With one of the world’s highest HIV prevalence rates at 18.3 percent, the South African Department of Health has ambitious goals to actively identify and link all people living with HIV to high-quality health services.
“We are striving to scale up index testing and HIV self-testing; however, we have a few challenges with actively linking newly diagnosed people to care and HIV treatment because of both structural and client-related barriers such as long waiting times, health-seeking behavior, treatment readiness, and socio-economic challenges,” said Tshepo Molapo, PhD, acting director for Care and Treatment at the South Africa Department of Health (NDOH). “This has contributed to an antiretroviral treatment (ART) gap of over 1.8 million.”
Therefore, with CQUIN support, South Africa participated in a learning visit to Nigeria to observe their community-based pharmacy model.
From February 19 to 24, 2023, the Nigeria Ministry of Health, led by Irene Esu, MBBS, MPH, FMCPH, ART coordinator, hosted the five-day learning visit, which included trips to several health facilities, including primary health care facilities, a major district hospital, and three community pharmacies.
The South African delegation included South Africa’s Care and Treatment directorate team members. “We were really impressed with Nigeria’s system and learned a lot about how the country tracks and monitors patient care, to the comprehensiveness of services offered at pharmacies. There were many lessons learned which we plan to implement over the coming year,” said Musa Manganye, MPH, DrPH, DSD coordinator with the South Africa Department of Health.
“We were keen on learning and understanding the impact of Decentralized Drug Distribution through private pharmacies and other community-based ART Models to come up with ideas on how to get care to hard-to-reach populations within the community,” said Dr. Manganye.
South Africa hopes to optimize health care worker and recipient of care relations and rapport. The NDOH is also considering engaging community pharmacies to enhance ‘test and treat’ in communities, among other considerations made due to the visit. “Nigeria seems to have maximized and sustained a provider–client relationship to enhance positive clinical outcomes,” Dr. Manganye added.
“It was a pleasure hosting the South Africa team. We look forward to hosting more countries and taking them through our successes and challenges to help them conduct the needed assessments before implementing a community DSD model,” said Dr. Esu.
“South Africa has hosted several country learning visits; this was their first visit to learn from another country,” said Martin Msukwa, MPH, BSN, CQUIN regional advisor, who accompanied the delegation on the visit. “The focus of their visit was to learn about the use of community pharmacies to provide ART services, especially in rural areas. CQUIN was happy to facilitate this country visit and will work with the South Africa team to implement best practices learned from Nigeria.”
CQUIN member countries participate in country-to-country (C2C) visits to learn from one another and see Differentiated Service Delivery-related (DSD) best practices in action. C2C visits tap into the shared innovation of the member network, empowering participants to identify new approaches, learn from current successes, and further enhance the scale-up of DSD. Visiting teams generally include representatives of the ministry of health, the national network of people living with HIV, donors, implementing partners, and other stakeholders.