In Namibia, despite progress made in the provision of antiretroviral therapy (ART) nutrition assessment, counseling and support (NACS) services, retention in care is a challenge where approximately 50% of clients who enroll in NACS are lost to follow up in addition to a significant number of clients relapsing into clinical treatment after discharge from NACS. The lack of awareness of existing community services, as well as the lack of a functional, systematic clinic-to-community referral system to link HIV affected and NACS clients to complementary care for the maintenance of health gains were noted as key contributors to these challenges by Ministry of Health and Social Services (MOHSS).
Since October 2013, LIFT has sought to address these gaps through the development of formal linkage networks. Through a series of key activities including service mapping, stakeholder coordination, tools development and adaptation, training and capacity building, LIFT has developed an adaptable referral resource kit and supported the establishment and launch of clinic-to-community referral networks in Katutura (Khomas Region) and Engela (Ohangwena Region). Working with and through a variety of local stakeholders from multiple sectors, these referral networks were launched between June and July 2014, and they are systematically linking HIV-affected and malnourished clients to appropriate economic strengthening, livelihoods and food security (ES/L/FS) services based on their economic and food security status and needs.
To learn from the investments in Namibia to date, in December 2014, LIFT undertook an assessment of the networks in order to distill lessons learned related to both the process used by LIFT in establishing the networks and the functionality of the system that has been put in place after 4-6 months of implementation. Namibia has been among the first tier of countries in which LIFT has supported the development of these clinic-community referral networks as well as the first country in which the project is exiting. The assessment was designed to provide valuable lessons and information for USAID/Namibia, MOHSS, LIFT and the broader development community to understand how to establish effective and sustainable referral networks.