Provider costs associated with differentiated models of service delivery for HIV treatment in Sub-Saharan Africa AMBIT Project Report Number 02

By Salome Kuchukhidze  Dr. Lawrence Long  Professor Sydney Rosen  Dr. Sophie Pascoe  Dr. Amy Huber  Dr. Matthew Fox  Dr. Brooke Nichols  |  | 

According to the most recent estimates, 16.4 million people are receiving antiretroviral therapy (ART) for HIV in sub-Saharan Africa.1 Global “90-90-90” targets for HIV diagnosis, treatment, and viral suppression call for universal access and rapid-scale-up of treatment coverage, which would require another 3 million patients to be added to the national HIV treatment programs in
eastern and southern Africa.1 Meanwhile, donor spending in low and middle-income countries has declined over the past 5 years, which has led countries, implementers and funders to seek avenues of greater efficiency in service delivery.2,3 One response to this challenge is the development of “differentiated service delivery models” (DSD models) for HIV treatment. DSD models, which typically reduce clinic visits and/or move services out of the clinic, aim to improve clinical treatment outcomes; make treatment more patient-centric by lessening the burden of frequent
clinic visits; and reduce costs to both the healthcare system and to patients.

Changes in staff roles and increased task-shifting with DSD models could allow for higher quality care for advanced HIV disease patients, better care of patients with non-HIV concerns, more time for training, or improved data management, among

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