DAPCU West Godavari Response to DCC for HIV-TB

1.                  What are the advantages of DCC in HIV-TB collaboration activity?

DPM sharing the data to Hon’ble Collector Dr.G.Vani Mohan IAS 

      

• As the District Collector is the Chairman of DCC it is easier to convincing regarding the urgency of HIV-TB collaboration throughout the district to effect the required mainstreaming and convergence both inside the health and other line departments.
• The DCC meeting comprises not only HIV testing service provider unit but all the facilities providing services related to HIV are involved for their performance / achievement review such as ICTC, F-ICTC, TU, DMC, ART, TI, CCC, DIC, DSRC, BB & NGO/CBO under one umbrella i.e. District Collector.
• Helps to take in time decision and in other hand helps to save the time.
• Builds a close coordination between all platforms.
• All the stakeholders from different wings perceive their roles and responsibilities in the HIV-TB collaboration activity.
• Appropriate and strategic plans are taken into decision at the time of gap analysis of target vrs achievement.

Share examples from your districts - How can DCC for TB – HIV strengthen the cross referrals between the ICTC and RNTCP (diagnostic and treatment services, and ART and DOTS services, and overall implementation of the National framework for TB – HIV Collaborative activities).

• Counseled clients where HIV testing facility is not available. Clients are followed up by concerned counselors for their HIV test at nearest ICTC.
• Even clients are accompanied by ASHA / LW or counselor for the betterment of the client.
• Where the DMCs are not co located with ICTC clients are being referred to nearest ICTC and they are looked after by concerned STS.
• However through the convening of DCC in every quarter, our performance in the field of cross referral, co-infection detection and CPT administration has remarkably increased.

Share examples from your districts - Appropriate measures are taken to prevent the spread of TB infection in facilities caring for HIV – AIDS and spread of HIV infection through safe injection practices in the facilities providing RNTCP treatment services.

The consistent increase of referrals from ICTC to RNTCP is maintaining but there is decline of referrals from RNTCP to ICTC and on the same hand we can also elicit that the case detection for co infection is also declining by the below given indicators

Year	RNTCP to ICTC	ICTC to RNTCP	Co-Infection
2009	2723	4169	432
2010	2520	3753	415
2011	2413	3141	346
2012	2000	4787	291

• All RNTCP lab Technicians are trained on SD Bio Line Rapid Test Kit training so that they can do HIV Screening at DMC level.
• ANM’s and ASHAs are sensitized by ICTC counselor in their sector meeting regularly so that they can motivate all symptomatic cases every month.
• All ASHAs are referring and accompanying the suspected TB cases to DMC.
• At regular intervals ANM, staff nurses are sensitized regarding HIV-AIDS specifically on safe injection practices.
• Universal precaution guidelines are always being adhered to for ensuring non transmission through the processes of health care provision at any of the service delivery units of HIV, TB and its CST.

Share examples from your districts - Role of ICTCs, ART, and Care and Support Centres in intensified TB case findings. 

• DTCO had taken utmost responsibility in sharing the responsibilities of RNTCP staff in coordination and cooperation with NACP staff structures
• All STS and STLS are linked to ICTC’s and they were given the responsibility of testing all cases for identified TB positives
• We have 3 Community Care Centers and all the 3 CCC’s were equipped as DMC’s, hence the identification, drugs and followup had been more easier than earlier. (DAPCU had made many efforts in setting up of DMC’s and FI ICTC’s in PPP Mode in one place)
• All co-infected cases are being followed by STS, Counselor and ART Centre regularly.
• They are also given medicines at their door steps.
• Positive ANC’s and TB line list positives are also being followed by ILFS and PPTCT ORW’s

Share examples from your districts - What are the strategies DAPCU should opt for 100%   treatment, care and support for TB – HIV co- infection cases?

• Leprosy Dy.Para Medical Officers are also shared the responsibility of tracking the cases for Tuberculosis.           
• Client specific / personified co-infected cases are reviewed (Date of detection, CPT administration, ART adherence etc.) in monthly HIV-TB co-ordination cum review meeting.
• Counselors of ICTC are attending the ASHA sector meeting for more no. of referrals to ICTC for service uptake.
• Responsibility is given to ICTC-Counselor and STS/STLS of respective areas.
• Feed back is taken jointly by DPM and DTO for each client.