The Community Adherence and Support Group Strategy in Niassa Province, Mozambique: A Process Evaluation of Group Formation Dynamics

Abstract

In Mozambique, where 11.5% of the population is infected with HIV, there is an ongoing struggle to scale-up HIV care and treatment including the expansion of ART access and improvement of coverage rates. To achieve the ambitious goal of scaling up ART coverage (while assuring high rates of ART adherence and retention in care), it is necessary to explore new models for HIV service delivery that account for practical challenges such as understaffed health facilities and barriers to patient access and adherence to ART. A new model known as the Community and Adherence Support Group (CASG) strategy, which involves stable patients on ART forming groups to share treatment distribution responsibilities, was piloted by the Ministry of Health in 2010. This research was a part of a process evaluation that generated formative, qualitative data around group formation dynamics at 3 study sites of the national pilot. This research took place in Niassa Province.