Health care worker-managed groups

Western Cape adherence clubs

Clinical
Specific populations
Context

In the Western Cape province of South Africa, the provincial Department of Health and City of Cape Town Health are the main implementers of adherence clubs. There is an adherence club policy in place and the target is for 50% of the ART cohort to be in an adherence club. As of March 2015, 55 of 70 ART sites offered adherence clubs and a total of 32,429 clients were receiving their care, treatment and support in an adherence club. Adherence clubs in the Western Cape meet five times per year. Over the October/November period, the adherence club client receives 4 months of ART to support the high level of migration that happens out of the province at year end.

Who is eligible for this model?

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

ART refills

WHAT

ART refill
Group adherence support
Brief symptom screen
Weighed
Psychosocial support
Referral if unwell
Laboratory tests (ART refill visit prior to clinical consultation)

WHEN

5/year
(receive a 4-month refill at year end)

WHERE

Primary care clinic
Community venue

WHO

Lay health care worker

Clinical consultation

WHAT

ART rescripting
Clinical monitoring
ART refill

WHEN

Annual

WHERE

Primary care clinic

WHO

Nurse
Physician

Summary of the model (per year)

Location

Western Cape province, South Africa

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