A Decision Framework for differentiated antiretroviral therapy delivery for children, adolescents and pregnant and breastfeeding women
A Decision Framework for ART Delivery for children, adolescents and pregnant and breastfeeding women, or the Decision Framework for Specific Populations as it is referred to throughout this document for ease, is aimed at supporting HIV programme managers at the national and district level to adapt or build differentiated models of ART delivery.
The document guides the reader through how to assess the data and identify priorities to address specific and local challenges, and is supported by an online compendium of tools and best practices, available at www.differentiatedcare.org.
In Part 1, an overview of differentiated care and differentiated ART delivery is provided, and the core principles for the specifi cpopulations are defined. Part 2 describes a 5-step plan to guide ART programme managers to prioritize which interventions to implement in response to the specific context. In Part 3, the key “elements” of a client, including their clinical characteristics, specific population(s) group(s) and context in which they live, are outlined. Part 4 presents two key questions to consider before proceeding with building a new differentiated ART delivery model: (i) whether to adapt differentiated ART delivery models for adults; or (ii) whether to adapt current psychosocial support interventions for specific populations. The “building blocks” of service delivery are presented in Part 5 with illustrative examples.
To respond to the needs of specific populations and improve ART delivery within a public health approach, the HIV response must now deliver differently. Coordinated support from donors, implementing agencies and networks of PLHIV is needed to take on this challenge. The Decision Framework for Specific Populations is a practical tool to guide how to consider specific populations differently with the aim of providing children, adolescents and PBFW with quality HIV services when, where and how they want it.