“I am pleased that CQUIN was able to help Sierra Leone adapt and enhance their approach to DSD,” said Maureen Syowai, MBChB, regional technical advisor for ICAP in Kenya, following her recent technical assistance visit to Sierra Leone.Dr. Syowai visited the West African country, one of the newest members of the CQUIN learning network, to aid the National HIV/AIDS Control Program (NACP) in developing Sierra Leone’s differentiated service delivery (DSD) guidance and operational package.
Sierra Leone will now implement DSD models for recipients of care doing well on treatment and those with advanced HIV disease, as well as models designed to support family-centered care, adolescent care, pregnant and breastfeeding women, men, and working-class populations.
Before Sierra Leone joined CQUIN in September 2019, there was no structured approach to DSD in the country. “Our goal in piloting DSD is to provide more options for people doing well on HIV treatment, so we can hopefully decongest health centers and improve quality of care,” said Alren Vandy, MD, MPH, national ART coordinator and DSD focal person at Sierra Leone’s NACP, Ministry of Health and Sanitation.
During Dr. Syowai’s visit, the NACP reviewed current evidence and successes of DSD implementation in other CQUIN Learning Network countries and applied these to develop national DSD guidance for Sierra Leone. Dr. Syowai also helped the NACP to develop a national DSD operational package, including an M&E framework, and a brief for Sierra Leone’s new HIV National Strategic Plan. “I wanted the team to understand that these models work in a particular way, and when taken to scale, they bring the desired results,” she said.
Dr. Syowai also met with the Network of HIV Positives in Sierra Leone (NETHIPS), who were pleased to have support from the CQUIN Learning Network to provide structure to DSD implementation in Sierra Leone.
Accompanied by the NACP National ART Coordinator, Dr. Syowai, also visited two health facilities, Connaught Hospital and George Brook Community Health Center, to observe DSD models at the facility level. At the facilities, Dr. Syowai noted some gaps, such as documenting and updating patient records when conducting patient outreach, which she believes Sierra Leone can efficiently address with proper DSD implementation.
Sierra Leone is drafting national ARV guidelines that introduce DSD as a critical paradigm shift in HIV service delivery to enhance person-centered care and accelerate progress towards HIV epidemic control.
