DAPCU Dimapur (Nagaland) Response to the Theme : Data Quality

DAPCU Dimapur (Nagaland) conducts monthly review meeting of all the NACP facilities on 3^rd of every month where all the reports are brought by the concern staffs of NACP facilities to review and submit the reports. DAPCU team ensures that all the facilities submit the monthly report in time before entering the data’s in SIMS. During the meeting, preceding months analysis are highlighted where DAPCU team highlights the gaps and achievement of the NACP facilities and in which areas focus should be made to achieve the targets.

During the meeting the NACP facilities submits their hard and soft copy of reports, the DAPCU team cross checks the for reporting errors.

The ICTCs do not enter the data online in SIMS due to non availability of internet facilities/data card in their respective center's and for which the facilities submits the soft copy to DAPCU. DAPCU teams make sure that all data are being captured and entered in soft copy and after proper cross checking the DAPCU team enters and upload the data in SIMS and then forwards it to SACS.

DAPCU staff have also developed the SIMS information details in Excel format where the team enters all the details of hard copies submitted by the facilities where it has become easier for DAPCU to extract the data and records of all the ICTCs and through that format DAPCU does the analysis and highlights to the facilities during the month review meeting and also during the DAPCU review meetings.

SIMS Compilation sheet with all ICTCs

Many a times the DAPCU team has observed while cross-checking and reporting the discrepancies in referral and linkages from TIs to ICTCs in regard to HRGs testing the data reported by the facilities does not tally with the TI Reports. So inorder to have quality, accurate and standard reporting from all the facilities, DAPCU have developed another format in excel sheet to validate Targeted Intervention (TI) to ICTCs referral.

DAPCU developed format to validate TI to ICTC referrals.

The above format have been sent to all the 11 (eleven) TI NGOs in Dimapur district where the TI NGOs reports every month about the HRGs being tested in different facilities. Through that format DAPCU teams can easily identify the referral of TI HRGs tested in different ICTCs and can find out how many HRGs were tested in ICTCs and the same report is being cross checked with the ICTCs report while submitting their monthly report. The same format is being used by DAPCU while going for supervisory visit to ICTCs and TI NGOs in order to cross check with their reports and records.

Another format developed by DAPCU teams is the TI to ICTC comparison mainly to track the HIV positive detected from the TI NGOs. Through this format DAPCU can identify the numbers of HIV positive detected in TI NGOs.

Through all these formats and records maintained by DAPCU, the team can easily identify the discrepancies with the concern facilities and rectify the errors and also helps DAPCU to extract the data as and when required for information and this has also reduced the data discrepancies to a large extent in our district which is consider as the highest HIV positive detection in our state Nagaland.

DAPCU Ernakulam (Kerala) Response to the Theme : Data Quality

In Ernakulam, all facilities are reporting in SIMS by 2^nd working day of the month. On 3^rd working day DAPCU verifies the reports submitted by the facilities and if any data mismatch is identified the report is sent back to the concerned facility informing them to clarify.

 On 4^th Working day DAPCU conducts coordination meeting with HIV facilities and cross verifies referrals and linkage against SIMS reports submitted. Mismatch identified in report will be discussed in the meeting. Example: Cross verifying ICTC testing of TI projects with referral slip of ICTC and TI’s to ensure accuracy SIMS report. If any staff turnover reported by facilities DAPCU will arrange SIMS training without any time delay. DAPCU ensures 100% reporting from FICTC although frequent staff turnover is common at the FICTC level. During supportive supervisory visit DAPCU staff giving training to in charge staff.

DAPCU, Ernakulam has developed a district template for ICTC’s to verify linkage and referrals. Any facility not reporting in SIMS on or before 2^nd working day, DAPCU will inform the DACO and concerned divisions at KSACS.

DAPCU submits facility wise SIMS reporting status to DMO (H), every month. DACO presents the report at DMO conference and instructs the medical officers to ensure timely reporting from their centre.

DAPCU Organizing Refreshment Training on SIMS

DAPCU Yavatmal (Maharashtra) Response to the Theme : Data Quality

In the Yavatmal district, every month review meeting is conducted with all HIV facilities such as (ICTC, ART, NGO, SRL, BLOOD BANK Etc..). In review meeting, first will look in to the reporting status in SIMS whether all facilities have submitted reports with in the time period or not. During the meeting M&E officer will review the reports submitted by the facilities, also in the review meeting MRD data and Line list data will be cross checked whether facilities entering the same data in the reports or not. Etc. If any data queries arise the same will be discussed and clearing in the meeting by M&E officer in that meeting. Every quarter hands on training is providing to the facility staff on SIMS Reports and improving data quality.

In district total 115 facilities and all facilities are entering data in SIMS within timeline. DIS and M&E analysing the data every month after getting all facilities reports, the reports at times have  data gap for some of the indicators such as age wise positive, male female positive, total testing etc.  After reviewing the data gaps DIS and M&E instructions the facilities to review the data and correct it in the system at the earliest.

During field visits the DAPCU staff verify the registers and submitted reports whether reporting data is matching with registers or not. This improves the submission of quality data.

                 

DAPCU Balasore (Orissa) Response to the Theme : Data Quality

The following process is adopted by DAPCU to ensure the Data Quality in SIMS

1.   DAPCU is taking care that all the facilities are submitting reports in time with complete and correct data. Also, DAPCU developed a format for data quality checks.

2.    All NACP facilities submitted their hard copy report by 3^rd of every month, then on the basis of their hard copy, a complete compilation report is prepared   which also helps to validate the data in online SIMS.

3.    Once reports are received from facilities, they are crosschecked especially indicators like in referral & out referral system of all facilities.

4.  Also, DAPCU conducts monthly review meeting with all NACP facilities. In that meeting all the reports are submitted, DAPCU presents facility wise data gaps and discuss about how to rectify the problems.

5.    During the field visit the DAPCU staff, crosscheck the data with registers. This helps to improve the quality of data.

6.  DAPCU staff attended the NHM meetings where data is verified with the facility reports. The indicators which are cross verify in that meeting is ANC registration, HIV testing, RPR/VDRL testing and institutional delivery in Govt. health facility.

DAPCU Kozhikode (Kerala) Response to the Theme : DAPCU's role in addressing stigma and discrimination and mobilizing support for high risk groups and people living with HIV

In Kozhikode district of Kerala, the reported cases of stigma and discrimination have steadily declined over the last two years. Awareness programmes for general population, sensitization sessions for government staff and social interactions between community and people living with HIV were organized, which helped address institutional discrimination, social exclusion and self-stigma. In the past, people living with HIV were reluctant and afraid to approach government departments and access service facilities. With increased awareness and acceptance across society, people living with HIV are now even willing to publicly disclose their status, play an active part during interactions with government departments and confidently avail health services.

Recently, a person living with HIV reported that an officer in the Revenue Department was delaying assessment and processing of a file related to land document. DAPCU team accompanied the beneficiary to interact with the concerned officer and his staff, sensitized them about HIV and explained the role of DAPCC in reviewing cases of this nature. The meeting helped remove misconceptions from the mind of the officer and staff and the file was processed without further delay. The beneficiary played a lead role in resolving this matter by actively participating in all interactions with the department.

To address community based stigma issues and establish a supportive environment for people living with HIV and their families, DAPCU brought together and sensitized local self-government officials, health functionaries and community leaders. Linkages with NACP service facilities have also been strengthened.

Facilitating access to social protection schemes for people living with HIV and Most At Risk Populations (MARPs) is included as an agenda item in DAPCC meetings. DAPCU has helped beneficiaries apply for and obtain government social entitlements. DAPCU assisted CSC Vihaan in receiving BPL status for people living with HIV by raising the issue in DAPCC meetings and following up with District Administration officials.

DAPCU Banda (Uttar Pradesh) Response to the Theme : DAPCU's role in addressing stigma and discrimination and mobilizing support for high risk groups and people living with HIV

DAPCU Banda organized a sensitization camp to address the issue of stigma and discrimination experienced by people living with HIV. Participants included Gram Panchayat Head, Block Development Officer, Village Development Officer, Anganwadi Worker and ASHA Worker. DAPCU DPM and DIS sensitized the audience on HIV transmission, HIV counselling and testing services, Anti Retro Viral treatment, stigma, discrimination and rights of people living with HIV to access health services and government social benefit schemes. The session also focused on how various levels of government can support, facilitate and improve access to service facilities, legal aid and social benefit schemes for people living with HIV.

Recently, DAPCU Banda resolved the case of an HIV positive person belonging to the high-risk group who was abused by his family members. When the matter was reported, DAPCU worked closely with the Targeted Intervention (TI) NGO, crisis response committee and an advocate to resolve the issue. The family was counselled and sensitized on the rights of people living with HIV.

DAPCU Surat (Gujarat) Response to the Theme : DAPCU's role in addressing stigma and discrimination and mobilizing support for high risk groups and people living with HIV

DAPCU Surat would like to share a case study that demonstrates the steps taken to mobilize support and address stigma and discrimination faced by high risk groups and people living with HIV.

A woman working in the Mid-Day Meal Programme at a Primary School for the past six years was asked by the school Principal to submit a medical report for renewing her contract. When the woman disclosed her HIV positive status, the school Principal and Deputy Mamlatdar of Taluka Panchayat refused to renew her contract. The woman contacted the ICTC Counsellor who reported the matter to DAPCU Surat and District Level Network. DAPCU team in coordination with District Level Network made a joint visit to meet the school authorities and Taluka Development Officer and submitted a written complaint.

DAPCU also raised the issue at the DAPCC meeting followed by submission of a written complaint to the District Magistrate and Collector requesting necessary action against the Taluka Development Officer and school Principal. A notice was issued by the District Magistrate and Collector to the Taluka Development Officer and school Principal asking them to explain their position. Upon enquiring this matter and finding no justification for the decision, the District Magistrate and Collector ordered that the woman’s contract as a Mid-Day Meal Worker should be renewed. DAPCU’s persistent efforts helped the woman receive a contract and she continues to work with the Mid-Day Meal Programme performing her role competently.

DAPCU Kanyakumari (Tamilnadu) Response to the Theme : DAPCU's role in addressing stigma and discrimination and mobilizing support for high risk groups and people living with HIV

To address stigma and discrimination and mobilize support for high risk groups and people living with HIV, DAPCU Kanyakumari has conducted sensitization programmes for Government departments, schools and the general public.

Government Departments

 Incidents of stigma and discrimination were discussed with Heads of Department to mobilize their support. Sensitization and training programmes have been conducted for department staff, which has resulted in improved delivery of social welfare services to high risk groups and people living with HIV. When beneficiaries approach departments to apply for social benefit schemes, staff now respond to requests with greater sensitivity and understanding. Since participating in the sensitization and training Programme, staff offer necessary support to the client for claiming social entitlements and even enquire about the person’s family situation.

Schools

 School Headmasters have been sensitized to carefully handle cases of stigma and discrimination experienced by students living with or affected by HIV as well as take steps to prevent any harassment due to their status.

Case study

The following case study highlights the role played by DAPCU Kanyakumari in mobilizing support and addressing stigma and discrimination in our community.

In one of the villages, a person living with HIV was not being considered for daily wage work and neighbours were maintaining a distance from her knowing that she was positive. When the lady approached with a complaint, DAPCU took immediate action. With support from the Ward Councilor, a sensitization Programme was conducted in the village. DAPCU raised awareness about HIV, routes of transmission, and common myths surrounding HIV and AIDS. During the Programme, the audience sat near the HIV positive person and shook hands to demonstrate that they accept her as any other person. DAPCU has observed a change in the community’s attitude towards the person since the sensitization Programme was organized.

DAPCU AhmedNagar (Maharashtra) Response to the Theme : Strategies for reducing Pre - ART LFUs at district

DAPCU Ahmednagar is conducting monthly co-ordination meetings with ART centre and Vihaan (CSC) staff to discuss the number of pre-ART LFU cases, efforts made to track them and the number of pre-ART LFUs who reached the ART centre. CSC staff are offered guidance on effective strategies that may be used for follow-up with clients. DAPCU emphasizes the importance of quality counselling by ICTC and ART centre Counsellors and capacity building of CSC staff for improving performance. Efforts are being made by DAPCU and ART centre to decongest the ART centre by shifting eligible clients to the Link ART centre. This will help improve the quality of counselling at the ART centre, encourage more clients to register for ART and adhere to treatment. ART centre staff have been instructed by DAPCU team to make follow-ups with clients through phone calls. From this month, DAPCU Ahmednagar is initiating group counseling during OPD twice a month with the help of ART Counselor and District ICTC Supervisor on specific topics, such as, ART adherence, opportunistic infections, diet and hygiene.

DAPCU Thoothukudi (Tamilnadu) Response to the Theme : Strategies for reducing Pre - ART LFUs at district

DAPCU Thoothukudi compares the line list of HIV positive clients from ICTC with the registered cases at ART Centre. A list of clients who have tested positive for HIV but have not registered at the ART centre is prepared for tracking and follow-up. For persons coming from neighboring districts, the client details are shared with the concerned DAPCU and the nearest ICTC for follow-up and registration. Similarly, for those who are from other states, DAPCU sends a communication to the concerned SACS for follow-up. When required, the ICTC Counsellor accompanies the client to the ART centre for registration. The DAPCU team and ICTC Counsellor make house visits to motivate clients who are not willing to visit the ART centre. Outreach Worker from the positive people’s network and Peer Educator from the TI project are also involved in making sure that the client gets registered at the ART centre. Linkages to social protection schemes are strengthened through the legal aid clinic as a motivation for clients to avail ART services.

DPM, DAPCU Thoothukudi facilitating block-level meeting one the importance of reducing Pre-ART LFU in the district

DAPCU Surat (Gujarat) Response to the Theme : Strategies for reducing Pre - ART LFUs at district

DAPCU Surat has been successful in reducing the number of pre-ART LFU cases by strengthening the tracking system through improved coordination among facilities, regular monitoring, supportive supervision and monthly review meetings. All patients registered for pre-ART undergo a CD4 test every six months. The ART centre Lab Technician maintains a ‘’due list’’ of patients who are due for CD4 testing. This list is prepared from the CD4 laboratory register. If any patient does not visit the ART centre to undergo CD4 test within one week of their due date, they are followed up by phone call to ensure CD4 test is done on the next visit. ICTC centre staff also motivate and support clients during post-test counseling session for ART registration.

Last Five Years Pre - ART LFU cases status of Surat District.

*As per ART Centers data source

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

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

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.