Nigeria's Early Adoption of Differentiated Services Delivery Model Buffers Effect of Covid-19 Pandemic Among People Living With HIV

Abuja — As the COVID-19 pandemic gained momentum across the world with many countries, including Nigeria going on lockdown, there arose fears that the people living with HIV (PLHIV) might not have access to Antiretroviral (ARTs). The fears of the outbreak disrupting ARTs supplies to PLHIV in Nigeria was, however, not as devastating because the country had already adopted the Differentiated Service Delivery (DSD) model in December, 2019. The gains of the model became noticeable during the imposed lockdown by the government.

The DSD model is a client-centred approach that simplifies and adapts HIV services to reflect the preferences and expectations of various groups of people living with HIV (PLHIV) while reducing unnecessary burdens on the health system. Nigeria approved the DSD policy in 2019 and currently implemented in the 36 states and the Federal Capital Territory. The gains of the model became noticeable during the imposed lockdown by the government.

"All we had to do during the lockdown was improve communication and mobilize some community volunteers to take supplies to others who needed the drugs within their vicinities," says Obatunde Oladapo, the co-founder and Executive Director of PLAN Health Advocacy and Development Foundation (PLAN Foundation).

Mr Oladapo said Nigeria's earlier adoption of DSD in 2019 was helpful during the lockdown as many PLHIV had enough drug supplies. The DSD model tailor's HIV package of care toward individual needs using facilities and community-based approaches. The model was quite helpful in solving the issue of access which would have been encountered during the lockdown and ensuring that no one is left behind during the COVID-19 crisis.

"Some female PLHIV served as community distributors - taking drugs to the doorstep of the clients and providing excess supplies to last them for months. They also visited hard to reach semi-urban and rural areas to facilitate the home delivery of HIV treatment and medicines for those in need of supplies" Oladapo said.

Implementation of DSD

The implementation of the DSD model has been all-inclusive comprising of stakeholders from the Network of People Living with HIV to Civil Societies Organization, donors, implementing partners, community service provides and private health sector providers among others. To ensure the smooth running of the DSD model during the lockdown, the World Health Organization (WHO) supported the Federal Government through the National AIDS and STIs Control Programme (NASCP) in developing and disseminating a guideline on Continuity of HIV services in the context of Pandemics and ensured HIV is well captured in the wider Health sector continuity of essential services guidance. Also, WHO provided technical assistance in setting up and running national and state HIV situation rooms to ensure that antiretroviral ART (drugs) get to the end-users- PLHIVs.

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