Prakasam's Response to Theme- DAPCUs and F-ICTCs

DAPCUs and F-ICTCs:

DAPCU Play impartment role in establishing of FI ICTCs in Prakasam District Since July 2009 we are trying to functioning FI-ICTCs in these processes we approached District Medical & Health Officer. With help of District Medical & Health Officer we started Two FI-ICTCs at FI-ICTC PHC Cherukur, FI-ICTC PHC Marripudi were Stand alone ICTCs very far. Slowly we are trying to enhance all PHCs converted to FI-ICTCs now we are functioning 79 FI-ICTCs in PHCs and 10 FI-ICTCs PPP model in Hospitals where ANC load is high. 

Locating a suitable health facility to establish  F-ICTCs

Prakasma District having 56 Mandals and 85 PHCs. We have 15 Stand alone ICTCs. These Stand alone ICTCs are not covered entire district.  Some Costal areas are high prone areas; there was risk due to high mobility and Fishing. For this we coordinated with NRHM Officials and focused PHCs where facilities are available like Medical Officer, Staff Nurse and Lab technician. 

Capacity building of the F-ICTC (i. e. training of staff, providing registers/ formats, providing guidance, supervision etc.)

As per guideline given by APSACS we collected monthly reports from concern PHCs. APSACS given code number, supplied registers and report formats to the PHCs. We conducted capacity building trainings to all PHCs Staff nurses and LTs on Counselling and testing. We linked some of the PHCs to Standalone ICTC’s Counsellors for collecting the reports and conducting the testing. Our Standalone ICTC counsellors were participated in PHC level ASHA day meetings for demand generation.

Strengthening of linkages between F-ICTC and Designated ICTCs

Standalone ICTCs are taken an active role in strengthening of FI- ICTCs. Counsellors are participated in cluster level meetings. They coordinated with Senior Public Health Officer (SPHO) and concerned FI- ICTC medical officer for strengthening FI-ICTCs. They visited FI-ICTCs and onsite training to the PHC staff. FI-ICTCs are conducting single test, if they found positive referred to nearest Standalone ICTCs. They conduct conformation test (Three tests) and further follow-up of client.

Monitoring and evaluation of F-ICTCs

DAPCU team is monitoring all F-ICTCs. Due to effective monitoring system we achieved 100% reporting from F-ICTCs. We involved FI-ICTCs staff in monthly review meeting also we evaluate the F-ICTCs functioning and we focus where low performance centre. We are also participating in NRHM meetings and discussed the performance indicator in presence of NRHM officials.

Achievements:

F-ICTC conducted outreach and collected samples from ANCs

1.79 PHCs are functioning as F- ICTCs out of 85 PHCs
2.10 PPP model F- ICTCs in private Nursing homes
3.89 F- ICTCs are reporting (100%)
4.F- ICTCs are increasing testing and conducting testing of HRGs and general also.
5.All Designated Microscope centre are conducting HIV testing  

DAPCU Davangere Response to Role of DAPCU and F-ICTC

        1.     Role of DAPCUs in locating a suitable health facility to establish                         F-ICTCs:

DAPCUs play crucial role in establishing F-ICTCs at health facility depending on:

·         OPD load of health facility accessing service

·         Total no of deliveries

·         Total no of HIV+ves, STI/RTI, HIV/TB, HRGs & Migrants

·         Based on geography: hilly, mountain, region, tribal population, roads liked with National/State highways

    2.     Capacity building of FICTCs:

·         DAPCUs can help in enhancing the capacity of FICTCs by providing Induction training & Refresher training on HIV/AIDS counseling & testing services, training in documentation of client details, providing printed register/forms, training manuals updated

·         Training guidance  in reporting of correctly on all relevant indicators & make supervisory &  monitoring  progress of FICTCs

    3.     Strengthening linkage b/n FICTC & designated ICTCs:                                      

• Strengthening F-ICTC by monitoring ICTC activity through designated ICTCs, issue of HIV test KITS through  ICTCs, monthly supervisory visits by ICTC staff during Thursday ANC camp/Saturday out- reach visits.
•  Conducting quarterly Review meeting for MOs:F-ICTCs
• Involving F-ICTC staff [LT/SN] in DAPCU monthly meeting on rotation basis randomly
• Regular vehicle provision for DAPCU staff to make supervisory visits toF-ICTCs linked with mother ICTC  
• To ensure consistent supply of SPOT TEST to F-ICTCs, printed registers, forms, consumables[if required] thro’ designated ICTCs

    4.     Monitoring  & Evaluation  of F-ICTCs:

•    Monitoring throgh supervisory visits, activity  & reporting of the same indicator –wise correctly
•    Quarterly Review meeting for MOs:F-ICTCs to evaluate progress & identify gaps
•     Evaluation through  100% screening of registered ANCs, confirmation of +ves at designated ICTCs & 100% linkage to ART, screening of STI cases,100% screening of TB & TB suspects, linking of eligible PLHIVs/family members to social entitlements
•      Check case of Stigma & discrimination,
•      IEC promotion & condom supply
•       Monitoring & Evaluation by DHO, THOs, POs of F-ICTC activity
•         To ensure daily testing & ensure the same is well documented

5.Achievements to share:

  Total 24x7 PHCs in the dist are 41 & F-ICTCs functioning are 36.Few not started regular as LT not available.  We are planning to start three F-ICTCs  in urban PHCs shortly & staff have been trained recently [Feb/Mar.13]. In our dist F-ICTCs Thyavangi & Gundagathi are performing well & activity documented.  

DAPCU Mysore Response to Role of DAPCU's & F-ICTC

Role of DAPCU in  Locating a suitable health facility to establish  F-ICTCs
o       DAPCU play an important role in establishing F-ICTC in a District. DAPCU   has to find out the nursing home/hospital, who have more than  50  deliveries and  50 HIV tests.


Capacity building of the F-ICTC (i. e. training of staff, providing registers/ formats, providing guidance, supervision etc.)
o       We give F-ICTC details to SACS,they  will arrange training facility to F-ICTC. Then in District level, DAPCU will intimate all F-ICTC and arrange training to staff nurses and LTs. In training we provide register and report format to the F-ICTC.


Strengthening of linkages between F-ICTC and Designated ICTCs

We link all F-ICTCs to stand alone ICTC  and  given the responsibity to collect reports and  to follow up of positive case.In F-ICTC they do 1st test and for  2nd and 3rd test, they refer the client  to stand alone ICTC.When the case linked to ICTC,the whole responsibily is lies with ICTC.DAPCU can review the case with ICTC.                                                                                                       

Monitoring and evaluation of F-ICTCs
Stand alone ICTC will monitor F-ICTC programme at their end and enter SIMs                           report also.In District level we review LTs of  F-ICTCs  in LTs monthly meeting.DAPCU  will monitor the programme when visit the centre.And  review the programme with MO,Counsellor and LTs

Share a few achievements from your districts in this regard
It will be easy to cover  ANCs and more TB patients through F-ICTCs.We have achived 100% ANC coverage as per NRHM data.And few PHCs  are linked to F-ICTC and  do counseling and testing   at PHC  and give report to F-ICTCs.

East Delhi's Response to Theme- Supportive Supervision

How do you plan and implement your visits for supportive supervision?

1. The plan for supportive supervision visits are done based on the reports of the
previous months and tentative visit plan is prepared in last week of the month.        
2. We analysis the gaps from ICTCs to ART, STIs, TIs & RNTCP.
3. Supervision the counseling session
4. Meeting with Nodal Officer of Centers to discuss the issue, if any.
5. Prepare the visit report in check list while doing the supervisory visit and share this report to SACS & DACO.

What should DAPCU’s keep in mind while undertaking supervision?

During a supervisory visit, the supervisor should conduct the following main steps:


1. Try to solve the issue related to the center
2. Supervisor always keep in mind that this is a supportive supervisory visit
3. Positive attitude 
4. Provide corrective and supportive feedback on performance
5. Explores common problems with supervision of facility
6. Discussion will be done to all the concerned of the issues
7. If problems are major than discussed with higher authorities



Do’s

1. Supportive supervision
2. Observation of performance
3. Collect Information
4. Listening the staff problem
5. Discussion on issues and problems
6. Friendly Relationship with staff
7. Improve their skills

Don’ts

1. Don’t confuse
2. Don’t aggressive supervision
3. Don’t manipulate the data & information
4. Don’t misguide
5. Don’t compare with others
6. Don’t give any false assurance for any issues

DAPCU Wardha Response for Supportive Supervision

Supervision

Supervision means the act of watching over the work or tasks of another who may lack full knowledge of the concept at hand. Supervision does not mean control of another but guidance in a work, professional or personal context.

Plan and Implementation

A plan is typically any diagram or list of steps with timing and resources, used to achieve an objective. 

In other words, Planning  is the process of thinking about and organizing the activities required to achieve a desired goal

Planning is the important tool for Supervision, if the planning is perfect than easy to supervise the work , in the DAPCU activity the Visit plan is very important , through that it is easily understand ,what’s the objective or purpose of visit or what is the area where we want the improvement,  planning also is depend  on the previous performance of the ICTC work,  following points take into consideration during the plan of visit

• Plan the visit according to the Low to High performance of Facility (in the same rout)
• Choose Only one or two facility for Effective supervision   same day 
• Prepared the list of points which are discussed during the visit
• Take the last month performance to identify the gap in areas where the improvements  possible
• Time and work load of the take into consideration of respective ICTC where the visit planned
• Look the areas for work in facility

Implementation is the carrying out, execution, or practice of a plan, a method, or any design for doing something

Do visit according to the Plan, time management is very important during the execution of plan, first take the important issues and Programme Indicators and do visit according to plan

DAPCU Keep’s the Following points During the Supportive supervision Visit

• DAPCU always keep in mind that we are come here for guidance and not for inspection
• Behave like the supportive person not  a officer
• Understand the situation when entered in the ICTC centre, don’t disturb the counseling session
• Shared the all new guidelines related to the program me with the ICTC staff including ICTC incharge
• Tray to understand the problem and its solution with use of available resources
• Explain the need and importance of time during the work
• Develop the confidence of the staff
• Help and guide the ICTC staff to plan their routine activities
• Praise and encourage the staff for their achievements  and also motivate them for continues good work
• Analysis the Gap and give proper feedback to ICTC Incharge, and take active participation from them to improvement of work
• Check the visit book, to look  for  improvement in last month’s points
• Noted the visit observation with achievements of the work in Visit book
• Identify the Staff’s requirement, inform the authorities and work as per suggestion
• Explain and demonstrate (if possible) each and every points in details and clear all the queries of staff
• Use the 2 way communication skills  during supervision
• Keep the friendly condition during the visit not behave like officer
• Consider a burden /load of the centre (try to decentralized if possible to reduce the lode for better performance), and also the overall performance of the centre
• Establish the good relation with all  team members  and explain the importance of TEAM work
• Welcome the new ideas of ICTC staff about the work, give full response to the Staff  (with proper correction in Ideas)
• Give feed back to the ICTC work
• Identify the burden of work and try to give solution for it
• Identify the burn out situation of the ICTC staff and give them the new ideas about the work, reduce the risk of burnout

Do	Don't
Work at establishing friendly relationships with staff	Allow romantic or "special" caring to develop with persons supervised
Treat staff members equitably	Show or appear to show favor to some staff members
Confront problems and issues when first realized	Confuse the value of the person with his or her behaviors
Support the decisions of superiors with subordinate staff	Hide disagreement from supervisor during decision making process
Publicly admit when wrong or mistaken	Criticize (correct) staff members publicly
Deal with staff members face to face	Discuss a staff member's problem behavior with another subordinate or coequal staff member
Keep confidences	Hesitate to consult with supervisors or other professionals
Be direct, open, and honest	Try to send indirect message or message thorough a third party to a staff member about his or her conduct
Keep records of supervisory contacts	Rely on memory for details of supervisory sessions
Recognize and reward achievement	Assume that a "good job" is the norm and does not require acknowledgment
Make explicit connection between supervision and staff development activities	Assume that staff members can always identify the areas in which they need to develop skills or acquire knowledge
Listen and learn from staff supervised	Assume final knowledge about supervision or about a supervisory relationship
Use two way communication	Don’t give order
Identify the need of staff	Don’t give wrong assurance or feedback

DAPCU, Imphal West Response for Supervision

1. Supervision
 Supervision is a constant motivation or handling to enhance the performance of reporting units such as TI-NGOs, CCC, ART Centre, ICTCs, Blood Bank, STI Clinics etc.

2. Plans and Implement of our visits for Supportive Supervision following points are need

• Identify the gaps
• Prepare a Checklist
• Inform the concern reporting units
• Try to solve the problems
• Getting Feedback
• Check the Work Plan.
• Two ways of Communication

3.  Some of the things before undertaking Supervision, DAPCUs keep in mind are given below:-

• Receive reports from all the HIV/AIDS facilities in Imphal West District.
• Follow up instructions of SACS/NACO for strengthening District Level Programmes.
• Provide technical support to district level organisations/departments to integrate HIV in their functions.
• Conduct District level IEC campaign.
• Report about non-availability of supplies (HIV test kits, reagents, lab consumables, condoms, drugs, IEC materials etc) through field visits and review of reports.
• Ensure regular monthly review meetings for TB- HIV and for HIV-STI linkages.
• Based on the field visits identify gaps/needs in the capacities of the various facility personnel and communication to SACS.
• Through field visits and reports from the service delivery, identify the gaps and needs.

4. List a Few Dos and Do Not s.

DOs :
It is Team Work so everybody should share knowledge and 2 ways of Communication.

Donts :
Every report should not send without signed by DACO.