Implementation of multi-month dispensing among people living with HIV in Tanzania

The global efforts to end the HIV pandemic are currently geared towards achieving ideal viral suppression among People Living with HIV (PLHIV) on ART. Tanzania adopted a number of strategies including Multi-Months Dispensing (MMD) allowing stable clients to attend the clinic twice or three times a year. This study examined the implementation of MMD in Tanzania. This was a cross-sectional study that employed quantitative methods. A total of 44 high-volume health facilities i.e. those contributing 80% of PLHIV in the six regions were involved in this evaluation. All electronic client files in the HIV Care and Treatment Clinics for review on MMD eligibility and implementation status. Open Data Kit (ODK) was used to collect data on facility-level factors that influenced implementation of MMD. Out of 51,478 stable clients, 82.1% were put on MMD while 17.9% did not receive MMD. On the other hand, 33.7% of unstable clients were provided with 3 months or more ARV drugs. The overall compliance to MMD policy was found to be 76% and was unevenly distributed across health facilities. This was contributed by different factors including the type of facility, geographical location and availability of quality CTC services. MMD has proved to be an important strategy for delivering HIV services, if well executed it will facilitate improvement of the health outcome of HIV clients. Implementation of MMD is influenced by several factors such as type of facility, rural-urban dichotomies, quality of service and distance to health facility.