Mkushi college of applied science
Department of nursing
January 2025 intake
Name : Lawrence mulenga
1D. : 2025//01/040
Course: PHN 2
Lecturer : MS. HIMAKUNI
due date : 18/07/2025
Questions
1. Explain the classifications and eligibility criteria of differentiated
service delivery models.
2. Discuss the building blocks and benefits of differentiated service
delivery models
Introduction
Differentiated Service Delivery (DSD) models have emerged as innovative approaches to
optimize healthcare delivery by tailoring services to the specific needs of different client
groups. Particularly in the context of chronic disease management, such as HIV care,
DSD aims to enhance treatment outcomes, improve patient satisfaction, and reduce the
burden on health systems. By categorizing service delivery into various models and
establishing eligibility criteria, DSD facilitates more efficient and client-centered care,
ensuring that resources are used effectively while maintaining high-quality health
services.
Question 1 Explain the classifications and eligibility criteria of differentiated service delivery
models.
classifications of DSD models commonly include:
1. Facility based individual models: Services are provided within health facilities but adjusted to
client needs, such as fast track refills or extended consultation intervals.
2. Out of facility individual models: Services are delivered outside conventional health facilities,
for example, through community pickup points or home delivery.
3. Health care worker managed groups: Small groups of clients meet regularly and are managed
by health workers, facilitating peer support and streamlined service delivery.
4. Client managed groups: Groups formed and managed by clients themselves, like community
adherence clubs or support groups.
Eligibility criteria for clients to access differentiated models typically include:
Stable clinical status, e.g., viral suppression in HIV care.
Adherence to treatment.
No current opportunistic infections or complications.
Duration on treatment (often a minimum period, such as six months).These criteria ensure clients
receive care appropriate to their stability and support needs.
Question 2 Discuss the building blocks and benefits of differentiated service delivery models.
Answer
The building blocks of differentiated service delivery models include:
Clientcentered service design tailored to diverse needs.
Decentralization of services away from congested health facilities.
Task shifting and sharing among health workers.
Use of peer support and community engagement.
Benefits of DSD models include:
Improved retention and adherence to treatment.
Reduced burden on health facilities and staff.
Enhanced client satisfaction and convenience.
Greater efficiency in resource use.
Strengthened community involvement and support networks.
Conclusion
Differentiated service delivery models represent a transformative approach in healthcare,
particularly in managing chronic conditions like HIV. By classifying services into
facility-based and community-based models and applying clear eligibility criteria, these
models ensure that clients receive tailored care that matches their stability and support
needs. The building blocks—including client-centered design, decentralization, task
shifting, and community engagement—facilitate more efficient, accessible, and
sustainable healthcare delivery. Ultimately, DSD models improve treatment adherence,
reduce health system burdens, and enhance client satisfaction, making them essential in
achieving better health outcomes.
References
Grimsrud, A., Bygrave, H., Doherty, M., Ehrenkranz, P., Ellman, T., Ferris, R., … & Ford,
N. (2016). Reimagining HIV service delivery: the role of differentiated care from prevention
to suppression. Journal of the International AIDS Society, 19(1),
21484. https://doi.org/10.7448/IAS.19.1.21484
World Health Organization (2016). Consolidated guidelines on the use of antiretroviral
drugs for treating and preventing HIV infection. Recommendations for a public health
approach. 2nd edition. Geneva: WHO. Available
at: https://www.who.int/hiv/pub/arv/arv-2016/en/
Tsondai, P., Davies, M. A., Stinson, K., Abrams, E. J., & Technau, K. G. (2017).
Differentiated models of care for HIV-infected adolescents and youth in resource-limited
settings: A systematic review. Journal of the International AIDS Society, 20(Suppl 3),
e25044. https://doi.org/10.1002/jia2.25044
