Health care worker-managed groups

Youth clubs

Clinical
Specific populations
Context

Youth clubs have been implemented at two clinics (a youth-specific clinic and a general clinic) in the Khayelitsha area of Cape Town by MSF in partnership with local health authorities. In addition, the model has been endorsed in the South African national adherence policy. Youth clubs are closed groups of approximately 20 members, including youth who are ART ineligible, newly initiated and stable on ART. Separate groups are formed for youth still attending school and older youth. Youth clubs are led by lay health care workers and have a nurse allocated to support clinical duties. Groups meet monthly for the first 6 months and 2 monthly thereafter at the clinic. ART refills, HIV clinical management and family planning are integrated into the youth club model. Youth stable on ART receive their ART refill in the group while newly initiated youth are given their ART refill by the club nurse during their clinical consultation taking place immediately after the group meeting. There is a structured interactive activity-based group session at each visit, and this provides the opportunity for development of a peer dynamic and support system.

Who is eligible for this model?

Youth (clients 12-25) living with HIV. Youth clubs include youth clients who are newly diagnosed but ineligible for ART, newly on ART and stable on ART (on ART >12 months, 1st or 2nd line ART, 2 consecutive undetectable VLs, no active TB, no condition requiring regular clinical follow up)

 

ART refills

WHAT

ART refill
Brief symptom screen
Weighed
Family planning provision
Structured youth focused group adherence support
Phone number check

Referral if unwell
Laboratory tests (ART refill visit prior to clinical consultation)

WHEN

8-10 times for year 1
5-6 times/year thereafter

 

WHERE

Primary care clinic
 

WHO

Lay health care worker

Clinical consultation

WHAT

ART rescripting
Clinical monitoring
ART refill
 

WHEN

Annual (if stable on ART)
6 times in 1st year (if new on ART)
6 monthly (if ART ineligible)

WHERE

Primary care clinic

WHO

Nurse
 

Summary of the model (year 1)

Summary of the model (after year 1)

*The number of times clinical bloods are completed is 2 if ineligible for ART. 
**Monthly until after first VL, then once after second VL. 
    The number of clincial consultations is 2 if ART ineligible. 

Location

Youth clubs
Cape Town Metro, Western Cape, South Africa

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