More Time, Less Burden: How Multi-Month ART Refills Are Transforming Lives in Mara Region

More Time, Less Burden: How Multi-Month ART Refills Are Transforming Lives in Mara Region

At Nyasho Health Center in Tanzania’s Mara Region, Bulalo Masaka smiles as she reflects on a shift that has brought stability and ease into her life. Like many others living with HIV, Bulalo used to travel to the clinic each month for her medication. It was expensive, exhausting, and disruptive.

Today, that has changed.

Thanks to multi-month dispensing (MMD), she now receives six months’ worth of antiretroviral therapy (ART) at once. Instead of twelve trips a year, she visits the clinic only twice once for a clinical check-up, and again for her annual viral load test.

“I used to spend TZS 24,000 every month just to get to the clinic,” she says. “Now I can save that money and focus on my small business. I feel less stressed, more free.” Bulalo’s experience speaks to the broader impact of MMD, a client centered approach that has been quietly reshaping how HIV care is delivered in Tanzania. Designed for people who are stable on treatment, MMD reduces the frequency of clinic visits while ensuring uninterrupted access to medication.

“It’s not just about saving money,” she adds. “It’s about time, dignity, and the freedom to live your life without constant interruptions.”

Clinician Fabian Haule, who supports clients at Nyasho Health Center, has seen the difference first-hand.

“With MMD, clinics are less crowded. Clients don’t have to wait as long, and providers have more time to focus on those who need extra care,” he explains.

The approach has also played a protective role during the COVID-19 pandemic, reducing congestion at health facilities and lowering the risk of transmission for both clients and healthcare workers.

Beyond convenience, MMD is helping to reduce the stigma that many people still experience when seeking HIV services.

“Fewer trips to the clinic mean fewer chances of being seen and questioned,” one client shared anonymously. “It’s a quiet form of protection, and it matters.”

For healthcare workers like Fabian, and clients like Bulalo, the benefits of MMD are clear: it’s not just about giving medication it’s about giving people their time, privacy, and dignity back.

The introduction of multi-month ART dispensing at Nyasho Health Center was part of the Afya Kamilifu project, a five-year initiative funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Centers for Disease Control and Prevention (CDC) in Tanzania. The project was implemented by Amref Health Africa in Tanzania, in partnership with the University of Maryland Baltimore (now CIHEB) and the Tanzania Communication and Development Center (TCDC), and in close collaboration with the Ministry of Health, the President’s Office – Regional Administration and Local Government (PO-RALG), and the Zanzibar Ministry of Health.