Annual Clinical Visit pilot
Preparing Community ART Refill Sites for quality implementation.
The Community ART Refill Sites programme is a GHS/NACP differentiated service-delivery model implemented with partners including Rural Watch. It uses a hub-and-spoke approach: stable clients complete an annual clinical assessment at their primary ART facility and collect six-month ART refills at approved community sites such as community pharmacies and CHPS compounds.
- Model at a glanceOne full annual clinical review at the hub; two six-month ART supplies each year; a viral-load threshold of ≤50 copies/ml; and two coordinated service points—hub and spoke.
- Care pathwayThe hub provides WHO staging, TB and NCD screening, mental-health screening, cervical-cancer referral where applicable, viral-load testing, adherence counselling, the first six-month supply and a refill schedule. The spoke provides the second six-month supply, screens new symptoms, documents the visit and refers concerns to the hospital.
- Strategic Information contributionLed the SI component covering monitoring, evaluation and KPI tools; timely entry in DHIS2’s individual-level workflow (e-Tracker); viral-load specimen dispatch and result documentation; ACV eligibility, enrolment, dual dispensing and reclassification.
- Implementation learningReadiness depends on complete tools and job aids, first-month supportive supervision, sufficient data-entry capacity, reliable testing inputs, clear hub-to-spoke communication and deliberate documentation of pilot lessons for national scale-up.
- Risks surfacedStaff shortages and turnover, ART nurses carrying both clinical and data-entry duties, PCR machine breakdowns and reagent shortages.