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”

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.

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.

Khammam DAPCU's Response - June 2012 Theme - Social Benefit Schemes for PLHIV and HRG

It is an innovative effort to write letters and e-mails to all the District Collectors on Social Benefit Schemes (vide ref. no. X-19014/341/2010/NACO (NTSU), Dated: 18-4-2012, from TL, NTSU at NACO. All the District Collectors have responded on the importance of the social benefit schemes especially for High Risk Groups and PLHIV. They wrote to DAPCUs for put up action plan with the focus on PLHIV and HRG.

Some Strategies
Grievance days are conducted every Monday in the District Collectorate or Selected Mandal.  All the beneficiaries were submitting their complaints/applications for social benefit schemes like White Ration Cards, Indiramma Houses, Widow Pension, Handicapped Pensions, etc. Our HRGs/HIGH RISK Group also submitting their applications and the District Collector is giving the priority for these groups and directly linking the concerned Govt. Officers in the Grievance day itself.  Recommendations through SC/ST/BC/Minority Corporations for getting govt. subsidy etc are also being provided.

Facility Contribution: In the District we are getting some contribution through the Positive Network (DLN) and Drop-In-Centre to identify the beneficiaries and linking them to the Mandal Revenue Officers and SC-Corporation for Ration cards and Bank loans.

Challenges:  

a)getting the social benefit scheme is not one time activity, it requires rigorous follow-up (at least 4-5 times from theDAPCU) HRG/PLHIV to meet the concerned officers for getting them. 

b)It is verymuch difficult to getting the loans from the banks as they have to convince the bank officers even after completion of all formalities from the Mandal Development Officer also. 

c) Indiramma houses: repeatedly submitting the applications but there is no progress in this. d) It is a challenge to route these activities through Link ART Centres, ART Centres and ICTC Centres.  Even though in all the monthly review meetings, we are addressing about linking the HRG and PLHIV for
the social benefit schemes.

An Example - One success story!

Through the District Collector’s Grievance day and continuous follow-up of the DAPCU Team,  A Positive Individual from Kothagudem revenue division , Khammam District got the House site from the MRO (through Housing  Board, Kothagudem). His two children (elder boy was +ve and is below 6 years) are also receiving double nutrition.

So many of them are under follow-up!

• 24 MSMs - applied for ration cards (after getting ration cards only they will be linked to other social benefit schemes)
• 15 HRGs applied for the various schemes like Kirana Shop, paper pressing plates  unit, dairy form (5 buffaloes), Clothes shops, Bangle Shops etc.