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Linking beyond health: Assessing clinic-to-community referral networks for people living with HIV

Tuesday, November 3, 2015

Cheryl Tam, Economic Development and Livelihoods Department, FHI 360, Washington, DC

As HIV care moves toward a chronic care approach, clients need a diverse array of services outside clinical settings to extend the continuum of care. Referral networks were launched between June and July 2014 in two districts in Namibia to systematically link PLHIV to existing economic strengthening, livelihoods and food security (ES/L/FS) services. We conducted an assessment of these networks to identify lessons learned from the referral network building process and to gauge the functionality of the resulting system.


In December 2014, we collected data from a convenience sample of community-based organization staff, government officials and network clients using individual and small group interviews four months after network launch.

lessons learned

Key considerations around the network development process include identification of and outreach to high-level decision makers to ensure political support prior to network launch as well as engaging appropriate stakeholders to serve as local champions of the system. To facilitate effective system functionality, recommendations include instituting regular network review meetings and refresher trainings, providing mentoring and on-site technical assistance, and ensuring that each network partner has a designated focal person present and available to conduct client referrals. Clients also reported that service utilization is facilitated when the rationale for referrals is clearly communicated, the community is sensitized to the network, and service providers are prepared to receive referred clients.


Namibia is among the first countries to establish clinic-community linkages to ES/L/FS, and findings will shape the deployment of referral networks in other sites and influence the institution of effective, sustainable networks.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice

Learning Objectives:
Formulate a list of recommendations to guide the development of clinic-community referral networks for people living with HIV (PLHIV)

Keyword(s): Adherence, Community-Based Partnership & Collaboration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working with community-based HIV/AIDS programming for the past 3 years and have been trained in qualitative and quantitative research methods and ethics as a part of my academic and professional development.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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