ART Program (At cost)
A new Innovative and cost effective way to
increase accessibility and sustainability of ART
for PHAs
Health services with..Payment by clientStandard services
Partnership between PSI and SQH network
Product supplyTechnical support
Improved healthPromoted Behavior
Malaria & STIs in 2003
TB in 2004
Pneumonia in 2008
PICT/ARTIn 2010
The partnership experience
FP in 2001
Accessibility
Affordability
Good retention
Proven Quality of care
HIV care package
Integrated services
Sustainability
Cost-effectiveness
Program
Rationale for ART at cost
ART Service Delivery Model
Technical support
Supportive supervision Drug Logistic MxMonitoring
Adherence follow up Quality Assurance MIS & Cohort Analysis
Treatment
Referral network
Monthly Reporting
Joint Activities Training Refresher TrainingPatient Selection Board
Specialist Hospital NAP NGO
Diagnosis Adherence counseling
Patient Selection criteria: ART naïve patients
• Eligibility for ART based on National Guidelines
• Social criteria
– being affordable to the price, and Lab cost
Non-ART naïve patients (25%)
• History of good adherence on d4T/3TC/NVP
• No evidence of clinical failure/immunological failure
• No Long Term Stavudine side effect
Patient Selection Board
1. Representative from AIDS/STD Team
2. Township Medical Officer/Representative
3. Sun Quality Health Provider
4. Representative of PHAs
Facilitated by PSI