The network convenes representatives from member countries committed to scaling up differentiated service delivery (DSD) for people living with HIV. Led by Ministries of Health, the country teams exchange best practices, pilot innovations, and work together on common areas of interest related to DSD, knowledge generation, and co-creation of tools and resources.
Burundi joined the CQUIN network in July 2020. The Burundian Ministry of Public Health and the Fight against AIDS, through the National AIDS Control and Sexually Transmitted Infections Program (PNLS / STI), has adopted Differentiated Service Delivery (DSD) in the national guidelines since 2016; implementation started in 2019.
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 DSD models for adult and adolescent recipients of care who are doing well on ART.
The Democratic Republic of the Congo (DRC) joined the CQUIN learning network in September 2019. DRC’s Ministry of Health and the National AIDS Control Program are committed to advancing the implementation of DSD models and are energized at the prospect of presenting more diverse options to recipients of care.
Eswatini joined the CQUIN learning network in 2017. The Eswatini Ministry of Health, through the Eswatini National AIDS Programme (ENAP), has been implementing DSD since 2014. Given the country’s very high HIV prevalence, the rollout of Test and Treat policies necessitated new models of antiretroviral (ART) delivery to relieve congested health centers.
Ethiopia joined the CQUIN learning network in 2017. Prior to joining, the Federal Ministry of Health (FMOH) had prioritized the scale-up of DSD, launching a national program in October 2016 to focus on a single less-intensive model—the appointment spacing model (ASM) with six-month multi-month ART distribution (6-MMD).
Ghana joined the CQUIN network in July 2020, with an innovative portfolio of facility-based DSD models and successful pilots of models for adolescents and pregnant women living with HIV.
Kenya joined the CQUIN learning network in 2016, bringing with it an existing national policy on DSD and a technical working group tasked with providing input and guidance on DSD implementation. Currently, Kenya’s Ministry of Health and the National AIDS and STI Control Program (NASCOP) provide guidance on DSD implementation and work toward improving and expanding upon existing DSD models to present recipients of care with more options.
Liberia joined the CQUIN learning network in September 2019. The Ministry of Health’s National AIDS and STI Control Program is committed to enhancing and creating DSD models to reach more recipients of care, with a focus on serving key and priority populations who are often most vulnerable to HIV.
Malawi joined the CQUIN learning network in 2017 and has since scaled up DSD through strong governance, a national technical working group inclusive of civil society organizations representing recipients of care, and the oversight of a national DSD coordinator. Malawi adopted the use of DSD models of care in 2006 as part of the national strategy to build a strong national HIV program around the needs of the country’s diverse population of people living with HIV.
Mozambique has been a member of the CQUIN learning network since 2017. Since joining the network, the country has rolled out multiple initiatives to scale-up DSD. While recipients of care are not currently engaged in the strategic planning of DSD-related activities, they are heavily involved in implementation, demand creation, and ongoing discussions regarding the quality of DSD services.
Nigeria joined the CQUIN network in November 2020. Since joining CQUIN, Nigeria has addressed gaps to strengthen DSD implementation. The country has finalized its DSD Operational Manual and developed training slides and facilitators’ manuals for the training of health care providers on delivering differentiated service delivery. The training of trainers at the national and state levels will commence in the fourth quarter of 2021.
Rwanda joined the CQUIN network in August 2020 with a mature DSD program enhanced by an efficient viral load testing system and robust engagement of recipients of care.
Sierra Leone joined the CQUIN learning network in September 2019. With a strong existing partnership between the Network of HIV Positives in Sierra Leone (NETHIPS) and the Ministry of Health’s National AIDS Control Programme, the country is well positioned to launch DSD implementation.
South Africa joined the CQUIN learning network in 2017 as a thought leader in DSD design. The country has cultivated a wide diversity of models—from appointment spacing to fast track to facility-based clubs to community-based antiretroviral (ART) groups, services for adolescents and key populations, and more. In 2015, South Africa’s National Department of Health (NDOH) introduced national adherence guidelines for chronic diseases, folding DSD into the guidelines with the overarching aim to improve the effectiveness of all health services.
Tanzania joined the CQUIN learning network in 2018. After adopting the 2015 World Health Organization (WHO) test and treat guidelines, and recognizing the need for client-centered care, Tanzania’s Ministry of Health and its National AIDS Control Programme (NACP) incorporated DSD models into its National Guidelines for the Management of HIV and AIDS.
Uganda joined the CQUIN learning network in 2017. Uganda’s National Guidelines for HIV Care and Treatment outline the need for diverse DSD models including facility- and community-based models that could be used to better reach recipients of care, and the need for robust quality and monitoring and evaluation standards.
Zambia joined the CQUIN learning network in 2017, as DSD was being integrated into Zambia’s National HIV Guidelines. DSD was first introduced in Zambia in 2013 in the form of single models and pilot projects offered by implementing partners, and has since become a fundamental service delivery mechanism for the National HIV program, growing in model diversity, increasing coverage for recipients of care, and reaching remote, rural areas of the country.
Zimbabwe joined the CQUIN learning network in 2017. DSD policies in Zimbabwe are supported by the national government’s HIV and ART guidelines and include operational and service delivery procedures to prioritize recipients of care doing well on antiretroviral (ART) medication and strengthen supply chain management and community health systems.