Project Last Mile in South Africa supports a national differentiated service delivery (DSD) model for integrated disease management and improved access to antiretrovirals (ARVs)

Sarah Christie, Lingrui Liu, Maggie Munsamy, Phil Roberts, Merlin Pillay, Erika Linnander, Mayur Desai

Background

In South Africa,

7.7M living with HIV and 4.8M on ARVs

NCDs account for 51% of mortality

Differentiated service delivery (DSD) is well-positioned to address both, but there are limited examples of integration at scale.

Intervention

Project Last Mile applies private sector expertise to strengthen public health systems in Africa. Since 2016, PLM supported the Central Chronic Medications Distribution and Dispensing (CCMDD) of the National Department of Health with:

Methods

Yale used mixed methods to assess the expansion of CCMDD over time.

Results

Since March 2016, CCMDD has reached:

  • 46 health districts (88% nationally)

  • 3,479 facilities (94.6% coverage)

  • 2,088 external pick-up points

  • 3 million registered patients


Integrated DSD models at national scale improve access to both ARVs and treatment for other chronic diseases, with benefit from private sector support.