Inspirational Post shared by DAPCU, Vizianagaram, AP

A brief note on participation in 

Mainstreaming Workshop at Jaipur on 5th February 2014

Date: 05-02-2014

Venue: Lebue Resort, Jaipur

           As per the communication received from Mainstreaming division, Department of AIDS Control, Delhi, P. Balajee, DPM, Vizianagaram was invited for a consultation workshop towards finalizing the Social Protection Guidelines in NACP-IV on 5th February at Jaipur.  After appropriate approvals and as per the instructions, DPM Vizianagaram reached the venue on 4th February evening. I met Mrs. Elizabeth Michael, Team Leader, Mainstreaming, Dr. Govind Bansal, DAPCU coordinator and Mr. Srikar, Consultant, Mainstreaming, APSACS during the dinner there and we discussed the DAPCUs presentations on which will be presented during workshop on 5th. 

                 The consultation workshop started at 10 am on following day, after registration of all participants, self introduction and some ground rules.  10 DAPCUs as per the recommendation of DAPCU National Resource Team (DNRT) and NTSU and Mainstreaming consultants from all SACS participated in the workshop.

   

The presentations & discussed are as follows:

1. Ms. Elizabeth Michael, Team Leader, Mainstreaming, said about the importance of Social Protection for People Living with HIV/AIDS and their families and its role in NACP IV.  She informed to all about the NACP IV launch on 12th by Union Health Minister. 

2. Dr. Govind Bansal, National DAPCU Coordinator made a presentation on Social Protection Schemes & Social entitlements activities done by the DAPCUs in the country and he also explained the structures in DAPCU and NTSU for the benefit of mainstreaming consultants.    His presentation gave an idea to all participants that DAPCUs are doing and trying to provide benefits of social protection schemes and Social entitlements to PLHIVs in their respective district. 

3. Sri. Chandrashekar Gowda, Director, Swasti made a presentation on the study finding which was done in Madhya Pradesh with a sample size of 800 on social protection schemes & Social entitlements among PLHIVs & HRGs.  His presentations focused more on Help Desk at all level in our programme for counseling, collecting information/documents and approaching concern departments.    The participants also learnt that Help Desk model is more useful and economic for our programme and some of the DAPCU expressed that they are doing it now but not at all levels, but at DAPCU.

4. Experience sharing by DAPCUs:

a. I spoke about various social protection schemes available for PLHIV in Andhra Pradesh as mentioned below:

     i. Rs. 200/- pension for all on ART PLHIVs is being implemented in Andhra Pradesh and APSACS has taken into considerations- all concern of PLHIVs like stigma, transport, transparency and many more into consideration for providing benefit to PLHIVs in AP.  It is implemented by APSACS in collaboration with SERP, DRDA. 

    ii. Bus Passes for all on ART PLHIVs for getting 50% of discount in bus fare for one time in a month to getting ART medicine every month.  It is implemented by APSACS in collabaration with APSRTC. 

   iii. Antyodaya Anna Yojana (AAY) card are being issued to PLHIVs in AP after issuing a GO by AP Government and DO letters by PD, APSACS to all DCs. But here we take consent of PLHIV for sharing his/her complete information with Civil Supply Department as the Ration Depot dealer will know the status of the beneficiaries.  For implementing this scheme,DAPCU sensitized all Ration Depot Dealers along with Heads of Civil Supply Dept to maintain confidentiality and given instructions through DC.

    iv. 13 GOs & DO letters have been issued in AP for providing Social Welfare Schemes to the PLHIVs for leading dignified life with HIV without any Stigma & Discrimination. 

   v. All District Collectors in Andhra Pradesh are giving priority for providing Welfare Schemes to the PLHIVs. 

   vi. Because of time constraint, I mentioned in brief about many other such initiatives like Foster Care Scheme for orphans through ICDS, Double Nutrition for CLHA/CAA, Double Ration for HIV positive ANCs and SC/ST/BC corporation loans and etc...

   vii. We also tried to show the DAPCUs responses in the country on Social Protection schemes in DAPCUBLOG as I am also one of the volunteers for moderation of the blog but due to technical reasons I couldn't show it online. However, I mentioned that 13 DAPCUs in the country have responded to the theme of Social Protection for PLHIV and the responses are available on web: www.dapcuspeak.blogspot.com for reference. 

b. Participants were impressed very well about the schemes in AP especially Rs. 200/- pension and precautionary measures taken by APSACS.  Participants also felt unhappy about bus pass as the pass is clearly written logo of AIDS and name of APSACS.  For this we mentioned that APSACS is planning to change bus pass design as it was also informed to all DAPCUs in AP. 

5. Later remaining DAPCUs from various states made presentation according to their state specific social protection scheme to the PLHIVs.  The presentations were made by Karnataka, Tamilnadu and Maharashtra. 

6. Later all participants were divided into 5 groups and given a topic that for brainstorming, discussing, proposal and presentation by the team.  The topics are mentioned below.

a. Planning Phase

b. Awareness Creation

c. Enabling Environment

d. Setting up Help Desk at Service Center

e. Monitoring Mechanism

f. Mr. P. Balajee, DPM, Vizianagaram participated in the group  of Awareness Creation, Mrs. Lalitha, DPM, CTTR  in Setting up Help Desk at Service Center and Mr. Srikar, Consultant, Mainstreaming, APSACS in Monitoring Mechanism.  We actively participated and gave inputs to the group activity. 

g. Teams were given formats by facilitators and facilitator sat with teams and teams discussed and wrote inputs in to the format for developing guidelines for Social Protection to PLHIVs in the country.  The inputs of all groups will help the DAC to design the process the how DAPCU implement the Social Protection activity in the district, how to document, how to approach, how to measure and how to monitor the activity.  

h. Later all groups made presentations from AP team Mr. Srikar got the opportunity to represent Monitoring Mechanism team for presentation and he did very well and all participants also recognized that he made presentation well and comprehensive  to all presentations done before.

      This workshop helped DAPCU, SACS and DAC lot to learn lessons from existing strategies and approaches and it will give fruitful results in developing guidelines on Social Protection to PLHIVs and their families.

   

       My heartfelt thanks to DNRT, NTSU, DAC, UNDP, APSACS and DACO, Vizianagaram for their help, support and encouragement for helping me in participating in a national level workshop for a Nobel cause. 

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

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

As per as mainstreaming is concern the FI-ICTC plays major role for integration of services and sustainability of the activity.  At present we are placing two types of FI-ICTCs in Andhra Pradesh that are  FI-ICTCs in 24 Hrs PHCs  and FI-ICTCs in Private Hospital/Nursing Homes –PPP model.  DAPCU has been given guidelines by APSACS for setting up of FI-ICTC in both models.  We are using the guidelines for locating suitable health facility and to meet necessary requirements for placing FI-ICTC.  

DAPCU is identifying the Health facilities for FI-ICTC which has Lab facility and Human resources to take up testing and counseling and verify the facility whether it can meet our guidelines or not.   The major requirement for setting up FI-ICTC is Human resources and infrastructure.

•Lab 
•Lab Technician (Testing)
•Staff Nurse (Counseling)
•Commitment of District administration(DM & HO) and Facility 

Capacity building of FICTCs:

DAPCU is listing out the Lab Technicians and Staff Nurses and sharing with APSACS for induction training.  APSACS has identified SRL (State Referral Laboratory), Micro Biology Department in Medical College and Psychology Department in Andhra University for conducting Capacity Building on periodical basis. 

DAPCU is also conducting Training programmes at District level for refresher to the FI-ICTC on modules developed by APSACS and providing hand on training during visits to FI-ICTC and deputing stand alone ICTC staff for capacity building at FI-ICTC level when existing FI-ICTC staff are transferred or changed. 

Strengthening linkage b/n FICTC & designated ICTCs:                                      

DAPCU used to involve FI-ICTCs in monthly review meeting along with stand alone ICTCs monthly only and develop linkages between stand alone center and FI-ICTCs.   After allotment of cluster to the Stand alone ICTCs, the responsibility has been given to taking care of linkages, strengthening, reporting and monitoring.  

All facilities (TIs, DICs, LWs, DSRCs and others) have been sensitized about FI-ICTC functions and its services and shared the information for communicating FI-ICTC and all facilities are using maximum services of the FI-ICTCs in the district for referral services. 

Monitoring & Evaluation of F-ICTCs:

The monitoring has been decentralized with stand alone ICTCs and FI-ICTCs can access the services of nearest stand alone ICTC for clarified doubts, getting kits, submitting report and any other coordination works.  

DAPCU monitors the FI-ICTC through visits made by ADM & HO (A&L), DPM and DIS and evaluates the programme in monthly review meeting and sending communications through DM & HO for improving performance of FI-ICTCs. 

DAPCU encourages the staff of FI-ICTCs by providing appreciation certificates and awards on various occasions like World AIDS Day, Independence Day and etc.

Achievements to share:

Total 24x7 PHCs in the district are 69 and all are equipped with F-ICTCs and all are functioning and reporting 100% and PPP model 16 FI-ICTC made MOU with our programme but 10 PPP model FI-ICTCs are functioning and reporting regularly.  We are putting our efforts to reach 100% reporting in PPP model.

There are some challenges in FI-ICTC functioning 

•Vacancies in PHCs 
•Supply whole Blood Testing Kits (for PPP model)
•Transfer of existing staff 
•No contingency for FI-ICTC
•Reporting by PPP model –FICTCs
•Quality in counseling
•Follow up 

APSACS recognized the efforts of DAPCU, Vizianagaram in starting, functioning and reporting of FI-ICTC in all 24X& PHC in the district and awarded us on the eve of World AIDS Day 1 December 2012 at Hyderabad.


 

Sensitization Program for Police on HIV/AIDS by DAPCU Vizianagaram

As per the instruction of APSACS, District AIDS Prevention & Control Unit, Vizianagaram organized Police Sensitization Programmes in Vizianagaram District on 10^th January 2013 at Batalion, Chintalavalasa, Vizianagaram and 20^th  February 2013 at District Police Training College, Nellimarla, Vizianagaram.   As per communication of APSACS District Police Training Centre and AP Special Police Training Centre approached DAPCU, Vizianagaram  requested us to conduct Training classes to trainees of Constable and Special Police in 2 batches on HIV/AIDS.

District AIDS Prevention & Control Unit, Vizianagaram got communication from APSACS to conduct Sensitization Programme for Trainees of various Police Training Centres in the District.  The Resource Persons for the Programme are as follows:

1.      Basics of HIV/AIDS                           - Dr. D. S. Patnaik, ADM & HO (AIDS & Leprosy)

2.      Components of HIV/AIDS                 - Mr. P. Balajee, DPM, DAPCU, Vizianagaram

3.      ITPA ACT                                          - Dr. D. S. Patnaik, ADM & HO (AIDS & Leprosy)

4.      TI Intervention & Its activities             - Mr. Ashok, President, CBO (MSM)

                                                                 -Mrs. Gowri, President, CBO (FSW)

                                                                - Mrs. Padma, Treasurer CBO (PLHA Network)

5.      Role of Police in HIV/AIDS                - Dr. D. S. Patnaik, ADM & HO(AIDS & Leprosy)

      DAPCU also involved Community in the Programme as per geographical areas of TIs, We involved CBO which are working with FSW/MSM in Vizianagaram Division.  The CBO members came and spoke about their activities.  Formal inauguration by the Head of Institution and Actual secession in the Trainings were facilitated as mentioned the below

    Dr. D. S. Patnaik, ADM & HO (AIDS & Leprosy) covered the Basics of HIV/AIDS, Myths & Misconceptions and clarified the doubts among Police after the completion of the session in every batch.  He also shared live examples in from field experience.

     Mr. P. Balajee, DPM, DAPCU, Vizianagaram spoke about Components of HIV/AIDS in APSACS and He also shared the available services in the District in each component and place of the facility.  It helped the police to know the available services in the District.

    The representative from CBOs participated in the Programme and they shared their activities like, Behavior Change Communication, Condom Promotion, Referrals & Linkages, STI Treatment, CBO formation and etc.   They shared their field experiences and the objectives behind their field work and requested Police for getting support and Cooperation while doing field work.  Police also responded very well and they understood the Programme.

     Mr. P. Gopal Rao, presented ITPA act and he did group activity for getting answers to the questions which are given in the presentation related to ITPA act.  Participants’ actively participated in the Group Discussions and also share their opinions and field experiences in the Session.

   Dr. D. S. Patnaik, ADM & HO (AIDS & Leprosy) told about the Police Role in HIV/AIDS Programme and he said deferent levels of involvement in the Programme and he mentioned the prevalence’s among Police Departments and other same Departments like ARMY and others.

      Finally the Head of the institutions discussed with the participants about take home points and he stressed about Stigma Discrimination in the Community and He requested all participants to help the HIV/AIDS cases while facing Stigma and Discrimination in Villages.

    Out Comes of the Programme:

  1. The Principals of Training Institutions in Vizianagaram District asked ADM & HO (A&L) to organize Sensitization Programme at Police Training Centers. 

    2.      The CBOs felt very happy about this Programme and they said it helped them in getting good support and cooperation from Police Department

    3.      Police People understood the objectives of the TI Programme and concept behind the work.

    4.      The Institution promised to conduct VBD camp in the month of Mach 2013 

DAPCU Vizianagaram Response to DCC for HIV-TB

1.          Advantages of DCC in HIV-TB collaboration activity

        

                     The coordination between two programmes is very essential in HIV/AIDS Control Programme that is National AIDS Control Programme & Revised National TB Control Programme.  The both deceases are going together to increase mortality in People Living with HIV/AIDS.  Until or unless diagnosis of TB and treating TB among HIV patients we can’t improve quality of life and reduce deaths.  Simultaneously the RNTCP also should make all TB patients test for HIV and send them for ART

District Coordination Committee chaired by District Collector and meets once in quarter to discuss the progress of the HIV-TB collaboration activities in the district and identifying gaps, issues and requirements for further improvement.  The members are ADM & HO (A&L), DTCO, DCHS, MOTC, MO- TU, MO-ART, MO/Counsellor – ICTC, MO-CCC, DPM, DIS and representative from ICDS.

·         Improves quality in service delivery both NACP & RNTCP

·         Coordination between both programmes will be improved

·         Address gaps and get the support from DC or Dept. Heads

2.      DCC for TB – HIV strengthen the cross referrals between the ICTC and RNTCP (diagnostic and treatment services, and ART and DOTS services, and overall implementation of the National framework for TB – HIV Collaborative activities).

DAPCU conducts DCC meeting every quarter as per the instructions of APSACS and sharing minutes with all for implementing the recommendations given by the committee.

·         All PHCs integrated with FICTC activities and RNTCP activities

·         All 36 DMCs were covered with HIV testing facility.

·         All DMC LTs were trained on HIV screening.

·         All TB suspects are also being tested for HIV in the District.

·         Line listing and pairing every month for finding missed TB cases for HIV testing through ICTC counsellors Outreach work and MICTC (Mobile ICTC).

·         DOT Plus Supervisor & DIS are jointly visiting ART Centre and ICTC for supportive supervision.

·         All Known HIV infected TB patients should be initiated on CPT and ART at time of registration.

·         Each and every person attending the ICTC with cough of two weeks duration and with cough of one day duration in HIV positive clients are referred to the Designated Microscopy Centre for sputum test.

·         All TB and HIV Positive Cases are getting ART with irrespective of CD4 count as per new guidelines.

·         We are involving with RNTCP staff in monthly review meetings under control of DM & HO to improve coordination between RNTCP and HIV/AIDS Programme

                                           Total TB cases in the District      : 3686

                                           Test for HIV                               : 3439

                                           %                                             : 93%

                                           HIV/TB Co- Infected cases          : 253

                                           in the district 

                                           HIV/TB Co- Infected cases          : 208

                                           put on ART 

                                           %                                              : 82%

3.  Appropriate measures are taken to prevent the spread of TB infection in facilities caring for HIV – AIDS and spread of HIV infection through safe injection practices in the facilities providing RNTCP treatment services.

            APSACS has supplied IEC material like posters and pamphlets on TB to DAPCU.  The messages on TB Prevention are spreading through IEC material at all facilities in the district.  DAPCU covers one topic on TB in every training, sensitization and review meetings and ASHAs, ANMs, AWWs, and Field level staff is being oriented regularly by NACP and RNTCP programmes. Universal precaution guidelines are always being adhered to for ensuring non transmission through the processes of health care provision at any of the service delivery units of HIV, TB and its CST.

4.    Role of ICTCs, ART, and Care and Support Centres in intensified TB case findings.

·         The testing of TB for all HIV cases before treating with ART is mandatory and strictly followed by ART centre.

·         Each and every person attending the ICTC with cough of two weeks duration and with cough of one day duration in HIV positive clients are referred to the Designated Microscopy Centre for sputum test.

Year	2011-2012(Dec)	2010-2011	2009-2010
ICTC to RNTCP referral	2548	4948	4216
RNTCP to ICTC referral	1429	1955	2321

5. Strategies DAPCU should opt for 100%   treatment, care and support for TB – HIV co- infection cases?

·         Team of NACP & RNTCP have been sensitized and oriented many times on importance of treating HIV-TB co infected cases and giving priority in providing services at ART.

·         Involving NGOs, RNTCP and General Health cadres in tracking of untreated HIV-TB co infected cases by sharing line list every month.

·         Encouraging DOT Plus supervisor to visit ART centre to identify the gaps and involving RNTCP staff for field level support.

·         Involving DTCO in ART Centre coordination meetings, Monthly review meetings. 

Vizianagaram Response to to Theme of the Month - Mainstreaming

Importance of mainstreaming

• To strengthen capacity, formulate policy and guide implementation to enable a decentralized response focused on local needs.
• The prevention messages in all government offices, organized and unorganized private sector and civil society organizations, and training and sensitization of stakeholders are passed on through.
• Paying special attention to socio-economic parameters that increase vulnerability to HIV/AIDS and making way towards high national productivity.
• Devising a multi-sector coordinated communication strategy
• To build right perspectives about NACP, its goal, rationale and objectives and to create an understanding on the need and rationale of NACP
• To develop right perspectives about mainstreaming and convergence issues related to HIV/AIDS with various departments
• Build a strong platform for DAPCUs’ smooth functioning in the districts
• Identify and build local resources for conducting similar kind of sensitization workshops at inter and intra department level

Strategies

• DAPCU sensitized 34 Department in the District on NACP III Goals and HIV/AIDS Programme in the District in the FY 2009-10
• Maximum Testing and Treatment facilities have been integrated in Regular Health system.
• Lot of Trainings have been conducted to Health Dept.            Personnel with the coordination of NRHM

Role of DAPCU:

• Involve Line Departments in Planning of District Annual Action Plan of DAPCU and take recommendations given by them.
• Communicate and involve line Departments in all the events and campaigns
• Get the information regular Meeting & Trainings of Line Departments and use it for sensitization activity
• DAPCU need to take opportunity of every invitation/communication of Line Departments and participate in their programmes.
• Recognize the involvement of line Departments in the events like World AIDS Day.
• Seek support in DAPCC or DCC meetings through chairman.
• Share the developments in HIV/AIDS programmes regularly
• Involvement Communities in committee meetings to sensitize line Departments by the communities (PLHA/FSW/MSM etc..)
• Documentation & Filing will help DAPCU in future collaboration with Line Departments and proposals. 

Activities done with Line Departments
Name of the Department	Activity Name	Progress
Women & Child Welfare Department	Jagruti Programme	HIV positive Children are getting Double nutrition at ICDS Centre HIV Positive ANCs are getting Double ration.
Nehru Yuva Kendra (NYK)	Youth Volunteers Training	3 TOTs were developed 30 Youth Volunteers were Trained in HIV/AIDS Programme as TOT. Distributed IEC Materials to all Mandals Involving in IEC & Folk Media Campaigns
Zilla Samakya	Chethana	District Level Resource Persons were already trained. Mandal level trainings were conducted for SHGs
District Rural Development Authority (DRDA)	Pensions	Rs. 200/-  Pension is being distributed through Andhra Bank ATM to all PLHAs who are on ART
District Civil Supplies Department	Service Deliviery	AAY cards have been released to HIV Positive families.
Zilla Parishad	Ward Member Training	1720 ward member were trained on HIV/AIDS in the District. And CEO, ZP came forward and develop IEC on their own.
Indira Kanthi Padham	Jyothi Project	2 Mandals were covered under Jyothi Project
Police Department	HIV testing at Jail Creating enabling environment for HRGs	Prisoners are being tested at Jails for HIV & Blood donation Camps were organized at PTC All Police personnel are being sensitized on ITPA Act and Target Intervention Activities.
Education Department	RRC Formation	RRCs formed in High Schools, Juior, Degree, DIET, BED & Vocational Colleges in the District.
Women & Child Welfare Department	Service Delivery	Providing Double ration to HIV infected & affected children in the district.
Integrated Tribal Welfare Department Agency	Trainings	Developed TOTs from Tribal Department and conducted Training for ITDA staff on HIV/AIDS activities. One consultant has been posted at ITDA to strengthen the HIV/AIDS facilities and improve the uptake of the services
AP Road & Transport Corporation	Bus Passes	Bus passes are being issued to the PLHA who are on ART for reaching ART centre once in a month.