Table 1

Differentiated service delivery models for HIV treatment in use in Zambia during the study period

CategoryModels in the categoryDescription
Adherence groupsCommunity adherence groups.Patient groups, consisting of ±6 members, meeting at an agreed time every 1–3 months. The groups are managed by the patients themselves and usually meet outside of the health facility. Members collect ART at clinical appointments for other members in a rotating fashion.7
Rural and urban adherence groups/clubs.Patient groups, consisting of 20–30 members, meeting at an agreed time every 2–3 months. Groups are often facilitated by the same healthcare worker or facility-based volunteer, also providing prepackaged ART.7
Community pick-up pointCentral dispensing units.A centralised model for ART distribution where medication is packed at a centrally located hub and distributed to patients at multiple approved pick-up points. Clinic visits occur every 6 months at the health facility.11
Community ART distribution points, community retail pharmacies and health posts.ART refills are provided to patients outside of health facilities, for example, schools, churches, community centres, community retail pharmacies and health posts.11
Mobile ART distribution models.A clinical outreach team linked to a facility does 3-monthly clinical assessments at community distribution points. This model is usually used for hard-to-reach areas.11
Extended clinic hoursBefore/after-hours models, weekend models and scholar models.These models allow patients to have a clinic visit and collect their ART outside the conventional operation times at the facility (early mornings, evenings and over weekends). These are beneficial to patients with competing priorities (eg, school or employment).
Fast-trackFast-track.A model that typically involves a separate, shorter queue to dispense ART to stable patients, allowing for a quick patient visit when a clinic visit is not required.23
Home ART deliveryHome ART delivery.Trained community health workers linked to facilities conduct home visits to deliver ART, conduct health screening, monitor adherence and refer patients as required.7
Multimonth dispensingMultimonth dispensing.Facility-based model in which the primary goal is to dispense medications for more than 1 month (usually 6 months). Dispensing is typically done during a clinic facility-based visit.
  • ART, antiretroviral therapy.