Response to the Theme Akola DAPCU: Stigma & Discrimination and DAPCU.

People living with HIV/AIDS (PLHA) are stigmatized and looked at negatively by people at large. Stigma, discrimination, and prejudice extend its reach to people associated with HIV-positive people such as health providers, hospital staff, as well as family member and friends.  DAPCU plays a major role in reducing stigma and

discrimination related to HIV/AIDS in the district. 
      Akola DAPCU coordinates various activities to reduce Stigma and Discrimination in the district viz.
1) Sensitization programs for the Line departments and peoples representatives: 
DAPCU with the help of District Administration arranged the sensitization programs for the line department. Akola DAPCU has conducted awareness programs for the revenue department, education department, panchayat members, SHG’s, police departments and health staff. Every year the annual action plan for sensitization program has submitted to SACS.
2) Maximum utilization of Electronic and Print media to prevent any issue related to S&D:  
DAPCU routinely connected with the print media and local electronic media of the district. DAPCU publishes the activities related to HIV/AIDS and also highlight the positive living of the PLHA.
3) IEC Activities : 
SACS has organized permanent hoarding at hot spots of the district. Twice in a year SACS has arranged the folk troupe campaign for HIV awareness and to reduce stigma & Discrimination in the society. At healthcare facility DAPCU pasted the hoarding and banners for sensitization of health facility. A big event like RRE also arranged twice in the district to aware general population.
4) Positive Speakers Contribution:
If any stigma and discrimination issue noted in the district that issue jointly handle by the DAPCU and PLHIV network. In every event DAPCU arranged positive speaker. The involvement of the positive speakers was really appreciable in the RRE event. 
5) Strengthening of PLHIV:
DAPCU provided care, support and treatment to the PLHIV by fascinating social benefit scheme approach. DAPCU Akola also run a intervention for strengthening of PLHIV in which PLHIV got a technical training for self employment. DAPCU formed the GIPA committee for sorting out any crucial issue at the district level.

Akola DAPCU Proposed Strategies for MIS & LFU Reduction

Introduction

DAPCUsare responsible for coordinating NACP activities at the district level. Across the country many DAPCUs have contributed significantly to the gains of the programme. DAPCU Akola observed a few common problems faced during service delivery. These problems were faced not just by Akola but across the state. The team especially Akola M&E designed the innovative strategy and conveyed to the MSACS which was very appreciated and included in AAP 2013-14. A very brief description of these processes is presented below

Problem

Each ART in the district faces the problem of LFU/MIS. A few common reasons observed by us were

•  If client found positive in one district sometimes she/he prefers to take the ART services from neighboring districtdue to stigma issue. In such situation the status of such client reflect LFU in parent ART centeri i.e.  If the client has not communicated to them or a proper transfer out process has not been followed
• ANC cases:  ANCscommonly avail services in two districts viz. at her parents’ home and at her marital home. Tracing and follow up between districts becomes difficult for \EID/DBS, 6 weeks, 6 months, 12 months, 18 months
• Positive HRG especially Migrants/Truckers/FSW travelling from one district to the other also leads to them being reflected as LFU MIS
• Clients test at multiple ICTC centers for confirmation of their HIV status. In such situation client’s pre-ART status shows failure.

The Akola team especially the M&E Assistant has been looking for solutions to these concerns. The data from the district was analyzed, different strategies were discussed. One of the strategies explored by the team was a software based solution. An innovative system was designed called “Electro Unique Profiling System(EUPS)”.A concept note for this was designed by the initiative of the Akola team

What is EUPS and how it supports to the District level activities?In the EUPS system each ICTC and ART center are connect through electronic system. In ART/ICTC counselor has to take the thumb impression of particular client and upload client’s data to the online server. The data of the client will become accessible for each ICTC/ART in the state.

The programme already has basic infrastructure required to develop and implement this system. Only the programme and biometric machines will be required additionally. 

Possible Advantages

• Due to implementation of this system we could avoid the problem of repeat registration/repeat testing as the profile of the client can be accessible to any facility through his thumb impression.
• Auto-updation of all the data of client at its parent ART center if the client came in Migrants/Trafficking FSW/Truckers  group.
• This system could strengthen the referral and linkages services for the client e.g. the client could identified for the social benefit scheme by analyzing his profile.
• Current regimen, status of CD4, OI history etc can be viewed by scanning clients thumb impression in any ART center.
• State could generate the line-list of any client at just single click.
• There will be no need to maintain separate line-listing of any positive client at any ICTC/ART because data could be generate in excel base format.
• SACS could avoid the major problems of data duplication by accepting this system.
• This system could give the exact epicenter of HIV infection and one could analyze the accurate prevalence of specific territory.
• As system providing auto-updation data so there is no need to cross communication barriers with other district.
• Gap in EID/DBS program could be avoided by testing infant to the other EID center. We could provide EID/DBS services to the any neighboring district.

MSACS has been appreciative of this idea and has included it in its 2013-14 AAP. We will update you on any significant progress through this blog.

DAPCU Akola Response to Comprehensive HIV/AIDS Service are provided to the HIV Positive Migrants

Providing services to the Migrant is supposed to be the tough challenge in front of DAPCU. DAPCU plays a vital role in this segment which is as follows.
i) Identification of gray area for tracking HRG activities in migrants in the district.
ii) Sensitization of industries/corporate sector for covering migrant group.
iii) Linking positive migrant client to the services.
iv) Tracking of LFU/MIS migrant client by coordinating with the neighboring district/state.
v) Transfer out of the migrant client to the native place for further follow-up.
     For early detection, DAPCU Akola coordinates with the industrial sector/corporate industries in the district. Arrange sensitization workshop for the workers in the industries. Arrange health camp for the workers. 
     Brick industry has the big set up in the Akola district.  The workers from Chhattisgarh and MP highly involve in the manufacturing of bricks. ICTC counselor arranges the health camp with the coordination of brick industry owner and provides the health services. The referral of this group to the ICTC is very high. If the positive migrant identified then ICTC counselor provide strong counseling to them and link them to the ART. If client willing to move to his residence then ART coordinate with the other DAPCU and transfer him to his native place ART.

Akola Response to Theme - Coordination between DAPCUs

In Maharashtra 30 DAPCUs are responsible for overall activities related to HIV/AIDS in the district. There is a strong inter-coordination among these DAPCU’s. The major coordination areas are as follows.

 I) Data sharing.(LFU/MIS, Social Benefit scheme, Transfer out etc.)
II) In emergency at stock out position of Kits and Consumables
III) Innovative Intervention ideas sharing
IV) NGO’s analysis
V) Jointly conducting Workshops through coordination.
VI) JAT and NGO selection etc

Following are the examples how Akola district coordinates with the other districts

1. Akola conducted Media workshop in the coordination with the Amravati DAPCU.

2. For kit transportation Akola DAPCU collects the kits for all the DAPCUs in the Akola Circle (i.e. Amravati, Yavatmal, Buldhana and Washim).
3. Every month share the data of ANC/LFU-MIS with the coordinating district Buldhana, Amravati and Washim.
4. In stock out condition Akola DAPCU took the HIV kits from the Amravati and Yavatmal DAPCU.
5. For greater learning of FSW-TI DPO Akola visited  Amravati DAPCU and implemented the learnings in Akola.
6. For conducting the Mega event like RRE, we take the help of Amravati DAPCU.
       
The learning from coordinating with DAPCUs is beneficial and it reflects in the overall reporting and results.

DAPCU Akola Response to Role of DAPCUs to Support TI

Akola district situated in the central part of Vidarbha in Maharashtra having population 18 lack plus. The Akola ART has a burden of more than 7500 PLHIV. The MSM population contributed approximately 30% of HRG in the district. TS/TG and MSM population also registered and getting ART from ART center.   Recently SACS has allotted MSM TI project to the Gunavant Shikshan Sanstha Akola by analyzing all these facts.

It was a great challenge to identify and coordinate this entire HRG group. It’s important to implement new strategy to identify this group, to aware them, to save them from HIV and those who are infected link them to ART services. The NGO has chosen the different way to work for this group. The NGO has organized the mega cultural event only for this group with vast advertising of the program. The NGO has coordinated more than 200 TS/TG populations in very short span of time. 

In the event, HIV/AIDS awareness message given to this group. STI services provided to the needful and HIV facilities were also made available by DAPCU. It has been found that out of 36 HIV testing 4 persons were found positive, which shows more than 11% positivity. These all four PLHIV linked to ART. Its today’s need to work differently for TI, implement new strategies and find out the new way to work out for this group. 

Akola District administration’s initiative Makes PLHIV self sufficient.

Akola district has more than 7400 PLHIV.  Most of the PLHIV population came from below poverty line (BPL). Maintaining the livelihood is difficult for these BPL families. It was very important not only to maintain the health of On-ART patients but also to provide the quality of life to all PLHIV. DAPCU identified this and discussed the matter with Honorable District Collector Shri Parimal Singh. DAPCU run the intervention to provide social benefit scheme (Financial Assistance) under the guidance of Hon. DC. Under this intervention DAPCU could able to provide benefit to more than 1200 PLHIVwith the help of PLHIV network through which they received Rs 700 per month from the Collector office. 

Hon. DC’s involvement in the program was admirable. DC has called the meeting of General Manager District Industrial Center (DIC) Shri. Uday Puri,  DPO,  DACO, Residential Deputy Collector and MCED officials to analyze the way to strengthen PLHIV. The outcome of the meeting was positive. It has been decided that DIC will train more than 300 PLHIV for different training programs (garment manufacturing, leather bag manufacturing, seed processing, mashroom manufacturing, mobile repairing, electrical maintenance, etc) and funding for the said training will be provided by DC under DPDC. DAPCU, in coordination with DIC and VNP+ started the first batch of female PLHIV for garment and leather bag manufacturing. During this training it has been taken care that PLHIV not only received the technical knowledge but also get income through small scale industry.

At the end of the training session, DAPCU had arranged the industrial visit for these ladies at garment manufacturing industry at Amravati MIDC. The owner of the industry was so impressed with the concept that he offered the jobs to the interested ladies. Seven of the ladies were found to be interested to join the company.

It was a great challenge in front of DAPCU to continue the enthusiasm of these ladies as they had no sewing machines to continue with this work. DAPCU had arranged the sewing machine for this group with the help of some donors.

Out of these 30 ladies, seven have decided to join the garment industry at Amravati, eight has started their own work and three has started the shop at Akola.

DAPCU Akola Response to DCC for HIV-TB

DAPCU Organizes the DCC meeting on a quarterly basis, in which all the ground level working staff (STS, Counselors), WHO consultant TB, DTO, DHO, CTO, TB MO, DACO, DPO, DS, ART SMO contribute their views. DAPCU analyzed the gaps through detailed presentation. All the members worked out on the poor factors and find out the remedies for the problem.

     The regular conduction of the meetings and follow-up of the activities bring the best outcome in the HIV-TB functioning. The following data can shows the qualitative part of the HIV-TB functioning in the district.

     The ICTC annual referral percentage of the TB patients is more than 11% whereas the detection rate is more than 8%. The HIV testing of the TB clients goes more than 94% in Dec 12. The ART referral is more than 8% whereas the TB detection of PLHIV goes more than 62%. All the NGO’s working in the HIV sectors are equally contributing their efforts for TB referral and HIV testing of TB clients.

     DAPCU not only taken the initiative for IEC improvisation in HIV-TB coordination activity but also run the sensitization programs for PHC MO/Private practitioner. Due to continuous follow-up of the activities HIV department has a strong coordination with the TB department. Quarterly DCC meetings help to strengthen the HIV-TB coordination activity of the district.

AKOLA Response for the Theme-Mainstreaming

Akola DAPCU contributing their efforts to coordinate with various  Departments for the benefit of PLHIV.

·         DAPCU has taken the continuous sensitization programs with various departments. Under the leadership of District Collector, DAPCU has successfully conducted the interventions for the benefit of PLHIV.

·         The Social Benefit Scheme run by the govt was a big hurdle for the PLHIV. After the mainstreaming efforts with the revenue department, DAPCU is able to provide benefit to more than 1200 PLHIV.

In the second intervention DAPCU plan a strategy to strengthen the PLHIV with the help of District Industrial Center.

·         DIC arranged the vocational training for the PLHIV, provide them a stipend, provide them equipments and also help them financially to establish small scale business.

DAPCU also taking continuous efforts with the other departments like-

·        Education departments for establishing RRC, Transport departments for testing HRG (Truckers), Women & Child Welfare Department for providing social benefit scheme to CLHIV, Police department for IEC & Blood Donation.

Theme of the month: NATIONAL VOLUNTARY BLOOD DONATION DAY

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The Role of Akola DAPCU in Voluntary Blood Donation

1^st October is celebrated as a Voluntary Blood Donation Day. NACO has taken this step to celebrate VBD to sensitize the society regarding voluntary Blood Donation. DAPCU is playing a major role to awake the society and trying for uninterrupted blood supply to the Blood Banks.

Akola DAPCU is also playing a major role in building up the donors through coordination with the Non-government organization, various Government department, and private firms and RRC in colleges. The major role is playing by the Blood Bank counselor with the help of DAPCU. DAPCU identify the opportunity or department and convey to the Blood Bank Counselor. Blood bank counselor takes all the efforts and personally takes the follow-up of all the activity. DAPCU motivate all the RRC in colleges to arrange the VBD camps, sensitization program on VBD and also participate in IEC activities. Blood Bank Counselor has made the directory of all the NGO’s, Voluntary blood donors, govt. organizations and RRC members who could help out in the critical situation of blood bank. DAPCU has made the network of NGO’s, Govt. departments those contributing continuously in blood donation programs.

Regional Police Training School (RPTS) is functioning in the Akola where more than 1000 trainer could get training at a time. From last 3 years DAPCU conducting a VBD sensitization program and Voluntary Blood Donation camp in this Regional center. On the 1^st Oct DAPCU arrange the sensitization program and immediate on the second day morning DAPCU arrange the VBD camp with the help of District level Blood Banks. 

There is a strong coordination of DAPCU with the police department, education department, revenue department and efficient NGO’s as far as the VBD is concerned. With this intervention DAPCU could equalize the graph of demand of blood against its supply. The day will be no longer when Blood Bank will have the continuous and uninterrupted blood supply.

Response to September Theme: DAPCU AKOLA

POSITIVE PREVENTION

Why Positive Prevention is necessary?

Positive prevention is necessary to slower down the prevalence rate of the district. Positive prevention is the main parameter which includes the prevention of HIV transformation from infected PLHIV to uninfected person, it also includes the upliftment of PLHIV by providing them a quality life through proper counseling, medicines, social benefit schemes.

Role of DAPCU Akola in Positive Prevention :

DAPCU Akola is working hard towards positive prevention , some areas are listed below:

1. By Strengthening the Counselling factor in ICTC & ART : 

This is the most important & basic parameter for positive prevention. Through proper counselling counselor build up the capacity of PLHIV. If required several sessions of counselling are conducted in the ART centre. Counselor suggest the ways to prevent infection from PLHIV to uninfected person and convince the mind of PLHIV to avoid any problematic condition.The linkages of ICTC-ART is more than 100% and taken care that each one should get quality counselling.

2. Proper supply of Condoms to the end person : 

DAPCU plays a major role for providing condoms to the end client. Link workers Scheme has established 162 condom depo(s) in rural part of the district whereas TI NGOs are taking care of all the brothel-base area and HRG spots. ICTC is also a major source where the condom promotion and distribution is taking place.

3. Blood Safety :

In each blood bank, care has been taken that each unit should be tested for HIV, HCB, HCV, Malaria and syphilis.

4.Counseling sessions through DIC & PACT : 

Drop in center is playing a major role by providing various services to the PLHIV. The major role of DIC to strengthen the capacity of PLHIV and guide them for quality of life. DIC providing various social benefit scheme to the PLHIV, providing them a counseling, distribution of mass stock of condoms, forming their Self help group for upliftment of their financial status.

5.Maximum utilization of IEC resources:

DAPCU utilizing all the resources for IEC ie. Link workers scheme, TI, PPTCT NGO, ICTC and Local media network etc.