Harare central hospital is arguably the largest referral hospital in Zimbabwe. Because congestion could occur, patients that are doing well on first line treatment are decentralised to municipal clinics close to where the patients reside. This move is not only meant to decongest the hospital, but also to shorten the distance travelled by patients to seek health care, cut on transport costs and remove technical barriers in accessing health care. However, patients that remain unwell are on fluconazole maintenance treatment and all those on second line treatment continue to be monitored at Harare hospital OI clinic. If decentralised patients develop treatment failure or fall ill while being seen at municipal clinics, they are referred back to Harare hospital OI clinic for specialist care.