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Implementation of differentiated service delivery for paediatric HIV care and treatment:opportunities,challenges and experience from seven sub-Saharan African countries

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Family Medicine and Community Health 2020年第3期8卷 36-41页

作者： Rebecca Abelman Catharina Alons Jeni Stockman Ivan Teri anna grimsrud Maryanne Ombija Christopher Makwindi Justine Odionyi Esther Tumbare Barry Longwe Mahoudo Bonou Juma Songoro Lawrence Mugumya Jennifer Cohn Internal Medicine Massachusetts General HospitalBostonMassachusettsUSA University of Pennsylvania Perelman School of Medicine PhiladelphiaPennsylvaniaUSA Technical Leaderhip and Program Optimization Elizabeth Glaser Pediatric AIDS FoundationWashingtonDistrict of ColumbiaUSA Elizabeth Glaser Pediatric AIDS Foundation WashingtonDistrict of ColumbiaUSA International AIDS Society Cape TownSouth Africa Elizabeth Glaser Pediatric AIDS Foundation MbabaneSwaziland Elizabeth Glaser Pediatric AIDS Foundation NairobiKenya Elizabeth Glaser Pediatric AIDS Foundation MaseruLesotho Elizabeth Glaser Pediatric AIDS Foundation LilongweMalawi Elizabeth Glaser Pediatric AIDS Foundation MaputoMozambique Elizabeth Glaser Pediatric AIDS Foundation Dar Es SalaamUnited Republic of Tanzania Elizabeth Glaser Pediatric AIDS Foundation KampalaUganda Infectious Diseases University of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA Elizabeth Glaser Pediatric AIDS Foundation GenevaSwitzerland

Differentiated service delivery(DSD)models for HIV often exclude children and *** that children and adolescents have lower rates of HIV diagnosis,treatment and viral load suppression,there is a need to use DSD to meet the needs of children and adolescents living with *** commentary reviews the concept of DSD,examines the application of DSD to the care of children and adolescents living with HIV,and describes national guidance on use of DSD for children and adolescents and implementation of DSD for HIV care and treatment in children and adolescents in Elizabeth Glaser Pediatric AIDS Foundation(EGPAF)-supported programmes in seven sub-Saharan countries between 2017 and *** descriptions include eligibility criteria,location and frequency of care delivery,healthcare cadre delivering the care,as well as the number of EGPAF-supported facilities supporting each type of DSD model.A range of DSD models were *** facility-based models predominate,several countries support community-based *** significant uptake of various DSD models for children and adolescents,there was variable coverage within countries and variability in age criteria for each *** the recent uptake of DSD models for children and adolescents suggests feasibility,more can be done to optimise and extend the use of DSD models for children and adolescents living with *** to further DSD uptake are described and solutions *** models for children and adolescents are a critical tool that can be optimised to improve the quality of HIV care and outcomes for children and adolescents.

关键词： treatment service supporting

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