Down Referral is a mechanism to increase access to care for large numbers of patients requiring Anti-RetroViral (ARV) therapy. Down referral to primary health care sites often ensures that patients receive treatment within walking distance of their homes, reducing the financial burden associated with transport and loss of income for clinic visits. In South Africa PEPFAR-funded NGO Right to Care has worked with US biotech company TherapyEdge to develop a module for TherapyEdge’s suite of HIV treatment products.
The system maintains patient record continuity between the initiation site and the primary health care down referral site. The higher level prescribes the drugs. The lower level records the details of each patient visit: if the the patient is stable the drugs are issued, if not the patinet is referred up again.
One minor problem wth the system: how many primary health care facilities have computers with internet connectivity?