Response from DAPCU East Delhi on WAD 2013 theme.

On 2 December 2013, an awareness program was conducted by DAPCU – East for the staff & Worker of FEMC-Pratibha JV workers / staff who are engaged in construction of Delhi Metro Rail Corporation Project at Delhi Metro Rail Corporation, Kalka Ji & Pushp Vihar. Around 250 Participant was present in the program.

DAPCU – East conduct a Sensitization / training workshop with the coordination of DSACS for the staff of Family Planning Association of India. The programme was conducted on 28 November 2013 from 11.30 to 4.40 p.m. Around 40 participants were present in the program. The Session was taken by:

1.    Basic of HIV/AIDS:  Mr. Sreedharan Nair, Branch Manager

2.    ICTC programme:   Mr. R K Tyagi

3.    Safe practice in prevention of HIV for medical practitioner and Post Exposure     Prophylaxis (PEP) – Dr. Suchitra Wadhwa

4.    PPTCT & EID programme – Dr. Rakhee Babbar

On 1 December 2013 (11:00 am to 3:00 pm), DAPCU – East was organized a Campaigning Programme (Rally) with the coordination of ACT (Migrant). Rally covered the area of Ambedkar Camp,B-Block Jhilmil Industrial Area, Friends Colony Industrial Area Rajiv Camp,Sonia Camp, A-Block Jhilmil Industrial Area And Dilshad Garden Metro Station.  DAPCU Staff & ICTC Counsellors were also participated in this program.

 

DAPCU - East Delhi response on the Theme: Care and Support Services for PLHIVs in the Absence of CCC

1. Has DAPCU faced any problems after closing CCC in the District? 

• CCCs were established by NACO for providing care, support & treatment to PLHIV.
• DAPCU East doesn’t have CCC & ART centre since beginning. So DAPCU-East didn’t face any problems after closing the CCC.

2. What measures have been taken by DAPCU to replace the services given by CCC?

• As we already mentioned that we didn’t have CCC & ART since beginning therefore we need not to take any measures for replacing the services given by ccc. 

3.How did DAPCUs integrate the In Patient & Out Patient services in the existing Govt. Health    facilities?

• Positive clients were referred to Link ART Centre.  In Link ART centre the counsellor provided proper counselling to PLHIV clients and after that they will get treatment from Link ART centre. In case PLHIVs face any problem in getting in Patient & out Patient services in the existing Govt. Health facilities, DAPCU - East coordinates with Govt. Health facilities with the help of CDMO office & District Administration.

4. What are the good practices or approaches adopted to provide medical care to PLHIV within the district?

• Time to time Sensitization programs on HIV-AIDS and PLHIV’s Stigma & Discrimination related issues are organized by DAPCU - East in  Government Health Facilities of the east District.
• DAPCU –East organized Workshop, Mega Camp, Health Camp & IEC activities in regular time frame.
• Linked PLHIV’s to available facilities to provide care & support services, as per their requirement.
• Linked PLHIV’s to Social Beneficiaries Schemes with the help of Local District Administration.
• In case of any problem to provide medical care to PLHIV within the district the matter was discussed in the DAPCC meeting.

DAPCU EAST Delhi Response : DAPCU- Stigma & Discrimination

Roles and responsibilities of DAPCUs with respect to Stigma and Discrimination relating to HIV.

The District AIDS Prevention & Control Unit plays a important role to reduce stigma and discrimination related to HIV in the district. DAPCU is conducting various activities to reducing stigma & Discrimination with the Coordination of District Administration & other Government Department.

v  Provide better services to HIV-AIDS positive clients.

v  Monitoring and supervision of HIV/AIDS facilities in the district.

v  Sensitization Program for M.Os, Hospital staffs, ANM & ASHAs, also trying to do sensitization program for  Private Practioners & Nursing Homes.

v  Awareness program in Schools, I.T.Is & Coaching Institutes.

v  Sensitization of Police personals.

v  Condom Promotion activities & Nukkad Natak.

v  Sensitize youth & students through Awareness campaigning.

v  Planning to sensitize Industrial Area.

Measures initiated to facilitate reduction of stigma and Discrimination in

      Access to services: Involvement of   counselor, ASHA and anganwadi worker is necessary to provide better service with out any discrimination and stigma at any stage.

                   Health Care Setting: DAPCU has organized full site sensitization workshop in the Health Facilities of ‘B’ & ‘C’ Category.

        District Administration and it Departments: DAPCU has organized a quarterly Meeting of DAPCC & DCC of TB-HIV and in the meeting, Issues related to stigma and discrimination is discussed with District Administration and is resolved with the support from them.

      PLHIVs are facilitated to obtaining the benefits of Welfare Schemes with the help of District Administration.

           Community Settings:

·         Creating awareness of community towards PLHIVs IEC (Information, Education & communication) through participation and activities in Health Camps, Mega Camps.

·         Awareness through Community Event organized by Tis with the coordination of DAPCUs.

Complaints from PLHIVs regarding Stigma and discrimination

One lady went to hospital in labour pain and some part of child has been come out at the out side the hospital gate , her husband carry her in hands due to non availability of stretcher. When he entered the labour room then sister on duty address him in a bed manner. Client husband phoned to DPM about the incident and due to out of station, DPM instruct to the concerned counselor to solve the issue. In mid night counselor try to solve the problem and next day DPM also meet to HOD & Sister on duty in charge. She apologizes about her behavior. 

Achievements of our district in fighting stigma and discrimination:

·   Attend Advocacy Meeting.

· Organized awareness meeting with various stakeholders& departments and sensitized   about HIV-AIDS and Stigma & Discrimination present in Society about the epidemic and PLHIVs.

·    Mainstreaming of line departments

·    Attend community meeting of TI’s.

East Delhi DAPCU Response to the Theme- Comprehensive HIV/AIDS Services to the HIV Positive Migrants

Comprehensive HIV/AIDS Service are provided to the HIV Positive Migrants:

East District Delhi is situated in border of Uttar Pardesh (Ghaziabad & Noida).  Patparganj & Jhil Mil industrial areas are also situated in East District, Delhi. The migration pattern is basically due to migration of Industrial workers. 

Services to Migrants Client: 

If any migrated client found positive ART counselor provide him all the services i.e. counseling, Pre-ART registration, CD4 testing etc.

Other District:

If client from other district found positive, that client is linked to ART center for pre ART registration CD4 count and if found eligible then on ART, if client is willing to continue the treatment from his own district then he can be transferred and informed to concerned ART.

Other State:

If positive client from other state found positive, the client is linked to ART center for Pre ART registration CD4 count and if found eligible then on ART, if client is willing to continue the treatment from his own state then he can be transferred and informed to concerned ART. Counselors note the permanent address of the client and provide the same to Concerned SACS.

Prevention and Early Detection:

DAPCU– East arrange IEC activity like Full Site Sensitization Programme, Mega Health Camps, Poster, Nukkad Natak etc. with co-ordination of DSACS, Youth Awareness by Nukkad Natak, Session regarding HIV-AIDS in Delhi Police, lectures on HIV-AIDS in schools, I.T.Is, awareness campaigning at Metro Station, Railway Station & I.S.B.T, Condom promotion activities in Industrial Areas & also 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:

We try our level best to ensure linkages. In ART center the patient is counseled for drug adherence, side effects of the ART medicine are explained to the client, family counseling is given to the positive client so that he / she should not face any discrimination.

Follow-up of LFU/MIS:

Collecting line list of Clients from ART center and trace out the same through Outreach workers and TI NGOs and after that share with respective ART centre.

 

 

East Delhi's Response to Theme- DAPCUs and F-ICTCs

Role of DAPCU in Locating a suitable health facility to establish FICTC:

DAPCU may play important role in establishment of FICTC at health facility on the basis of following observation:

• OPD Load of health facility and available services.
• Total ANC Registrations & Deliveries.
• Total STI cases, TB cases, HRGs & Migrants clients/ patients.
• High prevalence Area.

Capacity Building of FICTC (Training of staff, providing register/formats, providing guidance, supervision etc.)

DAPCU can provide essential FICTC’s details to the SACS. Accordingly they will arrange training for proposed FICTC staff, after that DAPCU will intimate the same to the staff of proposed FICTC and assist in arrangement of training to the concern staff of FICTC (ANMs & Lab Techs). In training, necessary Format, IEC Materials & Register etc can be provided by SACS.

Training and guidance for correct reporting with all relevant indicators and perform supervisory visits to monitor progress of FICTCs.

Strengthening of linkages between FICTC & Designated ICTCs:

• Strengthening the FICTC by monitoring ICTC activities through designated ICTCs. Issue of HIV test kits through designated ICTCs, Monthly supervisory visit by designated ICTC Staff during ANC days & Saturday outreach visit.
• Conducting Quarterly review meeting of Mo/IC (FICTC)
• Involving FICTC staff in DAPCU Review Meeting.
• To ensure consistent supply of spot test to FICTC printed register, Forms & Consumable (if required) through DAPCU Office.

Monitoring & Evaluation of FICTC:

• Monitoring through supervisory visit, activity & reporting of the same indicator – wise.
• Quarterly Review Meeting of Mo/IC (FICTC) to evaluate progress & identify gaps.
• Evaluation through screening of all registered ANCs. Confirmation of positive at designated ICTCs & 100% linkage to ART, Screening of STI cases, 100% screening of TB & TB suspects, linking of eligible PLHIVs / Family members to social entitlements.
• Check Stigma & discrimination in clients.
• IEC Promotion and condom supply.
• Monitoring & Evaluation by DACO, DPM and M&E Asst.

Achievements


Total 18 Dispensaries in the district. Total 14 FICTC are functioning after training provided by SACS.

DACO is taking a session on HIV/AIDS in RCH Training in East District, Delhi (First Step to open F-ICTC in District by DAPCU – East)

East Delhi's Response to Theme- Supportive Supervision

How do you plan and implement your visits for supportive supervision?

1. The plan for supportive supervision visits are done based on the reports of the
previous months and tentative visit plan is prepared in last week of the month.        
2. We analysis the gaps from ICTCs to ART, STIs, TIs & RNTCP.
3. Supervision the counseling session
4. Meeting with Nodal Officer of Centers to discuss the issue, if any.
5. Prepare the visit report in check list while doing the supervisory visit and share this report to SACS & DACO.

What should DAPCU’s keep in mind while undertaking supervision?

During a supervisory visit, the supervisor should conduct the following main steps:


1. Try to solve the issue related to the center
2. Supervisor always keep in mind that this is a supportive supervisory visit
3. Positive attitude 
4. Provide corrective and supportive feedback on performance
5. Explores common problems with supervision of facility
6. Discussion will be done to all the concerned of the issues
7. If problems are major than discussed with higher authorities



Do’s

1. Supportive supervision
2. Observation of performance
3. Collect Information
4. Listening the staff problem
5. Discussion on issues and problems
6. Friendly Relationship with staff
7. Improve their skills

Don’ts

1. Don’t confuse
2. Don’t aggressive supervision
3. Don’t manipulate the data & information
4. Don’t misguide
5. Don’t compare with others
6. Don’t give any false assurance for any issues

DAPCU East Delhi Response to Role of DAPCUs to Support TI

Coverage of HRGs Registration:

v    Meeting with TI & Peer Educator.

v    DAPCU attend DIC Meeting in regular intervals.

v    Regular Hotspot visit.

v    Support TI to cover unreached area.

v    Awareness campaigning with TI for Migrants community.

v    DAPCU-East also involves Three TI (FSW, MSM & IDU) as member in 

      DAPCC to raise their voice in different issues in front of DC-East.

v    DAPCU involves TIs in the District Program, events & Meetings 

      (i.e. Monthly review meeting of Counselors & Awareness Campaigning)

Improve ICTC services to the HRGs:

v    Arrange a meeting of TI Representative & ICTC Counselor for better coordination.

v    On Monthly basis, random visit at ICTC to find the Gap, and also visit respective 

      TI to check the status.

v    Regular touch with TI for latest update.

v    Joint visit with Counselor at TI & Hotspot.

v    Attend DIC Meeting and sensitized TI Staff.

v    Awareness campaign at TI & Hot Spot.

Pre ART Registration and Testing for CD4 count of HRG s found HIV Positive:

v    DAPCU support TI to link at ART, when HRG found positive.

v    DAPCU follow up the positive case of TI and ensure that the TI referred to ART center.

v    DAPCU cross checking the data with ART center, which is provided by TI.

Improve the STI Services to the HRGs:

v    Condom Promotion & distribution.

v    Regular Checkup of HRGs for STI in STI centers of district.

v    Follow up STI Patient.

Condom, Needle & Syringes to HRGs:

v    DAPCU, regular monitor & check the Stock status.

v    TIs inform to DAPCU on weekly basis, for their stock position.

v    TI maintains Stock Register.

v    TI also prepares distribution register.

v    DAPCU emphasized the importance of these in DIC meeting.

DIC Meeting

DAPCU-East provides the information to TI-NGO related to available Social Beneficiaries scheme. DPM also take a session on Social Beneficiaries scheme. DAPCU also update the data of beneficiaries.