Differentiated Service Delivery
What Differentiated Service Delivery does
The Differentiated Service Delivery (DSD) programme, established in 2015, drives the scale up of DSD for HIV and other chronic conditions. The aim is to improve access to high-quality prevention, testing, treatment and support services for people living with and affected by HIV and maximize synergies with other health areas.
DSD is a person-centred approach that simplifies and adapts HIV services across the cascade in ways that both serve the needs of people living with HIV better and reduce unnecessary burdens on the health system.
Differentiated Service Delivery in context
DSD for HIV emerged as an increasing number of people living with HIV were receiving antiretroviral therapy (ART). It was a response to the shift in HIV guidance from the World Health Organization recommending “Treat All”, meaning that all people living with HIV should be on ART regardless of CD4 cell count.
DSD addresses some of the issues that make it difficult for people to access health services and adhere to treatment. Among these are the frequency of clinical and treatment refill visits, long queues at facilities, having to visit different facilities for different health needs, and facilities located far from where clients live and work. DSD does this by integrating services, adapting the “who”,” when”, “where” and “what” building blocks of service delivery to client needs. These adaptations can lead to shorter waiting times, less travel and better resource allocation, resulting in improved client outcomes and more efficient healthcare systems.
It’s about taking services closer to people, rather than waking up and going to a clinic that is far away. It’s about making a clinic nearer to where you stay.
Person living with HIV receiving their HIV treatment in a DSD model, South Africa
Differentiated Service Delivery in action
The IAS DSD programme provides evidence on the effectiveness of this approach and practical guidance on how to implement integrated DSD and addresses gaps in HIV service delivery.
The IAS Differentiated Service Delivery programme:
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Advocates for DSD while expanding available tools to develop guidance to further support DSD uptake
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Strengthens engagement with and within countries and communities
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Leverages global best practices, tools and evidence
Key numbers
Upcoming activities
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Differentiation at re-engagement in HIV care: A multi-country workshop – Johannesburg, South Africa – 12-14 November 2024