Table 1 Summary characteristics of studies included in the scoping review
Author and year | Country | Types of evidence source | Aims | Study design | Information source |
|---|---|---|---|---|---|
Francis et al., 2017 [61] | Tanzania | Conference abstract/ Unpublished | To ascertain the acceptability and logistical feasibility of community health worker-led ART home-delivery in Dar es Salaam | Mixed method | Patients and healthcare providers |
Mashungu et al., 2018 [62] | Zimbabwe | Conference abstract/ Unpublished | To explore patient and service provider’s acceptability of community ART refill groups in Zimbabwe | Descriptive qualitative | ART service providers and stable patients enrolled in community ART refill groups |
Tshuma et al.,2017 [22] | South Africa | Primary study/Published | To assess acceptability, enablers, and barriers to rolling out community-based adherence clubs in South Africa | Descriptive qualitative | Nurses, club managers, data capturers, pharmacists, and pharmacy assistants who had been involved in facility-based treatment adherence clubs |
Rasschaert et al.,2014 [43] | Mozambique | Primary study/Published | To analyze the evolution of the community ART group model from 2008 to 2012 | Mixed method | Patients on ART in groups and in individual care, Nurses, Medecins Sans Frontieres Counsellors, Health authorities, and Medecins Sans Frontieres implementers |
Asieba et al., 2021 [44] | Nigeria | Primary study/Published | To assess the feasibility, acceptability, and outcomes of the community pharmacy-based ART refill model in Nigeria | Retrospective analysis | ART clients and Community Pharmacists |
Flamig et al., 2019 [12] | South Africa | Scoping literature review/Published | To identify factors that enable or jeopardize the sustainability of the Adherence Club model in the Western Cape of South Africa | Scoping literature review | Articles on ART adherence clubs in South Africa |
Mukumbang et al., 2019 [23] | South Africa | Primary study/Published | To test a theory on how and why the adherence club intervention works and in what health system context(s) in a primary healthcare facility in the Western Cape Province, South Africa | Realist evaluation | Nurses, counselors (club facilitators), and patients (both current and former club members) |
Laga et al., 2017 [42] | sub-Saharan Africa | Dissertation project/Unpublished | To describe the challenges with decentralization to community-based primary health care facilities, in Tete, Mozambique | Mixed method | Community ART groups |
Bemelmans et al., 2014 [45] | Malawi, South Africa, DRC, and Mozambique | Primary study/Published | To describe a number of community-supported models of ART delivery developed by Medecins Sans Frontieres together with Ministries of Health in public health facilities in sub-Saharan Africa | Routine program data analysis | Appointment spacing for clinical and drug refill visits in Malawi, peer educator-led ART refill groups in South Africa, community ART distribution points in the Democratic Republic of Congo, and patient-led community ART groups in Mozambique |
Ndlovu et al., 2020 [24] | South Africa | Master’s thesis project/Unpublished | To explore and compare the experiences of patients in three differentiated care models (Facility Adherence Clubs, Community Adherence Club, and Quick Pharmacy Pick-up) in a community health care facility in a township in Cape Town, South Africa | Descriptive qualitative | People living with HIV (18 years plus) receiving ART in a differentiated ART delivery model |
Ssonko et al., 2017 [46] | South Sudan,the Central African Republic, and the Democratic Republic of Congo | Primary study/Published | To review the implementation of differentiated HIV care and treatment approaches in Medecins Sans Frontieres-supported programs | Descriptive analysis | Routinely Program data |
Christ et al., 2020 [70] | Zimbabwe | Manuscript (preprint)/Unpublished | To assess the availability of differentiated ART models and the experience of health care professionals and clients in the rural district of Bikita, Masvingo Province, Zimbabwe | Mixed-method | ART clients and healthcare providers |
Sharer et al., 2019 [25] | South Africa | Primary study/Published | To (a) gain an in-depth understanding of perceived implementation barriers and enablers for differentiated ART delivery models in South Africa and (b) explore pragmatic concerns from program implementers and nurses related to sustainability and integration into existing ART programs to support treatment scale-up | Formative evaluation | Program implementers, nurses, and other health care providers |
Duffy et al., 2019 [47] | South Africa, Uganda, and Zimbabwe | Primary study/Published | To describe differentiated treatment distribution models and identify enablers, barriers, and benefits of the models by synthesizing findings from multistakeholder interviews and focus group discussions with participants in South Africa, Uganda, and Zimbabwe | Descriptive qualitative | High-level policymakers/influencers, Program designers, managers, and implementers, Health service providers, and Patients |
Hagey et al., 2018 [13] | sub-Saharan Africa | Scoping review/Published | To describe the range of HIV care for stable patients within the differentiated care framework | Scoping literature review | Manuscripts on differentiated HIV care |
Kuchukhidze et al., 2019 [14] | sub-Saharan Africa | A review of the grey literature/Unpublished | To conduct a comprehensive search of unpublished reports and other data sources posted online or directly from DSD implementers | Review of grey literature | Grey documents |
Long et al., 2020 [15] | sub-Saharan Africa | A rapid systematic review/Unpublished | To conduct a rapid review of the most recent peer-reviewed reports of the outcomes of DSD model implementation in sub-Saharan Africa | Rapid systematic review | Peer-reviewed reports of the outcomes of DSD model implementation |
Huber et al., 2020 [48] | Malawi, South Africa, and Zambia | Primary study/Published | To describe the diversity of DSD models being implemented | Cross-sectional | DSD model implementing organizations |
Mulenga et al., 2019 [63] | Zambia | Conference abstract/ Unpublished | To describe the model and early results herein | Descriptive analysis | People living with HIV on ART |
Adjetey et al., 2019 [49] | Ghana | Primary study/Published | To explore the possible predictors and acceptability of Community-based health service provision among people living with HIV accessing ART services at the Cape Coast Teaching Hospital in Ghana | Descriptive qualitative | People living with HIV accessing ART services |
Liu et al., 2021 [26] | South Africa | Manuscript (preprint) | To describe the expansion of central chronic medicines dispensing and distribution to a national scale | Mixed methods evaluation | Patients with chronic disease, including HIV |
Wilkinson et al., 2016 [27] | South Africa | Primary study/Published | To describe the implementation of the Adherence Club model across the Cape Metro health district in Cape Town, South Africa, between January 2011 and March 2015 | Data aggregate of the monthly monitoring report | Facilities offering adherence clubs and patients receiving ART care in the adherence club model |
Dudhia and Kagee, 2015 [28] | South Africa | Primary study/Published | To document the experiences of patients attending adherence clubs and health care workers at clinics where clubs were operating in South Africa | Descriptive qualitative | ART adherence club members and healthcare workers |
Kizito and Sabiti, 2021 [50] | Uganda | Primary study/Published | To describe the factors associated with the uptake of community client-led ART delivery model at Mulago Adult HIV clinic in Mulago National Referral Hospital | Mixed-method | Adult HIV patients who are stable on ART and receiving ART from Mulago adult HIV clinic and service providers |
Venables et al., 2017 [29] | South Africa | Conference abstract/Unpublished | To explore perceptions of clubs amongst members and non-members in two sites in Cape Town, South Africa | Descriptive qualitative | People living with HIV(current club members, eligible patients who had never joined a club, and club members who had been returned to routine care) |
Roy et al., 2018 [64] | Zambia | Conference abstract/Unpublished | To evaluate the implementation and effectiveness of urban adherence clubs in Zambia using a randomized study design | Randomized controlled trial | HIV-positive patients and healthcare workers |
Pasipamire et al., 2016 [65] | Swaziland | Conference abstract/Unpublished | To assess the feasibility of implementing community ART models in Swaziland | Cohort | Stable patients on ART |
Grimsrud et al., 2015 [30] | South Africa | Primary study/Published | To describe the implementation of community-based adherence clubs at a large, public-sector facility in peri-urban Cape Town, South Africa | Descriptive analysis | Community-based adherence clubs |
Wilkinson et al., 2015 [31] | South Africa | Conference abstract/Unpublished | To describe scale up of adherence clubs between Jan 2011-March 2015 in the Cape Metro, South Africa | Descriptive analysis | Stable ART patients |
Zakumumpa et al., 2021 [71] | Uganda | Manuscript (preprint)/Unpublished | To assess the extent of uptake of differentiated ART models and to describe barriers to uptake of either facility-based or community-based models in a national sample of health facilities in Uganda | Mixed-method | Health facilities, and ART clinic managers |
Zakumumpa et al., 2017 [51] | Uganda | Primary study/Published | To identify modifications to ART service delivery models by health facilities in Uganda to sustain ART interventions over 10 years (2004–2014) | Mixed method | Health facilities, and ART clinic managers |
Prust, 2017 [72] | Malawi | Process evaluation report/Unpublished | To explore the process and guidelines for implementation, the extent of implementation in participating facilities, provider and patient perspectives on the models, and costs of the differentiated service delivery models in Malawi | Process evaluation | Health facilities, healthcare workers, and patients |
Prust et al., 2017 [66] | Malawi | Conference abstract/Unpublished | To assess the extent to which patients are accurately differentiated as eligible or ineligible for multimonth scripting and explore potential causes of inaccurate patient differentiation in Malawi | Mixed -method | Health facilities, health workers, and clinic management |
Attah et al., 2018 [67] | Nigeria | Conference abstract/Unpublished | To assess the impact of Nigeria’s antiretroviral multimonth scripting on public health service delivery, infrastructure, and supply chain management systems across “high volume” ART clinics | Descriptive analysis | Clinic attendance records and ART refill providers |
Keene et al., 2020 [32] | South Africa | Primary study/Published | To explore patient, healthcare worker, and key informant experiences and perceptions of extending ART refills to 6 months in adherence clubs in Khayelitsha, South Africa | Descriptive qualitative | Patients, healthcare workers, and Key informants |
Prust et al., 2018 [52] | Malawi | Primary study/Published | To understand the challenges and successes of implementing these models of care and the process of patient differentiation in Malawi | Descriptive qualitative | Patients and health workers |
Venables et al., 2019 [33] | South Africa | Primary study/Published | To explore patient experiences of clubs in two sites in Cape Town, South Africa | Descriptive qualitative | Patients |
De Jager et al., 2018 [34] | South Africa | Primary study/Published | To investigate treatment adherence and patient satisfaction of stable HIV patients on ART in ART adherence clubs and clinics in South Africa | Cross-sectional | Stable HIV patients on ART in ART adherence clubs and clinics |
Mukumbang et al., 2018 [35] | South Africa | Primary study/Published | To determine how, why, for whom, and under what health system context the adherence club intervention works (or not) in real-life implementation in South Africa | Realist evaluation | Doctors, Adherence club nurses, Adherence club counselors/club facilitators, Patients in clubs, and Former club patients |
Mudavanhu et al., 2020 [36] | South Africa | Primary study/Published | To explore patient acceptability and attitudes towards community and clinic-based adherence clubs in South Africa | Mixed method | Patients on ART |
Phiri et al., 2021 [53] | Zambia | Primary study/Published | To understand providers’ perceptions of the benefits and challenges of six-month versus three-month ART dispensing in Zambia | Descriptive qualitative | Multimonth dispensing providers |
Rasschaert et al., 2014 [54] | Mozambique | Primary study/Published | To evaluate the relevance, dynamic, and impact of the community ART group model on patients, their communities, and the healthcare system in Tete, Mozambique | Descriptive qualitative | Patients on ART, nurses, Medecins Sans Frontieres lay counselors, and health authorities |
Hubbard et al., 2020 [55] | Malawi | Primary study/Published | To explore client and provider experiences with multimonth dispensing in Malawi as part of a cluster-randomized trial evaluating 3- versus 6-month ART dispensing | Descriptive qualitative | Providers and clients |
Bock et al., 2019 [37] | South Africa | Primary study/Published | To report on clinical outcomes among ART clients attending adherence clubs and client experiences and healthcare worker perceptions of factors key to successful adherence club implementation in the Cape Winelands District, South Africa | Crossectional and retrospective cohort | Clients and healthcare workers |
Roy et al., 2019 [16] | sub-Saharan Africa | Review/Published | To review the available published evidence on the implementation of DSD and suggest further health systems innovations needed to maximize the public health impact of DSD and future implementation science research directions in this expanding field | Review of literature | Published evidence |
Bochner et al., 2019 [56] | Zimbabwe | Primary study/Published | To assess the perceived effects of this new national service delivery model in Zimbabwe | Descriptive qualitative | Healthcare workers and ART clients |
MacGregor et al., 2018 [38] | South Africa | Primary study/Published | To explore the challenges associated with taking to scale a pilot that began as a relatively simple innovation by a non-governmental organization | Mixed -method | Health facilities, patients receiving ART in an adherence club, and staff working with ART adherence clubs |
Decroo et al., 2013 [57] | Mozambique | Primary study/Published | To describe the stepwise implementation and roll-out of Community ART groups in Mozambique | Descriptive study | Community ART groups |
Rasschaert et al., 2014 [58] | Mozambique | Primary study/Published | To identify factors influencing the sustainability of the community ART group model in Mozambique | Descriptive qualitative | Patients on ART, nurses, Medecins Sans Frontieres lay counselors, health authorities, and Medecins Sans Frontieres community ART group implementers |
Dorward et al., 2020 [39] | South Africa | Primary study/Published | To explore how centralized chronic medication dispensing and distribution influences engagement in HIV care | Descriptive qualitative | Clients receiving ART and healthcare workers |
Zakumumpa et al., 2020 [59] | Uganda | Primary study/Published | To explore patients’ and HIV service managers’ perspectives on barriers to the implementation of Differentiated ART service delivery | Descriptive qualitative | National-level HIV program managers, district health team leaders, representatives of United States President’s Emergency Plan for AIDS Relief implementing organizations, and ART clinic in-charges |
Hubbard et al., unknown year of presentation [68] | Malawi | Conference abstract/Unpublished | To explore client and provider experiences with the implementation of multi-month dispensing in Malawi as part of the INTERVAL study | Descriptive qualitative | ART client and provider |
Mukumbang et al., 2018 [35] | South Africa | Primary study/Published | To develop a refined program theory explicating how, why, for whom, and under what health system contexts the adherence club intervention works (or not) | Realist evaluation | Program designers and managers, available studies on group-based ART adherence support models in sub-Saharan Africa, and social, cognitive, and behavioral theories that have been applied to explain adherence to ART |
Roy et al., 2017 [69] | Zambia | Conference abstract/Unpublished | 1. To describe the uptake of the community adherence group model in Zambia using an implementation cascade for individuals offered community adherence groups 2. To identify adaptations to the community adherence group model during early implementation in Zambia | Program evaluation | Stable patients engaged in the community adherence group model |
Pellecchia et al., 2017 [60] | Malawi | Primary study/Published | To assess the benefits and challenges of community adherence groups from patients’ and healthcare workers’ perspectives | Descriptive qualitative | Community adherence group members, ART patients eligible for community ART refill groups who remained in conventional care, former community ART refill group members who returned to conventional care, and healthcare workers responsible for providing HIV care |
Mukumbang et al., 2019 [40] | South Africa | Document review/Published | To review the effectiveness of the rollout of the antiretroviral adherence club intervention in South Africa to date through an implementation research framework | Document review | Documents of the adherence club program |
Davey et al., 2018 [41] | South Africa | Conference abstract/Unpublished | To evaluate demographic and clinical characteristics and treatment outcomes in patients on differentiated care versus standard care | Crossectional | Documents of the adherence club program |