Wednesday, 8 February 2017

DAPCU North Tripura (Tripura) Response to the Theme : Strategies for reducing ART-LFU at district

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Action point taken to reduce the LFU & Pending CD4 count:
  • DAPCU has worked in close coordination with Tripura SACS, health department officials and NACP facility staff to put in place a strategy to collect blood for CD4 count testing at the Facility Integrated ART (FI-ART) centre itself. This strategy has reduced LFU cases as clients can reach the FI-ART easily instead of going to the Agartala Government Medical College (AGMC) located at a distance of 190 kms.
  • A sensitization workshop was organized for people living with HIV to discuss the importance of pre-ART registration, CD4 testing, ART adherence and reducing LFU cases.
DAPCU has initiated steps in coordination with facilities for tracing LFU cases through better outreach and improved counselling of people living with HIV. ANC mothers are  being tracked with the help of community members, ASHA and Multi Purpose Worker.

Mobilization and sensitization on CD4 testing for People Living with HIV at Dharmanagar, North Tripura

Blood sample collection by FI-ART centre at Dharmanagar, North Tripura


DAPCU Sri Ganga Nagar (Rajasthan) Response to the Theme : Strategies for reducing ART-LFU at district

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For effective tracking of LFUs, the line list of LFUs is shared with the concerned NACP facility staff and discussed in monthly review meetings organized by DAPCU. Facility staff are advised to follow-up with LFU clients telephonically first and then plan home visit if necessary. LFU clients are asked to share the underlying reasons for discontinuing ART and counselled about the importance of taking ART without missing a dose. The harmful effects of abruptly stopping the medication is explained to clients and their anxiety and misconceptions are addressed.

DAPCU is taking steps in coordination with ANM and ASHA to deal with stigma and discrimination faced by clients on ART, which may prevent them from coming to the ART centre for collecting medicines. Family counselling is done to create a supportive environment at home for the ART client.

Thursday, 29 December 2016

DAPCU Kurnool (Andhra Pradesh) Response to the Theme : Strategies for reducing ART-LFU at district

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DAPCU, Kurnool is one of the A category districts in Andhra Pradesh.  We have been implementing and practicing the following process to link PLHAs to ART center as well as reducing the LFUs in our district with the support of the entire district team.
  • DAPCU Kurnool facilitates and conducts meetings with ART Centre and Care and Support Centre (CSC) on fixed dates every month to focus on LFU and MIS cases with the involvement of Network, NGOs and LWS staff.
  • We have been conducting LFU Special Drive every year to re-start the LFU, MIS cases, collecting evidence based information on death cases and linking PLHAs with care and support services.
  • Mobile Messages (pre-alert) are sent for ART due date, focused on ANC cases with the support of PPP
  • Seven Link ART centers have been established at route corner areas in the district.
  • Providing free bus pass to PLHIVs and 50% concession to the Attender twice a month with the support of APSRTC. Conducted sensitization for APSRTC bus conductors and depot staff on HIV/AIDS and free bus passes to PLHIVs and avoiding stigma and discrimination.
  • DAPCU Kurnool is facilitating access to social security benefit schemes for PLHIVs through DAPCU Led Single Window Model with the support of line departments as well as District Collector.
Sensitization meeting facilitated by DAPCU Kurnool for ART centre and ICTC Counsellors and Mahila Mandali representatives. Participants were sensitized on tracking and reducing LFU cases and importance of taking ART medications without missing any doses.



DAPCU Imphal East (Manipur) Response to the Theme : Strategies for reducing ART-LFU at district

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DAPCU Imphal East is playing a vital role in tracking LFU clients in coordination with ART Centre, District Level Network (DLN), Care and Support Centre (CSC) and related NGOs in the district.
The following strategies have been executed by DAPCU Imphal East in reducing LFU:-
  1. Monthly review meetings are conducted with NACP facilities with a special agenda to discuss and resolve the issue of LFU.
  2. Two staff from CSC have been deployed to ICTC, JNMS (main ICTC where a number of HIV positive cases have been detected) to link clients with the ART Centre.
  3. DAPCU maintains the report of LFU cases in coordination with ART centre, CSC and DLN. Coordinated efforts are being made to track all lost clients.
  4. Service providers are advised to counsel care givers to ensure adherence to treatment by the clients on ART.

Thursday, 27 October 2016

DAPCU Khordha (Orissa) Response to the Theme : DAPCUs role in strengthening referral between ICTC - ART

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Linkages and referrals to the positive people are one of the major responsibility of the counselor at ICTCs. However, it is not ended with linkages only but to make proper follow up hence forth and to ensure partner notification for further test. In most of the DAPCU Districts it is being followed up and monitored to ensure 100% ART linkages. It may not be easy for the ICTCs which are far from the ART centre.

Although we have achieved good results in ART linkages, still the scenario was not so convenient in earlier days. There are some of the issues which are still could not be addressed. However, the percentage (%) of ART linkages under DAPCU Khordha was 94% during the period of 2012 and there was no such effort was made to ensure 100% ART linkages and also there is no system initiated to linkages the pending cases. And later these issues have been observed seriously and various efforts were made to ensure 100% ART linkages in the District. Now we have achieved 97% in ART linkages.

Efforts made:
It is viewed that number of testing were increased and number of positives too. So, it was challenge for us to link them with ART Centre. So, following efforts were made to reduce the linkage gaps between ICTC and ART.
  1. Discussions and review in the monthly TB- HIV cum coordination meeting with data, showing number of positive detection in the ICTC in the month and ART enrollment. Along with highlighting the no of cases (from the ICTC) are not yet enrolled at ART Center.
  2. Sharing of detected positive cases (source SIMS) of all ICTCs for the current month with the ART centre providing data in line listing format containing address, age, occupation, mode of transmission, ICTC where positive detected, date of detection etc to get filled Pre –ART number, Base line CD4, and ON ART Number if he/she eligible for ART.
  3. Cross verification of these data with the concerned ICTCs through meetings and through telephonic discussion and feed backs.
  4. All Counselors are suggested to ensure that the referred client has visited/reached to the ART center or not, through telephonic discussion / in a written format
  5. ART linkages is also been discussed in the monthly ART coordination meeting where DPM is attending in a regular basis.
  6. The drop out cases that are not visited to ART centre after detected positive, are the major challenge for us. Although we have no separate mechanism, but the concerned counselor is advised to visit her / his house with CSC / Link Worker/ ORW ( if it falls LWS/TI  area)  to convince them in each Saturday during the outreach activity.
  7. Simultaneously the line list of the PLHA who is denying for ART registration after given consent at ICTC are to be shared with the CSC for tracking and in this effort, the concerned counselors are also going with the CSC.
  8. Some long pending cases are also shared with CSC for tracking and the action taken report of those cases are submitted to DNO, DAPCU.
  9. The cases who are belong to other district are ensured that they are linked with their nearest ART centre if he/she is not enrolled at our ART center. This is facilitated through telephonic discussion with the concerned DAPCU/ ART. (recently 3 cases are linked through this process)
  10. Responsible also given concern TI NGO & LWS (for those cases referred by LWS/ TI and detected positive in ICTCs) to follow and ensure to ART registration.
  1. DIS and other DAPCU staffs are joint visit with CSC and Concerned counselor to the PLHA who are not agreed to visit ART center.
  2. CDMO & ADMO (PH) apprised concern counselors who are achieved 100% ART linkages in monthly meeting. So, that all counselors are taking initiate for achieved 100% ART linkages.
Constrains:
Difficulties to enrolled denying those cases who were agreed initially. Whereas the list of those cases could not be removed from the list.
100% enrollment is not happening due to death after detection and even for denying and absconded cases. 
Not achieving 100% in case of repeat cases.