Côte d’Ivoire

Differentiated Service Delivery in Côte d’Ivoire



Percent of health facilities providing less-intensive DART models.

(523 on a total of 2473 ART sites) providing Less intensive DSD models
Period: June 2022
Source: National DHIS2 and DSD DataView

% In Less-Intensive
Differentiated Treatment Models


Percent of people on ART who are enrolled in less-intensive DART models.

(147205/290459) ART patients enrolled in Less intensive DSD models, corresponding to 91% (147205 /161763) of stable patients
Period: June 2022
Source: National DHIS2 and DSD DataView

Multi-month ART Dispensing



Percent of people on ART receiving ≥ 6 months of ART at a time. 

MMD3-5: 36% (87652/242329)
MMD<3: 13% (30797/242329) Period: June 2022 Source: National DHIS2 and DSD DataView MMD data are from the sites reporting DSD data, and represent 83% of the national TX_CURR

DART Model

Number of groups for whom less-intensive DART models have been designed and implemented.

Differentiated ART Models are available for patients established in care as well as for additional category of patients
MIM (Conventional model; AHD)
FBI (AS+FT; AS w/o FT)
FBG (ART club),
CBI (outreach)
Period: June 2022
Source: National DHIS2 and DSD DataView

Differentiated Service Delivery Implementation in Côte d’Ivoire

Côte d’Ivoire joined CQUIN in 2018. The Côte d’Ivoire National Program for the Fight Against HIV (Programme National de Lutte Contre le SIDA, or PNLS), in collaboration with its donors and implementing partners, has prioritized two facility-based differentiated service delivery (DSD) models for adult and adolescent recipients of care who are doing well on ART. 

One of the first models to be launched was an individual appointment spacing model, in which people on ART receive three-monthly refills via fast track visits. The second was a group model, in which support groups (adherence clubs) are managed by community counselors and social assistants at health facilities. People in both models receive twice-yearly clinical evaluations with a medical doctor. These approaches continue to be rolled out and scaled up nationwide.

Once the two facility-based models had been launched, PNLS developed a community-based DSD model, designed specifically for people on ART living in remote areas where access to health facilities is difficult. 

Currently, five less-intensive DSD treatment models are available in Côte d’Ivoire, including:

  • Two facility-based individual models: six-month multi-month scripting and Fast Track
  • Two facility-based group models: the adult club model and a teen club model
  • One community-based group model: peer-led community ART group

In October 2019, PNLS estimated that Côte d’Ivoire had 2,035 facilities providing ART and that 937 of them (46 percent) offered at least one less-intensive model. As of June 2019, an estimated 70 percent of those on ART were enrolled in the conventional treatment model versus 30 percent enrolled in less-intensive DSD models. The majority of those in less-intensive models were enrolled in the fast track model, which accounts for 28 percent of all people on ART. 

Côte d’Ivoire has utilized a number of lessons learned from its participation in the CQUIN learning network, most notably the inclusion of community based DSD models. In June 2018, CQUIN members from Côte d’Ivoire visited Eswatini on a south-to-south visit to learn more about community-based ART outreach services. The visit, which included a site tour of Mbabane Government Hospital, allowed the team to observe early morning ART refills as well as Eswatini’s community-based outreach efforts coupled with clinical service provision. Following the exchange, Côte d’Ivoire began supporting early morning refills and ART community refills at selected health facilities. 

As Côte d’Ivoire continues to expand DSD implementation, increasing community-based models that are adapted to the local context remains a priority.


Taking Differentiated Service Delivery to Scale in Côte d’Ivoire: Building National Leadership to Catalyze DSD Scale-up

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