community-based

CFM: Improving mother-baby pair retention in integrated maternal and child health and HIV services in Eswatini

Mother-baby pairs who do not continually utilize critical integrated maternal, newborn, and child health (MNCH) and HIV services often have poor health outcomes in resource limited settings. The Community Focal Mother (CFM) model in Eswatini has demonstrated success in improving use of and retention in integrated MNCH and HIV services. This includes final knowledge of HIV status of 18-24 month infants, timely vaccination, and provision of mother baby health visits. Trained CFMs visit all mother baby pairs in their homes before they miss a visit to encourage continued attendance at health facilities for care. This model has seen 100 percent retention in services of mother baby pairs since its inception in 2017; all children have completed their child welfare visits per the Ministry of Health recommended schedule and received key integrated HIV and MNCH services.

 

Enhancing Community Engagement to Reach Men: Working with volunteer community advocates to sustain voluntary medical male circumcision demand in Tanzania

Voluntary medical male circumcision (VMMC) is an evidence-based prevention approach that can reduce HIV transmission. However, sustaining demand and lowering costs of this core intervention can be challenging. In Tanzania, engagement and use of a volunteer community-based cadre of lay workers to promote and create demand for VMMC led to an almost five-fold increase in VMMCs performed in health facilities. This increase was sustained over time, with a cumulative 45,182 VMMCs performed eighteen months after the introduction of this model. Moreover, this model also reduced costs by 13%.

Improving Retention, Viral Suppression, and Facility Congestion through Postes de Distribution Communautaire in the Democratic Republic of the Congo

In the Democratic Republic of the Congo (DRC), overall retention rates at the end of fiscal year 2016 (FY16/COP15) were documented to be 69.5%. As the country began transitioning to a Treat All model, many facility staff members were concerned they would be able to keep up with demand, given the ongoing long wait times for stable patients seen monthly in clinics. The Postes de Distribution Communautaire (PODI) plus model is a community-based, individual drug distribution and psychosocial support model. PODIs reduce the workload of overburdened health care workers by decreasing the number of patients individually attending the clinic, whilst maintaining good health outcomes for patients.  

Improving Access to HIV Treatment Services through Community Antiretroviral Therapy Distribution Points in Uganda

Because the majority of antiretroviral therapy (ART) services provided in resource-limited settings are done so in standardized yet inefficient ways, long-term ART adherence and retention is difficult. In Uganda, stable clients needed ways to access medications closer to their homes, which would reduce the cost and disruption of remaining adherent to ART.

Improving Patient Antiretroviral Therapy Retention through Community Adherence Groups in Zambia

Antiretroviral therapy (ART) is frequently distributed via health facilities and their pharmacies. An increased volume of medically-stable patients at facilities reduces the time clinicians can spend with those who require acute care and also discourages patients from attaining care, due to long wait times.  For medically-stable patients, going to a health facility for monthly refill pickup reduces the likelihood of retention on treatment for a variety of factors, including the transportation costs and financial losses of time missed at work incurred by a trip to the health facility . Importantly, retention on ART is vital to the health of HIV-positive individuals, but also to the well-being of the communities in which they live. Achieving higher rates of retention among HIV-positive patients, then, is crucial.