Facility-based individual models

Teen Clubs

Clinical
Specific populations
Context

In Malawi, pre-adolescents and adolescents who understand their HIV status are enrolled in Saturday teen clinics known as ‘Teen Clubs’ at a health facility.  These are run monthly on a Saturday or Sunday outside of normal clinic hours and are only for adolescents. Teen clubs range in size from 15-200 clients. The club is facilitated by a club mentor/s (trained and mentored in the Baylor Teen Club curriculum). The adolescents attend their club for adherence and psychosocial support, as well as for peer group building activities. In larger clubs, younger and older adolescents are split for purposes of psychosocial support with older teens also receiving sexual and reproductive health literacy.  During the club activities, a nurse sees each adolescent individually for their ART refill (including a pill count) and clinical review. Viral loads are taken in terms of national guidelines at 6 months, 2 years and then two yearly thereafter. Some facilities with high numbers enrolled in the model, continue to see the adolescents monthly for psychosocial support but only 2-monthly for clinical review and provide 2 month ART refill while others have moved fully onto a 2-monthly visit schedule. Attending adolescents receive transport reimbursement and a snack. This ART delivery model was developed and piloted by Baylor. Malawi MoH adopted it with implementing partners supporting scale out.  By mid-2017 there were 135 clubs in 26 out of 28 districts.

Who is eligible for this model?

10 – 19 years (fully disclosed, enrolled in the same ART clinic not married and not pregnant).

Clinical consultation and ART refill

WHAT

Clinical Review
ART rescripting
ART refill
Family Planning
Labs
Referral if necessary
Structured adolescent-focused adherence and psychosocial support

WHEN

1-monthly
2-monthly

WHERE

Community Health Centre
Hospital

WHO

Nurse
Trained Lay Provider

Summary of the model (per year)

Location

Teen Clubs
Malawi

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More information on how to implement this model.

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