Ganjam , Response to Question of the Month February 2012 - Facilitating Pre ART Registration

This post was in response to the February 2012 theme

Every month we prepare ICTC-wise PLHA line list, along with  details of  Pre ART, On ART registration and CD4 count etc from ART centre. This is collated prior to the monthly monthly meeting.  In the monthly meeting we discuss  gaps and share the data .  (Ganjam had provided a detailed ICTC wise list of found positives vs pre ART registration data for the month of Jan 2012, however we are presenting only the summary on their behalf) 

• HIV+ve detected (Jan 2012)  - 93
• Pre ART Reg (Jan 2012)  -  69 (74.2%) 

Surat DAPCU – Response to Question of the Month February 2012 - Facilitating Pre ART Registration

This post was in response to the February 2012 theme

1. For facilitating linkage between ICTC and ART we use ICTC –ART referral form. Quarter portion of this form mentioning name of ART center, patient name, Pre ART number & CD4 count is given to ICTC counselors in our monthly meet of ICTC by ART counselor who also attends this meeting.
2. We have also given mobile numbers of all ICTC counselors to ART centers so sometimes ART staff  also inform through SMS to concern ICTC counselor.
3. PPTCT centers  located near ART centers like Civil hospital & SMIMER hospital send their ORWs along with clients to ART  centers so that LFU chances be minimized.
4. We also have around 14 PMTCT ORWs who take list of LFUs from ICTC centers and follow up HIV positives for referral to ART center. These ORWs are posted at various ICTC centers and they have been assigned duty of LFUs follow up, ANC referral and DBS referral.

Kohima DAPCU's experience with District Annual Action Planning - 2012-13

Kohima DAPCU submitted this post on their experiences with DAAP. 

Doing District Annual Action Planning (DAAP) at Kohima was a new experience for all of us. Teams from different components of the HIV programme attended the DAAP processes and this has helped in fine tuning the plan to the specific requirements of the district. We feel that DAAP promotes interaction and collaborative effort between all the program components and various line departments.

DAPCU DPO- Ms Sentimongla Tzudir, NRHM DPM- Neisevonuo Linyii and Deputy CMO Dr Avino discussing              NACP- NRHM convergence during DAAP

One important outcome of DAAP in Kohima will be closer coordination with NRHM through their field workers, mobile medical units and village level health activities like VHNDs. Another important area for planning this year was taking forward the interest shown by the police health unit in operating FICTCs. In Kohima itself we have proposed two such FICTCs.

The medical officers of ART and Blood Bank  feel that by involving district level service units in DAAP, proper need based plans can be developed for the state. They were able to estimate their requirements of drugs and stocks and feel that when similar estimates are collected from all around the state it will be possible to ensure correct supply without shortage and wastage at facilities. 

Neisevonuo Linyii, DPM,NRHM,Kohima- “It is a good exercise. In NRHM also we have prepared action plan but we have not involved other departments. In this way this DAAP exercise is entirely different as it is involving all the departments at District. We know how to work in coordination.”

Dr.Vezokholu, DTO, Kohima- “ We are new to this kind of exercise. However it made us to understand how to work in coordination to improve cross referrals.”

Sentimongla Tzudir, DPO, DAPCU- “ Though the time given to us is short, we tried level best to complete plan. It is good to involve all the departments.  For next year we will be better prepared with the required block level data for better planning.”

Dahod DAPCU – Response to Question of the Month February 2012 - Facilitating Pre ART Registration

This post was in response to the February 2012 theme

Dahod is a tribal district of Gujarat. Migration is one of the major problems to provide continuous health services to people in the district. It was difficult to reach ARTC for PLWHA after diagnosed being tested positive. In the year 2010-11, Pre ART registration was very low (64%). DAPCU has tried to strengthen linkages between ICTC and ARTC for Pre ART registration of individuals diagnosed as HIV positive. DAPCU adopted some strategies for ICTCs to fill the gap of Pre ART registration.

• Proper referral mechanism.
• Co-ordination with ARTC Baroda and Godhara.
• Provision of transportation to reach ARTC. (Use vehicle of hospital under RKS-Rogi kalian Samiti)
• PLHA follow up for pre ART registration.
• Gradually started LAC and ARTC. (Now CD4 testing facility available in district.)
• Monthly review for ICTC- ARTC coordination.

Month2011	PLHA	Pri ART Registration	Remarks
April’11	22	22
May’11	20	17	1 -Not Cooperated - ICTC Dahod 2 -Follow up Awaited -ICTC Dhanpur
June’11	5	5
July’11	9	8	1- Death  - ICTC Sukhsar
August’11	9	7	1- Death - ICTC Dahod 1 - Not Cooperated - FICTC Dudhiya( Limkheda)
September’11	11	10	1- Death- ICTC Dahod
October’11	17	15	1- Follow up Awaited- ICTC Dahod 1- Death - ICTC Dahod
November’11	21	17	1- Follow up Awaited - FICTC -Jesawada( Garbada) 3- Death - ICTC Dahod
December’11	16	16
Total	130	117

Due to regular follow up and proper referral mechanism ICTC-ARTC referrals increased up to 90%.

Bangalore Urban , DAPCU – Response to Question of the Month February 2012 - Facilitating Pre ART Registration

Period	ANC positive	CD4	Eligible for ART	Put on ART
April 2010 to March 2011	226	106(47%)	23	12 (52%)
October 2011 - December 2011	48	40(83.3%)	10	10(100%)

Strategies in Bangalore Urban district to ensure people diagnosed HIV positive from ICTCs to reach the ART Centre for Pre - ART registration are as follows

1. We held NGO Co-ordination meeting at the DAPCU Office and discussed in detail about the situation of the gap between positives detected and the ART reached status in Bangalore Urban. 
2. The number of outreach workers was assessed and each ORW was allocated one or two ICTCs according to their concerned area of work. After this meeting the ORWs visited to their respected ICTCs once or twice in a month and took the list of positives not reached to ART centres and followed them up mainly through home visits and gave the feedback to the ICTC counsellors. This aspect was strictly reviewed during the monthly meetings.
3. The help of ORWs of DLN was also used in the same manner.
4. All the MOs of PHCs were instructed to utilise the help of ASHA workers for the follow up of HIV positives. Thanks to the NRHM for the incentives given to the ASHA workers for this work.
5. The Saturday outreach activity of ICTC counsellors is mandatorily reviewed in our monthly meetings.
6. The list of Non ART reached cases is being collected from the ICTC counsellor in the monthly meeting and shared with the RCHO, MOs for the follow-up using their field staff.

Balangir DAPCU – Response to Question of the Month February 2012 - Facilitating Pre ART Registration

The situation / problem / gap

1.   Non-cooperation and non-receipt of ART registration data from other ART centres.

2.   Inadequate Outreach and follow up by counselors and DLN

3.   Irregularity in Madhu Babu Pension Yojana (MBPY) and other State Govt. Social benefit schemes for PLHIV

Action initiated

1.   Encouraged effective post-test counseling by counselor and follow up.

2.   Follow up by self and through ORW by counselor.

3.   Through different ORW like TI / DIC (Positive Network) / PPTCT NGO (Utkal Sevak Samaj-USS) with block wise point person from positive network.

4.   Encouragement in the form of payment of travel cost (To and from). (In DAPCC meeting on 23-09-2011)

5.   Free of cost medical tests before ART registration. (In DAPCC meeting on 23-09-2011)

6.   Free distribution of mosquito net. (In District Coordination meeting of Positive Network on 14-12-2011- by CDMO)

7.   During monthly review meeting, the gap analysis is made between the HIV +ve detection and ART registration.

8.   Establishment of coordination with DLN, with ICTC.

Status 2010 and 2011

Year	Detection	Cumulative detection	Cumulative Pre -ART Regn.
2010	103	385	53 (14%)
2011	121	506	268 (53%)

Status August - September 2011

Month	Detection	Pre ART Regn.
Aug-11	13	10
Sep-11	9	7
Oct-11	9	4
Nov-11	9	5
Dec-11	5	2
Total	45	28 (62%)

Tirupur DAPCU – Response to Question of the Month February 2012 - Facilitating Pre ART Registration

This post was in response to the February 2012 theme

In Tirupur the ICTC Counselor conducts outreach visits and meets positive individuals every Saturday. This is found to be helpful and in GHQH Tirupur , GH Dharapuram and GPHC, Perumanallur  the outreach visits of 3  counselors were able to ensure Pre ART registration of clients within 10 days of their outreach/home visit.

S.No	Name of the ICTC	Name of the Counselor	Client's test date	Counselor Saturday Visit date	Client Pre ART Register date
1	GHQH, Tirupur	Mr.Kannan	30.11.11	10-12-11	15-12-11
2	GH, Dharapuram	Mr.Thangaraj	07.09.11	10.09.2011	14.09.2011
3	GPHC, Perumanallur	Mr.Vijai Prakash	13.01.2012	21.01.2012	28.01.2012