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

DAPCU Purba Medinipur Theme Response-Supportive Supervision

Supervision is a key role of DAPCUs

The main objective of the DAPCU is to institutionalize of the NACP at district level through interdepartmental collaboration and moreover mainstream the programme within the DH&FWS. This unit is created for providing overall support for implementing NACP at district level.

Supervision

Supervision is an act of assuring & maintaining of service quality that is offered from various facility centre of the district. It’s completely workplace based assessment which ensures support services from respective institutional heads and inter-linkages among governmental, non-governmental programme partners and other line departments. Through this structured assessment DAPCU supports to develop professional skill of members of facility centres and ensures growth in performance & timely reporting. In case of financial aspect DAPCU takes measures to prevent mal-practices in procurement of articles and maintenance of kits, equipment & other schedule consumables. Supervision by DAPCU also includes monitoring & supervision of IEC programme and performance of targeted interventions, Link workers’ Scheme, of DLN & RRC of colleges and other allied activities by local agencies.   

Planning & implementation of Supervision:
DAPCU prepare advance monthly visit plan in between 25th to end of the previous month. The plan is placed to the DACO & CMOH for their inputs & approval. After approval, DAPCU undertakes field visits sometimes with prior information, some time

makes surprise visits. Generally, visits are conducted by involving institutional heads – Superintendents, BMOHs/BPHNs/MOIC or observations are shared at the end of the visits. This involvement develops local supports if required by the unit and also extend a supervisory lead to the local authority. The supervisory checklists are submitted to the DACO for further action, in case of emergency or critical situation the issue is being informed to WBSAP &CS for necessary action.

DAPCU members keep in mind the following issues while undertaking supervision:

1.     Performance of last month of the unit.
2.      Observation was made in last visit.
3.      Carrying IEC materials, registers & other necessary items to the unit if to save time & transportation cost.
4.      Financial query if any.
5.      Check availability of respective staff or authority before visit.
6.      Make provision & arrangement for on-job orientation.
7.      Inform related departments, unit/ NGOs to strengthen linkages.

List of Dos & Don’ts,
Dos:
1.   Carry the supervisory checklist prescribed by NACO.
2.   Do physical verification of kit, condom, IEC material, other consumables and fixed assets.
3.   Meet the institutional head to give & get feedback of the unit to prevent any misappropriation.
4.   Support to perform better in documentation, reporting, keep other records updated.
5.   Assess the inter-departmental linkages and focus on gap which hindering their performance.
6.   Unbiased approach.
7.   Provide written on spot feedback in the visitor’s register & do follow-up.
8.   Do necessary field visits in case of TI NGOs, LWS project and other critical cases.
9.   Be strict to fulfil the objective of the programme.

Don’ts:
1.   Not to agitate the unit members to perform their daily duty.
2.   Don’t give any false assurance regarding supply of consumables, kits & HR related issue.
3.   Unnecessary & physical harassment should not be done.
4.   No dishonest approach.

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.