Inspirational Post shared by DAPCU, Vizianagaram, AP

A brief note on participation in 

Mainstreaming Workshop at Jaipur on 5th February 2014

Date: 05-02-2014

Venue: Lebue Resort, Jaipur

           As per the communication received from Mainstreaming division, Department of AIDS Control, Delhi, P. Balajee, DPM, Vizianagaram was invited for a consultation workshop towards finalizing the Social Protection Guidelines in NACP-IV on 5th February at Jaipur.  After appropriate approvals and as per the instructions, DPM Vizianagaram reached the venue on 4th February evening. I met Mrs. Elizabeth Michael, Team Leader, Mainstreaming, Dr. Govind Bansal, DAPCU coordinator and Mr. Srikar, Consultant, Mainstreaming, APSACS during the dinner there and we discussed the DAPCUs presentations on which will be presented during workshop on 5th. 

                 The consultation workshop started at 10 am on following day, after registration of all participants, self introduction and some ground rules.  10 DAPCUs as per the recommendation of DAPCU National Resource Team (DNRT) and NTSU and Mainstreaming consultants from all SACS participated in the workshop.

   

The presentations & discussed are as follows:

1. Ms. Elizabeth Michael, Team Leader, Mainstreaming, said about the importance of Social Protection for People Living with HIV/AIDS and their families and its role in NACP IV.  She informed to all about the NACP IV launch on 12th by Union Health Minister. 

2. Dr. Govind Bansal, National DAPCU Coordinator made a presentation on Social Protection Schemes & Social entitlements activities done by the DAPCUs in the country and he also explained the structures in DAPCU and NTSU for the benefit of mainstreaming consultants.    His presentation gave an idea to all participants that DAPCUs are doing and trying to provide benefits of social protection schemes and Social entitlements to PLHIVs in their respective district. 

3. Sri. Chandrashekar Gowda, Director, Swasti made a presentation on the study finding which was done in Madhya Pradesh with a sample size of 800 on social protection schemes & Social entitlements among PLHIVs & HRGs.  His presentations focused more on Help Desk at all level in our programme for counseling, collecting information/documents and approaching concern departments.    The participants also learnt that Help Desk model is more useful and economic for our programme and some of the DAPCU expressed that they are doing it now but not at all levels, but at DAPCU.

4. Experience sharing by DAPCUs:

a. I spoke about various social protection schemes available for PLHIV in Andhra Pradesh as mentioned below:

     i. Rs. 200/- pension for all on ART PLHIVs is being implemented in Andhra Pradesh and APSACS has taken into considerations- all concern of PLHIVs like stigma, transport, transparency and many more into consideration for providing benefit to PLHIVs in AP.  It is implemented by APSACS in collaboration with SERP, DRDA. 

    ii. Bus Passes for all on ART PLHIVs for getting 50% of discount in bus fare for one time in a month to getting ART medicine every month.  It is implemented by APSACS in collabaration with APSRTC. 

   iii. Antyodaya Anna Yojana (AAY) card are being issued to PLHIVs in AP after issuing a GO by AP Government and DO letters by PD, APSACS to all DCs. But here we take consent of PLHIV for sharing his/her complete information with Civil Supply Department as the Ration Depot dealer will know the status of the beneficiaries.  For implementing this scheme,DAPCU sensitized all Ration Depot Dealers along with Heads of Civil Supply Dept to maintain confidentiality and given instructions through DC.

    iv. 13 GOs & DO letters have been issued in AP for providing Social Welfare Schemes to the PLHIVs for leading dignified life with HIV without any Stigma & Discrimination. 

   v. All District Collectors in Andhra Pradesh are giving priority for providing Welfare Schemes to the PLHIVs. 

   vi. Because of time constraint, I mentioned in brief about many other such initiatives like Foster Care Scheme for orphans through ICDS, Double Nutrition for CLHA/CAA, Double Ration for HIV positive ANCs and SC/ST/BC corporation loans and etc...

   vii. We also tried to show the DAPCUs responses in the country on Social Protection schemes in DAPCUBLOG as I am also one of the volunteers for moderation of the blog but due to technical reasons I couldn't show it online. However, I mentioned that 13 DAPCUs in the country have responded to the theme of Social Protection for PLHIV and the responses are available on web: www.dapcuspeak.blogspot.com for reference. 

b. Participants were impressed very well about the schemes in AP especially Rs. 200/- pension and precautionary measures taken by APSACS.  Participants also felt unhappy about bus pass as the pass is clearly written logo of AIDS and name of APSACS.  For this we mentioned that APSACS is planning to change bus pass design as it was also informed to all DAPCUs in AP. 

5. Later remaining DAPCUs from various states made presentation according to their state specific social protection scheme to the PLHIVs.  The presentations were made by Karnataka, Tamilnadu and Maharashtra. 

6. Later all participants were divided into 5 groups and given a topic that for brainstorming, discussing, proposal and presentation by the team.  The topics are mentioned below.

a. Planning Phase

b. Awareness Creation

c. Enabling Environment

d. Setting up Help Desk at Service Center

e. Monitoring Mechanism

f. Mr. P. Balajee, DPM, Vizianagaram participated in the group  of Awareness Creation, Mrs. Lalitha, DPM, CTTR  in Setting up Help Desk at Service Center and Mr. Srikar, Consultant, Mainstreaming, APSACS in Monitoring Mechanism.  We actively participated and gave inputs to the group activity. 

g. Teams were given formats by facilitators and facilitator sat with teams and teams discussed and wrote inputs in to the format for developing guidelines for Social Protection to PLHIVs in the country.  The inputs of all groups will help the DAC to design the process the how DAPCU implement the Social Protection activity in the district, how to document, how to approach, how to measure and how to monitor the activity.  

h. Later all groups made presentations from AP team Mr. Srikar got the opportunity to represent Monitoring Mechanism team for presentation and he did very well and all participants also recognized that he made presentation well and comprehensive  to all presentations done before.

      This workshop helped DAPCU, SACS and DAC lot to learn lessons from existing strategies and approaches and it will give fruitful results in developing guidelines on Social Protection to PLHIVs and their families.

   

       My heartfelt thanks to DNRT, NTSU, DAC, UNDP, APSACS and DACO, Vizianagaram for their help, support and encouragement for helping me in participating in a national level workshop for a Nobel cause. 

Response of Adilabad District, AP on World AIDS Day 2013

World AIDS Day  2013 - Observation Adilabad District, AP

        Under the Leadership of Sri.Babu,IAS, District Collector, Adilabad, DAPCU Adilabad has organized World AIDS Day on 1st December 2013. 

On this day, we have observed 3 programmes: 

1. Community Breakfast with 30 Orphan CLHAs, District Officials and Print & Electronic Media people (includes Care takers of CLHAs)

          On this day, we have organized a "Community Breakfast” with HIV infected/affected orphan children, 30 District Officials and 45 Print & Electronic Media people at Collector's Camp office. Sri. Chandraiah, High Court Judge, Andhra Pradesh, has attended as a Chief Guest to the programme. 

          In the program, District Collector & High Court Judge had interacted with the CLHAs and their care takers. During their interaction they came to know many of their issues like Education, employment, housing, health etc. Immediately, the District Collector has instructed the concern Department heads to look into their problems. Sri Chandraiah, High Court Judge, has spoken many affectionate words towards the children and encouraged them to study well.

30 District Officials have sponsoring to CLHA/CAA including District Collector, Sri. Babu.A., IAS since from 15th August 2013. After that, all the District Officials had breakfast along with their Sponsored Children and care takers. Inviting Print & Electronic Media directly to the programme is the first time for us. After the Community Breakfast they also felt so happy that they knew more about the CLHAs and their life style. 

2. Massive Rally on Adilabad streets: 

Later, we have conducted a massive rally with nearly 1000 participants of Health, Education, DRDA, NGOs, and Youth etc with placards, banners and slogans. And we had carried a 15 feet HIV Red Ribbon in the rally. For this rally, District Collector flagged off and led the rally up to the Meeting venue. For the first time, in Adilabad, the District Collector walked along with complete rally for 2 kms.  

3. Special Meeting on World AIDS Day: 

After that Rally, we have conducted a Special Meeting on HIV/AIDS sensitization. Guests had given speeches on HIV/AIDS and stressed on Stigma & Discrimination towards the PLHAs. Later, Chief Guest, District Collector, Adilabad had given speech followed by a ‘special pledge’ on ‘commitment and  individual responsibility’ on ‘getting to zero’ of HIV infection in the district.  

At the end of the programme, woolen blankets were distributed to 30 HIV infected/affected orphans and followed by Awards distribution to the staff under DAPCU by the Chief Guest, Sri. Babu,A.,IAS. 

DAPCU Karimnagar Response for World AIDS Day 2013

DAPCU, Karimnagar observed World AIDS Day’ 13 focusing on theme of 2011-15 (Getting to Zero: Zero new HIV infections, Zero Stigma & Discrimination, Zero AIDS related deaths). Conducted Rally from Circus ground to Collectorate auditorium at district head quarter flag off by AJC Sri. Krishna Reddy. After ending the rally, conducted meeting at Collectorate auditorium under the chairmanship of AJC. Participants were DNMO, DAPCU team, DLSA Dist Secretary (Dist. Legal Services Authority), Dr Nagesh, DIO,  RRC ID Collge Principal, RRC Dist Co-ordinator, NCC NSS POs, KAJPS+ Network, NGOs, CBOs, NLEP Staff, Staff of ICTCs, DSRCs, ARTCs, Nursing students, College students, High School students, NYK Youth,  NSS Volunteers, NCC Cadets, MEPMA SHG woman, ASHAs, AWWs and ANMs. Total participants were about 1200.

Mobile ICTC participated in the programme.

Folk Media Campaign with trained and experienced troupe (Consisting 5 members) in Pallesuddulu category organized by the DAPCU at meeting hall. This troupe participated in the rally also.

Best ICTC Counsellor award given to Sri. Devender Reddy, Jagtial (Area Hospital); Sri. Sankar, AH-Godavarikhani; LT Srinivas AH-Godavarikhani; LT Mounika, CHC-Korutla; PPP-FI-ICTC LTs (2), LODI NGO PPTCT+ ORWs (2); Network PPTCT+ ORWs (2). Distributed prizes to students who won prizes in Essay writing and Elocution competitions.

Karimnagar district received “Best DAPCU” award by the Andhra Pradesh State AIDS Control Society (APSACS) on eve of WAD’ 13. ADM&HO (AIDS & Leprosy) received award at WAD programme, Hyderabad organized by the APSACS.

                                                                                                                

                                             

Few challenges faced 

DAPCU, Karimnagar was thinking about how to make huge gathering of students as the WAD’13 observed on Sunday. Finally DAPCU could able to make huge gathering with the help of Addl. Joint Collector and line departments. Co-ordination meeting conducted under the chairmanship of AJC with line departments prior to 3 days of WAD. AJC instructed the line departments regarding gathering. This helped a lot to DAPCU and the programme was ended success.

DAPCU Kadapa Response for -World AIDS Day-2013

https://drive.google.com/file/d/0B4TED9jZsXvKQllhOHE2Q0dobEU/edit?usp=sharing

DAPCU Khammam Response to the Theme: World AIDS Day-2013

• How did you observe this day at the district level? What was unique about your programme?

DAPCU Khammam, Andhra Pradesh – We have decentralized the programme to the Cluster Level, we are having 17 clusters in the district. Selected one PHC –Tallada which is divising the two National Highways. All areas Mass Rallies and Seminars were conducted by involving the Police, Revenue, NSS, NCC, students, lecturers and invited all the line department staff in all clusters and also involved the Print and Electronic Media. Coverage given in all the Leading News Papers.

• What are few challenges faced by you and how did you overcome it? 

This time WAD 2013 observed on SUN DAY.  From 22^nd November we have circulated the letters to all the line departments, personally met the heads of the Institutions and NSS, NCC, College Principals for voluntary participation and mobilizing the students in this Massive Rally.

Sri Srinivas, Sri Narish IAS, District Collector, Khammam has participated and flag off the Rally at Sathupally Cluster, Khammam District. Sri Babu Rao, Additional Joint Collector, Khammam has flag-off the Rally at District Head Quarter, Khammam.

By involving the SPHOs, PHC Medical Officers, ANMs under NRHM frame work, we have achieved the grand success of the WORLD AIDS DAY 2013. Kalajatha Teams were also participated in this programme.

All were given the messages on “Getting to Zero: Zero New HIV Infections, Zero Discrimination, and Zero AIDS related Deaths”

Kurnool DAPCU Response to the Theme- DAPCUs and Stigma and Discrimination

The District AIDS Prevention & Control Unit, Kurnool had conducted a so many activities for addressing stigma & Discrimination with the involvement of District Level network and all Govt department Key officials and elected political leaders. Dr.U.Rajasubba Rao, Addl. DM&HO (A&L) and Mr.Ali Hyder, District Program Manger, DAPCU contacted Sri.Ramsankar Naik. I.A.S, collector & District Magistrate Kurnool and discussed in detailed on these activities and got approval with detailed action plan.

The following activities were implemented:

1. Conducted community feast with CLHA and PLHAs
2. Setup IEC Stalls at District Head Quarters as well as where the rallies & meetings conducting.
3. Sanitization to all APSRTC Depots staff (Drivers, Conductors and  mechanical  staff)
4. Conducting  Competitions at Educational institutions 

Community Feast (Tiffin) with CLHAs & PLHAs:

The community feast was started at Regional Training centre (Female), Kurnool at 8.30 am with involvement of CLHAs & PLHAS.  In this occasion Sri. S.V.Mohan Reddy, MLC, and Sri.Ramsankar Naik,I.A.S collector & District Magistrate, Kurnool, Dr.U.Rajasubba Rao, ADM&HO(A&L), Smt.Zubeda begum, Project  Director-ICDS,  DAPCU Staff, Network Staff, CCC Staff, PLHAS, CLHAs, TI NGOs, ART Staff, Cultural teams were took part in this program for the purpose of to reduce stigma & discrimination  with the connection of World AIDS DAY-2011 theme.

{Sri.S.V.Mohan Reddy, MLC & Sri .Ramsankar Naik.I.A.S Dist.Collector, CLHAS, PLHAs Participated in Community Fest.}

{Dr. U. Rajasubba Rao, ADM&HO (A&L) & Smt.S.Zubeda begum, Project  Director – ICDS, Kurnool took part}

Role play on Stigma & Discrimination by cultural teams

Sensitization to APSRTC Staff:

The DAPCU conducted a sensitization workshop to all 7 APSRTC Depot Manager including Regional Manager at Kurnool APSRTC Regional training institute on HIV/AIDS, Stigma  & Discrimination  issues  with PLHAs during accepting Buss Passes, which is implementing in A.P state with the co ordination of SERF & APSRTC department.  After completion of this workshop all the depot Managers extended their support and come forwarded voluntarily to conduct the sensitization meeting to their staff depot wise. The following staff involved for conducting the meeting District Level Network, local ICTC, PPTCT, TI Partner staff.  The entire district was covered on war foot base, with this activity the APSRTC sanctioned bus passes to the PLHAS without any discrimination and allowing them with respectable manager.                       

Response on Coordination between DAPCUs - MEHABUBNAGAR District - AP

Is there a need for DAPCUs to work in coordination with each other?

• Yes there is a need for DAPCUs to work in co-ordination with each other, which gives platform for Experiences sharing & review among them to become strengthened and in turn pave a way to effective implementation HIV/AIDS Program
• Regarding DAPCU – Mahabubnagar, Andhra Pradesh, highly Backward District, falls between Hyderabad, Kurnool Districts and surrounded by  Range Reddy District.
• Since Highly draught prone are, General and seasonal  migration  to Hyderabad, Other parts of Andra Pradesh and even parts of  India is very high
• Since non availability of specialized Medical Services at District, people are referred to Hyderabad and Kurnool districts 

If so share how are DAPCUs in your state are doing this.

• Coordination meetings at every quarter between DAPCU Hyderabad, DAPCU Rangareddy, DAPCU Medak, DAPCU Mahabubnagar Districts held at conference hall, APSACS, Hyderabad.

What are the issues on which DAPCUs support each other and how is this coordination achieved?

Tracing LFUs, MIS cases and evidence of Death cases

• Reduce the Gap at cases found Positive at ICTCs  & Registered  at ART centre and  LFUs, MIS cases among  Pre  and On ART Registrations
• It is found in context of DAPCU - Mahabubnagar, the district near to Capital City and general & as well seasonal migration is high. Most of the people getting tested at ICTCS centres Mahabubnagar but they are getting registered at ART Centres,  Hyderabad and some cases they are getting both, tested at ICTC Centres Hyderabad  and Registered at ART Centres Hyderabad. And now most of them become MIS/LFUs, they need to be followed up, traced effectively with evidence by DAPCUs – Mahabubnagar, Hyderabad & Rangareddy Districts.

Strengthen Effective Referrals &Linkages mechanisms between above Districts

• Strengthen Effective Referrals &Linkages mechanisms between ART Centres and DAPCUs above said Districts to Tracing LFUs, MIS cases and evidence of Death cases

Sharing & Strengthening of Outreach Activities by data sharing between DAPCUs

• Sharing & Strengthening of Outreach Activities at far way Mandals from Mahbaubnagar ART center, which close to          Rangareddy & Hyderabad Districts. Utilize the Outreach Mechanism to trace LFUs/ MIS & Death cases
• Prepare & sharing the list of cases referred for specialised medical services for follow ups

Stock & Materials Management

• Stock outs situations, Proper & acceptable mechanisms to share stock & material  between DAPCU

What role do the SACS play in enhancing this co-ordination?

• Already regional wise review initiated by APSACS, and instructed all DAPCUs  to have zonal wise reviews ( 4 to 5 DAPCUs fall under each Zonal)  

Examples in which you have taken the support of other DAPCUs

• DAPCUs, Hyderabad & Rangareddy helped us in a follow-up & tracking of LFU, MIS and Death cases.

Examples of the results achieved by inter DAPCU coordination.

• Able to trace 27 LFUs and 3 critical Positive deliveries at Nay pool Hospital, Hyderabad

Khammam Response to Theme - Coordination between DAPCUs

YES ! there is  a need for DAPCUs to work in coordination with each other.

• HIV Testing Kits Requirement
• DSRC Services-requirement of the kits
• Sharing of the consumables, etc
• Taking the suggestions from the role model districts to improve the performance in own  district.
• Implementation of the new PPTCT Regimen Guidelines (ARV/ART, ANC data sharing for the migrant clients and their deliveries and follow-up of the babies upto 18 months and tailing)
• Follow-up of the ART clients (LFU/MIS Cases)

What role do the SACS play in enhancing this co-ordination?

• At present, SACS regularly every forth night conducting the video conference to identify the issues and enhance the programme.
• Review and identity the needs of the DAPCUs
• Supportive supervision to reach the given targets

Share a few examples in which you have taken the support of other DAPCUs and how it has helped you.

• When the HIV Testing kits were shortage in the district, we have spoken with the neighbouring districts and got HIV Testing kits. And over come the problem of the shortage of the HIV testing Kits with theintimation to the APSACS.
• DSRC kits: we got the short expiry kits from neighbouring districts and  utilized in the district (optimum utilized) with the intimation to the APSACS.

Share a few examples of the results achieved by inter DAPCU coordination.

• Follow-up of the ANC Cases (Migrant) for the ARV Prophylaxis and Delivery in the other districts.
• Follow-up of the LFU/MIS Cases in the other Districts.
• Follow-up of the Co-infected clients in the Other Districts.

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

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

Facility integrated counselling and testing centre is a place where a person is counselled and Tested for HIV, on his/her own free will or as advised by a medical provider. 

The main Objectives of F ICTC includes;

Early detection of HIV, Provision of basic information on modes of transmission and prevention of HIV/AIDS and Link people with other care and treatment services.

Each primary health facility should have one ICTC for all groups of people. The FICTC located in facilities that serve specific categories of people such as pregnant women, Accordingly the FICTC located in the grass route level primary health centres and private maternity hospitals where the majority of clients who access counselling and testing services of pregnant women. The FICTC consisting staff nurse, Lab technician and pharmacist and they performing test for diagnose of HIV and referring the clients to nearest ICTC for confirmatory test and the need for providing prophylaxis to prevent the transmission of HIV from infected pregnant women to their infants.  

The role of DAPCUs in establishing F-ICTCs;

Identify the existing PHCs in the district, enquire about the staffing position like Doctors/Pharmacists/Staff nurses/ANM & lab technician. Ensure the lab-facilities and ANC flow of the facility also ensure the distance from the nearest ICTC

Then the DAPCU is communicated DM&HO regarding establishment of new FICTCs and as per the directions of PD, APSACS the official G.O copy with all FICTC related infrastructure developed with the support of concern facility medical officer.

 

Capacity building to the F-ICTC staff (Training on maintaining the registers, records and submission of monthly reports etc.)

During capacity building the existing staffs like ANM, Staff Nurse and the Lab-technician were involved and provided training on FICTC functionaries services by DAPCU. Also gave training in the District level for the above staffs on CMIS. According the supply chain management system, DAPCU provided the registers, all types of reporting formats and testing kits also. Finally the DAPCU is co-ordinating with NRHM regarding supply of other equipment for laboratory.

Strengthening of linkages between F-ICTC and ICTCs

DAPCU is strengthening the co-ordination by timely supplying the required logistics and deputing the nearest ICTC Counsellor and LT twice in a month to visit the FICTCs for proper support and guidance. Standalone ICTCs are playing an active role in strengthening of FICTCs. The concerns ICTC Counsellors are participated in cluster level meetings and coordinating with Senior Public Health Officer (SPHO) and concerned FI- ICTC medical officer for strengthening the FICTCs. Also coordinate with RNTCP staff for cross referral.

Monitoring and evaluation of F-ICTCs

The DAPCU team, Addl. DM&HO, DPM, DIS and the nearest ICTC counsellor are regularly visiting the F-ICTCs and monitoring the centre performance and if any gap is identified in the centre, the concern standalone counsellor or concern cluster senior public health officer (SPHO) is immediately suggested by DAPCU to take actions for minimize the gap and also provide proper support and guidance to the F-ICTC. 

Future Plans

1.Planning to conduct training to all FICTCs staff nurses on SIMU package

2.Send the details to APSACS on remaining 8 new FICTCs out of 72 for universal centre official code

3.Planning to conduct meeting with all SPHOs to review the performance of each FICTC and orient on new PPTCT drug regimen program in the district.

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

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

As per as mainstreaming is concern the FI-ICTC plays major role for integration of services and sustainability of the activity.  At present we are placing two types of FI-ICTCs in Andhra Pradesh that are  FI-ICTCs in 24 Hrs PHCs  and FI-ICTCs in Private Hospital/Nursing Homes –PPP model.  DAPCU has been given guidelines by APSACS for setting up of FI-ICTC in both models.  We are using the guidelines for locating suitable health facility and to meet necessary requirements for placing FI-ICTC.  

DAPCU is identifying the Health facilities for FI-ICTC which has Lab facility and Human resources to take up testing and counseling and verify the facility whether it can meet our guidelines or not.   The major requirement for setting up FI-ICTC is Human resources and infrastructure.

•Lab 
•Lab Technician (Testing)
•Staff Nurse (Counseling)
•Commitment of District administration(DM & HO) and Facility 

Capacity building of FICTCs:

DAPCU is listing out the Lab Technicians and Staff Nurses and sharing with APSACS for induction training.  APSACS has identified SRL (State Referral Laboratory), Micro Biology Department in Medical College and Psychology Department in Andhra University for conducting Capacity Building on periodical basis. 

DAPCU is also conducting Training programmes at District level for refresher to the FI-ICTC on modules developed by APSACS and providing hand on training during visits to FI-ICTC and deputing stand alone ICTC staff for capacity building at FI-ICTC level when existing FI-ICTC staff are transferred or changed. 

Strengthening linkage b/n FICTC & designated ICTCs:                                      

DAPCU used to involve FI-ICTCs in monthly review meeting along with stand alone ICTCs monthly only and develop linkages between stand alone center and FI-ICTCs.   After allotment of cluster to the Stand alone ICTCs, the responsibility has been given to taking care of linkages, strengthening, reporting and monitoring.  

All facilities (TIs, DICs, LWs, DSRCs and others) have been sensitized about FI-ICTC functions and its services and shared the information for communicating FI-ICTC and all facilities are using maximum services of the FI-ICTCs in the district for referral services. 

Monitoring & Evaluation of F-ICTCs:

The monitoring has been decentralized with stand alone ICTCs and FI-ICTCs can access the services of nearest stand alone ICTC for clarified doubts, getting kits, submitting report and any other coordination works.  

DAPCU monitors the FI-ICTC through visits made by ADM & HO (A&L), DPM and DIS and evaluates the programme in monthly review meeting and sending communications through DM & HO for improving performance of FI-ICTCs. 

DAPCU encourages the staff of FI-ICTCs by providing appreciation certificates and awards on various occasions like World AIDS Day, Independence Day and etc.

Achievements to share:

Total 24x7 PHCs in the district are 69 and all are equipped with F-ICTCs and all are functioning and reporting 100% and PPP model 16 FI-ICTC made MOU with our programme but 10 PPP model FI-ICTCs are functioning and reporting regularly.  We are putting our efforts to reach 100% reporting in PPP model.

There are some challenges in FI-ICTC functioning 

•Vacancies in PHCs 
•Supply whole Blood Testing Kits (for PPP model)
•Transfer of existing staff 
•No contingency for FI-ICTC
•Reporting by PPP model –FICTCs
•Quality in counseling
•Follow up 

APSACS recognized the efforts of DAPCU, Vizianagaram in starting, functioning and reporting of FI-ICTC in all 24X& PHC in the district and awarded us on the eve of World AIDS Day 1 December 2012 at Hyderabad.


 

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

What is the role of DAPCUs in establishing F-ICTCs? How do you help in

DAPCU role is very critical and very responsible role in the working of the FI-ICTCs. Continuous mobilization and continuous follow-up is required.  Mobilization in terms of the Cluster SPHOs, PHC Medical Officers they should own the programme.

Locating a suitable health facility to establish  F-ICTCs

General Out Patients morethan 30 clients per day 2. Existence of the Lab Technician (for HIV Tests) and Staff Nurse (Counseling and follow-up) 3. Priority should be given to the Designated Microscopic Centre if existed. 4. This facility is far away (more than 20 kms) from the CHC/Area Hospital. 

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

Training of the Staff; Lab Technician should be trained at nearby Area Hospital/District Hospital for TWO Days for HIV Testing and Universal Precautions, Waste management, registers Maintenance, Kit’s maintenance and testing Protocols/charts, registers like lab register, stock register, etc.

Staff Nurse Should be given induction at the nearby Area Hospital/District Hospital (for THREE Days)  by the existing Counselor  on the counseling skills, consent forms, pre-test counseling (individual & group counseling), lab forms,  post-test counseling, referrals to DMC, DSRC, if positive, ART etc., and counseling registers, universal precautions.

Strengthening of linkages between F-ICTC and Designated ICTCs 

If found positive after first test, they should be referred to the nearest designated ICTCs for confirmatory testing, continuous follow-up and counseling.

Monitoring and evaluation of F-ICTCs

Every 15 days, DIS/ADM&HO/DPM should visit the FI-ICTCs and identify the gaps and counsel the staff for gaps identified and overcome them in the presence of the Medical Officer.

Share a few achievements from your districts in this regard 

After continuous mobilization of the LT, we have started the FI-ICTC at PHC, Karepalli.2. After continuous mobilization of the LT, we have started the FI-ICTC at the PHC Kalluru (now doing the tests only for the TB clients) and FI-ICTC Kusumanchi.

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  

Social Benefit Schemes - Loans have been sanctioned to 200 PLHIVs in Guntur District, Andhra Pradesh

This write up on this achievement  was originally submitted in Telegu by the Guntur DAPCU. An english abstract in english is provided below. To read the full telegu version - click here

Rs. 10,000/- has been sanctioned as a loans to 200 People Living with HIV/AIDS by SC Corporation on 8^th April2013 , Guntur

         SHIP is an organization, run by People Living with HIV/AIDS(Positive Network).They approached Dr. Umadevi, DACO and Addl. DM &HO(AIDS & Leprosy), Guntur for getting benefit for self employment of HIV infected women in the district.  The Addl. DM & HO (A&L) discussed this proposal with Sri. S. Suresh Kumar, IAS, District Collector and requested support to the unemployed womenPLHA.   The District collector responded immediately and instructed to list 200 SC PLHAs who require loans and instructed the administration to process the request on it its receipt.

        SHIP listed the beneficiaries submitted the list to SC Corporation for loans. DAPCU and SHIP organized a meeting and  gathered all beneficiaries on 8^thApril 2013 at the Meeting Hall of the SC Corporation and invited the District Collector as a Chief Guest and Dr. P. Rani, ED, SC Corporation as a Guest.  Dr. Umadevi, DACO and Addl. DM &HO(AIDS & Leprosy), Mrs. Ramadevi, President, SHIP and Mr. Ramesh Babu, President, TNP Plus expressed their gratitude for support of the Distinct Collector and ED, SC Corporations.  The District Collector addressed the gathering in the meeting and shared that the government is doing lot of work and help for People living with HIV/AIDS and with these loans women can live on their own and feed their children and send their children to school.  The cheques Rs. 10000/- were distributed to the beneficiaries by District Collector.