An evidence-based exploration of differentiated service delivery models, examining implementation considerations, patient selection criteria, and programmatic outcomes across diverse healthcare contexts.
Differentiated service delivery represents a shift in HIV care delivery paradigms, moving from uniform, facility-based models toward approaches that tailor services to patient needs and preferences. This course examines the evidence base supporting various DSD models, implementation frameworks, and considerations for program design and monitoring.
The content reflects current WHO guidelines on differentiated service delivery while acknowledging the heterogeneity of health systems and the importance of context-specific adaptation. Learners will examine DSD models through multiple lenses including clinical safety, patient experience, health system capacity, and programmatic sustainability.
This course is for educational purposes only and does not constitute medical advice. Clinical decisions must be made by qualified healthcare professionals based on individual patient assessment, national guidelines, and local protocols. Implementation of DSD models requires appropriate health system infrastructure, trained personnel, and quality assurance mechanisms.
Upon completion of this course, learners will be able to:
This module establishes the conceptual framework for DSD, examining how healthcare delivery models have evolved in response to the changing epidemiology of HIV and the shift toward chronic disease management. The content addresses the tension between standardization for quality assurance and differentiation for patient-centeredness.
Learners explore the evidence base from implementation science studies, examining outcomes across diverse settings. The module presents WHO recommendations within the broader context of health systems strengthening and universal health coverage.
Examination of specific DSD models including multi-month dispensing, community-based ART distribution, differentiated appointment spacing, and facility-based group models. For each approach, the module addresses clinical eligibility criteria, operational requirements, and monitoring considerations.
Patient selection frameworks are presented with attention to clinical stability definitions, risk stratification, and the balance between expanding access and ensuring safety. The content acknowledges debates around eligibility criteria and presents various approaches implemented across different programs.
Analysis of health system requirements for DSD implementation including human resources, supply chain management, information systems, and quality assurance mechanisms. The module examines both facility-level considerations and broader health system enablers.
Implementation challenges are examined through case studies, with attention to how programs have addressed barriers related to policy frameworks, stakeholder engagement, and integration with existing services. The content emphasizes the iterative nature of implementation and the importance of programmatic learning.
Development of monitoring frameworks specific to DSD programs, including indicator selection, data collection methods, and interpretation of programmatic data. The module addresses both clinical outcomes and process indicators that reflect program quality and fidelity to DSD principles.
Quality assurance approaches are examined, including mechanisms for ensuring appropriate patient selection, maintaining treatment adherence support, and identifying patients who require return to conventional care models. The content emphasizes data use for program improvement.
This course is designed for:
The course assumes familiarity with HIV treatment principles and basic understanding of antiretroviral therapy. Knowledge of health systems concepts is beneficial but not required.
This course is not appropriate for:
The course consists of four modules delivered through text-based content, visual aids, and case studies. Learners may progress at their own pace. Estimated completion time is approximately six hours, though individual learners may require more or less time depending on prior knowledge and depth of engagement with supplementary materials.
Access: This course is provided free of charge. No registration fees or subscription costs apply. Content is accessible globally without geographic restrictions.
Course content is derived from peer-reviewed literature, WHO technical guidance, and implementation science studies. Key references include:
Full citation information is provided within course modules. Content is updated periodically to reflect new evidence and guideline revisions.
The implementation of differentiated service delivery raises important ethical considerations including patient autonomy, informed consent, equity in access, and the balance between efficiency and individualized care. Programs must ensure that differentiation does not create barriers to care or compromise treatment quality.
DSD models should be implemented within frameworks that respect patient rights, maintain confidentiality, and ensure that patients can opt out of differentiated approaches without negative consequences. Quality assurance mechanisms must be in place to protect patient safety.
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Last updated: January 2026 | Course ID: IAS-DSD-001