Mobile clinics for antiretroviral therapy in rural Mozambique.
OBJECTIVE
Despite seven years of investment from the President's Emergency Plan For AIDS Relief (PEPFAR), the expansion of human immunodeficiency virus (HIV)-related services continues to challenge Mozambique's health-care infrastructure, especially in the country's rural regions.


METHODS
In 2012, as part of a national acceleration plan for HIV care and treatment, Namacurra district employed a mobile clinic strategy to provide temporary manpower and physical space to expand services at four rural peripheral clinics. This paper describes the strategy deployed, the uptake of services and the key lessons learnt in the first 18 months of implementation.


METHODS
In 2012, Namacurra´s adult population was estimated to be 125,425, and of those 15,803 were estimated to be HIV infected. Although there is consistent government support of antiretroviral therapy (ART) programmes, national coverage remains low, with less than 15% of those eligible having received ART by December 2012.


RESULTS
Between April 2012 and September 2013, Namacurra district enrolled 4832 new patients into HIV care and treatment. By using the mobile clinic strategy for ART expansion, the district was able to expand provision of ART from two to six (of a desired seven) clinics by September 2013.


CONCLUSIONS
Mobile clinic strategies could rapidly expand HIV care and treatment in under-funded settings in ways that both build local capacity and are sustainable for local health systems. The clinics best serve as a transition to improved capacity at fixed-site services.
Vanderbilt Institute for Global Health, 2525 West End Avenue, Suite 750, Nashville, Tennessee 37203, United States of America (USA).
Troy D
TD
Moon
Friends in Global Health, Limited Liability Corporation, Quelimane, Mozambique .
Tito
T
Jequicene
Vanderbilt Institute for Global Health, 2525 West End Avenue, Suite 750, Nashville, Tennessee 37203, United States of America (USA).
Meridith
M
Blevins
Friends in Global Health, Limited Liability Corporation, Quelimane, Mozambique .
Eurico
E
José
Friends in Global Health, Limited Liability Corporation, Quelimane, Mozambique .
Julie R
JR
Lankford
Vanderbilt Institute for Global Health, 2525 West End Avenue, Suite 750, Nashville, Tennessee 37203, United States of America (USA).
C William
CW
Wester
Real Medicine Foundation, Los Angeles, California, USA .
Martina C
MC
Fuchs
Vanderbilt Institute for Global Health, 2525 West End Avenue, Suite 750, Nashville, Tennessee 37203, United States of America (USA).
Sten H
SH
Vermund
D019380:Anti-HIV Agents / Q000600:supply & distribution*; D006078:Government Programs; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006297:Health Services Accessibility; D006801:Humans; D008952:Mobile Health Units; D009073:Mozambique / Q000453:epidemiology; D012424:Rural Population
D019380:Anti-HIV Agents