The One Stop Clinic Ifakara (OSC, founded 2014) provides an exemplary medical setting for HIV-affected families unifying all services for HIV-positive pregnant women and their families need under one roof. Nested within CDCI and located at the Clinic for Reproduction and Child Care of the St. Francis Referral Hospital (SFRH), the OSC aims to improve access to care and treatment for HIV-infected pregnant women, their offspring and partners living in the Kilombero district and serves as a model clinic for other rural settings in Tanzania and sub-Saharan Africa.
Within the OSC programme HIV-positive women access pregnancy care, paediatric care, HIV care, vaccination services, cervical cancer screening programmes and care for exposed infants by one visit only reducing the number of appointments, long waiting times and expenses for transport fees. This model showed to improve retention in care greatly.
Furthermore, the OSC has successfully improved the awareness and clinical skills of health workers involved in Prevention of Mother-To-Child Transmission of HIV (PMTCT) and Pediatric HIV by regular trainings within the district. Besides healthcare workers, collaboration with district authorities and representatives of USAID in the Morogoro Region are key of success. The One Stop Clinic has developed tools to guide and facilitate management of HIV-infected pregnant women, mothers and children.
Since the One Stop Clinic was established in 2014, the Mother-To-Child HIV-transmission (MTCT) rate has been reduced to impressive 2%, reaching the WHO goal of elimination of MTCT (<5%). During breastfeeding virally suppressed women do no longer transmit HIV. Lifelong antiretroviral treatment throughout pregnancy and the breastfeeding period showed to not only reduce transmission but also improve maternal outcomes.
Children and adolescents remain a particularly vulnerable patient population, who are disproportionally affected and often have poorer treatment outcomes with lower viral suppression rates and a higher risk of poor treatment outcome. Within the One Stop Clinic specialized care is offered with integrated counselling and teen groups. We address the specific needs in children failing on antiretroviral treatment within a multi-site trial (GIVE MOVE trial). Support programmes for HIV care in adolescents are evaluated in another trial (Sauti ya vijana).