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Multi-monthly dispensing (MMD) is the dispensing of antiretrovirals (ARVs) and other drugs to ensure the treatment of people living with HIV (PLHIV) for a period of 3 to 6 months. It is prescribed as an alternative to monthly dispensing, which is done at the beginning of the PLHIV's follow-up or when the patient is not stable. Monthly dispensing requires the patient to make monthly clinical review visits, which is not the case for DMM.

The management of people living with HIV requires regular follow-up to achieve viral load suppression, hence the monthly visits to the management facilities. However, a patient who is compliant with ARV treatment and has an undetectable viral load is stable and should be put on DMM.

This dispensing model is much more advantageous to beneficiaries, as Dr. Gaston IRANKUNDA, Manager of the mobile clinic at Service Yezu Mwiza, explains: "Patients undergoing DMM will not have to go to the health facilities (FOSA) as often, which means saving time and money every month. The money saved can be used for other important needs in the family. Also, the time saved can be used for other self-development activities and to fulfill other family duties. The time improves their physical and mental health and there is less risk of missing appointments".

A patient in consultation during the visit of SYM mobile clinic

For the health facility, this model also has a significant advantage, "health care providers no longer have a large volume of patients to serve, it gives them enough time to properly process cases and thus provide quality services to patients, who need it most", he adds.

Although this distribution model has many advantages for patients and the facility, there are also disadvantages: "Some patients are late in getting their viral load and other follow-up tests. This means that SYM providers have to make a lot of effort to remind patients of their appointments to have these tests done", he concludes.