Koraput's Response to Theme- DAPCUs and F-ICTCs

District AIDs Prevention and Control Units (DAPCU) have a major role in identifying and establishing the F-ICTCs in districts. In basing upon   some of the important   data, the F-ICTCs will be established. They are as follows:

1. Identifying the area basing upon HRG population/ANC load/TB cases/Positivity/In & out migrated population.
2. After identifying the area, co-ordinate with CDMO/ADMO (PH) in district level and apprise them for establishing the F-ICTC. And also to the SACS level for providing of further training of Staffs (One Staff-Nurse or head quarter ANM for In-charge Counselor and LT from pathology/Malaria/RNTCP).
3. Consult & Co-ordinate with the concerned M.O I/C to take the list of staffs for training and discuss the strategy of opening and running a new F-ICTC at their end.
4. Discuss with the M.O. I/c about the procurement the ICTC items for  Laboratory  use from RKS fund (NRHM) and Testing Kits/Registers/Formats /IEC materials  from SACS though DAPCU level.
5. After procurement of items and training of staffs F-ICTC will be fictionalized.

These above things are carried out by DAPCU. So DAPCU has a major role in establishing the F-ICTC.

After establishing the F-ICTCs in district, DAPCU has to monitor once or twice in case of need to the F-ICTCs and provide hand hold support to the both (Counseller/LT) for maintaining the registers and preparing CMIS reports for month wise. In each stage, they must be followed up by the DAPCU staff.

In Koraput district, 7 F-ICTCs had been proposed to establish. Out of them, 4 F-ICTCs are already functioning and reporting to DAPCU/SACS in the district. One F-ICTC is going to be functionalized from 10th July, 2013 onward (at Bandhugaon) and rest two F-ICTCs (at Kunduli & Narayanpatna) will be functionalized during next month (i. e. August 2013) after completion of training of Counselors/LTs at SACS, all other necessary arrangements have been done. DAPCU, Koraput is also showing interest to establish the F-ICTCs in other near districts like Malkangiri & Nabarangpur. 

Purba Medinipur's Response to Theme- DAPCUs and F-ICTCs

 Role of DAPCUs in establishing F-ICTCs:

Facility Integrated Counselling & Testing Centre for HIV screening is relatively new concept introduced in NACP-III by NACO under intradepartmental convergence strategy. The basic idea of establishing FICTC is to cover more people of a district by utilizing existing human resource & infrastructure of health department. The Counsellor of Anwesha (Adolescent) clinic and LT of DMCs are being trained and deployed to perform screening of HIV at BPHC/CHCs/PHCs. To these counsellors and LTs this HIV test seems to be an additional task to perform, and hence they resist. Here comes the role of DAPCU to explain the importance of the test and motivate the team and the authority of the respective institutions to incorporate the service along with other running programmes.

DACO delivering speech in a sensitization programme 

 In Purba Medinipur District, DAPCU supports the district authority as well as unit authority to carry out the SWOT analysis before launching the programme in a unit. Through this analysis authority of respective units realize the infrastructural strength, client load at OPD & Pathology unit, workload of respective staffs and benefits of community people as well as medical staffs. DAPCU also follows, informs & coordinates with FICTCs & WBSAP&CS regarding the geographical gaps, migration pattern, occupational trends, vulnerability issue and the need aroused from Spatial Map analysis. Moreover, DAPCU play a proactive role to comply with the administrative order of WBSAP&CS regarding the opening of FICTC. 

Capacity building of FICTC

• In West Bengal WBSAP&CS organizes training programmes for Counsellors (Anwesha Clinic) & LTs as per their plan, DAPCU supports them by providing release order from the end of CMOH to concern FICTCs. 

  

  District level orientation session on FICTC

• DAPCU organizes sensitization programmes on HIV/AIDS, orientation on NACP deliverables, status & information of other NACP facilities of the district, ART information, orientation on PEP etc for MO, ANMs, Indoor staffs, Supervisors, ASHA and all other working staffs of BPHCs (Block Primary Health Centre).
• DAPCU also organizes on-spot orientation of LTs by involving MT Labs of Standalone ICTCs.
• Moreover, DAPCU provides orientation & handholding support in documentation and reporting.
• DAPCU also guides the team regarding the linkage of FICTC with other NACP facilities.
• DAPCU also arrange to provide logistic support like centrifuge machine, micro-pipette, HIV testing kit, syringe, needle, scheduled registers, consent forms, reporting pad etc.

Strengthening of linkages between F-ICTC and ICTCs

           

As per the standard testing protocol all clients screened as HIV reactive at FICTC are to be referred to the nearest ICTC for conducting confirmatory test. So, FICTCs are informed about the contact details of all ICTCs of the districts, even at the initial stage DAPCU plays a vital role to link clients of FICTC to ICTC. In due course FICTCs are linked with DLN, TI NGOs & LWS for better linkage.    

Monitoring and evaluation of F-ICTCs

DPM is trying to resolve conflict of Erashal FICTC

  DAPCU provides supportive supervision to FICTCs in each month by utilizing the monitoring format of ICTC provided by NACO. During on-site visit DAPCU religiously verify stock position, referral linkage and documentation. DAPCU also organizes monthly review meetings at district level where analysis are done on achievements, gaps and problems faced etc.

Few achievements

            Currently there are seven numbers of FICTC are functional (03 in 2011-12 and 04 in 2013-14) along with 10 ICTCs and notably some FICTCs are performing equally like an ICTC. Till date FICTCs have catered 5311 clients in the districts. A comparative achievement is presented hereunder. Though the time frame is different and in between a good numbers of sensitization and IEC programmes were conducted in the district by DAPCU. The figure shows that the concept of FICTC is an effective strategy to cover more numbers of people of a district. If close monitoring not ensured the public interest may be hampered and also mishandling of kit and other logistics may occur. 

                

	New ICTCs				FICTCs
Month wise Performance starting from inception	Reapara	Mugberia	Paikpari		Khejurberia	Bhagwanpur	Moyna
	July'10	March'10	June'10		August'11	August' 11	January'12
	Testing				Testing
1st	35	11	27		39	24	21
2nd	38	24	85		66	98	257
3rd	69	72	71		58	55	238
4th	32	63	46		116	0	107
5th	52	84	59		154	0	137
6th	32	66	74		103	0	122
Total	258	320	362		536	177	882

Angul Response to Theme- DAPCUs and F-ICTCs

What is the role of DAPCUs in establishing F-ICTCs? How do you help in locating a suitable health facility to establish F-ICTCs
Angul is centrally located district in the state of Odisha.  In Angul district there are only 9. of ICTCs to provide HIV/AIDS counseling & testing facility. 5. FICTC   was    established at following places:

• CHC, Kosala– July’2011
• Banarpal – Feb.’2012
• Bantala – Feb.’2012
• Godibandah – Aug.’2012
• Boinda - - Aug.’2012

 DAPCU played a vital role in establishment of FICTC in Angul district.  Before  the establishment of  FICTC the DAPCU staff visited the different PHC/private Hospital, where ICTC  was   not  established and collected information.-like daily average patient load, monthly average patient load, No. of ANC client load and No. of delivery   conducted in the concerned /PHC ,  infrastructure facility available, human resource facilities   available   etc. DAPCU discussed this with ADMO (PH) & CDMO and with their approval DAPCU submitted a proposal to OSACS for opening of FICTC at concerned PHC.

After establishment of FICTC the Medical Officer of selected the Counselor & LT from the existing staff such as usually ANM/Staff Nurse for Counselor and for LT from RNTCP/General Pathology.
In FICTC the staff provides counseling and testing along with other services and OSACS through DAPCU provides rapid HIV testing kit, quality assurance, PEP drugs & supply IEC Material, Flip Chart & Posters etc.

Capacity building of the F-ICTC (i. e. training of staff, providing registers/ formats, providing guidance, supervision etc.)
DAPCU recommended the   name of FICTC staff for training to OSACS in consultation with 
Medical Officer of concerned CHC/PHC and occasionally DAPCU provided handholding    training/support to the FICTC staff for quality of service. Besides training DAPCU also provided register format, consent form, reporting form    IEC material; Condom   demonstration model etc. to FICTC.

DAPCU supervise the activity of FICTC and provide supportive supervision for quality counseling.  DAPCU staff also guided the FICTC staff    during     preparation of CMIS report in the   initial stages

Strengthening of linkages between F-ICTC and Designated ICTCs

Only 1st system testing kit was provided to FICTC. After detection of HIV +ve in 1st system the FICTC counselor are expected to refer the client to the nearest standalone ICTC for confirmatory test. After confirmatory test the ICTC counselor provides the report to the concerned client and shares the status of concerned client with FICTC counselor and refers the client to ART Centre & DMC. Again during outreach work the ICTC Counselor follows the client for Pre-ART/`On-Art & institutional delivery.

Monitoring and evaluation of F-ICTCs
During field visit the DAPCU Staff verify the counseling register/ Lab Register, Stock register/ Kit expiry date,  kit stock, condom stock , Refrigerator temperature,. consent form Maintain or not, IEC Material properly displayed or not, Flip chart /leaflet etc in the counselor table or not,, Condom & condom demonstration model , PEP chart is with counselor or not. Cross check the    DMC referral with the referral of FICTC and vice versa. consumables provided by the concerned CHC/PHC or not. HIV-TB 10 point     scale   is     with counselor or not. Etc.The problem of FICTC was discussed in DHS review meeting. 

Share a few achievements from your districts in this regard
In Angul district all clients referred from FICTC have reached the nearest ICTC for confirmatory test. During recent visit of NACO & OSACS official on 03.07.2013 it was observed that they verify the record of FICTC, Bantala and cross check with the record of ICTC, DHH, Angul. and found  that all the 5 clients referred by Counselor of Bantala after detection of +v e  in screening test., tested in ICTC-I and all the 5 Nos of  clients   registered their name in ART Centre, DHH, Angul   Again  one +ve delivery was conducted on 08.05.13 at DHH Angul and both  the Mother & baby pair received Nevirapine. Again     all   the FICTC staff submitting    CMIS   report in time.

Khorda Response to Theme- DAPCUs and F-ICTCs

DAPCUs have been playing a great role in linkages between facilities in the grass root level.  They also have a vital role in establishing FICTCs in the district. Some of the important aspects are as follows 

• Gather information about the area, demographic profile; analyze the risk and hazards, type of community, vulnerability, as well as mapping of facilities available in the area.
• Analyze the spatial map and data based on the health aspects like available of health facilities, number  of deliveries conducted in a month ,manpower available and reasons of vulnerability etc. 
• Apprise to concerned authorities of concerned area i.e. district health authorities and SACS regarding the need for FICTC.
• Facilitate procurement of equipment from RKS / other sources.  DAPCUs also need to ensure that technical guidelines for quality assurance of the equipments and supply consumables to the facility are followed.
• Facilitate the process of establishing FICTC and provide hand holding support for establishment and functioning 

How do you help in Locating a suitable health facility to establish  F-ICTCs
CHC/ PHCs are the major health units in the area where primary and secondary treatment is provided so the CHC are the suitable units to establish FICTCs. Apart from this the following aspects are considered

• Number of deliveries conducted  at the CHCs  in the month 
• Availability of Human resource at the CHC
• Other support facilities must exist like DMC, TI or LWS programme at the area.
• Close to a designated ICTC for referrals  

Capacity building of the F-ICTC (i. e. training of staff, providing registers/ formats, providing guidance, supervision etc)

DAPCU need to facilitate capacity building training for the staff ( Staff nurse for HIV counseling and LT for HIV testing )   in consultation with SACS . While selecting the staff for training the MO I/C must provide consent and ensure the regularity of the staff. 

To enhance the quality and interest of the staff  of  FICTC ,DAPCU can arrange exposure through visits to other facilities or to depute the trained staff of ICTC to the FICTC to provide hand holding support and for trouble shouting.  However during the field visits the DAPCU staff provides hand holding support for the counselor to ensure proper counseling and helps to maintain registers, CMIS etc. During t he visits of the DAPCU staff the records , documents like consent papers , lab registers etc are seen and provided supports relating to any shortcomings. During all the visits the progress have been briefed to the medical officer in charge of the Facility and apprises for improvement. The FICTCs are visited more than one time in a month to provide maximum support and facilitate the process. While visiting,  programme based indicators are also discussed to enhance their capacity on the other hand the staff are also invited for monthly coordination meetings in the DAPCU.     

Strengthening of linkages between F-ICTC and Designated ICTCs Monitoring and evaluation of F-ICTCs

There should be a proper coordination in between Facility and Designated ICTC to reduce loss cases There should be regular intervention in between two facilities. The counselor of SA ICTC need to visit or to attained meeting of the referred facility to establish and strengthen the referrals. The counselor of FICTC must have proper counseling (post test counseling  especially) to ensure that the referred client has reached at the Designated ICTC and he or she has to inform the counselor regarding the referral. On the other hand the TI and Non TI NGOS can play a vital role to facilitate and ensures that the referred clients are tested at the Designated ICTC. The counselor of FICTC need to maintain referral records so that she/ he can track the case

DAPCU plays a major role for trouble shouting in between two facilities and to ensure linkages during the field visits .Good relation and coordination need  established in between two. DAPCU  team while field visits need to look after the system and the evaluate the process and facilitate to short out issues . During the field visits  the records and reports need to be validate and ensure them  for proper maintenance.  

Share a few achievements from KHORDA districts

Three FICTCs had been planned in the Khordha District( CHC Tangi, CHC Mendhasal and CHC Banapur) and out of three two are functional now. During the last one year we have an experience to setup 2 FICTCs (at CHC Mendhasal and CHC Banapur). Earlier only one FICTC ( CHC Tangi) was only functional.  

To set up of the FICTCs DAPCU has discussed with the CDMO, Nodal officer at the district regarding functionalization of FICTC. The matter has also been discussed in the Medical Officers’ monthly meetings by the DPM. The matter has repeatedly  discussed and follow up with the concerned Block Programme Managers   during the field visits and during their Monthly meetings at the District.

Problem faced 

While facilitate for the process for establishment of FICTCs  DAPCU faced lot  of problem. After repeated discussions in the monthly meetings no actions was taken in the concerned CHCs. Issues like the there is no room available , no funds at RKS , it is not been passed in RKS meeting  and members are not paying attention etc were cited. So when ever DAPCU visit the CHC for follow up found no action has been taken. 
The LTs who are given HIV testing training were not interested for HIV testing saying that they have been over burdened with other works etc.

Strategies 

Frequent field visits ensured the concerned CHCs to apprise MO I/C  to facilitate the process and to provide designated space for FICTC .Along with this DAPCU has also facilitate to provide specifications of the equipments  for quality assurance and the name of the supplying agency.
Supplying of consumables and records to the facilitate and ensure the staff to is well aware of the use and maintenance of algorithm of test and facilitate to understand records and CMIS  during the Field Visits by the DAPCU staff.  

Administrative orders passed to the concerned persons to facilitate the process. In our district CDMO played a vital role to activate these facilities.

The DPM, NRHM has also been approached to facilitate to procurement of equipments from RKS and to facilitate for functionalisation of FICTC. 
Output

At present all the FICTCs are equipped with the required equipments.  Out of three FICTCs two Facilities (CHC Banapur , CHC Mendhasal)are reporting regularly in a single reporting format supplied by SACS.  One Facility is not reporting due to transfer of the trained staff nurse and LT at CHC Tangi.  

 Future plan
The list of \staff nurse/ ANM and LT   from CHC Tangi for HIV counseling and testing training in coordination with SACS 
The names of the staff (counselor/ LTs) of CHC Tangi and also CHC Mendhasal has been informed  to SACS for imparting HIV counseling and testing training.   

Anantapuram's Response to Theme- DAPCUs and F-ICTCs

What is the role of DAPCUs in establishing F-ICTCs? How do you help in locating a suitable health facility to establish F-ICTCs:

DAPCU plays a vital role in establishing FICTCs at Primary Health Centers (PHCs) as well as at Private Hospitals (FICTC-PPP). To identify suitable health facility for FICTC, DAPCU relies on the guidelines circulated by the State AIDS Control Society. Primarily, DAPCUs established FICTCs in all 24x7 PHCs as per the instructions from APSACS and later on, establishing FICTCs in all Primary Health Centers became essential to make HIV testing services available to all pregnant women and other vulnerable population at the nearest possible distance. The criterion for establishment of FICTC at private hospitals is based on the load of the hospital, especially total number deliveries occur in the hospital in a month (at least 50 per month - on an average). The identification and establishment of FICTC at private hospitals is done with the help of SAATHII (NGO) in Andhra Pradesh.

Capacity building of the F-ICTC (i.e., training of staff, providing registers/ formats, providing guidance, supervision etc.):

Once a facility is identified for FICTC, DAPCU concentrates on identifying human resources, to be trained on HIV counseling and testing, with the help of NRHM cadres. The training for the identified staff will be provided at the attached Nursing Colleges for Staff Nurses/ANMs (act as counselor at FICTC) and at State Reference Laboratories for Lab Technicians (conducts HIV tests at FICTC). After training, registers, records and HIV testing kits will be supplied to FICTCs by DAPCU. DAPCU team visits frequently to monitor the FICTCs and necessary inputs are provided to the staff regarding recording and reporting. On hand training will be provided to untrained staff by the trained one to make FICTC functional without any interlude. 

Strengthening of linkages between F-ICTC and Designated ICTCs:

Only primary screening for HIV is done at FICTCs. As per NACO guidelines, HIV positivity has to be confirmed by conducting 3 HIV rapid tests. If any case found HIV positive at FICTC, it has to be linked to nearest Standalone ICTC (designated centre, where specialist counsellor and LT is available) for confirmation. The FICTC staffs are involved in the monthly DAPCU review meeting, where they get an opportunity to meet stand alone ICTC counsellors and to build up rapport. The list of standalone ICTCs and FICTCs linked is shared with FICTC staff. Once a positive case is found in screening test at FICTC, the details of case will be intimated to District Supervisor of DAPCU and is closely monitored and followed up by DAPCU immediately till it reaches to standalone ICTC. 

Monitoring and evaluation of F-ICTCs:

Regular monitoring visits to FICTC will be done by ADM&HO (A&L) and DAPCU staff (DPM, DIS & DSMA). Necessary inputs will be given to FICTC staff on recording and reporting and data discrepancies are corrected (if any). The need for linkages among various services will be explained. Medical Officers of the PHCs are apprised of the FICTC functioning during visits and are requested for necessary support.

Achievements:

We were able to establish 68 FICTCs among 80 PHCs with the invaluable support of District Medical & Health Officer. All these FICTCs report regularly to the DAPCU. 12 FICTCs are functional even with insufficient staff (Counseling and testing is done by either Staff Nurse or LT) and performed consistently even though there is no supply of whole blood kits.

Group work done by the participants 

F-ICTC Staff Nurses Training on HIV Counseling

Balasore's Response to Theme- DAPCUs and F-ICTCs

What is the role of DAPCUs in establishing F-ICTCs?

• Identify the location for the establishment of F-ICTC
• Coordinate with health facility, district health administration & OSACS
• Facilitate documentary evidence with health facility, district health administration & OSACS

Locating a suitable health facility to establish F-ICTCs

• Identify the suitable heath facility for the establishments of F-ICTC through verify & analyze the data of ANC registration & institutional delivery conducted, TB case load & availability of Human resources.
• Submit all physical data to OSCS through recommendation of District Health Authorit

Capacity building of the F-ICTC (i. e. training of staff, providing registers/ formats, providing guidance, supervision etc.)

• Facilitate to recommend the name of Lab. Technician & Staff Nurse to OSACS for training and in reverse DAPCU facilitate & coordinate with health facility & OSACS for training of Lab. Technician & Staff Nurse 
• DAPCU provides all registers & formats to F-ICTC received from OSACS
• Provides guidance to health facility / F-ICTC through regular supportive supervision, meeting with institutional head & staff for smooth function of F-ICTC

Strengthening of linkages between F-ICTC and Designated ICTCs

• Review the function & linkages in the review meeting of Counselors & LTs of F-ICTC & ICTC
• During field visits verify the records of F-ICTCs regarding referral and linkages to designated ICTCs and discussed with F-ICTCs staff and Medical Officer. 
• Cross verification of  F-I CTC referral with designated ICTC record and analyze the gap and feedback to concerned F-ICTC

Monitoring and evaluation of F-ICTCs

• Regular field visit for supportive supervision and monitoring 
• Review the activities of F-ICTCS on monthly basis 
• Verify the records, validate the Data and on time reporting to OSACS 
• Accompanies and coordinate for monitoring and evaluation by higher authority like OSACS etc
• Regular discussion with CDMO, ADMO (PH) and OSACS on F-ICTC status and if gap identified

Few achievements:

• Established 5F-ICTCs in Balasore district 
• On time reporting of F-ICTCs 
• All F-ICTCs staffs are participating in district level Monthly Meeting 
• Facilitated supply of equipment and consumables from RKS Fund to F-ICTCs
• Three locations were identified and proposal has been sent to OSACS for opening of new F-ICTC in Balasore District
• Sensitize all hospital staffs of F-ICTC on HIV/AIDS

Kodagu's Response to Theme- DAPCUs and F-ICTCs

1.Role of DAPCUs in locating a suitable health facility to establish F-ICTCs:

As per the guideline from SACS DAPCU’s have to identify the F-ICTC’s in the District. While identifying the F-ICTC DAPCU’s will look into the following indicators:

• Number of case load at the OPD
• No  of deliveries per month
• DMC’s
• Need for ICTC depending the key population, like Tribal Area, More no of positivity identified, High Risk Area, Migrant Population etc
• If it is PPP number of Deliveries & Number HIV test conducted will be taken for consideration

2.Capacity building of FICTCs:

• List of identified F-ICTC’s will be sent to SAC
• Induction Training on Counseling for the Staff Nurse will be conducted through SACS at the regional level
• Induction Training for the Lab-Technicians will be conducted through SACS at SRL’s
• At District level Staff Nurse & Lab-Technicians are oriented on ICTC Service, Follow-up and Documentation & Reporting
• Importance of ICTC services will be briefed during the orientation

3.Strengthening linkage b/n FICTC & designated ICTCs:

• Strengthening of F-ICTC through regular Monitoring & Supervision by DPO, DIS & concerned ICTC Staff
• Each F-ICTC will be linked to One Stand Alone ICTC, wherein they have guide the concerned
• F-ICTC staff proper Counselling & Testing service at F-ICTC
• As per the need Review meeting for F-ICTC Staff
• To ensure regular supply of TEST KITS
• Follow-up of clients found reactive for 1st test at F-ICTC & immediate referral to Stand alone ICTC

4.Monitoring  & Evaluation  of F-ICTCs:

• Monitoring & Evaluation of F-ICTC through timely submission of Complete & correct Reports, Proper documentation of clients counseled & tested in the Register
• Review meeting for F-ICTC staff to review the progress, & gaps in the programme & issues related to F-ICTC will be discussed in the Taluka Meeting & also in the District level Medical Officers Meeting
• IEC promotion & condom supply
• To ensure daily testing & ensure the same is well documented

5.Achievements to share:

• There is 10 F-ICTC & 2 PPP ICTC’s in the District and doing well related counseling, testing,documentation & reporting
• From July-2013  07 more F-ICTC’s in the District are going to function

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

Role of DAPCU in locating a suitable health facility to establish F-ICTCs:

An analysis of client load at the health facilities such that PHCs, CHCs, FRUs, Charitable Hospitals, Private Hospitals, Sub District Hospitals etc. in the districts can be performed by DAPCUs to list out the suitable facilities where ICTCs can be established. Data regarding client load may be gathered by DAPCU with the help of NRHM establishment in the district. Not only the client load but categories of clients should also be considered in the process of finding a suitable health facility. Facilities having comparatively more ANCs, HRGs, Migrants should be given preference.   If it will find feasible economically to open an ICTC in the health facility than a stand- alone ICTC may be established otherwise an F-ICTC may be established in the health facility. 

   

Role of DAPCU in the capacity building of the F-ICTCs:

Needs for capacity building of F-ICTCs can be assessed by DAPCU staff during supportive supervisory visits of the F-ICTCs and assessments may be shared with the SACS and NACO. DAPCUs can assist the SACS and NACO in arrangement and providing Induction and Refresher trainings to F-ICTC staff. It can also helps in the delivery of logistics to the F-ICTCs. Queries (if, any) of the F-ICTC staff can be answered by DAPCU Staff (if possible), at the time of supervisory visits itself. Necessary corrective actions (if required) may also be taken during the supervisory visits. On Job Training may be facilitated by DAPCU, for the staff of newly established F-ICTC at the designated ICTC with co-ordination of the Nodal/ Medical Officers of the designated ICTC. Programmatic Updates and other necessary information received at DAPCU from different sources may be conveyed to the F-ICTCs.

Role of DAPCU in the strengthening and linkages between F-ICTCs and designated ICTCs:

Linkages between F-ICTC and designated ICTCs in the district can be defined and established by DAPCUs. It can be further strengthened by the process of rapport building between the Officers/ officials of F-ICTC and designated ICTC by including them in regular meetings at district and state level organized by SACS and DAPCUs. 

Role of DAPCU in the Monitoring & Evaluation of F-ICTCs:

Monitoring and Evaluation of F-ICTCs can be done by DAPCU through regular supervisory visits, analysis of monthly reports of F-ICTCs and review of their performances during regular meetings at the state and district levels. Feedbacks should be provided by the DAPCU to the F-ICTCs regularly on their respective performances. Corrective actions (if required) should be taken on time by DAPCUs concern to functioning of the F-ICTCs.

Achievements of our district:

• Five F-ICTCs have been established since December 2012 in the Districts looked after by our DAPCU. 
• Required logistics such that Registers, Referral slips etc., are provided to the F-ICTCs by DAPCU-Central.
• All established F-ICTCs are continuously being monitored and supervised by DAPCU Team Members through supervisory visits. Staffs of F-ICTCs are oriented regarding maintenance and updation of registers and other documentations during the supervisory visits. 
• Monthly reports of all established F-ICTCs in the district are being submitted in DAPCU-Central Delhi regularly.
• Staffs from F-ICTCs are being invited in the regular review meetings at State and District Levels. They also regularly participating in the aforesaid meetings.
• Programmatic updates are being conveyed to the F-ICTCs regularly by DAPCU-Central.
• Data of Client Loads in the different health facilities has been gathered, compiled and submitted to the DSACS by DAPCU-Central regarding find out the possibility for establishment of new F-ICTCs in the district.