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How Home Delivery of Antiretroviral Drugs Ensured Uninterrupted HIV Treatment During COVID-19: Experiences From Indonesia, Laos, Nepal, and Nigeria.
Hoke, Theresa; Bateganya, Moses; Toyo, Otoyo; Francis, Caroline; Shrestha, Bhagawan; Philakone, Phayvieng; Pandey, Satish Raj; Persaud, Navindra; Cassell, Michael M; Wilcher, Rose; Mahler, Hally.
  • Hoke T; FHI 360, Durham, NC, USA. thoke@fhi360.org.
  • Bateganya M; FHI 360, Durham, NC, USA.
  • Toyo O; Achieving Health Nigeria Initiative, Akwa Ibom, Nigeria.
  • Francis C; FHI 360, Jakarta, Indonesia.
  • Shrestha B; FHI 360, Kathmandu, Nepal.
  • Philakone P; FHI 360, Vientiane, Laos.
  • Pandey SR; FHI 360, Abuja, Nigeria.
  • Persaud N; FHI 360, Washington, DC, USA.
  • Cassell MM; FHI 360, Hanoi, Vietnam.
  • Wilcher R; FHI 360, Durham, NC, USA.
  • Mahler H; FHI 360, Washington, DC, USA.
Glob Health Sci Pract ; 9(4): 978-989, 2021 12 31.
Article in English | MEDLINE | ID: covidwho-1633289
ABSTRACT

INTRODUCTION:

Faced with the coronavirus disease (COVID-19) pandemic, governments worldwide instituted lockdowns to curtail virus spread. Health facility closures and travel restrictions disrupted access to antiretroviral (ARV) therapy for people living with HIV. This report describes how HIV programs in Indonesia, Laos, Nepal, and Nigeria supported treatment continuation by introducing home delivery of ARVs.

METHODS:

Staff supporting the programs provided accounts of when and how decisions were taken to support ARV home delivery. They captured programmatic information about home delivery implementation using an intervention documentation tool. The 4 country experiences revealed lessons learned about factors favoring successful expansion of ARV home delivery.

RESULTS:

Three of the countries relied on existing networks of community health workers for ARV delivery; the fourth country, Indonesia, relied on a private sector courier service. Across the 4 countries, between 19% and 51% of eligible clients were served by home delivery. The experiences showed that ARV home delivery is feasible and acceptable to health service providers, clients, and other stakeholders. Essential to success was rapid mobilization of stakeholders who led the design of the home delivery mechanisms and provided leadership support of the service innovations. Timely service adaptation was made possible by pre-existing differentiated models of care supportive of community-based ARV provision by outreach workers. Home delivery models prioritized protection of client confidentiality and prevention measures for COVID-19. Sustainability of the innovation depends on reinforcement of the commodity management infrastructure and investment in financing mechanisms.

CONCLUSION:

Home delivery of ARVs is a feasible client-centered approach to be included among the options for decentralized drug distribution. It serves as a measure for expanding access to care both when access to health services is disrupted and under routine circumstances.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pharmaceutical Preparations / HIV Infections / COVID-19 Type of study: Prognostic study Limits: Humans Country/Region as subject: Africa / Asia Language: English Journal: Glob Health Sci Pract Year: 2021 Document Type: Article Affiliation country: GHSP-D-21-00168

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pharmaceutical Preparations / HIV Infections / COVID-19 Type of study: Prognostic study Limits: Humans Country/Region as subject: Africa / Asia Language: English Journal: Glob Health Sci Pract Year: 2021 Document Type: Article Affiliation country: GHSP-D-21-00168