Bibliographic information
Recommendation
Decentralization of HIV treatment and care should be considered as a way to increase access to and improve retention in care: initiation of ART in hospitals with maintenance of ART in health facilities
Recommended in favor
Strong
Certainty of evidence
Low
Notes and Remarks
- The optimal decentralization model depends on local disease burden and health system capacity. Partial decentralization models include specialist-led shared care, teleconsultation, nurse-led follow-up and community refill sites.
- Programme managers should consider client preferences, expected volumes and whether decentralization brings services closer to people; community engagement should be supported to ensure personcentred decisions.
- Standards of care, roles and responsibilities should be clearly defined at each level, including the private sector.
- Decentralization must be supported by strong linkage and referral systems and adequate laboratory services, monitoring and evaluation and supply management.
- Decentralized services should be adapted for key populations, pregnant and postpartum women and HIVexposed children and children living with HIV.
Also Featured In
This recommendation also appears in the following guidelines:
Consolidated guidelines on general HIV care and the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach
Consolidated guidelines on general HIV care and the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach
Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations
Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach
Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations
Consolidated guideline on sexual and reproductive health and rights of women living with HIV
Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach