DAPCU Balangir Response to Role of DAPCUs to Support TI

     
 1.      Coverage of HRGs registration:

HRG registration master registers are cross checked during field visit to Hot spot areas of TI operational areas. Their age group is also verified in case of FSW. Some times it is advised not to take old cases.

     
 2.      Strategies to improve ICTC service to the HRG’s (twice a year):

In each and every month the gap between referral to ICTC and reach of HRG at ICTC is observed / analysed and during monthly coordination cum review meeting to reduce the gaps. It is also advised to PEs that to keep contact with their concerned counsellors (if required) for the availability of the counsellor if the HRGs want to come ICTC beyond the working hour.

      
3.      Pre ART Registration and Testing for CD4 Count of HRGs found HIV Positive:

PM-TI and PEs are encouraged to accompany the detected clients to ART centre for ART registration. During field visit to TIs it is verified the gaps between detection vs ART registration and the same also discussed before the CDMO in monthly review cum coordination meeting at district level. ART staffs are also keeping contact with TIs to refer their HRG positive clients for ART registration.

      4.      Measures to improve the STI service to the HRG’s and ensure RMCs:

During staff review meeting of TIs client wise STI / RMC / PT etc. service provided are checked and some times cross checked at PPPs to ensure the STI service provision to HRGs. Cross verification is also done through STD clinic if any client has received the STI related treatment.

      5.      Distribution of condoms, needle & syringes to all HRGs:

Though there is no TI on IDU in Balangir, condom distribution is monitored according to their calculation for demand of condoms according to HRG (High, Medium, and Low). PEs are encouraged for promotion of social marketing condoms for proper utilization of condoms and in turn it will prevent infection transmission. Condom stock / availability at TIs are regularly monitored.

      6.      How do DAPCUs and TSUs coordinate to support TIs? Please give examples:

In monthly review cum coordination meeting held under DAPCU under the Chairmanship of CDMO, PO-TSU is invited to attend the meeting and give feedback to the programme. TI performance is also presented before him and triangular suggestions are taken for better implementation of TI programme.

      7.      Does DAPCU support TIs in accessing the district administration? Are there any good practices related to getting social benefit schemes for PLHIV:

In quarterly DAPCC/DCC meeting which is held under the Chairmanship of Collector & Dist. Magistrate all technical and critical decisions are taken immediately into consideration as Dist Collector is the apex body of the committee. It helps a lot to solve the problems related to access the social benefit schemes by PLHIVs (not only to HRGs but to General PLHIVs also) at the very moment.

For an example: opening of zero (0) balance account in bank to get monthly Madhu Babu Pension Yojana (MBPY) & delay in sanction of MBPY and Mo Kudia Yojana (MKY-Concrete House) to PLHIVs. Now in Balangir district 10 nos. of applications are in process of disbursement of MKY through Block Development Officers at Block level.

DAPCU Koraput Response to Role of DAPCUs to Support TI

Strategies utilized in Koraput district for coverage of HRGs registration and improve ICTC service to the HRGs (twice a year)

• DAPCU, Koraput has been conducting Review meeting of all facility of service providing agencies like CCC, DIC, ICTCs, and RNTCP including TIs. So, in these review-cum-Co-ordination meeting issues related to HRGs like how would they involved in various schemes as well as how the cent percent of the cases reach to ICTC for HIV screening and to fulfill the target of the TIs i.e. screening of HRGs twice in a year are being discussed and try to solve the problem in presence of CDMO & ADMO (PH) & DNO (AIDS), Koraput.
• While visiting to TIs, DAPCU staffs discussed with PEs of TIs and discuss what are the problems involved while referring of HRGs to ICTCs and we also made a suggesting action to mitigate these problems.
• DAPCU also involved with TIs during programme at hotspot level and motivating these clients to be tested at the ICTCs.
• Pre-ART registration and testing for CD4 count of HRGs found HIV +ve measures to improve the STI services to the HRGs and ensure RMC distribution of condoms, needle & syringes to all the HRGs.
• When a case referred from TIs among HRGs to ICTCs and found HIV +ve them the case referred to ART centre and ensured by the counsellor of ICTC whether the case reached at the ART centre or not. Then, the blood specimen utilized to count the CD4 cell. If the CD4 status is below 350 then ART medication being started for the case with the direct observance of the case.
• All such types of cases reviewed during the monthly review-cum-co-ordination meeting and all type of assistance has been given to TIs for including these cases in various schemes. Sometime DAPCU staffs also appraising District Collector & DM, Koraput for the same.

How do DAPCUs and TSUs coordinate to support TIs?

• DAPCU staffs and staffs of TSU visited the TIs (FSWs) in every month and discussed with all the staffs of TIs like Project Manager, Counsellor, ORWs & Peer Educators and try to solve the issues related to them.
• DAPCU also involved PM or other representative in Co-ordination-cum-Review meeting as well as DAPCC meeting and place their issues before other Service Delivery Units as well as District level line department to provide them different type of assistance and to solve the base level issues.

Does DAPCU support TIs in accessing the district administration? Are there in good practices related to getting Social benefits schemes for PLHIVs?

• DAPCU always invited the TIs to include them in the monthly Co-ordination-cum-Review meeting on TB-HIV and there the issues related to health, which need to be addressed before CDMO or ADMO (PH) & DNO (AIDS) for the sake of providing various support related to HRGs, are being discussed and necessary step has been taken by CDMO as the head of the District Health Administration. As like same, when required we also drag the attention of District Collector and DM, Koraput relating to some issues what will not be solved by the CDMO, Koraput.
• Few among the HIV identified cases among HRG cases are involved in livelihood schemes by providing them loan. Some also involved in BPL schemes. DAPCU staffs also consulted with Co-ordinator, Mission Shakti to involve the HRGs (FSWs) in various livelihood supports, so that they will be motivated to involve with such livelihood programme and earn some good price out of it. Very soon we will include them in these schemes. 
• All the HRGs are involved in Self Help Groups and their accounts has already been opened at the banks and some among them also took loan from the banks to initiate some income generating activities.

DAPCU Akola Response to Role of DAPCUs to Support TI

Akola district situated in the central part of Vidarbha in Maharashtra having population 18 lack plus. The Akola ART has a burden of more than 7500 PLHIV. The MSM population contributed approximately 30% of HRG in the district. TS/TG and MSM population also registered and getting ART from ART center.   Recently SACS has allotted MSM TI project to the Gunavant Shikshan Sanstha Akola by analyzing all these facts.

It was a great challenge to identify and coordinate this entire HRG group. It’s important to implement new strategy to identify this group, to aware them, to save them from HIV and those who are infected link them to ART services. The NGO has chosen the different way to work for this group. The NGO has organized the mega cultural event only for this group with vast advertising of the program. The NGO has coordinated more than 200 TS/TG populations in very short span of time. 

In the event, HIV/AIDS awareness message given to this group. STI services provided to the needful and HIV facilities were also made available by DAPCU. It has been found that out of 36 HIV testing 4 persons were found positive, which shows more than 11% positivity. These all four PLHIV linked to ART. Its today’s need to work differently for TI, implement new strategies and find out the new way to work out for this group. 

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.

DAPCU Jalpaiguri 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 & Migrants. TI-NGOs work on different HRG Groups with the predefined targets of registration & contact. DAPCUs monitor their performance periodically with respect to targets achieved by them, gaps between targets and their achievements, reasons for gaps and hindrances faced by them during their efforts. At present, all the works related HIV-AIDS at the district level in West Bengal are being looked after by DAPCUs. TI-NGOs are being supported by us to reach their targets through various manners such that pointing out the gaps between their (TI-NGOs) targets & achievements and giving suggestions to them concerning how to fill those gaps. Truckers Project in our district has been facilitated by providing HIV-Testing facility through Mobile ICTC Vans.

DAPCU Churachandpur Response to Role of DAPCUs to Support TI

TI NGOs are the back bone and essential establishment to detect HIV/AIDS and the main provider of support to HRGs & PLHIV on the field in the reality. As such, TI NGOs required technical support for any activities they perform relating to HIV/AIDS Programme. Most of the time, due to limited resources and part-time doctors; numbers of clients visit are too less especially for STD/STI cases. Therefore, following are some suggestions proposed for supporting TI NGOs:

1.  Doctors of TI NGOs should be instructed by Chief Medical Officer to visit timely to particular TI NGOs as per their duty roster.

2. TI-NGOs may be supported with providing medicines from NRHM side. State & National level authorities may be requested to issue the Circular for the same.

3. Joint visit may be performed with Mobile ICTC Van for far-flung areas which are difficult to reach.

If these suggestions could be implemented and accomplished in every district, performance of TI NGOs will become better. Moreover, we hope that actual clients will be get benefitted from the Programme implemented at National Level.

DAPCU Central Delhi Response to Role of DAPCUs to Support TI

To support TIs, DAPCUs and TSUs are coordinated by following means.

o   Joint supervisory visits & assessments of TI-NGOs are performed by Officers of DAPCU & TSU whenever possible.

o   After joint visits of Hot Spots of the HRGs in co-ordination of PO- TSU; strategies are suggested to TI-NGOs to improve registration and coverage of genuine HRGs and providing services to them.

o   Issues related to TI-NGOs i.e. their functioning, performance & difficulties faced are tackled by DAPCU in cooperation & consideration of Officers of TSUs.

o   Representatives from TSU are always invited in District Level Meetings of HIV-AIDS Health Facilities organized by DAPCU-Central.

Following Strategies are being opted in Central Delhi district for:

o   Coverage of HRGs registration.

Various activities are being performed with TI-NGOs i.e. community events, events on festivals, exhibition of products manufactured by HRGs, health camps, health talks etc. for HRGs benefit & interest so that they are be in regular contact with TIs. Consequently, full coverage of HRGs registration has been ensured.

S. No.	Typology	HRGs
		Estimated as per mapping 2006	Target 2012-13	Registered (Till 31st January 2013)
1	FSW	3327	2500	2644
2	IDU	1480	600	1077
3	Migrant	--	10000	16000+

To improve ICTC service to the HRG’s (twice a year).

DAPCU supports the route map planning for Mobile ICTC Services and camps with the help of DSACS & TI-NGOs. This ensures that facilities are available to at the sites and times opportune to HRGs.  

It was observed that there are many obstacles to bring FSWs to ICTC Centers at G B Road Area. Consequently a strategy has been adopted by DAPCU-Central with the help of Joint TI-NGO working at G B Road to overcome those obstacles:

Head of Brothels are also being sensitized to encourage FSWs to get benefits of HIV-AIDS Health Services which are being provided to them so that spread of epidemic can be stopped & reversed in the area very sensitive for the same.

Pre ART Registration and Testing for CD4 Count of HRGs found HIV Positive.

Good co-ordination and linkages among workforces from TI-NGOs, ICTCs and ART Centres have been ascertained through productive interactions & discussions in regular meetings at district level by DAPCU, so that Pre ART Registration, CD4 Testing, ART Services & Follow-ups have been ensured for each and every HRG found HIV Positive.

To improve the STI service to the HRG’s and ensures RMCs.

Joint TI-NGO working for FSWs in the district has been linked with nearby Delhi Government Dispensary under DHS to provide General Medicines to FSWs at STI Clinic.

As numerous DSACS designated STI Clinics are situated within the same space provided for ICTC/PPTCTs in the District. Therefore, HRGs are being encouraged to obtain benefits of both services at the same time.  

Distribution of condoms, needle & syringes to all HRGs

DAPCU manages the situation of shortage of condoms at TI-NGOs by arrangement of the same through other TI-NGOs and Health Facilities under different authorities’ i.e. Delhi Government, MCD, NDMC etc.

 Steps taken by DAPCU-Central to  support TIs in accessing the District Administration are:             

 Advocacy Meetings with Police Department have been conducted in cooperation of TSU in the District. Problems face by HRGs related to crime, law & orders and their possible remedies were discussed. A good rapport was developed between Police Administration & TI-NGOs working at the district level.

  Representatives of TI-NGOs have been included in the DAPCC & DCC for HIV-TB constituted under the chairmanship of Deputy Commissioner (Revenue). Hence better coordination between District Administration & TI-NGOs has been building.

Social Benefit Schemes:

TI-NGOs are always motivated & supported by DAPCU-Central to educated & enrolled HRGs in Social Benefit Schemes of various departments of Governments.

TI-NGO Maitri has taken an initiative to facilitate the migrant and homeless population community to get their identity in Delhi by getting their Voter ID cards. Over 1500 migrant population have been benefited from the same. 

Successes:

Mobile ICTCs provided by DSACS are also being used to provide the counselling and testing facilities to HRGs at their activity areas.

More than 100% HRGs are registered in TI-NGOs with respect to targets provide to them by DSACS.

General Medicines are provided to HRGs at STI Clinic of Joint TI-NGO in co-ordination with Dispensary under DHS.

A good rapport was developed between Police Administration & TI-NGOs working at the district level through Advocacy Meetings facilitated by DAPCU-Central in co-ordination with TSUs for the benefit of HRGs.

Challenges faced:

Difficulties to bring Brothel based HRGs (FSWs) to ICTC for counseling & Testing.

Non-availability of Identification proofs of HRGs which is necessary to enrolled in various Social Benefit Schemes of Governments.

      

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.