Partnerships support the provision of individualized HIV testing, care, and treatment in Ghana

We honor one woman’s story in observance of International Women’s Day.

Pokua (1) and her husband’s dancing at their wedding last year was wonderful to witness. Pokua was diagnosed with HIV at birth, began antiretroviral medication (ART) at age 4, and has since led an active life. This was in part feasible thanks to Ghana’s acceptance of the WHO recommended “treat all” approach that enabled accessible, person-centred HIV services for persons with HIV. Pokua has benefited from a new multi-month dispensing technique since she adheres to her ART and is virally suppressed.

Because her antiretroviral medications come in 3-month supply packages, she visits the clinic less frequently and the staff at the clinic has less work to do. Since her virus has been suppressed and she is aware that she cannot transmit HIV to her boyfriend, Pokua feels good about her health right now. She spends less time at the clinic now that the Differentiated Service Delivery (DSD) model has been implemented.

In Ghana, a recent emphasis on DSD for HIV-positive individuals seeks to modify health care in person-centered ways without taxing the health system. While the Ghana HIV program has made strides in expanding its accessibility, significant treatment gaps still exist; countrywide, about 40% of persons with HIV have not begun life-saving ART, highlighting the need to strengthen the connection between testing and treatment services. Yet, the majority of patients receiving therapy (79%) have their virus suppressed, showing the effectiveness of the program in encouraging adherence to ART.

The Differentiated Service Delivery Strategic Initiative (DSD SI), launched by the Global Fund to Fight AIDS, Tuberculosis, and Malaria (the Global Fund) in conjunction with WHO, makes technical assistance for the rapid scale-up of DSD techniques accessible in Ghana and 9 other countries in 2019. The Initiative was created to hasten the adoption of DSD methods suggested by the WHO inside projects funded by the Global Fund. Governments, implementing partners, and members of the civil society were all included in country-level conversations that were organized by WHO to build workplans for DSD technical support. Three Ghanaian organizations were chosen to provide technical help for the project:

JHPIEGO to support the creation of a toolkit with updated DSD guidelines, training and communication materials, and a DSD scale-up plan; SH:24 to support the creation of an online platform for the distribution of HIVST and pre-exposure prophylaxis (PrEP), with a focus on key populations; and EQUIP Health Ghana to provide site level capacity building of health care workers for DSD. The DSD SI is being used by Ghana’s HIV program, which also ensures that investment meets national goals and complements current programs.

The WHO coordinates the DSD SI, working at three levels (country office, regional office, and headquarters), making sure technical assistance providers promote WHO recommendations and are in line with the objectives of the national program. The DSD SI has helped the quality improvement initiatives build facility-level capacity for routine clinic data reviews. At a recent WHO visit, Mawusi Allu, a nurse and member of the QI team from the Kpone Polyclinic in Ghana, gave this account of her experiences. “With the addition of the QI support, I am now able to provide specialized services to my loyal and dependable clients, such as the distribution of several months’ worth of ARVs.

Shorter wait times for clients and more one-on-one time with each client are the results of improving their happiness and lowering daily client quantities. Indicators of HIV service delivery at Kpone Polyclinic improved, with the linkage to ART rising from 85% (before to the implementation of the DSD QI activities) to 99% a year later, according to program data.

Ambitious 95%-95%-95% targets for HIV testing, treatment, and viral suppression are part of Ghana’s national strategy plan for HIV 2021–2025. The DSD SI’s technical assistance provides focused support to close important gaps as the national program moves toward its objectives. According to Dr. Meg Doherty, Director of WHO Global HIV, Hepatitis and STI Programmes, “The DSD SI is a crucial tool for making varied approaches for HIV testing, diagnosis, and treatment accessible in the 10 countries. “It is assisting in the acceleration of national programs, like Ghana’s, to provide scaled-up person-centered HIV services.” More people like Pokua will have access to practical person-centered health services thanks to diversified service delivery.

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