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Barriers and Enablers Associated with Differentiated Models of ART Distribution at the Community Level

A Three-Country Study

In an effort to expand access to antiretroviral treatment (ART), countries across sub-Saharan Africa have begun to implement and scale up differentiated approaches to ART distribution, particularly at the community level. These distribution models are typically designed to cater to stable adult patients and aim to bring ART closer to where patients live, which, in turn, serves to decongest clinics and reduce the overall strain on a country’s health system. While documentation on the results of these models exists, there is limited information on the specific barriers and enablers that have impacted the implementation of such models. This cross-country study describes various models of differentiated ART distribution and the barriers and enablers associated with their implementation.