Health provider perspectives on differentiated service delivery for HIV in Oyo state, Nigeria: exploring the experiences of service providers from a demand perspective

Abstract Background Differentiated Service Delivery (DSD) models have been introduced to optimise HIV care by adapting services to client needs while reducing the burden on healthcare systems. In Nigeria, where HIV prevalence remains high. Understanding provider perspectives is critical to improving...

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Main Authors: Adelaja Modupe Gift, Folahanmi Tomiwa Akinsolu, Olunike Rebecca Abodunrin, Akim Tafadzwa Lukwa, Mobolaji Timothy Olagunju, Adekemi Akinpelu, Ogunwale Mercy Mary, Ola Oluwabukola Mary, Dolapo Omotayo Raji, Lilian Ogochukwu Ezechi, Aisha Oluwaseun Gambari, Oliver Chukwujekwu Ezechi
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-025-13283-7
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author Adelaja Modupe Gift
Folahanmi Tomiwa Akinsolu
Olunike Rebecca Abodunrin
Akim Tafadzwa Lukwa
Mobolaji Timothy Olagunju
Adekemi Akinpelu
Ogunwale Mercy Mary
Ola Oluwabukola Mary
Dolapo Omotayo Raji
Lilian Ogochukwu Ezechi
Aisha Oluwaseun Gambari
Oliver Chukwujekwu Ezechi
author_facet Adelaja Modupe Gift
Folahanmi Tomiwa Akinsolu
Olunike Rebecca Abodunrin
Akim Tafadzwa Lukwa
Mobolaji Timothy Olagunju
Adekemi Akinpelu
Ogunwale Mercy Mary
Ola Oluwabukola Mary
Dolapo Omotayo Raji
Lilian Ogochukwu Ezechi
Aisha Oluwaseun Gambari
Oliver Chukwujekwu Ezechi
author_sort Adelaja Modupe Gift
collection DOAJ
description Abstract Background Differentiated Service Delivery (DSD) models have been introduced to optimise HIV care by adapting services to client needs while reducing the burden on healthcare systems. In Nigeria, where HIV prevalence remains high. Understanding provider perspectives is critical to improving and sustaining DSD implementation. This study explored the experiences, challenges, and recommendations of healthcare providers involved in DSD delivery in Ibadan North, Oyo State. Methods A qualitative descriptive study was conducted between July and September 2024, involving 11 key informant interviews and two focus group discussions across three DSD-implementing facilities. Participants included clinicians, ART counsellors, HTS providers, retention officers, and program managers. Data were analysed thematically using NVivo 12 software, following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results Five core themes emerged: perceived benefits of DSD models, implementation challenges, eligibility and suitability of clients, human resource capacity and training, and strategic recommendations for sustainability. Providers reported that DSD models improved accessibility, reduced clinic congestion, and enhanced patient retention and viral suppression. However, challenges such as inaccurate client data, dependency on community models, systemic inefficiencies, and inadequate training impeded effective implementation. Participants emphasised the need for policy alignment, community engagement, capacity building, and stronger monitoring systems. Conclusion DSD models hold promise for improving HIV service delivery in Nigeria. However, their success depends on addressing structural and operational challenges, tailoring approaches to local contexts, and strengthening health workforce capacity. These findings provide critical insights to inform national policy, support program scale-up, and contribute to achieving the UNAIDS 95-95-95 and SDG 3.3 targets.
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spelling doaj-art-0f12cfc886c2407c9c072738aa3cdeda2025-08-24T11:15:24ZengBMCBMC Health Services Research1472-69632025-08-0125111410.1186/s12913-025-13283-7Health provider perspectives on differentiated service delivery for HIV in Oyo state, Nigeria: exploring the experiences of service providers from a demand perspectiveAdelaja Modupe Gift0Folahanmi Tomiwa Akinsolu1Olunike Rebecca Abodunrin2Akim Tafadzwa Lukwa3Mobolaji Timothy Olagunju4Adekemi Akinpelu5Ogunwale Mercy Mary6Ola Oluwabukola Mary7Dolapo Omotayo Raji8Lilian Ogochukwu Ezechi9Aisha Oluwaseun Gambari10Oliver Chukwujekwu Ezechi11Department of Public Health, Faculty of Basic Medical and Health Sciences, Lead City UniversityDepartment of Public Health, Faculty of Basic Medical and Health Sciences, Lead City UniversityDepartment of Public Health, Faculty of Basic Medical and Health Sciences, Lead City UniversityHealth Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape TownDepartment of Biostatistics and Epidemiology, Nanjing Medical UniversityDepartment of Public Health, Faculty of Basic Medical and Health Sciences, Lead City UniversityDepartment of Public Health, Faculty of Basic Medical and Health Sciences, Lead City UniversityDepartment of Public Health, Faculty of Basic Medical and Health Sciences, Lead City UniversityCenter for Reproduction and Population Health Studies, Nigerian Institute of Medical ResearchCenter for Reproduction and Population Health Studies, Nigerian Institute of Medical ResearchCenter for Reproduction and Population Health Studies, Nigerian Institute of Medical ResearchDepartment of Public Health, Faculty of Basic Medical and Health Sciences, Lead City UniversityAbstract Background Differentiated Service Delivery (DSD) models have been introduced to optimise HIV care by adapting services to client needs while reducing the burden on healthcare systems. In Nigeria, where HIV prevalence remains high. Understanding provider perspectives is critical to improving and sustaining DSD implementation. This study explored the experiences, challenges, and recommendations of healthcare providers involved in DSD delivery in Ibadan North, Oyo State. Methods A qualitative descriptive study was conducted between July and September 2024, involving 11 key informant interviews and two focus group discussions across three DSD-implementing facilities. Participants included clinicians, ART counsellors, HTS providers, retention officers, and program managers. Data were analysed thematically using NVivo 12 software, following the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results Five core themes emerged: perceived benefits of DSD models, implementation challenges, eligibility and suitability of clients, human resource capacity and training, and strategic recommendations for sustainability. Providers reported that DSD models improved accessibility, reduced clinic congestion, and enhanced patient retention and viral suppression. However, challenges such as inaccurate client data, dependency on community models, systemic inefficiencies, and inadequate training impeded effective implementation. Participants emphasised the need for policy alignment, community engagement, capacity building, and stronger monitoring systems. Conclusion DSD models hold promise for improving HIV service delivery in Nigeria. However, their success depends on addressing structural and operational challenges, tailoring approaches to local contexts, and strengthening health workforce capacity. These findings provide critical insights to inform national policy, support program scale-up, and contribute to achieving the UNAIDS 95-95-95 and SDG 3.3 targets.https://doi.org/10.1186/s12913-025-13283-7Differentiated service deliveryHIV careAntiretroviral therapyART adherencePatient retentionQualitative study
spellingShingle Adelaja Modupe Gift
Folahanmi Tomiwa Akinsolu
Olunike Rebecca Abodunrin
Akim Tafadzwa Lukwa
Mobolaji Timothy Olagunju
Adekemi Akinpelu
Ogunwale Mercy Mary
Ola Oluwabukola Mary
Dolapo Omotayo Raji
Lilian Ogochukwu Ezechi
Aisha Oluwaseun Gambari
Oliver Chukwujekwu Ezechi
Health provider perspectives on differentiated service delivery for HIV in Oyo state, Nigeria: exploring the experiences of service providers from a demand perspective
BMC Health Services Research
Differentiated service delivery
HIV care
Antiretroviral therapy
ART adherence
Patient retention
Qualitative study
title Health provider perspectives on differentiated service delivery for HIV in Oyo state, Nigeria: exploring the experiences of service providers from a demand perspective
title_full Health provider perspectives on differentiated service delivery for HIV in Oyo state, Nigeria: exploring the experiences of service providers from a demand perspective
title_fullStr Health provider perspectives on differentiated service delivery for HIV in Oyo state, Nigeria: exploring the experiences of service providers from a demand perspective
title_full_unstemmed Health provider perspectives on differentiated service delivery for HIV in Oyo state, Nigeria: exploring the experiences of service providers from a demand perspective
title_short Health provider perspectives on differentiated service delivery for HIV in Oyo state, Nigeria: exploring the experiences of service providers from a demand perspective
title_sort health provider perspectives on differentiated service delivery for hiv in oyo state nigeria exploring the experiences of service providers from a demand perspective
topic Differentiated service delivery
HIV care
Antiretroviral therapy
ART adherence
Patient retention
Qualitative study
url https://doi.org/10.1186/s12913-025-13283-7
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