Operational Handbooks

Generally, integration of TB care and treatment into DSD models requires adaptations at multiple levels of the health system, including national, facility and community levels (177). This includes enhancement of leadership and coordination, adaptation of guidelines, capacity-building, adjustments in logistics management, alignment of existing recording and reporting tools, and community engagement. Other factors to consider include the local burden of HIV and TB disease, existing infrastructure and
human resources.

The concept of DSD (previously referred to as differentiated care) is increasingly being applied during the provision of comprehensive HIV services (78). In the context of HIV, DSD is a people-centred approach that simplifies and adapts HIV services to better serve the needs of people living with HIV and to optimize the available resources in health systems. DSD is premised on the fact that delivery of services is not a one-size-fits-all model but rather recognizes the diversity of people who seek the services.