DAPCU and Stigma & discrimination-Dist. BHANDARA

Role and Responsibility of DAPCU

• To prevent transmission of HIV infection among workers and their families.
• To protect right of those who are infected and provide access to available care support and treatment.
• To protect workers from stigma and discrimination related to HIV/ AIDS by assuring them equity and dignity at the work place.
• To ensure safe migration and mobility with access to information services on HIV /AIDS.
• To provide education and training at all levels in workplace ,set up interventions for behavior change through peer educators/ by initiating programs at workplace like the training of Human resource department , welfare department and corporate social responsibility.
• To set up intervention for unorganized and informal sector workers and migrant workers based on risk assessment.
• To access to condom, treatment of STI /RTI infection, Motivating for HIV testing.
• To make available the scope for social security coverage to include HIV in employee and family assistance programs and health insurance. 

Measures initiated to facilitate reduction of stigma and Discrimination in

    ·         Access to Services-

At district level GIPA (Greater involvement of People living with HIV/AIDS) Committee has been established, under chairmanship of district collector in which officers of all the line departments are involved so that any issue of stigma and discrimination can be managed effectively. The information about the GIPA committee aims and objectives are disseminated through News paper Inter -currently so that the PLHIV can have easy access to avail the remedial intervention.

    ·         Health Care Settings-

We have ten stand alone ICTCs and Thirty three Facility based ICTCs along with four PPP ICTCs where one counselor and one lab technician are provided who work for counseling to the attaining clients in order to reduce the stigma and discrimination issues. The IEC material is also made available to the ICTCs.

    ·         District administration and its departments-

As the GIPA committee has been established at district level under chairmanship of district collector in which officers of all the line departments are involved so that any issue of stigma and discrimination can be managed effectively. The information about the GIPA committee aims and objectives are disseminated through News paper Inter -currently so that the PLHIV can have easy access to avail the remedial intervention.

    ·         Community setting-

In the community setting the DLN (District Level Network of Positive People) has been established as a sarthi Kalyankari Sanstha Bhandara , the representative are working for the welfare of PLHIV in relation to linking them to Social benefit scheme so that they can improve their social and economic status and can get rid of stigma and discrimination. Whenever there is any issue of stigma and discrimination among any PLHIV in the district they approach to the network and representative of the network take that issue to the GIPA committee through DAPCU.

·         Issue of Stigma and Discrimination addressed in the District-  

    One old lady was working on  daily wedges and when the sarpanch of the village came to know the positive status of that lady ,he forced that lady to stay outside the village ,as the lady was connected to DLN network , the DLN representative and TB representative approached DAPCU office ,DAPCU staff had meeting and went to the village and had conducted sensitization session with the serpanch and other community members .As a result of this the sarpanch and community members convinced to allow the lady to stay in the village and take the responsibility to take care of her .

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

In Bhandara district generally the positive migrant patients are from Gondia, Nagpur districts and very rarely the other state positive patients are from Madhya Pradesh. within district positive patients are provided comprehensive services by linking them with nodal ART center for PreART  registration ,CD4 count, counseling for drug adherence , psychosocial support etc. if the patient found stable on ART for six months then he can be shifted to the link ART center nearer to his residence.

Other District; whenever there is patient from other district found positive, that patient is linked to nodal ART center for pre ART registration CD4 count and if found eligible then taken ON ART, if patient is willing to continue the treatment from his own district then he can be transferred out to that particular district and the same is communicated to the concerned district.

Other State; whenever there is positive migrant from other state the patient is linked to nodal ART center for PreART registration CD4 count and if found eligible then taken ON ART, if patient is willing to continue the treatment from his own state then he can be transferred out to that particular district of the state and the same is communicated to the concerned district. 

Example- In the month of July 13 we had three positive patients from Hyderabad district state of Andhra Pradesh who were transferred out there after all necessary requirements and their linkage is confirmed. In this way the comprehensive HIV AIDS services are provided to the positive patients belonging to other districts and states.

Prevention and Early Detection

For prevention and early detection we arrange IEC activity like awareness camps, wall painting,  street play etc, in coordination with the NGOs working with DAPCU, provide counseling to college going students on every Saturday, maintain the line list of discordant couple and ensure their testing every 3 months

Linking to ART center, Treatment adherence, follow -up of LFU/MIS and PPTCT Services

Linking the positive patient to ART center is key indicator of the program and we ensure 100% linkage by taking special efforts with the help of counselor by taking the patient personally to ART centre for pre ART registration. At ART center the patient is counseled for drug adherence, side effects of the ART medicine are explained to the patient, family counseling is given to the patient so that he should not face any discrimination within his family. The patient is also linked to District level network of positive people so that he can get psychosocial support from them and should be free from any stigma. Follow-up of LFU/MIS is ensured by collecting line list of such patients from ART center and then the same is handover to Link workers, DLN network people and PPTCT NGO outreach workers so that they can trace out the patient detail and can inform the ART centre in return. 

Bhandara Response to coordination among DAPCUs

Issues on which DAPCUs support to each other;
1) Reallocation of consumable
2) EID follow up
3) Transferring out of Pre ART Patients
4) Tracking of LFU/MISS patients
5) Provision of training to Health staff

Whenever there is scarcity of any consumable at DAPCU level, the same is informed to MSACS .In return we receive the consumable stock position of other DAPCUs so that we can contact them and ensure transportation of that particular commodity to our DAPCU.   

In a few instances the positive delivery conducted at our hospital but as the particular woman originally resides at other district, the EID follow-up has to be done at that particular district. So this specific information is shared between two the DAPCU and the required follow up is done.

Suppose a positive patient gets Pre ART regd. At our ART centre but due to his willingness to continue the treatment at ART centre of other DAPCU, he is transferred out and the same thing is communicated to that DAPCU so that that Particular patient receives the treatment as per his willingness and convenience.

Similarly when an on ART patient comes under the category of LFU/Miss, the status of that patient is communicated to the DAPCU, to which he belongs, so that he can be tracked and brought back to on ART status.

On many occasion the HIV/STI training is arranged at some specific nodal centers, at that time the DAPCU which comes under that nodal center plays the role of coordinating centre with other DAPCUs so that their participation can be ensured.

Role of SACS in coordination
SACS play the vital role to continue this coordination among DAPCUS by issuing required instructions to all DAPCUs time to time.

Examples of support taken from other DAPCU and Result achieved by coordination
During last month we had shortage of vacuum tubes at our DAPCU .so we communicated the same to SACS, they have given us the status of excess vacuum tubes in DAPCU Pune . We communicated to Pune DPO and ensured and planed the transportation of the same, as a result of this we are likely to get it very shortly.

Similarly the ANM training was scheduled at Sewagram Wardha; the DPO has communicated the details of the training to all nearby DAPCUs so that we could send the ANM for training on time.
In this way the inter coordination among DAPCU is the BEDROCK of the program so far as the effective implementation of various program components are concerned.

Bhandara DAPCU's Response to May 2012 Theme - DAPCC Achievements 0 comments

Advantages of DAPCC Meeting

• DAPCC gives opportunities for better co-ordination with various departments. After DAPCC meetings the process of social benefits schemes has become easier to certain extent.
• Through  DAPCC meetings, the DLN and PLHIV have been motivated  to apply for schemes (taluka wise)  &  follow up  with  concerned  officers to  sort out  the problems in sanctioning  the social  benefits schemes.
• In DAPCC meeting a emphasis  was given  over the follow up of the PLHIV  who are on ART.
• Other Departments agreed  to help in detection of HIV  from various sectors like Labour organisations, Migrants etc.

 Achievements

• 100% coverage of ANC for  HIV testing become much  easier  [Target - 4776, Achievement- 5457 (114%)]
• HIV Testing in General clients has been increased - [Target -5844, Achievement -8145 (139%)]