learning from mobile detox april 2017 -...
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LearningfromamobiledetoxpilotinPakistan
InnovationisanimportantpillarofworkforMainlineundertheBridgingtheGaps2(BtG2)programme.ThroughoutBtG2,Mainlineaimstopilotnewinterventions;disseminatesuccessfulresultstoothercountries,keypopulationsandpartnersaswellasfurtherinnovatetheharmreductionfield.
Webelievethatnotallinnovationswillhavetheirintendedeffectsandthatpilotsoftenhaveoutcomeswhicharedifferentthanexpected.OneexampleofalearningexperiencefromapilotinterventionisthemobiledetoxinPakistan.
GreatresultsMainlinehassupporteditslocalpartnerNaiZindagiinPakistanwiththedevelopmentofanARVAdherenceUnit(AAU)–an8weekin-houseprogrammewhereclientsreceiveddetoxification,ARVmedicationandsupportonmanagementandadherence.TheevaluationoftheAAUshowedgreatresults.AU-graduatesreportedbetteradherenceratesthannon-AAUclients,evenwhentheyrelapsedintodruguse.Themobiledetoxpilotwasafollow-upinitiativetogiveAAU-graduateswhorelapsedintodruguseanotherpossibilitytoundergodetoxification.
Theinitialideawastosetupapublic-privatepartnershipinfourcitieswithamobileunittosupportlocalclientsinoneofthefourdistricts.TheDistrictAIDSCouncils
providedthe15daysresidentialprogrammespaces,andamobilemedicalteamofNaiZindagimovedfromdistricttodistrictonceabatchof10AAU-graduateswasidentifiedandconsentedfordrugtreatment.
Theresultswereencouraging.96%ofthe283clientswhocompletedtheprogrammewereadherent,whichisa20%increasecomparedtoregularAAU-graduates.However,therealisationofthemobilecomponentturnedouttobetoo
complicatedandcouldnotcontinueduetohighexploitationcosts.Moreover,thedemandsideexceededthesupplyside.
Asaresult,themedicalteamdidnothavethetimeorspacetomovetothenextcity.Asaresultofthispilot,NaiZindagiestablishedstaticdetoxunits–insteadofmobileunits–inordertomeetthedemandandtoprovidecomprehensivetreatmenttoAAU-graduates.Theadaptationoftheplansbasedontheclients’needsprovedtobeavaluablelearningexperienceforMainlineandallthepartnersinvolvedintheproject.