DAPCU Mehsana (Gujrat) Response to the Theme : Views on DAPCU's role in Non-DAPCU Districts

How can the DAPCUs extend their support to non-DAPCU districts to manage/ coordinate the NACP activities?

In Gujarat there are 10 high Prevalence (i.e. ‘A’ & ‘B’ category) Districts out of 33 Districts. In all the high prevalence districts DAPCUs were established in 2008-09.

• Supervision & monitoring is the essential part for achieving the goals & objectives of NACP-IV.
• The DAPCUs are playing a critical role to achieve the objectives of NACP-IV in the DAPCU districts. However, there is also a need to ensure similar coordination in Non DAPCU districts.
• Currently Gujarat state has evolved unique models to concentrate in Non DAPCU districts by the existing DAPCU team.
• GSACS has allotted one or two non DAPCU districts to each DAPCU. Respective DAPCU team is managing and coordinating HIV activities in Non DAPCU districts. Generally, the DAPCUs allotted neighboring Non DAPCU districts for easy access and efficient coordination.
• GSACS has allotted Sabarkantha as one of Non DAPCU district for extending technical and coordination support.
• DAPCU team has evolved a plan of action for providing specific time and support to the Sabarkantha district. In Sabarkantha district (Non DAPCU) managed and coordinated NACP activities, with the support of existing DAPCU staff.
• Support has also been provided to NACP facilities in the non- DAPCU districts, Poor performing centers in Non-DAPCU district are visited on periodic basis.

Based on our experience DAPCU district can Support the non-DAPCU districts to manage/ coordinate HIV activities on the following aspects:

1. Participation and Conducting Monthly Review Meeting in non-DAPCU districts every month with the NACP facilities (including HIV-TB coordination meeting). 

• DS DAPCU Mehsana is participating and conducting Monthly review meeting for reviewing the performance by referral and linkages between ICTC /PPTCT/DSRC, TI, CSC & ART centers of Non-DAPCU district.
• DS DAPCU Mehsana Coordinates with the concerned Nodal officer (DTO) of NACP activities and all NACP facilities staff in the District.
• The DS also extend support in planning review meetings, evolving agenda by topics for discussion, Etc.

The Minutes of the meeting are being prepared by District level ICTC Counsellor and finalized by DS. The minutes of meetings are shared with the participants / facilities and initiating for follow up action. Basically, the DAPCU extend their support in introducing systems similar to DAPCU districts for achieving the desired objectives as per NACP IV.

2. Support is given through monitoring and Supportive Supervisory Field Visits.

DAPCU district DS will supervise the work of ICTC & Coordination visit to ARTC, DSRC, Blood Bank, CSC & TI NGO. During the monitoring and supervision visit to ICTC, the DS DAPCU will cross check the SIMS Report, registers/referral & linkage/ data validation etc & giving suggestions to the ICTC Counsellor & LT to improve the quality.

3. Ensuring strengthening the referral and linkage between the NACP facilitates ICTC – RNTCP and among HIV/AIDS facilities.

DAPCU Mehsana is emphasizing on strengthening the referral and linkages between the facilitates i.e. ICTC-RNTCP and between HIV/AIDS facilities by validating the data and maintaining line listing data.

• Minimize gap between referral and linkage loss through establishing coordination between the facilities. This can be done through field visits at regular intervals.
• DS DAPCU will visit the facilities for ensuring data validation, cross verification of data from source registers, ensuring correct and timely reporting. Also ensure 100% reporting through SIMS.

4. Supply Chain Management.

• DAPCU DS also manage the stock of ICTC Kits by coordinating with all ICTCs in Sabarkantha District.

5. Replication of good practices of DAPCU.

Experiences will include:

• Opportunity to replicate the best practices in Non DAPCU districts.
• Opportunity to learn newer initiatives to overcome the existing gaps in the DAPCU districts.
• The team felt it is an opportunity to guide and learn than consider it to be an additional responsibility.
• The team at Non DAPCU districts feel happy to receive additional support/hand holding.

6. Financial Management.

• DAPCU will need to co-ordinate with facilities in the Non-DAPCU districts for submission of SOE & UCs in time.

Inspirational post from DAPCU, Mehsana, Gujarat

An Experience DIS DAPCU, Mehsana in Consultation Workshop on finalizing Social Protection Guidelines at Jaipur on 5th February-2014

           On behalf of DAPCU Mehsana I had attended the Consultation Workshop on Social Protection Guideline at Lebua Resort, Jaipur on  5th February-2014. It was an honour to be a part of the team witnessing the first ever national meet. Experience in the Workshop added lots of values and boosted my enthusiasm and courage to work closely for the cause. Lot of things I came to know from the events where I had participated and shared. This will be reflected in the steps taken ahead for my district. Followings are some of my experiences and learning from the Workshop.

               The requirement of National AIDS Control Programme is not confined to care support and treatment but has extended to linkages of the PLHA for social protection scheme. Now the time has came to advocate for various schemes to give humanitarian touch for the people living with HIV AIDS. 

               Although DAPCU in Mehsana have already been involved in facilitating PLHA and HRG to avail schemes still there is long way forward. I came to know about the thematic components, efforts in policy and strategies adopted by different states and nations as well for linkages of PLHA to social protection schemes. 

                This is my first ever participation and exposure in National level Consultation Workshop on Social Protection Guideline which helped me to understand various schemes, policies and strategies to link PLHA in to social protection schemes. It also enriched my knowledge and boosted my confidence to work for the PLHA in my district.I had shared my views and challenges faced in my District during group discussions held during the Workshop for Prepare SP Guideline.During the one days of the Workshop, I met Cosultant Mainstreaming, DACO & DPM  of  Verious  State &  District  and  we discussed about  How to Provide  Benefit  of  social protections schemes to PLHAs and HRGs.I came to know about the  importance given to linkages of  PLHA in to social protection schemes in NACP phase-IV and that all  DAPCUs need to play a pivotal role i,e facilitator for linkages to the schemes.I realized that  DAPCU need to ensure effective mechanism for delivery of social protection schemes.

             

                    My utmost gratitude to Elizabeth Michael,Team Leader, Mainstreaming & Partnerships Dept. of AIDS Control, Delhi for giving me chance to attend the Workshop on Social Protection Guideline and sincere gratefulness to Dr.Govind Bansal DAPCU Coordinator, National Resource Team(DNRT) for  support and confidence imposed on me and nominating my candidature.I must be thankful to our Additional Project Director, GSACS for his Approval to me for Attend the Workshop.

                  The efforts of UNDP and Dept. of AIDS Control, Delhi are really appreciable. This was an important and very good initiative to bring different Sate & District on to one platform to discuss and plan Social Protection Guideline for the People Living with HIV and AIDS & HRGs.

             

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

Profile of the District: 

Mehsana district is located in North Gujarat, about 75 km from Ahmedabad.The district borders with Banaskantha district in the north, Patan and Surendranagar districts in the west, Gandhinagar and Ahmedabad districts in the south and Sabarkantha district in the east.The major crops of Mehsana are Potato, Cotton, Tobacco, Oilseeds, Castor Seeds, Cumin, Psyllium and Anise .Asia’s second largest dairy ‘Dudhsagar Milk Cooperative Dairy’ and largest market yard ‘Unjha’ is located in Mehsana.‘Sun Temple’ at Modhera is an important tourist destination of Mehsana district. High out-migration to Surat and Mumbai for Diamond work, courier services (Angadiya) and for Transport related work from across the District and abroad also.High in-migration from Rajasthan and other parts of Gujarat.

In Mehsana district generally the positive migrant clients are from Banaskantha, Sabarkantha, Patan & other nearest district and also from Rajasthan state & Maharastra state. Within the District migrant positive clients are linked to ART Center nearer to Patan & nearest district at Govt.District Hospital, Patan, Banaskantha & Sabarkantha for Pre-ART registration, CD4 count.  If CD4 count is less than 350 then efforts are made for registering the positive clients on ART at ART Center.

Whenever any client found positive from other district (Patan, Sabarkantha & Banaskantha), counselor provides option to Client for taking ART treatment according to Client choice. If client is willing to continue the treatment from his own district then Client is transfer out to that particular district ART Center for further treatment, if CD4 count is less than 350 we put him on ART. Counselors note down the permanent, current address & Mobile number of respective client for further follow up.

The MIS/LFU line-list share with the LWS, ICTCs, DSRCs, CSC, Jatan Project for tracking the LFU/MIS patient and revert back them to ART. DAPCU plays a major role for taking the follow-up of such activities.

DAPCU track the migrant ANC delivery as per EDD & also confirm the EID Follow up by tracking PPTCT calendar.

DAPCU & ART Center conduct the Monthly meeting with LWS, ICTCs, DSRCs, CSC, Jatan Project for LFU & Linkages.

Example:

In the month of July-13 one Couple HIV positive Diagnosed (1 is ANC & 1 is General Client) in ICTC Unjha from Banaskantha District, who is ART Registration at ARTC Patan.

            ANCs commonly 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 month.

Example:

In the month of March-13 we had one ANC HIV positive Diagnosed (first test) in FICTC Ambaliyasan from Sabarkantha District, than she go to her parents’ home at Sunsar Ta.Bhiloda Di.Sabarkantha. District Supervisor DAPCU Mehsana informed to ICTC Counselor Bhiloda for Confirmation. She reached to ICTC & Confirmatory test done at ICTC Bhiloda & She found HIV Positive & ICTC Counselor Bhiloda counsel her & she agree for delivery at ICTC Bhiloda. 

Mehsana Response to coordination among DAPCUs

Coordination between DAPCUs is very necessary in all the AIDS control activities.

Following are the examples how Mehsana district coordinates with the other districts:

1. As per need we have shared the data of LFU-MIS with the coordinating district Banaskantha, Surendranagar & Ahmedabad.
2. Innovative Intervention ideas sharing.
3. We have coordinated to DAPCU Banaskantha for ART Registration of ANC PLHA & General PLHA.    
4. We have coordinated to DAPCU Ahmedabad for HIV Exposed Child DBS/Rapid Test.    

The learning from coordinating with DAPCUs is beneficial and it reflects in the overall reporting and results. 

DAPCU Mehsana Response to Role of DAPCUs to Support TI

The role of DAPCUs to support TI-NGOs is very important because DAPCUs are working with TI-NGOs at ground level to support in the betterment of their performance with the goal of reduction in the rate of HIV Positivity in the HRGs.

1. Every month DAPCU reviews TIs with respect to targets achieved by them, gaps between targets and their achievements, reasons for gaps and hindrances faced by them during their efforts.
2. Coordination between TIs & ICTCs facilitated by providing HIV-Testing facility through ICTCs.
3. Whenever any HRG is detected as positive immediately s/he will be sent to ART centre in coordination with the TI people.
4. Regular visits of TI-NGOs by DAPCU Staff for Supervision.

Improving access to Educational Scholarships for infected and affected children of PLHIV

  Mehsana is a Category- A District in Gujarat with ANC prevalence of 1.50 % (as per HSS- 2008). Migration rates in Mehsana District from/to other States and Districts are very high. Educational scholarships provide Motivation to parents in continuing the education of their children.

The Department of Social Justice and Empowerment Govt. of Gujarat (GR-No.anth /102009/ n.ba.37/chh) provides educational scholarships to infected or affected children of PLHIV. According to this GR, infected or affected children of PLHIV can avail a scholarship of Rs. 2000/- to 3000/- per year. Meeting with District Child Protection Unit (DCPU) Mehsana Staff, DIC Staff & DIS to discuss about educational scholarships to infected or affected children of PLHIV was held in July-2012.

Efforts to provide advantages of the scheme to the entitled were made in coordination of DAPCU and DLN. DAPCU-Mehsana along with DLN, DIC and DCPU-Mehsana initiated efforts towards facilitating the scheme for infected and affected children. The processes are outlined in the flow cited at the end.

In the year 2012- 13, 85 children received scholarships amounting to a sum of        Rs. 2, 27,000. Fresh applications for scholarships are invited each year.

For further information, DAPCU Mehsana can be contacted through DTHO, Dr. D. C. Naik -8980041001 and DIS Bhavesh Rana-7567889079, E-mail dapcu_mehsana@yahoo.Com). DIC coordinator Rohitbhai can be contacted on 9662515342.

Process of facilitating scholarships in Mehsana District is as follows:

Step 1- Identification of HIV infected and affected children

-          Children are identified through positive network, ART centers and ICTCs.

Step 2- Application

-          Meeting with DCPU Mehsana Staff.

-      Taluka wise Meeting of PLHA & DIC to support parents/guardians in filling relevant forms. DCPU Mehsana Staff also attends the Meeting to provide support for filling the form.

-          -Documents required are:

o   Certificate from school principal

o   Mark sheet of the previous year

o   ICTC report of child or parent

o   Death certificate (in case of death of parents)

Step 3- Submission and Review

o   Forms submit to observation home through DCPU-Mehsana for review.

o   Approved Forms are forwarded by the observation home to the  District Authorities

Step 4- Award of Scholarship

o   The scholarship cheques are forwarded from observation homes to DCPU-Mehsana to Taluka Panchayat office & Taluka Panchayat for further forwarding to concern School/Collage.

o   DCPU-Mehsana reports all the activities to the DAPCU and positive network

Mehsana DAPCU's Response to- Familiarizing new District Collectors to the HIV programme in the district

This post is in response to the April theme

DAPCU is functional in the district since May-2008 and during this period we  have faced this situation. 2 DCs took charge of our district. Usually every quarter we have NRHM review meeting where all health programmes including HIV/AIDS programme will be reviewed by DC. Hence in this meeting when new DC joins we introduce about our programmes and its functioning in the district.  During the DAPCC meeting we make a presentation (Hard Copy) of district profile in which the following components will be included in brief and the same thing will be informed to him in detail

1. Services available in the district under DAPCU.
2. HIV testing & Positive Scenario in the district last 3-4 years(year wise) in general and ANC clients and present  prevalence in the district.
3. Graphical presentation of the programme indicators
4. He is also informed about the NRHM and NACP convergence strategies adapted in the district.
5. We have also discussed about NACP Achievement & gaps of the programme in the District.