Authors: M.O. Titus 1, J. Anyanti 2, G. Omoregie 3, J.C. Bako 4, T. Ogungbenro 1
1Society for Family Health Nigeria, Adolescent 360 Amplify, Abuja, Nigeria, 2Society for Family Health Nigeria, Programs and Strategy, Abuja, Nigeria, 3Society for Family Health Nigeria, Global Fund HIV, Abuja, Nigeria, 4University of Ibadan, Institute of African Studies, Ibadan, Nigeria
Category: D2: Impact evaluation of differentiated service delivery Country of research: Nigeria
Background: Nigeria’s HIV epidemic affects all population groups and geographic areas of the country. Key populations (KP) are disproportionately impacted by this epidemic, the IBBSS 2014 revealed the following HIV prevalence among Key Populations: Female sex workers(FSW): brothel-based FSW (19.4%); and 8.6% among non-brothel based FSW; men who have sex with men(MSM) (23%) and People who inject drugs(PWID) (3.4%). This study, with funding from funding from International AIDS Society, sought to document the success or otherwise of the differentiated service delivery (DSD) for KPs in Nigeria.
Methods: This study was a cross sectional study which utilized focus group discussions and key informant interviews for data collection. The target participants for this study included: PWID, FSW, MSM DSD beneficiaries, MSM and FSW key opinion leader, health care workers (HCWs), State AIDS program coordinator, and State Agency for the Control of AIDS in three selected states. Research Assistants were trained centrally for uniformity. The data was transcribed and analyzed using a constant comparison analysis technique.
Results: The study revealed that the trainings of the HCWs were adequate and relevant. Due to these trainings, HCWs were perceived to be more KP-friendly and more professional in the services they provided, waiting time at the ART clinics also reduced due to the differentiated service delivery models. Participants also said that ARVs were always available at the OSS facilities. All participants belong to and participate in a support group. Some of the support groups are KP-led and gender differentiated while others are not. The models of Differentiated Service Delivery implemented across the states included the Facility based model, the Out-of-facility model and the Client managed group models. Sources of finances included government and other donors. The DSD implemented in each state had a positive influence on loss to follow up among KPs.
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Conclusions: Conclusively, the DSD models have improved service delivery in the study sites, reduced waiting times at the ART clinics, improved KP-friendliness among HCWs, and increased demand for ART services among KPs. Therefore, it is suggested that DSD models be scaled up to national level in order to improve ART service delivery across the country.