MMD has increased the quality of treatment and care for ART patients, as health care workers now have enough time to interact with patients and address their specific needs. Botswana Health System adopted differentiated service delivery models, including the multi-month dispensing approach to improve the impact of the country’s HIV response in meeting the UNAIDS 2030’s 95-95-95 targets through improved treatment adherence and improved health system efficiencies. The MMD comes in two categories: three months (3MM) and six months (6MM). The choice of either category depends mainly on the patient meeting set eligibility criteria and availability of the drugs. As a result, the supply chain plays a pivotal role in ensuring that MMD is achieved across the health system.
GHSC-PSM worked with the Ministry of Health and Welfare (MOHW) to ensure that MMD implementation is clear and fluent. The support includes successful development of the MMD eligibility flow chart and its guidelines in collaboration with the MOHW and other implementing partners. GHSC-PSM continues to facilitate stakeholder engagement meetings and workshops to promote the benefits of MMD in antiretroviral drug (ARV) management and, as a result, how the supply chain continuum will respond to MMD implementation requirements.
Central Medical Stores together with GHSC-PSM has also modified the dispensary register to include MMD capturing and subsequent reporting by the facilities. This development in the dispensary register would help to know which MMD category is commonly used and what the implications are on supply chain management. GHSC-PSM also continues to support the MOHW with monitoring the MMD roll-out during the quarterly monitoring and support visits. Through this exercise, the MOHW can assess the progress made since MMD was adopted, as well as assess the facilities’ readiness for implementing the MMD, thus for those that have not yet started implementing it.
