Reducing LFUs - DAPCUs brainstorm strategies

Pleased to share with you a compilation of responses received on our question to DAPCUs on reducing LFUs (Dec 2011). We received responses from 55 DAPCUs covering a very wide range of strategies. While some DAPCUs have suggested strategies in preventing LFUs others have provided their suggestions on tracing and re-entering them. 


Here is a glimpse at what DAPCUs have to say 

Knowing the cause can help you find solutions.  Talk to counselors, doctors, PLHIV networks and try to understand why people do not reach the ART centre. You will find multiple reasons – inability to tolerate side effects, travel, migration, death etc. Understand the causes in your district - and then look for solutions.

Do you know how/where to contact PLHIV on ART? understand how details of contacts are maintained at the ART centre.  Ensure that complete contact information is recorded. If you don't know where they live or how to get in touch with them, how can you support them in getting back on ART? 

Provide support for travel - Travel concessions are available for PLHIV on ART and they should be informed about them.  Provide concessions to those in need it and are eligible. 
No travel schemes in your district? Talk to the District Collector and Health Department about creating local provisions . There will be solutions, let’s look for them.

Send reminders: Some counselors in ART centres send messages or make phone calls prior to the date of  visit to remind them of the same. Some DAPCUs share that special attention must be devoted to PLHIV who miss appointments. Lets be in touch with those due for an ART visit prior to their dates. Today’s MIS could be tomorrow’s LFUs.

Map the LFUs - Pool the grass root team: Mobilizing grassroots teams for follow up can be a good strategy for re entering LFUs.  Compile a list of all the grass root workers  (ORWs , PEs, Link Workers etc, PLHIV networks) and LFUs. Map both LFUs and the grassroot teams blockwise and assign responsibilities to the team. 
There will be enough people to support LFU re-entry. Mobilise them, use review meetings to discuss this strategy and tune it to the needs of your district.  

LACs can help: based on guidelines and willingness of the PLHIV  transfer out PLHIV to LACs convenient to them. This will not only make it easier for the PLHIV but also help in reducing the load at the ART centre. The ART centre will then be able to focus on PLHIV with adherence issues and LFUs etc more closely. If your district needs more LACs, speak to SACS.

Think beyond your district : It is possible that PLHIV receiving ART from your district are residents from other districts/states. In such a case find out whether they would like to be transferred to their District/State . If the PLHIV is already LFU and cannot be traced in your district contact the district where he/she comes from, ask them to help you trace this PLHIV. All DAPCU and ART centre contact details are provided on the NACO website. http://www.nacoonline.org/ListofARTCenter/. The problems in the neighbouring district/state might be similar. Support them too.

Other suggestions received include, provision of social benefit schemes, ensuring filling up of all vacancies in the district so that uninterrupted and quality services may be provided; spreading awareness about faulty promises of HIV cure; family counselling etc.

Thanks to all DAPCUs who contributed to this discussion.  We are sure that we will all be able to learn from each other. 

If you have something more to say or want add more about the success of your district, please click on comments and type in your information. Or you can write to dapcuspeak@gmail.com