Integrated service delivery: HIV, TB, STIs, GBV in one visit

Integration in the EpiC model means that a single client contact can deliver HIV testing, PrEP/PEP screening, family planning counselling, sexually transmitted infection screening, tuberculosis symptom screening, GBV first-line response, mental health brief intervention, and onward referral, all without the client moving between providers or repeating their story.

This requires a re-engineered contact protocol, multi-skilled providers, a single client record, and a commodity supply chain that does not break the integration at the pharmacy door.

Across 3,640 one-stop contacts in 2022, test acceptance was 22 percent higher than at comparable single-service contacts in the same councils. Client satisfaction, measured through a quarterly anonymous exit survey, averaged 91 percent.

Integration also reduced no-show rates for follow-up appointments by 17 percent, an effect we attribute to the trust built when a single provider holds the relationship.

Provider fatigue is real. Integrated contacts are longer and emotionally heavier, and burnout is the operational risk we are watching most closely. The team is piloting structured peer debriefs and rotating contact types to protect provider sustainability.