Service delivery


Service delivery encompasses a range of activities including the assessment, strategic planning, and monitoring and evaluation of programmes. Models of service delivery vary with local, regional and national requirements.

The assessment of service delivery includes determining the current and required infrastructure, site readiness, staff selection, referral networks and the phasing and time frame for implementation and scaling up of HIV testing and counselling services. Strategic planning includes developing criteria for site selection, client registration and intake, testing protocols, counselling protocols, informed consent, disclosure, laboratory protocols, integration with other HIV/AIDS initiatives (e.g. PMTCT, ARV treatment), establishing referral networks, and post-test care. Monitoring and evaluation help to ensure that informed consent, confidentiality and counselling are present, as well as covering service accessibility, site monitoring, the evaluation of testing techniques, the adequacy of protocols, patient flow, referral use, and various methods of quality assurance, e.g. tools for counsellors, staff competency and client satisfaction. The issues discussed in this section include:

  • the context of HIV testing and counselling
  • models of service delivery
  • the planning of service delivery
  • operational issues and components of service delivery:
    • standardized protocols and patient selection;
    • linkages to other services, with involvement of a range of stakeholders including people with HIV;
    • strengthening service components related to HIV testing and counselling;
    • raising awareness of the benefits and availability of HIV testing and counselling;
    • strategies to promote prevention;
    • strategies to address stigma and discrimination;
    • monitoring and evaluation.