ZAMBIAN URBAN ADHERENCE CLUBS
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ZAMBIAN URBAN ADHERENCE CLUBS

  • 11/04/2016

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  • Description:
    Zambian Urban Adherence Clubs is group-level intervention and health services innovation using differentiated service delivery (DSD) designed to improve on-time drug pickup. An Adherence Club (AC) is a group of approximately 30 PWH on ART who meet during offhours at an HIV treatment facility to receive medication refills, symptom screening, counseling, and group psychosocial support. The Zambian AC is based on South African ACs that are nurse-led. The Zambian ACs are led by pharmacy technologists who pre-package ART medication and dispense it to the members at the meeting. Groups are supported by two lay community health workers (CHW) who conduct symptom screening and lead a group counseling session. AC members meet every two months in the first 6 months after club formation and continue to visit the facility every six months for both clinical follow-up and laboratory monitoring. Patients who are unable to attend the meeting in person can send a buddy for medication pickup on their behalf. No restrictions are placed on the frequency of use of the buddy system, and lack of meeting attendance is not considered a criterion for removal from the club and does not affect referral back to facility-based care, if needed. Patients are referred from the AC to the facility in the case of acute illness or positive symptom screening and are transferred out of the AC if they became pregnant or because of patient or clinician preference.
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