Rollout of HIV services, including the initiation and continued distribution of antiretroviral (ARV) medications at the primary healthcare level, is an enormous challenge facing the Department of Health in South Africa.

With an ever-growing population of people receiving treatment in the country, a system of care centred at the secondary hospital level is unsustainable. Using heath systems improvement methods, it has been possible to rapidly devolve ARV care from a District Hospital ARV site to surrounding primary heathcare clinics (PHCs).

Brandon Bennett, IHI Developing Countries Project Manager in KwaZulu-Natal, presented this poster on down referral of patients at the 3rd South African AIDS conference, June 5-8, 2007, in Durban, South Africa.