{"id":4907,"date":"2025-07-29T05:04:13","date_gmt":"2025-07-29T05:04:13","guid":{"rendered":"https:\/\/csaude.org.mz\/?p=4907"},"modified":"2025-07-29T07:41:33","modified_gmt":"2025-07-29T07:41:33","slug":"half-year-refills-full-year-freedom-positive-impact-of-the-six-monthly-medication-dispensation-6mmd-model","status":"publish","type":"post","link":"https:\/\/csaude.org.mz\/pt\/2025\/07\/29\/half-year-refills-full-year-freedom-positive-impact-of-the-six-monthly-medication-dispensation-6mmd-model\/","title":{"rendered":"Refor\u00e7o Semestral, Liberdade Anual: Impacto Positivo do Modelo de Dispensa Semestral de Antirretrovirais (6MMD)"},"content":{"rendered":"
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\u201cO modelo de dispensa semestral chegou no momento certo. Agora posso passar mais tempo na minha machamba e j\u00e1 n\u00e3o preciso de estar sempre a explicar por que vou tantas vezes ao hospital.\u201d\n\u2014 Arlindo Nalili, paciente na unidade sanit\u00e1ria 17 de Setembro<\/span>
\u2014 Arlindo Nalili, patient at 17 de Setembro Health Facility<\/span><\/p>\n

<\/span><\/p>\n

No cora\u00e7\u00e3o da prov\u00edncia da Zamb\u00e9zia, muitas fam\u00edlias enfrentam diariamente o desafio de viver com o HIV enquanto procuram sustentar os seus meios de vida em contextos de escassez de recursos. At\u00e9 finais de 2024, os pacientes clinicamente est\u00e1veis precisavam de retornar \u00e0s unidades sanit\u00e1rias a cada um a tr\u00eas meses para levantar a medica\u00e7\u00e3o antirretroviral (TARV) um ciclo que implicava longas desloca\u00e7\u00f5es, perda de rendimento e o peso silencioso do estigma nas comunidades mais unidas. <\/span><\/p>\n

Na altura, apenas sete unidades sanit\u00e1rias na prov\u00edncia tinham iniciado a implementa\u00e7\u00e3o do modelo de Dispensa Semestral de Medicamentos, que reduz as visitas cl\u00ednicas de rotina de at\u00e9 doze vezes por ano para apenas duas. Esta mudan\u00e7a simples, mas transformadora, proporcionou a pacientes como Manuel Albano a liberdade de se focar nas suas fam\u00edlias, nas machambas e no futuro em vez de passarem boa parte do tempo \u00e0 espera por servi\u00e7os nas unidades de sa\u00fade lotadas. No entanto, escalar este modelo numa prov\u00edncia t\u00e3o extensa e diversa como a Zamb\u00e9zia exigiu o envolvimento coordenado de gestores a n\u00edvel nacional, provincial e distrital, t\u00e9cnicos de farm\u00e1cia, digitadores de dados, enfermeiros e ativistas comunit\u00e1rios.<\/span><\/p>\n

Reconhecendo o seu potencial, o Minist\u00e9rio da Sa\u00fade aprovou, em outubro de 2024, uma estrat\u00e9gia coordenada de expans\u00e3o. Liderada pela Dire\u00e7\u00e3o Provincial de Sa\u00fade da Zamb\u00e9zia (DPSZ), com apoio da C-Sa\u00fade, as equipas distritais de sa\u00fade e os mentores da C-Sa\u00fade organizaram oficinas intensivas sobre as diretrizes da Dispensa Sementral, com exerc\u00edcios pr\u00e1ticos para a actualiza\u00e7\u00e3o de cart\u00f5es mestres e uso da base de dados de seguimento de pacientes para identificar os utentes eleg\u00edveis. Sess\u00f5es virtuais semanais e visitas mensais presenciais de supervis\u00e3o permitiram resolver desafios e fortalecer a implementa\u00e7\u00e3o, enquanto os gestores de dados apoiavam as unidades na gera\u00e7\u00e3o autom\u00e1tica de relat\u00f3rios sobre taxas de ades\u00e3o e n\u00edveis de stock, permitindo ajustes r\u00e1pidos sempre que surgiam constrangimentos.<\/span><\/p>\n

O envolvimento comunit\u00e1rio foi igualmente essencial. Na Unidade Sanit\u00e1ria 17 de Setembro, em Quelimane, um grupo multissetorial composto por ativistas locais, l\u00edderes tradicionais e pessoal cl\u00ednico organizou palestras interativas, nas quais os pacientes puderam colocar quest\u00f5es, partilhar preocupa\u00e7\u00f5es e ouvir testemunhos de outros pacientes que j\u00e1 aderiram ao modelo. Cartazes e programas de r\u00e1dio em l\u00ednguas locais e em portugu\u00eas refor\u00e7aram que os refor\u00e7os semestrais n\u00e3o significam redu\u00e7\u00e3o na qualidade do cuidado, mas sim reconhecimento da estabilidade cl\u00ednica dos pacientes oferecendo-lhes mais autonomia e dignidade. Na Unidade Sanit\u00e1ria de Mocubela Sede, os comit\u00e9s de sa\u00fade comunit\u00e1ria incentivaram os pacientes a \u201ctrazerem um amigo\u201d nos dias de inscri\u00e7\u00e3o, criando pares entre rec\u00e9m-chegados e utentes que j\u00e1 vivenciavam os benef\u00edcios dos intervalos prolongados.
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Entre outubro de 2024 e junho de 2025, estes esfor\u00e7os come\u00e7aram a dar frutos. O n\u00famero de unidades sanit\u00e1rias envolvidas aumentou de 7 para 37, cobrindo a maioria dos distritos da prov\u00edncia. A cobertura do modelo 6MMD entre pacientes eleg\u00edveis quase duplicou de 9% na linha de base para 20% no final do per\u00edodo de refer\u00eancia com mais de 79.000 pacientes inscritos no modelo. Na Unidade 17 de Setembro, mais de 72% dos pacientes eleg\u00edveis aderiram ao modelo, com as equipas a ajustarem os fluxos de trabalho para dias espec\u00edficos de levantamento de TARV e os digitadores de dados a garantirem um registo rigoroso dos inscritos. Mesmo em Mocubela Sede, onde os desafios estruturais eram mais acentuados, 70% dos pacientes est\u00e1veis j\u00e1 beneficiam da dispensa\u00e7\u00e3o semestral.<\/span><\/p>\n

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O impacto foi al\u00e9m dos n\u00fameros. Enfermeiros relataram melhorias no fluxo de atendimento, com menos levantamentos di\u00e1rios de TARV, o que lhes permitiu dedicar mais tempo ao aconselhamento de pacientes rec\u00e9m-inscritos ou com casos mais complexos. T\u00e9cnicos de farm\u00e1cia, antes sobrecarregados, passaram a ter mais tempo para reconciliar invent\u00e1rios e prestar apoio \u00e0 ades\u00e3o. Pacientes partilharam que passaram a sentir-se menos como \"visitantes da cl\u00ednica\" e mais como parceiros ativos nos seus cuidados, podendo agora cultivar as suas machambas, vender nos mercados e participar em eventos comunit\u00e1rios sem o dilema das constantes visitas ao hospital.<\/span><\/p>\n

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Olhando para o futuro, as autoridades provinciais de sa\u00fade e a C-Sa\u00fade, com apoio do CDC\/PEPFAR, est\u00e3o comprometidas em expandir o acesso \u00e0 dispensa\u00e7\u00e3o semestral em todas as unidades sanit\u00e1rias apoiadas que re\u00fanam os crit\u00e9rios estruturais e de pessoal at\u00e9 dezembro de 2025. Os planos incluem o refor\u00e7o das equipas m\u00f3veis de supervis\u00e3o e apoio t\u00e9cnico para chegar aos locais mais remotos, a integra\u00e7\u00e3o de pain\u00e9is de desempenho em tempo real a n\u00edvel distrital, e o aprofundamento das parcerias com redes comunit\u00e1rias para manter a procura e responder \u00e0s novas preocupa\u00e7\u00f5es dos pacientes.<\/span><\/p>\n

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Para pacientes como Manuel Albano, que agora pode cuidar da sua produ\u00e7\u00e3o agr\u00edcola sem as viagens mensais \u00e0 cl\u00ednica, o 6MMD \u00e9 mais do que um programa \u00e9 uma porta para a normalidade, produtividade e esperan\u00e7a. \u00c0 medida que Mo\u00e7ambique avan\u00e7a no controlo da epidemia, abordagens diferenciadas de presta\u00e7\u00e3o de cuidados como esta representam um modelo equilibrado entre rigor cl\u00ednico e dignidade humana, transformando a forma como os cuidados de HIV s\u00e3o prestados tanto em zonas rurais como em centros urbanos.<\/span><\/p>\n

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Profissionais de sa\u00fade da Unidade Sanit\u00e1ria 17 de Setembro realizam uma revis\u00e3o t\u00e9cnica dos crit\u00e9rios cl\u00ednicos de elegibilidade para a Dispensa Semestral de Medicamentos (6MMD), refor\u00e7ando a implementa\u00e7\u00e3o de cuidados diferenciados com base em dados, protocolos nacionais e tomada de decis\u00e3o colaborativa.<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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\u201cThe Six-Month Dispensation model came at the right time. Now, I can spend more time on my farm and don\u2019t have to explain so often why I go to the hospital.\u201d\u2014 Arlindo Nalili, patient at 17 de Setembro Health Facility In the heart of Zamb\u00e9zia Province, many families confront the daily reality of living with HIV while striving to maintain their livelihoods amid scarce resources. Until late 2024, clinically stable patients typically returned to health facilities every one to three months for antiretroviral therapy (ART) refills – a rhythm that imposed long journeys, lost wages, and the quiet toll of stigma in tight-knit communities. At that time, only seven health facilities in the province had begun implementing Six-Monthly Medication Dispensation (6MMD), which reduces routine clinical visits from as many as twelve per year to just two. This simple yet transformative change provided patients like Manuel Albano the freedom to focus on their families, farms, and futures rather than spending considerable amounts of time waiting to receive clinical services at busy health facilities. But scaling it across a province as large and varied as Zamb\u00e9zia demanded buy-in from national, provincial, and district managers, nurses and pharmacy technicians, data clerks, and community advocates alike. Acknowledging the potential, the Ministry of Health approved a coordinated expansion strategy in October 2024. Led by the Zamb\u00e9zia Province Health Directorate (DPSZ) with support from C-Sa\u00fade, district health officers and C-Sa\u00fade mentors organized intensive workshops on the 6MMD guidelines, paired with hands-on exercises in updating master cards and using the patient-tracking database to flag eligible clients. Weekly virtual check-ins and monthly in-person supervisory visits provided troubleshooting and encouragement, while data managers helped facilities generate automatic reports on uptake rates and stock levels, enabling rapid course corrections whenever bottlenecks emerged. Community engagement proved equally vital. At the 17 de Setembro Health Facility in Quelimane, a multisectoral task force comprising local activists, traditional leaders, and clinic staff hosted interactive health talks, where patients asked questions, shared concerns, and heard testimonials from early adopters. Posters and radio spots in local languages and Portuguese emphasized that six-monthly medication refills were not a reduction in care but a recognition of patients\u2019 stability, granting them autonomy and dignity. In the rural Mocubela Sede Health Facility, community health committees invited patients to \u201ccome with a friend\u201d during enrollment days, pairing newcomers with peers who had already experienced the convenience of longer dispensing intervals. Between October 2024 and June 2025, these efforts bore fruit. The number of supported facilities surged from seven to 37, covering most of the province\u2019s districts. Province-wide coverage of 6MMD among eligible clients nearly doubled, from nine percent at baseline to 20 percent by the end of the reporting period, by which time more than 79,000 clients were enrolled in 6MMD. At 17 de Setembro, more than 72% of eligible patients opted in as workflows shifted to accommodate dedicated ART pick-up days and data clerks ensured accurate enrollment tracking. Even in Mocubela Sede, where infrastructure challenges once loomed large, 70% of stable patients now enjoy six-monthly medication refills. The impact extended beyond the numbers. Nurses reported a smoother outpatient flow, with fewer ART pickups per clinic day, allowing them to provide more focused counseling for newly enrolled or complex patients. Pharmacy technicians, once pressed by constant dispensing demands, found time to conduct inventory reconciliations and provide adherence support. Patients described feeling less like clinic visitors and more like empowered partners in their own care, able to sow fields, attend market days, and participate in community events without the dilemma of frequent hospital trips. Looking ahead, provincial health authorities and C-Sa\u00fade, through CDC\/PEPFAR support, are committed to improving access to six-monthly drug dispensation in all supported health facilities that meet the necessary structural and staffing criteria by December 2025. Plans include scaling up mobile supervision and technical support teams to reach the most remote sites, integrating real-time performance dashboards at the district level, and deepening partnerships with community networks to sustain demand and address emerging patient concerns. For patients like Manuel Albano, who can now tend to his crops without the monthly trek to the clinic, six-monthly drug dispensation is more than a program, it is a gateway to normalcy, productivity, and hope. As Mozambique continues its journey toward epidemic control, differentiated service delivery approaches such as this offer a blueprint for balancing clinical rigor with human dignity, transforming the way HIV care is delivered across rural landscapes and urban centers alike. Health providers at 17 de Setembro Health Facility, conducting a technical review of the clinical eligibility criteria for the Six-Monthly Drug Dispensation (6MMD), reinforcing the implementation of differentiated care based on data, national protocols and collaborative decision-making.<\/p>","protected":false},"author":2,"featured_media":4908,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[5],"tags":[],"class_list":["post-4907","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-historias-de-sucesso"],"yoast_head":"\nHalf-Year Refills, Full-Year Freedom: Positive Impact of the Six-Monthly Medication Dispensation (6MMD) Model - C-Sa\u00fade<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/csaude.org.mz\/pt\/2025\/07\/29\/half-year-refills-full-year-freedom-positive-impact-of-the-six-monthly-medication-dispensation-6mmd-model\/\" \/>\n<meta property=\"og:locale\" content=\"pt_PT\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Half-Year Refills, Full-Year Freedom: Positive Impact of the Six-Monthly Medication Dispensation (6MMD) Model - C-Sa\u00fade\" \/>\n<meta property=\"og:description\" content=\"\u201cThe Six-Month Dispensation model came at the right time. Now, I can spend more time on my farm and don\u2019t have to explain so often why I go to the hospital.\u201d\u2014 Arlindo Nalili, patient at 17 de Setembro Health Facility In the heart of Zamb\u00e9zia Province, many families confront the daily reality of living with HIV while striving to maintain their livelihoods amid scarce resources. Until late 2024, clinically stable patients typically returned to health facilities every one to three months for antiretroviral therapy (ART) refills – a rhythm that imposed long journeys, lost wages, and the quiet toll of stigma in tight-knit communities. At that time, only seven health facilities in the province had begun implementing Six-Monthly Medication Dispensation (6MMD), which reduces routine clinical visits from as many as twelve per year to just two. This simple yet transformative change provided patients like Manuel Albano the freedom to focus on their families, farms, and futures rather than spending considerable amounts of time waiting to receive clinical services at busy health facilities. But scaling it across a province as large and varied as Zamb\u00e9zia demanded buy-in from national, provincial, and district managers, nurses and pharmacy technicians, data clerks, and community advocates alike. Acknowledging the potential, the Ministry of Health approved a coordinated expansion strategy in October 2024. Led by the Zamb\u00e9zia Province Health Directorate (DPSZ) with support from C-Sa\u00fade, district health officers and C-Sa\u00fade mentors organized intensive workshops on the 6MMD guidelines, paired with hands-on exercises in updating master cards and using the patient-tracking database to flag eligible clients. Weekly virtual check-ins and monthly in-person supervisory visits provided troubleshooting and encouragement, while data managers helped facilities generate automatic reports on uptake rates and stock levels, enabling rapid course corrections whenever bottlenecks emerged. Community engagement proved equally vital. At the 17 de Setembro Health Facility in Quelimane, a multisectoral task force comprising local activists, traditional leaders, and clinic staff hosted interactive health talks, where patients asked questions, shared concerns, and heard testimonials from early adopters. Posters and radio spots in local languages and Portuguese emphasized that six-monthly medication refills were not a reduction in care but a recognition of patients\u2019 stability, granting them autonomy and dignity. In the rural Mocubela Sede Health Facility, community health committees invited patients to \u201ccome with a friend\u201d during enrollment days, pairing newcomers with peers who had already experienced the convenience of longer dispensing intervals. Between October 2024 and June 2025, these efforts bore fruit. The number of supported facilities surged from seven to 37, covering most of the province\u2019s districts. Province-wide coverage of 6MMD among eligible clients nearly doubled, from nine percent at baseline to 20 percent by the end of the reporting period, by which time more than 79,000 clients were enrolled in 6MMD. At 17 de Setembro, more than 72% of eligible patients opted in as workflows shifted to accommodate dedicated ART pick-up days and data clerks ensured accurate enrollment tracking. Even in Mocubela Sede, where infrastructure challenges once loomed large, 70% of stable patients now enjoy six-monthly medication refills. The impact extended beyond the numbers. Nurses reported a smoother outpatient flow, with fewer ART pickups per clinic day, allowing them to provide more focused counseling for newly enrolled or complex patients. Pharmacy technicians, once pressed by constant dispensing demands, found time to conduct inventory reconciliations and provide adherence support. Patients described feeling less like clinic visitors and more like empowered partners in their own care, able to sow fields, attend market days, and participate in community events without the dilemma of frequent hospital trips. Looking ahead, provincial health authorities and C-Sa\u00fade, through CDC\/PEPFAR support, are committed to improving access to six-monthly drug dispensation in all supported health facilities that meet the necessary structural and staffing criteria by December 2025. Plans include scaling up mobile supervision and technical support teams to reach the most remote sites, integrating real-time performance dashboards at the district level, and deepening partnerships with community networks to sustain demand and address emerging patient concerns. For patients like Manuel Albano, who can now tend to his crops without the monthly trek to the clinic, six-monthly drug dispensation is more than a program, it is a gateway to normalcy, productivity, and hope. As Mozambique continues its journey toward epidemic control, differentiated service delivery approaches such as this offer a blueprint for balancing clinical rigor with human dignity, transforming the way HIV care is delivered across rural landscapes and urban centers alike. Health providers at 17 de Setembro Health Facility, conducting a technical review of the clinical eligibility criteria for the Six-Monthly Drug Dispensation (6MMD), reinforcing the implementation of differentiated care based on data, national protocols and collaborative decision-making.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/csaude.org.mz\/pt\/2025\/07\/29\/half-year-refills-full-year-freedom-positive-impact-of-the-six-monthly-medication-dispensation-6mmd-model\/\" \/>\n<meta property=\"og:site_name\" content=\"C-Sa\u00fade\" \/>\n<meta property=\"article:published_time\" content=\"2025-07-29T05:04:13+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-07-29T07:41:33+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/csaude.org.mz\/wp-content\/uploads\/2025\/07\/WhatsApp-Image-2025-07-17-at-10.23.54-scaled-e1753766822533.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"1810\" \/>\n\t<meta property=\"og:image:height\" content=\"1524\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"CSAUDE Mozambique\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"CSAUDE Mozambique\" \/>\n\t<meta name=\"twitter:label2\" content=\"Tempo estimado de leitura\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/csaude.org.mz\/2025\/07\/29\/half-year-refills-full-year-freedom-positive-impact-of-the-six-monthly-medication-dispensation-6mmd-model\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/csaude.org.mz\/2025\/07\/29\/half-year-refills-full-year-freedom-positive-impact-of-the-six-monthly-medication-dispensation-6mmd-model\/\"},\"author\":{\"name\":\"CSAUDE Mozambique\",\"@id\":\"https:\/\/csaude.org.mz\/#\/schema\/person\/21f8c5706602baf376339aa34c5d4efa\"},\"headline\":\"Half-Year Refills, Full-Year Freedom: Positive Impact of the Six-Monthly Medication Dispensation (6MMD) Model\",\"datePublished\":\"2025-07-29T05:04:13+00:00\",\"dateModified\":\"2025-07-29T07:41:33+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/csaude.org.mz\/2025\/07\/29\/half-year-refills-full-year-freedom-positive-impact-of-the-six-monthly-medication-dispensation-6mmd-model\/\"},\"wordCount\":785,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/csaude.org.mz\/#organization\"},\"image\":{\"@id\":\"https:\/\/csaude.org.mz\/2025\/07\/29\/half-year-refills-full-year-freedom-positive-impact-of-the-six-monthly-medication-dispensation-6mmd-model\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/csaude.org.mz\/wp-content\/uploads\/2025\/07\/WhatsApp-Image-2025-07-17-at-10.23.54-scaled-e1753766822533.jpeg\",\"articleSection\":[\"Success Stories\"],\"inLanguage\":\"pt-PT\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/csaude.org.mz\/2025\/07\/29\/half-year-refills-full-year-freedom-positive-impact-of-the-six-monthly-medication-dispensation-6mmd-model\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/csaude.org.mz\/2025\/07\/29\/half-year-refills-full-year-freedom-positive-impact-of-the-six-monthly-medication-dispensation-6mmd-model\/\",\"url\":\"https:\/\/csaude.org.mz\/2025\/07\/29\/half-year-refills-full-year-freedom-positive-impact-of-the-six-monthly-medication-dispensation-6mmd-model\/\",\"name\":\"Half-Year Refills, Full-Year Freedom: Positive Impact of the Six-Monthly Medication Dispensation (6MMD) Model - 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C-Sa\u00fade","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/csaude.org.mz\/pt\/2025\/07\/29\/half-year-refills-full-year-freedom-positive-impact-of-the-six-monthly-medication-dispensation-6mmd-model\/","og_locale":"pt_PT","og_type":"article","og_title":"Half-Year Refills, Full-Year Freedom: Positive Impact of the Six-Monthly Medication Dispensation (6MMD) Model - C-Sa\u00fade","og_description":"\u201cThe Six-Month Dispensation model came at the right time. Now, I can spend more time on my farm and don\u2019t have to explain so often why I go to the hospital.\u201d\u2014 Arlindo Nalili, patient at 17 de Setembro Health Facility In the heart of Zamb\u00e9zia Province, many families confront the daily reality of living with HIV while striving to maintain their livelihoods amid scarce resources. Until late 2024, clinically stable patients typically returned to health facilities every one to three months for antiretroviral therapy (ART) refills – a rhythm that imposed long journeys, lost wages, and the quiet toll of stigma in tight-knit communities. At that time, only seven health facilities in the province had begun implementing Six-Monthly Medication Dispensation (6MMD), which reduces routine clinical visits from as many as twelve per year to just two. This simple yet transformative change provided patients like Manuel Albano the freedom to focus on their families, farms, and futures rather than spending considerable amounts of time waiting to receive clinical services at busy health facilities. But scaling it across a province as large and varied as Zamb\u00e9zia demanded buy-in from national, provincial, and district managers, nurses and pharmacy technicians, data clerks, and community advocates alike. Acknowledging the potential, the Ministry of Health approved a coordinated expansion strategy in October 2024. Led by the Zamb\u00e9zia Province Health Directorate (DPSZ) with support from C-Sa\u00fade, district health officers and C-Sa\u00fade mentors organized intensive workshops on the 6MMD guidelines, paired with hands-on exercises in updating master cards and using the patient-tracking database to flag eligible clients. Weekly virtual check-ins and monthly in-person supervisory visits provided troubleshooting and encouragement, while data managers helped facilities generate automatic reports on uptake rates and stock levels, enabling rapid course corrections whenever bottlenecks emerged. Community engagement proved equally vital. At the 17 de Setembro Health Facility in Quelimane, a multisectoral task force comprising local activists, traditional leaders, and clinic staff hosted interactive health talks, where patients asked questions, shared concerns, and heard testimonials from early adopters. Posters and radio spots in local languages and Portuguese emphasized that six-monthly medication refills were not a reduction in care but a recognition of patients\u2019 stability, granting them autonomy and dignity. In the rural Mocubela Sede Health Facility, community health committees invited patients to \u201ccome with a friend\u201d during enrollment days, pairing newcomers with peers who had already experienced the convenience of longer dispensing intervals. Between October 2024 and June 2025, these efforts bore fruit. The number of supported facilities surged from seven to 37, covering most of the province\u2019s districts. Province-wide coverage of 6MMD among eligible clients nearly doubled, from nine percent at baseline to 20 percent by the end of the reporting period, by which time more than 79,000 clients were enrolled in 6MMD. At 17 de Setembro, more than 72% of eligible patients opted in as workflows shifted to accommodate dedicated ART pick-up days and data clerks ensured accurate enrollment tracking. Even in Mocubela Sede, where infrastructure challenges once loomed large, 70% of stable patients now enjoy six-monthly medication refills. The impact extended beyond the numbers. Nurses reported a smoother outpatient flow, with fewer ART pickups per clinic day, allowing them to provide more focused counseling for newly enrolled or complex patients. Pharmacy technicians, once pressed by constant dispensing demands, found time to conduct inventory reconciliations and provide adherence support. Patients described feeling less like clinic visitors and more like empowered partners in their own care, able to sow fields, attend market days, and participate in community events without the dilemma of frequent hospital trips. Looking ahead, provincial health authorities and C-Sa\u00fade, through CDC\/PEPFAR support, are committed to improving access to six-monthly drug dispensation in all supported health facilities that meet the necessary structural and staffing criteria by December 2025. Plans include scaling up mobile supervision and technical support teams to reach the most remote sites, integrating real-time performance dashboards at the district level, and deepening partnerships with community networks to sustain demand and address emerging patient concerns. For patients like Manuel Albano, who can now tend to his crops without the monthly trek to the clinic, six-monthly drug dispensation is more than a program, it is a gateway to normalcy, productivity, and hope. As Mozambique continues its journey toward epidemic control, differentiated service delivery approaches such as this offer a blueprint for balancing clinical rigor with human dignity, transforming the way HIV care is delivered across rural landscapes and urban centers alike. 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