Through funding from USAID, FPD implemented a community-based HIV counselling and testing project. The overarching goal of the programme was to implement high yield, community-based HIV counselling and testing (CBCT) services with an aim to identify People Living with HIV (PLHIV) and to effectively link them into HIV and TB care and treatment programmes. By implementing CBCT modalities in high incidence communities near where people live and work, CBCT complemented facility-based HIV Testing Services (HTS) and reached HIV positive community members who may not access HTS in the health facility setting. The community-based HIV counselling and testing programme (CBCT) offered HIV testing in six provinces within 13 selected districts (Tshwane, Bojanala, COJ, Sedibeng, Capricorn, Mopani, Ehlanzeni, Gert Sibande, eThekwini, Ugu, King Cetswhayo, Zululand, Buffalo City) covering 33 sub districts working with SUB partners: SFH and HPPSA.
Building on a concept described by Chang et al. CBCT is implemented using a “combination implementation” approach. Combination implementation in the context of CBCT is defined as the pragmatic, localised application of a coordinated package of evidence-based HTS modalities delivered at community level using optimised implementation and operational strategies to achieve high yield. The identified high yield HTS modalities for CBCT include targeted home-based HTS, index patient trailing HTS, mobile HTS (including near-home, workplace and twilight implementation models). The CBCT combination implementation approach layers three to four complementary, high yield HTS modalities within a single sub-district with an aim to reach a maximum number of PLHIV and rapidly facilitate their entry into facility-based HIV care and treatment programmes; the programme also aimed to identify HIV negative individuals at high risk of HIV infection and rapidly facilitate their entry into combination prevention programmes (MMC,PrEP, SRH/ FP, SGBV, and NCD). This project ended in 31 December 2018.
Under the umbrella of CBCT, FPD designed an innovative system of delivering HTS through the social franchise HTS (SFHTS) model which organises local entrepreneurs to deliver standards-based HTS services (inclusive of a basic package of care and linkage services) under a common brand.
The SFHTS model was implemented as a pilot in Tshwane district where a district-based franchisor (FPD) is based. FPD systematise and prescribe standards for HTS, proficiency, counselling, health education, referral and linkage as well as manage and oversee the quality assurance of social-franchisees (SFs).
Possible benefits of HTS Social Franchise model are:
Key results from FPD’s USAID/PEPFAR CBCT programme (October 2013 – September
The USAID funded project closed-out officially in December 2018 after implementation of five years with successful results indicated below: