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. 2022 Aug;26(8):2600-2612.
doi: 10.1007/s10461-022-03602-y. Epub 2022 Feb 4.

Implementation of South Africa's Central Chronic Medicine Dispensing and Distribution Program for HIV Treatment: A Qualitative Evaluation

Laura M Bogart  1 , Zinhle Shazi  2 , Sarah MacCarthy  3   4 , Alexandra Mendoza-Graf  3 , Nafisa J Wara  5 , Dani Zionts  5 , Nduduzo Dube  2 , Sabina Govere  2 , Ingrid V Bassett  5   6   7   8
Affiliations

Implementation of South Africa's Central Chronic Medicine Dispensing and Distribution Program for HIV Treatment: A Qualitative Evaluation

Laura M Bogart et al. AIDS Behav. 2022 Aug.

Abstract

We used the Practical, Robust Implementation and Sustainability Model to evaluate implementation of South Africa's Central Chronic Medicine Dispensing and Distribution (CCMDD) program, a differentiated service delivery program which allows clinically stable HIV-positive patients to receive antiretroviral therapy refills at clinic- or community-based pick-up points. Across ten clinics, we conducted 109 semi-structured interviews with stakeholders (pick-up point staff, CCMDD service providers and administrators) and 16 focus groups with 138 patients. Participants had highly favorable attitudes and said CCMDD decreased stigma concerns. Patient-level barriers included inadequate education about CCMDD and inability to get refills on designated dates. Organizational-level barriers included challenges with communication and transportation, errors in medication packaging and tracking, rigid CCMDD rules, and inadequate infrastructure. Recommendations included: (1) provide patient education and improve communication around refills (at the patient level); (2) provide dedicated space and staff, and ongoing training (at the organizational/clinic level); and (3) allow for prescription renewal at pick-up points and less frequent refills, and provide feedback to clinics (at the CCMDD program level).

Keywords: Antiretroviral therapy; Differentiated service delivery; HIV/AIDS; Implementation science; Qualitative; South Africa.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose; the authors have no conflicts of interest to declare that are relevant to the content of this article; all authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript; and the authors have no financial or proprietary interests in any material discussed in this article.

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