DAPCU Thoubal (Manipur) Response to the Theme : DAPCUs role in strengthening referral between ICTC - ART

What strategies are currently being adopted to ensure linkages between ICTC and ART centre in your District?
DAPCU is making an effort to integrate the CST services within the health system. Accessing of free Health Check-up , free treatment  under government, giving of Transportation charges to all PLHIV who are  taking  drugs from ART centre under the NACO guideline, intercommunication or sharing of information in between the ART and ICTCs. ART Visit by ICTC Counselor, utilization of Outreach worker of TI –NGOs to link all the Positive Clients to ART, co-ordination with RNTCP Staffs and DOTs providers, ASHA are the main current strategies which are adopted by DAPCU Thoubal.
The delivery of Care and treatment services to the people living with HIV/AIDS   need three –tier service structure, a part from the maintenance of reconciliation sheet of ICTC- ART linkages data because these three-tier systems will help a lot to strengthen the ICTC and ART linkages. So, we need various level of service accessibility.
They are: -

1. Centre of Excellence and link ART.

2. ART Centre.

3.  Decentralized Link- ART centre& link ART plus centre.

 ART centres are also linked with community support centre run by NGOS for a comprehensive packages of services. Detection of HIV positive is the normal duty of the ICTC and accessing of treatment and care activity is for ART centre, both are the two sides of a coin. There  are many challenges for PLHIV and care givers  for taking of Drugs  and for giving drugs, in terms of transportation, cost to access ART and  Stock availability, late entry of PLHIV into ART  and also the poor ownership of ART centres by Health system etc. so, the understanding these problem of Staffs and PLHIV help to strengthen the  linkages of ICTCs /ART. Proper pre –ART counseling , regular follow –up  of every 6 months, strengthening coordination and flow of information between the various services  starting from  Pre-ART enrollment to  continuum care will also  support to strengthen the linkages of ICTC/ART centres.

What steps can DAPCU take to link all the patients who are detected positives for HIV at the ICTCs to ART?

DAPCU is the monitoring and supervision unit. DAPCU has taken some steps to link all the positive clients to the ART centre:

They are: -

1. Maintenance of proper reconciliation sheet.
2. Regular field visit.
3. Organized monthly ICTC/ART Review meeting and sharing of all the information between the ICTC/ ART center.
4. To Link to the Line department for the entitlement of Social benefits scheme & nutritional support to PLHIV.
5. Reduction of Stigma and Discrimination at the health facilities and community link to the Line department for the entitlement of Social benefit scheme & nutritional support to PLHIVs are also the main activities of DAPCU.
6.  Organizing District coordination meeting of CSC/ART and TI-NGO etc.

DAPCU Thoubal response to theme of the month

• Why is positive prevention important?

Positive prevention is important because....

1. It is going to stop further transmission of HIV/AIDS from infected peoples to uninfected peoples.
2. It will control sexually transmitted infections.
3. It will increase the standard of living for PLHIVs.

• What are the strategies for positive prevention undergoing in your district?

Some of the strategies in our district are,

1.proper counselling to PLHIVs.

2. cent percent ART referral of all HIV positives.

3.Effective Condom promotion

4. Proper and regular STI checkups.

5.Mid-media campaign

6.Strengthening the role of LWS and PPTCT NGOs

7. Enhancing IEC Campasign

8. Mainstreaming with public and private sector viz. other Govt. health dept. Education Dept. Etc
9. Strenthenging the role of TI NGOs

• What role does the DAPCU play in this regard?

Role played by DAPCU Thoubal

1. Proper monitoring for pre and post-test counselling of our ICTCs, ARTC and STI centres by the counsellors.
2. All the ICTC tested positives are sent to ARTCs.
3. Proper and regular STI check-ups.
4. Strengthening the work of CST.
5. Taking due care in blood safety.
6. Condom promotion and more focus on condom outlets.
7. Mid-media campaign especially in folk troups.
8. Mainstreaming with NRHM and other line departments.

Thoubal DAPCU - Special Camp for PLHIV in Coordination with NRHM

The DAPCU and NRHM team of Thoubal District, Manipur have a continuum of convergence. It is an on-going process of coordination and co-operation in delivery of health services. CMO, DACO and DPM at Serou Medical Camp organised by DMMU (Mobile Medical Unit) in February 2012 and discussed the feasibility of organising a health camp for PLHIVs in Thoubal District. DAPCU has participated routinely in the mobile medical unit health camps on NRHM and a special camp for PLHIV was seen as an opportunity where health concerns of PLHIV could be addressed by the team and also PLHIV could come together and discuss their concerns.

As an offshoot of this discussion, NRHM Thoubal in consultation with DAPCU organised a Mega Health Camp at Wangbal Community Hall, Thoubal District on the 15th of March 2012 using all the resources of DMMU (District Mobile Medical Unit) of NRHM, Thoubal. The Mega Health Camp consisted of 2 sessions. First session consisted of Health Check Up followed by an interactive session to discuss the challenges faced and opportunities available for PLHIV.

During the health check-up 178 PLHIV met with the doctors and of these 70% were women.  In the interactive session a panel of officials from various departments introduced the group to the services available. The interactive session was a lively session where the PLHIVs (around 300 in number inclusive of the patients treated) queried the resource persons for every type of information. While The CDPO and Social Welfare discussed the welfare schemes, The Health Program Officers discussed the health issues and medical facilities which are available free of cost in the district. The whole interactive session was facilitated by the DPM, and as per the query the appropriate resource person is given the opportunity to reply. Currently, PLHIV access MNREGS, AAY benefits and through this camp other facilities such as double nutrition were also brought to light. Close to 300 PLHIV participated in the camp.

Camps such as these at fixed intervals can provide a good opportunity for PLHIV to interact with the district administration officials and the health system.


Thoubal DAPCU can be contacted at dapcu.thoubal@gmail.com