Clients alternate fast-track SPEEDI visits with routine clinical review visits and thus are required to see the clinician 2-3 times a year. Clients have their viral load taken once a year, at the ART refill visit prior to their clinical review allowing for assessment as part of the clinical review.

Who is eligible for this model?

Child or adolescent (or young adult), on ART >6 months, suppressed VL*, no medical or social complications, good adherence, presence of a reliable caregiver  
* since 2016

 

ART refills

WHAT

ART refill
Pill count
Vital signs and anthropometrics
Dosage check and ART rescripting
Laboratory tests

Referral if unwell

WHEN

Two monthly
Three monthly

WHERE

Specialized paediatric HIV clinic

WHO

Triage team
(Clinician/lay HCW)
Pharmacist

Clinical consultation

WHAT

ART rescripting
Clinical monitoring
ART refill

WHEN

4 monthly
6 monthly

WHERE

Specialized paediatric HIV clinic

WHO

Doctor

Summary of the model (per year)

Location

SPEEDI
Mbeya, Tanzania

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