Table 2 Summary of referral system activities and main emerging issues

Financial constraints

Transport allowance

TAZAMA

• Helped many PLHIV attend the HIV clinic

• Could become difficult for VCT counsellors to administer

• Sometimes spent on items other than fare

Reaching the clinic

Escort

TUMAINI

• Facilitated initial access to the HIV clinic for many PLHIV, especially those not familiar with city environment

• Heavy and possibly unsustainable workload for volunteer with an increasing number of patients

• Difficulties in arranging convenient times for escort and patients to meet

Referral forms

TAZAMA/BMC hospital

• Effective in facilitating access to the HIV clinic and enabling HIV clinic staff to identify Kisesa patients

• Enabled low uptake of referral appointments to be identified and described

• Enabled list of non-attendees to be generated for tracing by home-based care teams

• Facilitated data exchange between VCT clinic & HIV clinic

Initiating clinic visits

Supportive counselling

VCT counsellors/TUMAINI

• Helped some patients overcome concerns about initiating HIV clinic visits

• Supportive counselling from VCT counsellors was mostly accessed by residents living close by