Multi-month dispensing (MMD) is the prescribing and dispensing of three to six months of antiretrovirals (ARV) and other medicines required for treatment of people living with HIV (PLHIV). While many programs have moved to providing MMD for adults, implementation in children has been particularly challenging due to a variety of factors such as pediatric ARV shortages, the perception that children and adolescents living with HIV (CALHIV) are sicker, and anxiety that more frequent follow up is necessary to provide quality pediatric care. However, at the start of the COVID-19 pandemic, it was recognized that providing MMD for all PLHIV, including children, was a necessary strategy to ensure that the few gains made in the fight against pediatric HIV were not lost.
The Technical Guide for Healthcare Workers on Pediatric Multi-Month Dispensing (MMD) was developed by ICAP and its partners at PEPFAR, USAID, EPiC, RISE, and ACHIEVE to address some of the key barriers at the facility level in order to enable MMD to be offered to all CALHIV. The technical guide reviews the key competencies needed by health care workers to manage treatment for CALHIV in the context of MMD. A companion guide provides guidance for community-based health workers, including those working with programs for orphans and vulnerable children (OVC), to ensure that other services, such as psychosocial support and family-centered care, continue to be available at the community or household level.