DAPCU Dimapur Response-Supportive Supevision

What according to you is Supervision?

Supervision is an intervention to direct, guide, and monitors the counselor. Identify the problem, providesupport, feedback regarding the performance of the work done, so as to ensure and provide quality care and services and improve capacity and performance.

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

• Identify center wise issues and discrepancies.
• During preparation of monthly work plan discussed with DAPCU staffs, DACO and DIS, and prepare a plan for the visits base on priority.
• Prepare the check list to cross check with the last 3months report to ensure uniformity.
• Discussed with the Medical Officer i/c regarding the observation and findings.
• Provide feedback and suggestion to the counselor for improvement and assistin finding a solution for the problem.

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

• A plan set of process and use tools such as Checklist.
•  Focused more on inspection and fault finding rather than problem solving to improve the performance.
• Give constructive suggestion to improve work and end with praise and encouragement keeping in mind the issue and challenges faced in different centers which might not same in all.
• If there is any weaknesses identify the causes e.g. lack of training, less understanding of the task etc.
• Capturing major observation.
• Status of stocks and records keeping.
• Linkages and referrals.
• Strengthen the ability of the counselor to work more effectively
• Supportive supervision should result in measurable outcome.

DO’s and DON’T

• Praise what is done well and encourage but don’t discourage.
• Give feedback and suggest for improvement in a respectful way rather than abusive.
• Be affectionate and sociable rather than unfriendly.

DAPCU Kohima Response to DCC for HIV-TB

We apologize the delay in posting this response from Kohima

1. The DAPCU Kohima alongwith all the ICTC Counsellors, Counsellor Blood bank and STI, and the RNTCP staff conduct Monthly meetings where we get to know each other's programs, targets and achievements, issues, grievances, and how to address these problems. These meetings have been found to be extremely fruitful to all as we get to learn and share on a common platform. The counsellors are not scared to speak out and hence we get to know and address their problems.
2.  The DAPCU office Kohima is attached to the District Tuberculosis Centre (DTC) so whenever there is shortage of staffs at DTC, the DAPCU staffs accompany the clients for testing to the nearest ICTC centre.
3. We go for field visits to centres together with the RNTCP staff.
4. We attend Health Melas together with the RNCTP staff.
5. We share IEC materials when there is need.

DAPCU Phek Response to DCC for HIV-TB

Aadvantages of DCC in HIV-TB collaboration activity 

• Data sharing takes place which helps in cleaning data between the two offices.
• District specific issues can be solved during the meetings.

Strengthening of TB – HIV Collaborative activities 

• Taking the example of Phek district, initially referrals from RNTCP to ICTC was very low, but the data of this financial year shows that 90% of TB patients have been referred to ICTC for HIV testing. However, very sadly referrals from ICTC to RNTCP was very low; justification being that symptoms of TB could not be observed in clients entering ICTC first. It has also been learned that most of the clients are referred to RNTCP by OPD doctors.
• During one such meeting, we felt the need to be oriented on TB symptoms and therefore the DTO presented on such a topic to all the ICTC counsellors. To scale up referrals from ICTC-RNTCP, it has been decided that at least 10% of the total clients will be referred to RNTCP.
• One of our ICTC centres is not attached to any DMCs and therefore referrals to RNTCP were not taking place in that particular centre. In this situation, we linked the clients to the nearby DMC giving responsibility to the ICTC counsellor attached to it and therefore tracking of referred clients became easy. 

Intensified TB case findings in Phek District

During one such HIV-TB co-ordination meeting, we were introduced to a NGO identified by RNTCP wherein the particular NGO collects sputum during their outreach and when found TB positive, they are referred to ICTC for HIV testing. Targeted Intervention (HIV) NGOs also collect sputum from their clients and sent the samples to RNTCP. 

Challenges in treatment, care and support for TB–HIV co- infection cases

Linking positive clients to nodal ART centre is one of the greatest challenges faced in our district, because of two main reasons; distance between ICTC centre Phek and nodal ART centre is 145 kms away wherein estimation of expenses incurred for one visit to nodal ART centre by a client comes to Rs.4000 and almost all our clients coming from poor economic background cannot afford the cost.

During one of our HIV-TB meetings, we came to a consensus that in case of such HIV-TB co-infection cases; we will directly link up to ART as we came to learn that they are eligible for ART even before getting their CD4 count being tested.

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

A few achievements of Kohima DAPCu and and Kohima Network of positive people 

1. Nutritional support to 180 women in 2011 through the Department of Women and Child Development.
2. Educational support to 43 student below 14 years in 2011 through Population Foundation of India. 
3. Supporting  monthly fee to 49 children  below 14 years through the François Xavier Bagnoud (FXB).

The Kohima postive People Network is very active and they were supported by The Nagaland Network of Positive People helped the KNP+ in facilitating these schemes. 

Moreover, SACS/DAPCU/NNP+ are in the process of identifying PLHIVs to avail free transport in State Transport Buses while going to the nearest ART Centre. This will be done with the help of the Transport Department.

DAPCU and KNP+ together still need to cover a lot of grounds for availing schemes for PLHIV. We are working together in approaching the various departments for schemes. There is a need to sensitize the officials in various Departments on HIV and PLHIV in the district and make them understand the plight of the affected and infected.  

Peren DAPCU's Response to May 2012 Theme - DAPCC Achievements

Benefits of DAPCC meeting

1. DAPCC meetings give platform to DAPCU and the DLNs to sensitize HODs of various departments about HIV/AIDS issues and scenario in the district.
2. Face-to- face sittings with other departments and stakeholders in turn helped DAPCU to voice its concerns and urge them to act. Some departments as well as organizations have started to include HIV/AIDS programs in their own departments with the help of DAPCU.
3. DAPCC meetings have helped DAPCU and the DLNs in familiarizing and building rapport with key persons in other departments/ organizations.
4. Other departments and organizations have assured in helping to reduce the epidemic and helping the PLHIV in their own capacities.

Some Achievements supported by DAPCC

DAPCU’s initiation to converge with stakeholders and other departments has been fruitful. Slowly, departments and even organizations like the church and students/village youth organizations have started to approach DAPCU to be resource persons or to conduct programs for them. A few examples

1. Sensitization program with police force and their wives at New Reserve, Peren: A sensitization program with police personnels and their wives at New Reserve, Peren was conducted on 6^th March 2012. The program initiated by DAPCU together with the Superintendent of Police, Peren. The program was attended by the SP, Addl. SP, other police officers along with the police staffs posted at New Reserve, Peren. Altogether, there were 82 participants who attended the program.
2. HIV/AIDS awareness conducted at Men’s Department, Jalukie Town Baptist Church, 28^th March 2012: Mr. Ngauzeulungbe M&E (Asst.) DAPCU, Peren gave a power point presentation in which he shared what HIV/AIDS is and how it is spread. He shared about the brief history of how HIV/AIDS was first detected.  He also shared about the various route of HIV/AIDS transmission, and highlighted about how Blood Transfusion, sharing of Needle & Syringes and Mother to Child can cause HIV/AIDS. He shared on Stigma & Discrimination, how it is one of the main reasons for the spread of HIV and AIDS and how we need to care for the positive people and help them live a normal and responsible life. He urged the participants to educate their near and dear ones about HIV/AIDS and also help to eradicate stigma and discrimination in the society.
3. FGD conducted by NRHM (Convergence activities with NRHM): Four FGDs were conducted at Peren Town by NRHM from 22^nd- 23^rd March 2012. M&E (asst) of DAPCU peren was the resource person. The FGD was focused on STI/RTI and the participants were mainly women folk comprising of lactating mother’s, pregnant women, newly married and stakeholders. The M&E(asst)not only stressed on STI/RTI, pre-natal care, child care but also talked on the basics HIV/AIDS and stigma and discrimination. The participants were responsive and many queries were clarified.

A few other programs were

1. Sensitization Program conducted at Poilwa Village, 11^th January 2012
2. HIV Awareness and Blood testing at Sub-jail, 24^th January 2012
3. Sensitization Program conducted at Tening Block with Legislatures Forum on HIV/AIDS (LFA) on 12^th May 2012  

  

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

This post is in response to the April theme

This is the experience of DAPCU Kohima, Nagaland on the question for the DAPCU blog -

When we approach the DC we present to him the District HIV scenario. We present the spatial map prepared by DAPCU Kohima. The Spatial map provides a crisp and overall view of HIV scenario and facilities in the District. We also submit monthly the District Dashboard indicator to the DC.

We think that the major areas on which the DCs should be informed and oriented firstly is about DAPCU, the staff, DAPCU's roles and responsibilities followed by, the various facilities in the District and thirdly and the HIV scenario

We are pleased to share the presentation we made to our DC in March 2012

Kohima spatial mapping

View more presentations from DAPCUSPEAK.

Kohima DAPCU's experience with District Annual Action Planning - 2012-13

Kohima DAPCU submitted this post on their experiences with DAAP. 

Doing District Annual Action Planning (DAAP) at Kohima was a new experience for all of us. Teams from different components of the HIV programme attended the DAAP processes and this has helped in fine tuning the plan to the specific requirements of the district. We feel that DAAP promotes interaction and collaborative effort between all the program components and various line departments.

DAPCU DPO- Ms Sentimongla Tzudir, NRHM DPM- Neisevonuo Linyii and Deputy CMO Dr Avino discussing              NACP- NRHM convergence during DAAP

One important outcome of DAAP in Kohima will be closer coordination with NRHM through their field workers, mobile medical units and village level health activities like VHNDs. Another important area for planning this year was taking forward the interest shown by the police health unit in operating FICTCs. In Kohima itself we have proposed two such FICTCs.

The medical officers of ART and Blood Bank  feel that by involving district level service units in DAAP, proper need based plans can be developed for the state. They were able to estimate their requirements of drugs and stocks and feel that when similar estimates are collected from all around the state it will be possible to ensure correct supply without shortage and wastage at facilities. 

Neisevonuo Linyii, DPM,NRHM,Kohima- “It is a good exercise. In NRHM also we have prepared action plan but we have not involved other departments. In this way this DAAP exercise is entirely different as it is involving all the departments at District. We know how to work in coordination.”

Dr.Vezokholu, DTO, Kohima- “ We are new to this kind of exercise. However it made us to understand how to work in coordination to improve cross referrals.”

Sentimongla Tzudir, DPO, DAPCU- “ Though the time given to us is short, we tried level best to complete plan. It is good to involve all the departments.  For next year we will be better prepared with the required block level data for better planning.”