Simplice Koffi Bohoussou, PhD, MBA, is an assistant in the Care and Treatment Department of Côte d’Ivoire’s National Program to Combat AIDS (PNLS), and the national differentiated service delivery (DSD) coordinator. Bohoussou has been participating in CQUIN activities since the 2018 annual meeting in Eswatini. For him, Côte d’Ivoire’s involvement in the network has helped the country expand and enhance the maturity of its national DSD program, changes reflected on the CQUIN dashboard.
What is the state of DSD in Côte d’Ivoire?
Since Côte d’Ivoire joined CQUIN, there has been a lot of improvement in differentiated service delivery. In 2018, a DSD dashboard review revealed that outside of the policy and guidelines where we had light green and dark green scores, respectively, Côte d’Ivoire was practically in the red on implementing various DSD models. We had only one model – the accelerated dispensation of ARVs. However, we have made major improvements since then in:
- Increasing our DSD models from 1 to 5 to include the accelerated dispensation of antiretrovirals, 6-multi-month dispensation (6MMD) with visit spacing, stable patient self-support group, proximity model, and community adherence groups.
- Engaging a national DSD coordinator based at PNLS, who is responsible for planning and coordinating DSD activities with the support of CQUIN and the Global Fund.
- Improving community mobilization and engagement, so recipients of care are now fully involved in the implementation and evaluation of DSD policies.
- Developing a monitoring and evaluation system for DSD services.
- Adapting CQUIN quality standards to our context and ensuring that health providers meet established national quality standards.
Côte d’Ivoire has been part of CQUIN since 2018, how has the network helped to influence DSD policy in the country?
CQUIN has supported Côte d’Ivoire by championing the national DSD coordinator position, supporting DSD Performance Reviews that enable PNLS and its partners to collect and analyze data on DSD implementation, supporting two south-to-south visits, including one from Côte d’Ivoire to Eswatini that directly informed our Advanced HIV Disease (AHD) models, enabling our participation in multiple communities of practice, and providing technical assistance to develop standard operating procedures and training modules. All these actions have enabled Côte d’Ivoire to reach a good maturity in DSD implementation.
Côte d’Ivoire has also benefitted from four international meetings, as well as webinars and workshops. In addition, other countries have also come to learn from us to see how we have been implementing our 6-multi-month and community-based ART models.
What do you hope to achieve for Côte d’Ivoire in your role as DSD coordinator?
As the DSD coordinator, my goal is to make sure Côte d’Ivoire improves its performance in all 13 areas of the DSD dashboard. This includes diversifying DSD models by implementing policies to strengthen DSD coverage for people with advanced HIV disease, maternal and child health, adolescent, and key population groups.
What future of DSD in Côte d’Ivoire?
In my opinion, Côte d’Ivoire will need to evaluate the quality of the DSD services in all the health facilities at the national level. We need to improve DSD services by evaluating the satisfaction of recipients of care and the health providers.