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

What is the role of DAPCUs in establishing F-ICTCs? How do you help in locating a suitable health facility to establish F-ICTCs:

DAPCU plays a vital role in establishing FICTCs at Primary Health Centers (PHCs) as well as at Private Hospitals (FICTC-PPP). To identify suitable health facility for FICTC, DAPCU relies on the guidelines circulated by the State AIDS Control Society. Primarily, DAPCUs established FICTCs in all 24x7 PHCs as per the instructions from APSACS and later on, establishing FICTCs in all Primary Health Centers became essential to make HIV testing services available to all pregnant women and other vulnerable population at the nearest possible distance. The criterion for establishment of FICTC at private hospitals is based on the load of the hospital, especially total number deliveries occur in the hospital in a month (at least 50 per month - on an average). The identification and establishment of FICTC at private hospitals is done with the help of SAATHII (NGO) in Andhra Pradesh.

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

Once a facility is identified for FICTC, DAPCU concentrates on identifying human resources, to be trained on HIV counseling and testing, with the help of NRHM cadres. The training for the identified staff will be provided at the attached Nursing Colleges for Staff Nurses/ANMs (act as counselor at FICTC) and at State Reference Laboratories for Lab Technicians (conducts HIV tests at FICTC). After training, registers, records and HIV testing kits will be supplied to FICTCs by DAPCU. DAPCU team visits frequently to monitor the FICTCs and necessary inputs are provided to the staff regarding recording and reporting. On hand training will be provided to untrained staff by the trained one to make FICTC functional without any interlude. 

Strengthening of linkages between F-ICTC and Designated ICTCs:

Only primary screening for HIV is done at FICTCs. As per NACO guidelines, HIV positivity has to be confirmed by conducting 3 HIV rapid tests. If any case found HIV positive at FICTC, it has to be linked to nearest Standalone ICTC (designated centre, where specialist counsellor and LT is available) for confirmation. The FICTC staffs are involved in the monthly DAPCU review meeting, where they get an opportunity to meet stand alone ICTC counsellors and to build up rapport. The list of standalone ICTCs and FICTCs linked is shared with FICTC staff. Once a positive case is found in screening test at FICTC, the details of case will be intimated to District Supervisor of DAPCU and is closely monitored and followed up by DAPCU immediately till it reaches to standalone ICTC. 

Monitoring and evaluation of F-ICTCs:

Regular monitoring visits to FICTC will be done by ADM&HO (A&L) and DAPCU staff (DPM, DIS & DSMA). Necessary inputs will be given to FICTC staff on recording and reporting and data discrepancies are corrected (if any). The need for linkages among various services will be explained. Medical Officers of the PHCs are apprised of the FICTC functioning during visits and are requested for necessary support.

Achievements:

We were able to establish 68 FICTCs among 80 PHCs with the invaluable support of District Medical & Health Officer. All these FICTCs report regularly to the DAPCU. 12 FICTCs are functional even with insufficient staff (Counseling and testing is done by either Staff Nurse or LT) and performed consistently even though there is no supply of whole blood kits.

Group work done by the participants 

F-ICTC Staff Nurses Training on HIV Counseling