The Lighthouse Trust piloted “Nurse-led Community ART Program (NCAP)” initiative aims to encourage long term retention to care of stable patients on ART by using outreach facilities identified by PLHIV support groups. This intervention aims to serve patients that are; registered with Lighthouse at Kamuzu Central Hospital (KCH) or Martin Preuss Centre at Bwaila hospital, adult (i.e. 18 years old and above), on the same first or second ART regimen for at least 12 months, cleared as a stable patient by a clinical officer: without serious complications or other related infectious diseases, Viralogically suppressed, and live within Lighthouse Community Health Services (CHS) catchment areas.

Clients that meet the above enrollment criteria are given an option of seeing a health care provider at a pre-selected outreach location identified by Lighthouse Community Health Services team. Once a client has been registered in the NCAP initiative, he/she will continue receiving HIV services, including ARV refills, at the outreach point in the community (except in special circumstances where referral to the clinic is necessary). This means that patients are provided 3 months ART supply and that they will be required to meet their next appointment in the community at the outreach point. The approach assures that patients see a health care provider every three months as recommended by the national guideline, receive limited essential services at a place convenient to them, and have the opportunity to come to Lighthouse Clinics to receive specialist care whenever appropriate.

Services provided at an outreach location include, but not limited to; adherence monitoring (pill count), refill of prescriptions, documentation of current status on patient passport and patient chart (that will later be entered into EMR), issuing of next appointment date, provision of condoms, screening for comorbidities such as tuberculosis, hypertension, among others.

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