A consultation on differentiated services for vulnerable populations was conducted by the Community Health Expertise and Services thematic group of the Civil Society Institute for Health in West and Central Africa. It is part of the capitalisation of innovative approaches to the fight against HIV/AIDS. A virtual meeting to validate the report produced was initiated by ARCAD Santé plus. Community actors from the DRC, Mali, Niger, Burkina Faso, Cote d'Ivoire, Cameroon, Togo and Senegal took part in these exchanges.
ARCAD Santé plus is the lead organisation of this thematic group, which has several organisations in its midst, ranging from 4 to over 20 years of existence. The literature shows a large number of differentiated services that encompass prevention, care and advocacy activities. Good practices and innovations were highlighted. Finally, recommendations were formulated.
In implementing differentiated services, CSOs face challenges such as: scarcity of funds, heavy dependence on external funding, access to conflict zones and violence by law enforcement agencies. Differentiated services can be defined as "a client-centred approach that simplifies and adapts HIV services to better meet the needs of people living with or at risk of HIV". It represents opportunities for improving access to care and treatment for people living with HIV. It was with the Covid-19 pandemic that multi-month community-based ARV dispensing for stable patients became widespread.
SDs help to bring otherwise hard-to-reach groups classified as "underground" into the continuum of care in a safe and trusting environment, but they also reduce the workload for the health system as a whole. Many agree that SDs make a significant contribution to achieving the 90-90-90 goals. They help to facilitate access to the right to health while avoiding the additional challenges of a repressive legal framework.
This document will be widely disseminated to community actors, civil society, state institutions and international organisations involved in the response to HIV/AIDS among vulnerable groups in West and Central Africa. This repository for capitalising on the experiences of the member organisations of the thematic group on "Community health expertise and services", aims on the one hand to increase the knowledge base on existing skills and expertise within civil society organisations in the region, and on the other hand to document the differentiated services offered to vulnerable populations. More generally, the study aims to highlight the individual efforts of the associations in the thematic group in the fight against HIV/AIDS in order to promote the sharing of experiences and good practices between organisations in West and Central Africa.
Important recommendations were also made. These include: intensifying communication between organisations, creating coalitions for advocacy in resource mobilisation, strengthening the technical capacity of CSOs, increasing awareness of policy makers and law enforcement agencies, and involving non-health CSOs in the implementation of differentiated services.