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Annual Report 2008 - 2009 CT Global Fund Project PFI |
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ANNUAL REPORT 2008–2009
ACCESS TO CARE AND TREATMENT – ACT
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ANNUAL REPORT 2008–2009
ACCESS TO CARE AND TREATMENT – ACT
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Acknowledgement
P opulation Foundation of India (PFI) is pleased to
present the fourth annual report of the program
“Access to Care and Treatment –ACT”. This program
is in its fourth year of implementation in the six high
prevalence states of India for providing care and support
to People Living with HIV/AIDS.
Population Foundation of India heartily acknowledges
the contribution of all its partners viz., Indian Network
for People living with HIV/AIDS (INP+), Freedom
Foundation, EngenderHealth Society and Confederation
of Indian Industry together with St. Joseph’s Leprosy
Hospital cum HIV/AIDS Care Centre, Tuticorin, Tamil
Nadu, Meetei Leimarol Sinnai Sang, Manipur, Imphal
and Development Association of Nagaland, Dimapur,
Nagaland for their continued support and efforts in
implementing the program.
The Governing Board, the Project Advisory Board and
the management team of PFI have been consistently
providing their support, supervision and guidance for
the timely and smooth implementation of the program.
PFI expresses its gratitude to all the members.
PFI thanks National AIDS Control Organization and
State AIDS Control Societies for their support in
implementation of the program.
PFI expresses its sincere thanks to The Global Fund
for extending their support for the care and support
program while addressing the needs of the people living
with HIV/AIDS in India.
The PLHIV have been the core of the program.
This program has helped them in enhancing their
capacity and facilitating access to treatment, care
and support. Their participation in the program
demonstrates their commitment in improving the lives
of fellow PLHIV.
PFI conveys its appreciation to the members of the
Project Management Unit at Delhi and the State
Program Coordination Units for their coordinated efforts
in managing the program.
Dr. Mary Verghese
Project Director
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Contents
Abbreviations
3
Executive Summary
5
Overview
7
Care and Support Activities
9
Advocacy
17
Capacity Building
19
Program Management
23
Lessons Learned
31
Financial Report
33
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Abbreviations
ACT
AIDS
ART
ARV
CCC
CCM
CCSC
CETC
CII
CMIS
DAN
DLN
DNO
DOTS
EHS
EQAS
FF
GFATM
HIV
IDU
INP+
MIS
MoU
NACO
NGO
OI
Access to Care and Treatment
Acquired Immuno-Deficiency Syndrome
Antiretroviral Therapy
Antiretroviral
Community Care Center
Country Coordinating Mechanism
Comprehensive Care and Support Center
Continuing Education and Training Center
Confederation of Indian Industry
Computerised Management Information System
Development Association of Nagaland
District Level Network
District Network Officer
Directly Observed Treatment (Short course)
EngenderHealth Society
External Quality Assurance System
Freedom Foundation
The Global Fund to fight AIDS, Tuberculosis and Malaria
Human Immunodeficiency Virus
Injecting Drug User
Indian Network for People living with HIV/AIDS
Management Information System
Memorandum of Understanding
National AIDS Control Organization
Non-Governmental Organization
Opportunistic Infections
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Abbreviations
PAB
PFI
PHC
PLC
PLHIV
PR
PTE
SACS
SDP
SPCU
SGM
SLN
SR
TCC
Project Advisory Board
Population Foundation of India
Primary Health Center
Positive Living Center
People Living with HIV
Principal Recipient
Peer Treatment Educator
States AIDS Control Society
Service Delivery Point
State Program Coordination Unit
Support Group Meeting
State Level Network
Sub Recipient
Treatment Counselling Center
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Executive Summary
T he program “Access to Care and Treatment-ACT”
commenced, in April 2005 for a period of five
years completed its fourth year of implementation
by March 2009. As of March 2009, 130 District Level
Networks have been established with 167,815
PLHIV enrolled for care and support services. District
Level Network is a voluntary association of PLHIV,
representing the collective interests of its members
for their care and support. The District Level Networks
enroll PLHIV in respective districts and offer preventive
care and support services. This includes adherence
counseling, Support Group Meetings, referral linkages
to other service providers and advocacy activities.
District Level Networks also provide social and legal
services, economic and occupational support and
advocacy with the local stakeholders. District Level
Networks identify PLHIV to be trained as peer educators
(Peer Treatment Educators or PTE), who carryout
treatment adherence counseling, nutrition education
and awareness on reproductive health among PLHIV.
The Treatment Education Access Officers (TEAOs) trained
by EngenderHealth Society (EHS) as Master Trainers,
are in turn expected to identify motivated PLHIV
and train them to work as PTE on voluntary basis at
respective taluks /blocks within the district.
Forty four Treatment Counseling Centers established
in the program complement the operational
effectiveness of the ART centers in the form of
adherence counseling, psychosocial support to PLHIV
and their family members through peer counseling,
networking and linkages with other service delivery
points, and in enhancing the overall quality of services
to the patients attending the ART centers. TCC provides
referral linkage to the PLHIV, with the District Level
Networks and other NGOs for specialized support.
Apart from providing the PLHIV with a referral linkage
to the District Level Networks, TCCs also inform
the respective District Level Networks of any ART
defaulters from the district. Tracing the ART defaulters
at the community level through out-reach work and
re-enrolling them to the ART center is carried out by
the PTEs.
The Positive Living Centers (PLCs) provides primary
health care facilities for PLHIV, including periodic
health checkups, provision of nutritional supplements,
undertake home visits (if needed), provide referral
linkages to ART centers in public hospitals, and support
the needs of infected/ affected women and children.
As of March 2009, 16 PLCs have been established and
provided services to 10,587 PLHIV. The Comprehensive
Care and Support Centers (CCSC), established as a
50-bedded health care service facility, provides
medical care and support, palliative care for those
who are terminally ill, counseling, and community
education. CCSC also offers services such as cremation
of PLHIV destitute or those disowned by their families.
The Community Care Centers (CCCs), established with
10 to 20 beds offer similar services to the PLHIV. CCSCs
have provided medical and psychosocial services to
15,116 PLHIV as of March 09. Six corporate supported
ART centers have been established under the overall
framework of public-private partnership. Under the
partnership government (NACO) provides the ART
drugs, test kits, and training while the corporate
organization provides infrastructure, funding of
equipments and staff.
The ACT project also envisaged building capacity
and organizational development for key functionaries
from District Level Network, TCC, PLC and CCSC through
training modules prepared on Treatment Adherence.
Training is imparted by the EngenderHealth Society
directly or through regional Educational Training
Centers (CETCs) on treatment adherence counseling,
community and home based care and other support
services. The training modules have been translated
in 6 languages (English, Hindi, Kannada, Tamil, Telugu
and Marathi).
The ACT program has mobilised the PLHIV community
and provided a number of benefits to them such as
reduction in stigma and discrimination and improving
the quality of life of PLHIV which may not be easily
quantified but is captured through the program
data, case studies and interviews. The program has
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decentralization structures and established support
group meetings at the block level. This has helped
in mobilizing PLHIV to access services and follow up
for adherence and also encouraged the involvement
of family.
The reinforcement counselling that takes place at
different levels and further reinforced at the support
group meetings have contributed to increased
adherence. PLHIV who are associated with the
program exhibit an increased confidence, better
health, reduced morbidity, better social acceptance
along with access to Government services and
other services which help to improve their lives and
livelihood. The greater involvement of PLHIV at the
district, state and national levels has been achieved
and an institutional base has been created for the
formation. The establishment of ART Centres through
private public partnership have provided a number
of models for increasing the availability of the ART
centres as well as widening the scope of the private
sector involvement Overall, the services provided
under the ACT program are seen to be making a
difference in the quality of lives of PLHIV. Service
utilisation is on the increase, showing both acceptance
and utility. While there is still a list of unmet needs such
as legal assistance in contesting cases, ambulance
services, place to stay over night when they come
for tests and medicines the primary needs have been
addressed. The program has also established effective
linkages and networking with NGOs and private
sector for services.
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Overview
T he Access to Care and Treatment (ACT)
program is implemented by the NGO/Private
sector consortium led by Population Foundation of
India (PFI) under the Global Fund Round 4 program
in the six high prevalence states of India (Tamil Nadu,
Andhra Pradesh, Karnataka, Maharashtra, Manipur and
Nagaland) in coordination with the National AIDS Control
Organization (NACO). The program started in April 2005.
It is currently in the second phase of implementation
and will ends by March 2010.
The overall goal of the program is to improve the
survival and quality of life of People Living with
HIV/AIDS and at reducing HIV transmission. The
objective of the program is to reduce morbidity
and mortality associated with HIV/AIDS and the
transmission of HIV in the six high prevalence states
by combining care, treatment (including ART),
prevention and support. National AIDS Control
Organization (NACO) is providing Anti-Retroviral
Treatment (ART) through the public health facilities.
The NGO/private sector consortium is providing care
and support to people living with HIV/AIDS (PLHIV)
in the six high prevalence states of India.
NGO consortium members are:
Population Foundation of India (PFI): The
Population Foundation of India is the Principal
Recipient and is responsible for managing the
program and grants.
Indian Network for People Living with HIV/
AIDS (INP+): The program has enabled INP+ to
establish and strengthen District Level Networks
(DLNs), Treatment Counselling Centres (TCCs) and
Positive Living Centres (PLCs).
EngenderHealth Society (EHS): EngenderHealth
Society has built the capacity of service providers
engaged in the Service Delivery Points and trained
NGOs in home based care.
Confederation of Indian Industry (CII): CII has
facilitated corporates to set up corporate ART
Centres.
Freedom Foundation (FF): Freedom Foundation
has established Comprehensive Care and Support
Centres.
Besides, three other NGOs are implementing Community
Care Centers in the program. They are:
St Joseph Leprosy Welfare Society, a 20-
bedded facility located in Tuticorin, Tamil Nadu,
for providing institutional care and support
services.
Development Association of Nagaland (Chavara
Home) a 10 bedded facility, located in Dimapur,
Nagaland, for providing institutional care and
support services.
Angel’s Care Centre, a 10-bedded facility, located
in Moreh, Chandel District, Manipur for providing
institutional care and support services.
The managerial and technical capacity of the Service
Delivery Points has been enhanced through, capacity
building of Service Delivery Point personnel, supportive
supervision and feedback.
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Care and Support Activities
“The aim of the “Access to Care and Treatment – ACT” program is to provide care and
support services to the People living with HIV/AIDS with the objective “to reduce
morbidity and mortality associated with HIV/AIDS and the transmission of HIV in six
high prevalence states by combining care, treatment, prevention and support’.
T he main service delivery points of the program
have been District Level Networks (DLNs),
Treatment Counseling Centers (TCCs) and Positive
Living Centers (PLCs). By March, 2009, 130 District
Level Networks, 44 Treatment Counseling Centers
and 16 Positive Living Centers have been established
and strengthened in the program to provide care
and support services to PLHIV across the six high
prevalence states.
The program has capacitated the staff and the PLHIV
community both to implement the program and sustain
their activities over a period. During the year, training for
counselors, master peer educators and peer educators
were conducted. Capacity building was done to enhance
leadership skills and quality improvement of services.
District Level Network
To provide care and support services under ACT
program, INP+ has signs MoUs with the State Level
Networks and District Level Networks. Before signing
MoU, District Level Network has to be registered as
a society by the District Registrar office. The District
Cumulative PLHIV enrollment at DLNs
2009
167815
2008
0
113047
50000
100000 150000 200000
Level Networks are civil society organizations that
represent the collective interests of PLHIV from
respective districts.
The total enrolment of PLHIV as of March 2009, was
167,815 out of which 61352 were on ART. Enrollment
includes men, women and children. Other vulnerable
groups like widows, Injecting Drug Users (IDUs),
Female Sex Workers (FSWs) and Men having sex
with Men (MSM) were also covered by District Level
Networks. The enrollment reflects the acceptability
and functional effectiveness of District Level
Networks, and also the unmet demand for care and
support services to the PLHIV. There is an increase
in the average of enrollment at each District Level
Network from 890 as on March 2008 to 1291 as on
March 2009.
Cumulative Enrolment at District Level Networks from
June 2005 to March 2009
A total of 4062 PLHIV were provided psychosocial
support through Support Group Meetings (SGM).
Master Peer Treatment Educators, who were
trained by EngenderHealth Society (EHS) further
trained 4722 Peer Treatment Educators.
District Level Networks have traced 1621 defaulters
and reported back to the ART centers in the year
2008–2009.
District Level Networks play a key role in HIV prevention,
care and support services, treatment adherence follow
up through outreach and promoting and protecting the
interests of PLHIV in the society. District Level Networks
are organized and managed by a small group of
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Cumulative State wise Enrollment at District Level Networks
60000
55000
50000
45000
40000
35000
30000
25000
20000
15000
10000
5000
0
AP
(23)
KN
MH
TN
MN
NG
(26)
(34)
(30)
(9)
(8)
ART Non-ART Converted from N- ART to ART Total
motivated PLHIV, who are responsible for the activities
of the District Level Network and its achievements. In
several places, District Level Networks have established
linkages with organizations such as government
departments, public sector banks, private entrepreneurs,
private health care providers and NGOs for a variety of
support services such as widow pension, job placement,
child education support, nutritional support, insurance,
income generation activities and vocational training.
Many District Level Networks have created opportunities
for its members in Income Generation Programs (IGPs)
such as tailoring, candle making, handicrafts, etc.
Some of the District Level Networks have a decentralized
(Taluk level) management of PLHIV groups. Block
level groups and District Level Networks have clear
earmarked responsibilities. The block level groups
handle support group meetings, enroll PLHIV and
sensitize service providers when there is discrimination
and denial of services to PLHIV at the local level.
Support Group Meetings-Taluk level –
District Level Network
takers participate in these meetings. Local resource
persons like counsellors from ICTCs and ART centers,
lab technician, nutritionist, doctors, SHG members,
government officials, NGOs and other stakeholders also
participate in the sessions.
Peer Conventions
The State Level Networks organized Peer Conventions
across the six states to motivate and encourage peer
educators. The peer educators educate and motivate
PLHIV on accessing services, positive prevention,
nutrition and treatment adherence. The best peer
educators were recognized on their performance in the
community.
Quarterly Program Reviews
INP+ officers, State Level Networks and PFI state offices
conduct state level review meetings on program and
MIS. The progress of the program and data are verified in
these meetings. Based on this review feedback is given
to service delivery points to develop their action plans.
Support Group Meetings are the platform for PLHIV to
share their experiences, gain information on life after
infection, positive living and positive prevention. Peer
educators help DLNs in conducting Support Group
Meetings at taluk level. Approximately 13 to 20 new
and old clients (on ART & not on ART) along with care
Strengthening Systems and Program
Implementation
INP+ has organised workshops for SLNs and District
Level Networks to strengthen systems and program
implementation at the district level. The President,
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Secretary, Treasurer, State Program Associate (SPA),
Treatment Education Officer and MIS Officer participated
in the workshops. These workshops focused on
governance, project updates, strategies, monitoring
mechanisms, specific roles of staff, communication
channel, reporting and documentation. Other than
program activities, technical aspects and updates on
HIV/AIDS were also discussed during the workshops.
Preparation of IEC materials
(Treatment, Education and Adherence
(TEA) diary)
INP+ developed and printed treatment, education and
adherence diary for PLHIV. TEA diary is an educational
tool and provides information on treatment adherence,
good nutritional practices, ART dos and don’ts, all the
network addresses, information about ART centres
and other services when they migrate or travel.
Pre-planned Support Group Meeting schedule is
available in the daily calendar for reference. These diaries
are distributed to PLHIV who are enrolled at District
Level Network for monitoring treatment adherence.
A daily ART calendar is available where PLHIV marks
when he/she has taken his/her daily doses. It also
provides space to include the PLHIV health status that
could be used in an emergency.
Promising Practices
The District Level Network at Theni, Tamil Nadu,
has been successful in reducing the stigma
and discrimination through proactive methods
and campaigns. The members are encouraged
to disclose their HIV status wherever possible
or needed while seeking services (e.g. while
receiving an injection in a health facility). Such
self disclosure, during the initial stages had
created a great deal of stigma, discrimination
and denial of services. However through rigorous
advocacy meetings and campaigns, District
Level Network members have been able to
slowly overcome the stigma in the community.
To illustrate the effectiveness of this campaign,
during the last local body elections, ten PLHIV
contested the elections with one of the women
member successfully getting elected as a
councilor.
The District Level Network at Anantapur, Andhra
Pradesh successfully negotiated with the local
administration to allot separate building and
physical space for the District Level Network and
DIC within the premises of the district hospital.
Khammam, Medak and Vizayanagaram District
Level Network are following post card method for
address verification and defaulter identification.
After receiving the list from ART center, District
Level Network outreach team plans the visits and
traced the defaulters.
Vizag District Level Network in coordination with
Vishakapatnam District AIDS Control Society
(VDASC) has taken up Income Generation
Programs for widowed PLHIV. Widows mobilised
some money through monthly savings. VDASC
has provided small grants to them. They
established a small unit for preparing phenyl
and bleaching powder. These products are
supplied to Greater Visakhapatnam Muncipal
Coorporation.
The Kohima Network of People living with HIV/
AIDS (KNP+), Nagaland was registered on the
28th April 2006 and started implementing ACT
program in August 2006. Despite initial difficulties
in program implementation in Nagaland due to
many drug relapse cases in the Board members
itself, the District Level Network was capacitated
with the constant support from the SLN and
PFI. They have approached many government
officials to explore government schemes. They
succeeded in getting a grant from Chief Minister
corpus fund of Rs. 3 Lakhs for Income Generation
Programs. KNP+ purchased a taxi and the income
earned is utilized for office maintenance. In
addition the vehicle is also used for emergency
services to transport the clients for treatment to
the hospital.
Dimapur Network for People Living with HIV/
AIDS (DNP+), Nagaland had collaborated with
the Entrepreneur Associates (EA). Entrepreneur
Associates provided one day orientation on
entrepreneurial skills development to PLHIV. 15
PLHIV living below poverty line were short listed
to set up their own business. Seven of them have
started grocery shop and eight members have
started piggery farm with the capital of Rs. 10,000
per person respectively.
In Karnataka, Hassan District Level Network
supports the needs of PLHIV by linking them with
various schemes available. Through the linkages,
they have provided housing facilities to 25 PLHIV
through Rajiv Gandhi Housing schemes; loans
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of Rs 5000/-each to 25 widows to initiate IGP
activities; BPL ration card facilities to 109 PLHIV and
nutrition supplements to 80 PLHIV and 25 CLHIV
every month with the help of Chikmangalore
Multipurpose Social Service Society, Swami
Vivekanada Youth Movement and Citizens Alliance
for Rural Developments and Training Society. They
have also formed District Women Forum and Self
Help Groups.
Belgaum District Level Network (Spandana)
started Children’s Care Home (Spandana Makkala
Dhama) at Hukkeri. 15 orphan children are
availing the residential and educational support
from there. District Level Network raised the fund
through organizing music concerts. The network
staff also donated their one month’s salary to the
Care Home.
In Maharashtra, Akola District Level Network
started orphanage for CLHIV with the help of a
NGO. At present 6 children are being provided
shelter and education. 100 PLHIV were supported
by facilitating their applications for Sanjay Gandhi
Niradhar Yojana. All the 100 applications were
sanctioned. 10 PLHIV got loan of Rs.10,000/-
each for self employment. Solapur District Level
Network has formed 12 SHG of WLHIV and have
started income generation program. Kolhapur
District Level Network trained PLHIV for making
leather bags through Maharashtra Udyojagta
Vikas Kendra.
The Imphal East Network have an income
generation program for male PLHIV which deals
in making soft board and white board. People
appreciate the products and there is demand for
these products. For female PLHIV, the network
is having a tailoring and wool knitting cum
production centre. The Network also supports
a Self Help Group of HIV of widows living with
HIV who are running a catering service as a part
of their income generating activity. The District
Level Network is also planning to start plantation
of flowers and orchids with support from the
Horticulture Department.
Some of the positive outcomes of the advocacy
initiative taken up by Ukhrul District Level Network
(UNP+) are as follows:
6 WLHIV have received Widow Scheme from
Social Welfare Department and 5 WLHIV
have been referred to Center for Women
Empowerment for vocational training and
have completed weaving and embroidery
course
6 Infected Orphan have received Child
Dependency Scheme from Social Welfare
Department, 3 Children have been referred
to Shishu Graha Orphanage Boarding School,
Phungreitang Ukhrul and 4 infected orphan
have been referred to Tabitha Ministry,
Mantripukhri, Imphal for foster care and
support
UNP+ advocated with Than Laboratory (local
private lab) for investigations fee concession
for the tests which were not available free of
cost at Government Hospital. Than Laboratory
agreed to provide concession of Rs. 70/-for
the PLHIV referred by UNP+
Treatment Counseling Centers
A team of three counsellors, TCC in-charge, Counsellor &
Peer Counsellor are responsible for counselling, referral
and coordination activities. All the three staff are directly
involve in providing counselling -one to one, family,
couple, discordant couple and group. TCC in-charge
maintains the records with the help of Counsellor and
Peer Counsellor. The TCC staff report to the ART Medical
Officer and State Program Associate of INP+.
TCCs also build linkages with ICTC, ART Centre, PPTCT
centre, TB unit, STI clinic, NGOs and other service
providers and refer clients based on their need. As of
March 2009, 44 TCCs have been established at the public
ART centers in the program.
The TCC team collects the defaulter list from the ART
centre and share it with the District Level Networks,
Positive Living Centres, NGOs and other service providers
for bringing the defaulter clients back to the ART centre
for continuing the treatment.
There are certain promising practices that have evolved
out of the functioning of the TCC:
The peer counseling using the triple-A principle
(Adherence, Admission and Attender) has
enabled patients who are initiated on ART to
understand the importance of taking the ART
medicines as prescribed by the Medical Officers
and compliance to scheduled visits to the ART
centers. Some TCCs in Tamil Nadu follow triple-A
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plan,duringpre-ART stageoverathreedayperiod.
On the first day, ART information and counseling
is provided; on the second day a question and
answer session is held with the same group of
PLHIV; and on the third day, further counseling
is carried out before the PLHIV is referred to the
ART Medical Officer for the drug prescription.
It is claimed that this strategy helps the PLHIV
to be mentally prepared and ready for the ART
drugs over a long period. Over 90% of the PLHIV
attend the consecutive three day sessions, while
the remaining PLHIV attend such sessions within
a week.
In certain ART centers, the TCC staff with the
help of pharmacists collect the list of persons
who were scheduled to visit the ART centre on
a particular day but have not attended the clinic
on that day. The patients who did not attend the
ART clinic on that day were followed up either
through telephone or by peer group member
or even by personal contact on the same day.
At KEM hospital Mumbai, the TCC staff prepares
a list of ART cases that did not report on that
day and follow up the concerned PLHIV
through a telephone call. Wrong telephone
numbers are corrected in due course. Separate
codes are used to indicate the status of the
missed PLHIV, such as wrong telephone number,
extended period of dosage, collection of drugs in
the following week.
The TCC at the Pediatric ART centre in Sion
Hospital, Mumbai, provides for TCC/ART
counselors as the first point of contact for the
patients. Data entry for registration is only at
the last stage, thus increasing the confidence
of the patients in the system. There are two
separate counselors attached to the TCC, who
also undertake out reach work.
Positive Living Centers
Since the inception 16 Positive Living Centers (PLCs)
have been established in the program. PLCs are
expected to hold Support Group Meeting, provide
drop in center facilities, follow-up through home
visits, assist the PLHIV needing ART (pre-ART) through
referral linkage to the ART centers, provide linkages to
other service providers, provide basic primary health
care facilities, address the needs of infected, affected
and vulnerable women and children and create an
enabling environment through advocacy, support
group meetings and linkages. PLCs also have strong
network with NGOs through a wide array of activities
including educational support to infected/affected
children. A total of 10,587 PLHIV were provided services
at PLC.
PLC facilitated the formation of support nets. The
support net has been initiated on a pilot basis. In 5
districts of Tamil Nadu 16 support net groups have
been started with 163 members. The objectives of
the support net are:
To reduce the stigma and discrimination
against PLHIV
To improve the socio economic status of
PLHIV
PLCs organized Life Skills Education (LSE) program for
children by using module developed by Family Health
International (FHI). INP+ facilitated 3 days training
program for PLC staff to build the capacity of PLCs on
Life Skills Education. Resource persons from FHI and
program officer of the State Level Network facilitated
the trainings.
Through PLCs, caregivers of the PLHIV were trained on
topics such as home based care, treatment adherence,
nutrition education, palliative care and OI referrals.
These trainings helped the caregivers to understand
the problems and issues faced by PLHIV. This helped in
reducing the level of stigma and discrimination in the
family and community.
The education kit with 10 notebooks, 10 pencils, 2 pens,
2 tiffin boxes, pencil box, bag, eraser, geometry box and
school uniform has been provided to orphan and semi
orphan children. This support has been provided once
a year to motivate children towards their studies. Apart
from educational support, 60 children were supported
by each PLC for their nutritional needs. Every year,
50 children were supported for one day education
trip. The places of visit were nearby industry, heritage
place or tourist place. The trip motivates, relaxes and
encourages children.
PLCs organize coordination meetings twice a year
to establish linkages with ICTC, PPTCT, ART Centre,
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Cumulative Enrollment at PLCs from June 05 to March 2009
3000
2500
2000
1746
2727
2890
2495
1500
1000
500
445
284
0
AP
KN
MH
TN
MN
NG
(2)
(3)
(3)
(4)
(2)
(2)
STI department, TB Unit and other important service
providers (like private hospitals, NGOs, volunteers, Lions
and Rotary clubs). PLCs also conduct workshops for
health care providers to orient them on Positive Living
Centre activities, HIV/AIDS, stigma and reproductive
health needs. These workshops help in developing
referral system with in the districts.
PLCs also organized events such as Women’s Day, World
AIDS Day, Children’s Day for the greater participation
and involvement of the community.
The Consultative meeting for effective functioning
of Positive Living Centers was held on 25th & 26th
September 2008. The meeting was attended by the
PLCs staff, INP+ ACT Team and State Coordinators
and Program Mangers from PFI.
Community Care centers (CCCs) setup in the program
is ranging 10 to 50-bedded. Till March 2009, 7 CCSCs
have been established 2 in Andhra Pradesh and
Tamil Nadu, and one each in Karnataka, Manipur and
Nagaland. Two CCCs were established in the last
year. One CCC was established at Moreh, Manipur.
It is a ten bedded facility and the other at Kakinada,
Andhra Pradesh is a 20 bedded facility. As of March 2009,
CCSCs have provided services to 15,116 PLHIV.
The Care Centers provide medical services to the clients
which include OP and IP services. IP services include
admissions for pre ART monitoring, Opportunistic
Infections (OI) management and palliative care.
Specialized treatment services are provided through
referrals and linkages. Centers are also linked to the
Directly Observed Treatment Short course (DOTS)
program. Nursing staff work in shifts and hence nursing
care is available round the clock.
Comprehensive Care and
Support Center
Comprehensive Care and Support Centers (CCSCs)
are functioning as a bridge between tertiary care
service available in the public health system and
primary health care. The bed capacity of CCSCs and
Most of the centers are equipped with a small
laboratory where basic bio-chemistry tests along with
microscopic examination of urine and sputum are
done. Higher investigations are out sourced to nearby
facilities.
The centers are providing nutrition and comprehensive
counseling services to the clients. CCSCs and CCCs
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Bed Occupancy and Bed –turn over at CCSCs/CCCs from April 2008 to March 09.
Freedom Foundation-Guntur
Freedom Foundation-Bagalkot
Freedom Foundation-Trichy
St Joseph's Leprosy Hospital-Tuticorin
Development Association of Nagaland
Bed Occupancy
88.7
85.9
77.3
101.9
54.0
Bed-Turn Over Ratio in days
10.7
8.3
9.9
8.2
11.3
have appointed one outreach worker at ART center for
referrals and to assist PLHIV who are sick.
Promising Practices
Formation of Treatment adherence group (TAG)
CCSCs have developed a six month module for the
group meetings. These groups are named as Treatment
Adherence Groups. These groups are intended to bring
PLHIV together so that they assist each other in achieving
better drug adherence for ART, Anti Tuberculosis
Treatment and other OI drugs.
Phone follow up for On-ART clients
A list of on-ART clients who are registered at the CCSC
is prepared with their ART follow up date. One day
prior to this follow up date, CCSC counsellors call the
clients and remind them to collect the medicine from
ART centre.
Nutritional assistance to the community
On World AIDS Day 2008, Bagalkot CCSC provided
nutritional assistance to the families of 100 CLHIV
and approached community leaders for their
support. Ms. Geetha Jeevan, Welfare Minister and
Dr. Sathyamoorthy, ART Medical Officer participated
at CCC, Tuticorin for the World AIDS Day event and
delivered the key messages. At Trichy CCSC, nutrition
pack was provided to first batch of 30 PLHIV whose
CD4 count was less than 200 and was below poverty
line. Since the health status of PLHIV improved after
the nutritional assistance, it was extended to another
30 and as of date 50 PLHIV have been provided
nutritional support.
Blood Mobilization Activities
CCSC coordinated with the Blood Banks to organize
blood donation camps, awareness programs in
the nearby colleges and other organizations. This
helped in increasing the voluntary donation and
helped the clients to have adequate units of blood
transfusion.
Yoga Therapy
Yoga therapy has been introduced at the CCSCs. Different
Asana were taught by the yoga therapist. This helped
clients to relax their body and mind
Children Camp
CCC at Tuticorin had organized a Children Camp with
the support of Standard Chartered Finance Limited
bank volunteers. Children’s camp provided a platform to
children to exhibit their talents and to learn team sprit
and cooperation.
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Advocacy
C II has conducted 3 advocacy workshops/
Conferences at Mumbai, Bangalore and Guwahati
with the theme of “HIV/AIDS: Business Response to
Prevention Care andTreatment”. Issues discussed at these
advocacy workshops were workplace interventions
towards prevention, care and treatment; corporate ART
Centres; partnerships in creating sustainable workplace
solutions to deliver services to employees and the larger
community; partnerships in health as a mechanism to
mobilize additional resources and support for health
activities were the issues discussed.
To discuss the issues related to the operationalising of
the ART Centres and showcasing the industry efforts
towards HIV/AIDS prevention care and treatment under
the GF Project, 43 meetings with the government, NACO
officials, SACS officials, consortium partners and other
stakeholders were organised by CII. Other than regular
correspondence with industry partners for setting up the
ART Centres, 35 small group meeting were conducted to
sort out the challenges and issues faced by the companies
for the smooth operation of the established ART Centre
and the setting up of a new ART Centre.
ART drugs and 3718 PLHIV have been treated for OIs.
Reliance ART Centre, Patalganga,
Maharashtra:
Reliance Industries Limited is the largest private sector
company in India with manufacturing units at various
parts of the country. They have established an 82-bed
state-of-art hospital, which serves the industrial workers
and the local community in general at Patalganga.
The ART Centre was established at the hospital by Reliance
Industries and has been operational since December 2008.
The centre provides counseling, testing and treatment
(ARVs and OIs) services for HIV/AIDS clients.
Bajaj-YCMH-ART Centre, Pimpri
Chinchwad, Maharashtra:
Bajaj Auto Ltd. has set up an ART centre at the Yeshwantrao
Business Response to HIV/
AIDS: Corporate ART Centres
Under the ACT program, CII has facilitated the
development of corporate ART centers. As of March
2009, 6 centers were established. At these centers, 4287
individuals have been tested for HIV. CD4 count has been
done for 4088 PLHIV. 1922 PLHIV have been provided
Inauguration of Bajaj – YCMH – ART Centre
Corporate ART centers established under the ACT program.
ACC-WADI Karnataka
BILT-Ballarpur-Maharashtra
ACTFID-Vellore, Tamilnadu
BAL-Chinchwad Hospital Pimpri, Pune
GODREJ-Godrej memorial hospital, Vikhroli, Mumbai
RELIANCE Patalganga-Maharashtra
L&T Centre, Andheri, Mumbai
Operational since January 2007
Operational since August 2007
Operational since March 2008
Operational since August 2008
Operational since December 2008
Operational since December 2008
MOU Siged with CII, fesasibility study conducted by NACO and centre
approved Centre will be operational by end of July 2009
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Chavan Memorial Hospital (YCMH) at Pimri, Chinchwad.
The centre functions under the guidance of National AIDS
Control Organization (NACO) at the hospital located in the
Pimpri Chinchwad industrial belt. NACO supplies drug for
the first line treatment. Bajaj Auto Ltd has provided the
CD-4 machine for the HIV patients while YCMH takes care
of laboratory tests and treats Opportunistic Infections
for the ART recipients. The centre has been operational
since August 2008. The Centre has set up at a cost of
approximately Rs 31 Lakh. The company will be funding
this Centre with recurring expenses of Rs 18 Lakh annually,
apart from other incidental expenses.
Godrej ART Centre, Vikhroli, Mumbai,
Maharashtra
Godrej has established an ART centre as part of the
Godrej Memorial Hospital at Pirojshah Nagar, Vikhroli
East Mumbai. Godrej Memorial Hospital is a Trust
hospital with a 110-bed hospital with all facilities
available at subsidized rates. The hospital has five
Operation Theatres with attached sterilization units
and an ambulance service too. The Centre started its
operations in December 2008.
Larsen & Toubro ART Centre, Mumbai,
Maharashtra
Larsen & Toubro has been at the forefront of the
movement in Indian industry to increase awareness
levels of HIV/AIDS. They were one of the first companies
to formulate a clearly enunciated and comprehensive
HIV Policy and are committed to following the policy in
letter and spirit. In the light of the above, L&T decided to
set up an ART Centre in Mumbai for counseling, testing
and treatment of HIV/AIDS patients.
L&T has signed the MoU with CII, and the centre has
been approved by NACO. The centre will be operational
by end of July 2009.
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Capacity Building
E ngenderHealth Society (EHS) is responsible for
capacity building of service providers involved in
the program such as peer educators, counselors, doctors
and health care workers and NGOs. In phase II, a total of
1314 service providers have been trained by the end of
Q16 against a target of 1299.
Trainings
EHS has trained 91 peer educators as master trainers
who would impart training to their peers in their
own respective districts. 90 counsellors from
Treatment Counselling Centres, Positive Living
Centres, District Level Networks and Comprehensive
Care and Support Centres have been trained.
EHS facilitate doctors to have hands on training
in HIV/AIDS management at St. John’s Medical
College, Bengaluru, Karnataka. St. John’s Medical
College is a NACO accredited training centre for
conducting doctors training on ART as part of GFATM
Round VII project. Doctors from Service Delivery Points
across six high prevalence states participated in the
training. NACO/WHO curriculum was used for training.
Training of NGO staff on Home Based
Care
Refresher Trainings
The objective of the 3-day refresher trainings is to update
peer educators and counsellors’ knowledge about
recent topics such as second line drugs, Opportunistic
Infections and co-infections and equip them with skills
to counsel, provide care and support to People Living
with HIV.
Field observations reveal that the participatory
methodologies enabled participants to learn and
understand the technical topics and its practical
application.Thesessionsincludeopportunisticinfections,
co-infections, second line drugs, chronic HIV care for
children, post exposure prophylaxis, bereavement
counselling, support to the dying and other issues
related to disclosure and positive prevention.
Backstopping of Peer Treatment
Educators (PTE) Trainings
EHS and INP+ with support from PFI developed a
backstopping plan where in a core team from each state
level network of INP+ was constituted. Core trainers’
team comprised of 1 State Treatment Education Officer
and 4 Master Peer Treatment Educators (MPTE) from
different geographical areas of each of the six states.
During the first phase, EHS has trained 311 NGO staff
representing 79 NGOs from the six high prevalence
states on Home based Care. In the second phase 183
staff from 111 additional NGOs were trained.
Backstopping aims to support and enhance the
skills of newly trained trainers so that they develop
competence and confidence to function as Master
Trainers. This methodology includes coaching newly
No. of staff trained.
Master Peer Educators
Peer Treatment Educators
Counselors and Social Workers
Health Care Workers
Health Care Workers and Field Staff of NGOs
April 08 to March
2009
91
4722
90
56
90
June 2005 to March
2009
354
11506
613
99
500
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Backstopping Training for Peer Treatment Educators
trained trainers by observing them as they train others,
providing constructive feedback and re-training, if
necessary. Backstopping has helped newly trained
trainers to enhance their technical and training skills.
12 MPTE core teams have been backstopped in five
states:
Maharashtra -3
Tamil Nadu-3
Karnataka-2
Andhra Pradesh-3
Nagaland -1
All training sessions were preceded by pre-test. Same
questionnaire was administered before and after the
training to assess change in knowledge and attitude.
The pre training test results were analysed on the first
day of training. If the participants performed poorly
on a specific theme, for eg, 60% of the participants
did not give correct answer on breastfeeding of
infants born to HIV infected mothers, the trainers
would spend more time on these sessions to fill in
the gaps in knowledge and attitude.
Field observations indicate that trainers were
knowledgeable and able to plan the sessions, conduct
and coordinate the training. The sessions were
conducted as per the training curricula. Peer Educators
were confident to make action plans for taking message
of treatment adherence education further to wider
audiences.
Implementation of COPE Tools
Client-Oriented and Provider-Efficient popularly known
as COPE is a package of participatory QI tools and
approaches developed by EngenderHealth for use in
improving health care delivery in low resource settings.
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Pre-testing of COPE
Pretesting of COPE tools was done at two service
delivery points CCSC of Freedom Foundation in
Chinakakani, Guntur and PLC of INP+, Singarayakonda,
Prakasam District in Andhra Pradesh from 09 to
11 September 2008. Based on the feedback, tools
were finalized for implementation. The tools have
helped the staff to identify gaps in the service delivery.
This became evident, when it was brought out by
staff who said, “The tools gives us more clarity
because while providing the services we tend to
think that we are doing every thing that we can, but
when one looks through a rights perspective, then
we know there are rights of the client and also the
provider and there are ways to strike the balance
between the two”.
Implementation and Follow-up of COPE
COPE committee comprising of staff at the sites were
formed to look into the problems and solutions outlined
in the action plan. At 4 sites, follow-up visits have been
undertaken to look into the implementation of action
plan. Field observations indicate that staff have started
taking a proactive role in adopting a team approach to
solving problems at the sites.
Training of Master Peer Educators and Counsellors
in Uttar Pradesh and Rajasthan under Global Fund
Round 6 project is being carried using the peer
educator curricula. SAMASTHA project, as part of
their capacity building on treatment adherence is
also reprinting the curricula for Peer Educators and
Counsellors developed under the ACT program.
These curricula have also been posted on WHO
India website. The link for curricula is http://www.
whoindia.org/EN/Section3/Section125_1499.htm.
EngenderHealth Society implemented COPE package at
6 service delivery sites at CCSC Guntur, Andhra Pradesh;
PLC Singrayakonda, Andhra Pradesh; CCSC Bagalkot,
Karnataka; PLC Pimpri, Maharashtra; CCSC Trichy, Tamil
Nadu and PLC Namakkal, Tamil Nadu.
The COPE exercise enabled staff to identify areas
and issues pertaining to service delivery which need
improvement at their site and develop action plan.
Some of the areas identified include infection
prevention, RTI/STI training, proper waste disposal,
appropriate signages and written policies on
confidentiality and discrimination.
Continuing Education and
Training Centers (CETC)
EngenderHealth Society established three Continuing
Education and Training Centers (CETCs), one at Swami
Vivekananda Youth Movement (SVYM) at Mysore,
Karnataka; DESH at Chennai, Tamil Nadu and Diocesan
Social Service Society (DSSS) at Imphal, Manipur.
The staff at CETC comprise of Project Manager, Project
Coordinator and MIS incharge, Project Accountant
and 2 trainers. The CETC teams have been trained in
participatory methodologies and monitoring and
evaluation of the trainings. CETCs have been provided
continuous technical and managerial assistance for both
institutional and individual capacity building.
Action Paln Development during COPE Implementation
The EHS State Coordinator (SC) coordinates with CETC
staff to facilitate participation of counsellors, social
workers, PLHIV and the health care providers for the
roll out of the trainings. The CETC team is responsible
for managing the logistics of the training, conducting
trainings, collecting pre and post assessment data on
participants as well as managing the travel, food and
accommodation of the participants. Each CETC team
is responsible for organizing trainings, preparing the
additional training materials as per requirement.
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Program Management
P opulation Foundation of India has established a
Program Management Unit (PMU), at New Delhi
and State Program Units in all the six states. PMU is
headed by the Project Director with a team of
professionals to support the day to day coordination
and management activities. State Program Units are
a team of 2 people for overseeing the state specific
implementation. The Executive Director of Population
Foundation of India oversees the program. A Project
Advisory Board (PAB) is also in place to provide strategic
directions for the program implementation. The
PAB meets quarterly and review the progress of the
program.
Coordination Meetings
Meetings with National AIDS Control
Society (NACO) and State AIDS
Control Societies (SACS)
To facilitate smooth program implementation and
coordination at different levels, meetings were held
with NACO and SACS. Principle Recipient (PR) and
Sub Recipients (SRs) participated in the meetings. PFI
state units have organised coordination committee
meetings with SACS. Partner organisations involved
in implementation of the program also participated
in the meetings and shared their progress. These
meeting were chaired by the Project Directors of
respective SACS. Training curricula and IEC material
developed on treatment adherence under the ACT
program have also been shared with SACSs during
the meetings.
In Andhra Pradesh, APSACS has agreed to supply
ICTC testing kits to CCSC Guntur and to train
human resources at the CCSC.
A strategy for tracing the defaulters’ cases in
Andhra Pradesh was also discussed in the meeting
according to the available outreach worker. The
state office also submitted the annual calendar
of interaction meetings to SACS to ensure
participation of ART doctors.
In Karnataka PFI state team took the lead and
facilitated the discussions with KSAPS in obtaining
sanction for ICTC center under PPP model for the
Bagalkote CCSC set up by Freedom Foundation.
As a result KSAPS has entered into an agreement
with Freedom Foundation for ICTC. Since
Karnataka has witnessed very frequent change
in KSAPS Project Directors, the PFI state team has
involved other KSAPS representatives like ART
consultant; MIS officer in the meetings to ensure
coordination and linkage with KSAPS.
Maharashtra State AIDS Control Society
(MSACS) offered financial support to NMP+ for
registration of network as Community Based
Organization. Jobs were also offered to PLHIV at
CCC. One WLHIV was appointed at CCC as a staff
nurse. MSACS also offered nursing training at
Bel-Air institute for PLHIV who have passed 12th
standard. After the training PLHIV will be offered
job at CCC.
MSACS conducted training of Link Workers in 6
regions of Maharashtra through NMP+, 225 PLHIV
were trained as link workers.
Coordination Meetings with Partners
Program Management Unit (PMU) and PFI state units
coordinate the monthly and quarterly coordination
meetings with partner organizations to facilitate the
effective implementation of ACT program across the
state.These meetings helped in identifying performance,
gaps and direction to improve program effectiveness.
To sort out the issues related to north-east region, state
offices of Manipur and Nagaland jointly facilitated the
Regional Coordination Meetings with partner agencies
from both the states.
Apart from meetings, PMU and PFI state units provide
onsite hand holding support, regular programmatic
inputs and support to the service delivery points through
regular field visits. PFI state units also organized training
programs on MIS and CMIS to enhance the capacity and
ensure the quality of data.
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Review Meetings
Two review meetings were organised by PMU with
the PFI state units. All state units from Round 4 and
Regional units from Round 6 program have participated
in the meetings. In the meetings State Units have
presented the performance of the program, gaps and
possible strategies to address the gaps in their states.
Skill building workshop on documentation was also
arranged in one of the meetings, which was done by
external resource persons.
Interaction Meetings
Through Interaction meetings an effort was made to
help the service delivery points in strengthening the
areas like coordination, linkages and advocacy. In these
meetings representatives from various stakeholders
such as District Level Network, ART center staff, ICTC
counselors, NGO representatives, PLHIV, Government
officials from Social Welfare Department, media
personnel and hospital staff participated. These
meetings enabled the service providers to understand
PLHIV needs and bridge the gaps in service provision.
Some of the outcomes are:
ART centre has agreed to refer all the PLHIV visiting
ART centre to District Level Network-Kadapa.
An NGO has come forward to supply water and
bananas at ART centre daily-Warangal.
Many PLHIV faced indifferent attitude of ART
centre staff, where Additional District Medical and
Health Officer agreed to sensitize the employees –
Medak district.
Local Media at Chittor district have come forward
to make a documentary of District Level Network
activities.
Interaction meeting has been instrumental in
sensitizing the church leaders. In Senapati, the
interaction meeting was held at church with the
attendance of church leaders.
The local MLA in Bishnupur district announced
the donation of Rs. 10,000/-in the interaction
meeting.
In Sugnu, the interaction meeting was attended
by the Nagar Panchayat elected members.
They expressed that this meeting has helped
them in understanding the issues of PLHIV
and assured the District Level Network of their
support.
Interaction meeting in general has help in
strengthening the linkages between District Level
Network and various NGOs/CBOs/GOs.
Exposition
During the year 2007–2008 expositions were organized
in all the six high prevalence states. These events gave
the state offices an opening to share the progress of the
program with the stakeholders in their respective states.
This also provided an opportunity for PLHIV to come
together and share their experiences with their peers
and program implementers.
In Andhra Pradesh the exposition program was carried
out in two phases in the month of June 2008. First phase
was organised at Vijayawada. Basic objective of this
program was to provide a platform for PLHIV to discuss,
advocate their unmet needs, and learn new aspects
about HIV. 100-PLHIV participated in the program.
Capacity building programs on need for advocacy and
legal issues associated with HIV/AIDS were organized.
Group discussions were organized on health and support
system, expectations from government and District Level
Networks, and problems faced by women. Final points
drafted from these group discussions were discussed
in a bigger forum at Hyderabad. District Level Networks
were clubbed into groups and were asked to keep
demonstration tents, which were earlier distributed to
them by PFI. Some recreational activities were also taken
up. Second phase was organized at Hyderabad. Objective
of this program was to bring all the service providers in
ACT project on a bigger platform to present their major
achievements and appreciate efforts made by service
delivery points. Participants were District Level Network
staff, major NGOs working in HIV/AIDS sector and SACS.
Karnataka state PFI unit conducted the exposition
program in coordination with the stake holders involved
in the ACT program. This was a three day program
during “World Population Day” week. Nearly 120 PLHIV
participated and contributed in the event. There were
various activities such as informative sessions on
topics like HIV/AIDS, STI, population control, health
and hygiene. On second day of the program, CD4
count test facility for all the PLHIV was organised in
coordination with Hubli ART centre and 96 PLHIV were
tested. The results were given to all the participants on
the same day. This was followed by a session on tips
and suggestion on how to maintain CD4 count level
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and diet requirement by Dr. Sajjan, Medical Officer, ART
center, Hubli.
Tamil Nadu State PFI unit organized two day program on
“The Power of Positive Living”on 4th and 5th April, 2008.
Mr. K.K. Abraham, President, INP+ and Dr. Beela Rajesh,
I.A.S., General Manager, The Handicrafts and Handlooms
Exports Corporation of India Ltd, Chennai participated as
Chief Guests. Other guests and resource persons were Mr.
A. Justin, DGM, Ashok Leyland, Ennore, Dr.Devshish Dutta,
Technical Specialist (HIV/AIDS), UNICEF – Tamil Nadu
and Kerala, Dr. P. Mahalingam, Program Manager, APAC –
VHS, Mr. Subrat Mohanty, Sr. Program Manager, PFI,
Mr. Senthil Kumar, Project Manager-ACT, INP+ and Mr.
Karunanithi, President, TNNP +.
Under the theme‘Empowerment through Participation’
Manipur State PFI unit had organized the exposition
program on 5th and 6th August 2008 at Retreat
House, Mantripukhri, Manipur. The exposition was
attended by 120 PLHIV (male, female and children),
ART and CCC Doctors from all the districts, MACS
official including the Project Director, NGOs, bilateral
agencies and community members. District Level
Networks exhibited their products for marketing,
which included pickles, jellies, jams, soft board, show
pieces, garments, pillow cover, bed sheets, etc. Skill
building sessions on counseling, IGP/SHG, Human
Rights, ART and HIV/Hepatitis C, PPTCT program and
pediatric issue were also organized.
A two-day Exposition Programme was organized by
Population Foundation of India Nagaland state unit in
collaboration with Naga Network of People Living with
HIV/AIDS (NNP+) with the theme of“Empowering People
Living with HIV/AIDS”. All together 65 participants
from District Level Networks (DLNs), Positive Living
Centre (PLC), Treatment Counseling Centers (TCCs) and
Community Care Centre (CCC) attended the programme.
The programme was conducted at Department of
Under Developed Areas (DUDA) Guest House, Kohima.
Shri. Menukhul John, Commissioner & Secretary, Health
& Family Welfare and Dr. Yanthan, Additional Project
Director, Nagaland State AIDS Control Society (NSACS)
also participated in the program.
World AIDS Day 2008
World AIDS Day was observed on 1st December 2008
by PFI and the partner organizations of the Global
Fund Round 4 and Round 6 programme. On this event
Programme Management Unit (PMU), New Delhi
released the first edition of its newsletter, ‘P-ACT News’
and a ‘Peer Educator Kit’ consisting of a diary for peer
educator, two flip books on ‘Living with HIV/AIDS’ and
‘Managing HIV/AIDS’ and four leaflets on HIV/AIDS. The
kit is available in six languages, namely, English, Hindi,
Telegu, Tamil, Kannada and Marathi. This kit is meant
for peer educators who are engaged in providing
information on prevention, treatment and care and
support.
PFI Nagaland unit along with Network of Peren District
People Living with HIV/AIDS (NPDP+) observed the
World AIDS Day under the theme ‘Leadership-Lead,
Empower, Deliver’ at Jalukie. This day was observed for
the first time in Jalukie and around 450 participants
attended the program. PFI Andhra Pradesh Unit in
collaboration with Freedom Foundation organized a
get together for widow women living with HIV who
are registered with Comprehensive Care and Support
Centre, Guntur. District legal services judge, Municipal
Chairperson, ICDC Project Director and Guntur ART
Medical Officer were involved in the program and
addressed the issues related to health, legal and
economic support. PFI has supported 55 widow
women with nutrition for one month. PFI Karnataka
unit also observed the “World AIDS Day” along with
Freedom Foundation’s Bagalkot CCSC. On this event
PFI state team distributed nutritional food packets to
the 100 PLHIV at Bagalkot CCSC. PFI state unit of Tamil
Nadu along with Tamil Nadu Network of People with
HIV/AIDS (TNP+) organized a rally and convention
on the World AIDS Day. Around 600 PLHIV including
women and children participated in this rally. The rally
was inaugurated by the Collector of Tiruchy, Thiru
Sowdayya and MLA Thiru Anbil Periyasamy.
In observance of World AIDS Day, 2008, a one day
workshop among female sex workers on health and
legal issues was organized by Population Foundation
of India (PFI) state unit Manipur in collaboration with
Meitei Leima Sinnai Sang (MLSS). In the workshop,
45 people participated. The workshop was organized
with the objectives to increase the knowledge on
sexual reproductive health and legal issues among the
female sex workers; to identify the issues & challenges
faced by female sex workers in the state and to put up
the recommendation of the workshop to the relevant
stakeholders – MACS, Social Welfare, Health Department,
Media and bilateral agencies.
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Group discussion on e ective use of IEC
Amravati DLN developed a format for Treatment outreach workers to maintain the record of utilization of IEC material
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IEC Orientation
PFI-PMU had organized an IEC orientation
meeting on 17th November 2008, for PFI and
INP+ representatives from Round 4 and Round 6
program units. In continuation to the orientation,
state units have held similar IEC orientation meetings
in their respective states. In these workshops
the participants from District Level Networks,
Positive Living Centres, Treatment Counselling
Centres, Comprehensive Care and Support Centres
and Community Care Centres were oriented to
the content, methodology and distribution of IEC
material. Participants performed role plays using
the flip charts and leaflets for better understanding
of the content. IEC kits were distributed to service
delivery points in the workshop.
Exposure Visit
A fourteen member team (SACS officials, NGO
representatives, and District Level Network team
members) from Nagaland visited Andhra Pradesh for an
exposure in December 2008. It was a two day visit where
team visited SLN, TCC-Krishna, Vasavya Mahila Mandal
(a premier NGO working in HIV/AIDS), Guntur District
Level Network and CCSC-Guntur.
An exposure trip to Tamil Nadu was conducted for
participants from Manipur from 2nd December to
6th December 2008. A total of 18 participants from
ACT program service delivery points were present
in the trip. The objective of the visit was to learn
the good practices from the service delivery points
in Tamil Nadu; share the knowledge and skills; and to
adapt the promising practices in Manipur. In Tamil Nadu,
the team has visited Comprehensive Care and Support
Center (CCSC) established by Freedom Foundation
at Trichy and District Level Networks at Trichy. They
also visited the DLN and TCC at Namakkal and INP+
secretariat.
Team visited SASO, Kripa Foundation, Bishnupur PLC,
Shalom-NGO, Manipur SLN, RIMS-TCC and Imphal
East DISTRICT LEVEL NETWORK. Visit has helped in
understanding the issue associated with IDU-PLHIV and
the mechanism adopted to improve ART adherence
and IDU rehabilitation.
Women Day 2009
Women Forum at TNNP+ in collaboration with the state
unit of Population Foundation of India (PFI), Tamil Nadu
organized a special event for the Women’s Day on 20th
of March 2009. The objective of the event was to make
women realize the importance of care for their fellow
women living with HIV/AIDS and enable them to access
services available from the government. This event also
helped to bring women together to share achievements
and highlight current social, economical and health
needs.The Medical Officer from the Dept. of Microbiology,
Govt. Rajaji Medical College Hospital and Mrs. Porkodi,
Advocate shared their views with the participants.
Monitoring and Evaluation
MIS and CMIS Refresher Trainings
Refresher trainings on MIS and CMIS were conducted
to the staff of all the DLNs, PLCs and CCSC/CCC. CMIS
workshops were also conducted to solve the technical
problems faced by the service delivery points in
the CMIS.
A team of six members from PFI state units of
Maharashtra, Tamil Nadu, Karnataka, and Andhra
Pradesh visited Manipur for an exposure trip from
27th January to 1st February, 2009. Main purpose
of the visit was to understand the link between
drug usage and HIV/AIDS and role of District Level
Networks, PLCs and other NGOs in addressing the
socioeconomic and health needs of IDU PLHIVs.
CMIS data review workshop at Nagaland
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Program Evaluation
Grants Management
PFI conducted mid-term evaluation of the ACT program For the year 2008–09, PFI received a disbursement
by a three member external team during October and of USD 3,983,864 from the Global Fund. In the same
November 2008. The team reviewed performance of the period, utilization of funds by PR and the SRs amounted
program and achievements during one-and-a-half years to USD 4,628,631. Overall, the cumulative utilization
of the phase II of the program. The review provided amounted to USD 11,901,157 against the cumulative
recommendations for next period of the program and receipt of USD 13,334,343 during the four years of the
offered key lessons that need to be incorporated for program since commencement.
future strategies.
The Global Fund conducted various trainings on
Special Studies
Enhanced Financial Reporting (EFR) on 30th and
31st July 2008, PSM workshop in Cochin from 22nd to
Potential for Impact Analysis of the ACT
Program
24th October 2008 and Regional Finance Workshop
in Nepal on 29th March 2009 to 1st April 2009. PFI
along with representatives from SRs attended these
The study ‘Potential for Impact Analysis of the ACT workshops. In the Nepal workshop, PFI as a PR from
Program’ was conducted for providing additional India facilitated a workshop on PR-SR relationship which
information on impact to the Global Fund for Rolling included presentation on PR’s experience and a brain
Continuation Channel (RCC) qualification. The objective storming questionnaire, which was well received by
of the impact analysis study was to understand the the participants from over 15 countries.
potential for impact of the ACT project in the lives of
the PLHIV in the project area by assessing the extent Based on the EFR workshop conducted by TGF, the
of utilisation of services by PLHIV, influence on quality Grants Department conducted Workshop on Enhanced
of living and identify strategies that have potential for Financial Reporting to all its partner agencies on
impact. The study was conducted at limited service 27th August 2009, in which PMU staff also participated.
delivery points.
This is to ensure familiarization of EFR among partners.
EFR is an additional requirement of The Global Fund
The study concluded that the project is making a and PR has been regular in submitting the report
difference in the lives of PLHIV in terms of providing in time.
them with psychosocial support, coming to terms
with their status, behavior change communication Component wise break up based on EFR submitted to
which has helped the PLHIV live a better life with HIV. TGF is presented below in the form of pie chart:
As summed up by
PLHIV participants
during Focus Group
Discussion (FGD)
Utilization
0%
in Andhra Pradesh
13%
Human Resource
(Krishna), treatment
has increased life
span, improved
health, reduced
opportunistic in-
fections, given the
PLHIV a courage to
get on with their
lives, given them
the belief that
6%
3%
6%
1%
7%
Technical Assistance (TA)
Training
Health Products and Health Equipment
Medicines and Pharmaceutical products
Procurement and supply Management cost (PSM)
46%
Infrastructure and other Equipment
Communication Materials
Monitoring & Evaluation (M&E)
Living Support to Client / Target population
they can also live
and support their
0%
2%
1%
Planning and Administration
Over Heads
children and do
their own work.
14%
1%
Others
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Meetings and Workshop
Regional Training Workshop on “Monitoring and
Evaluation” was held in Cochin, India from 21 to 23
October, 2008. The South and West Asia Regional Team
of The Global Fund organized this workshop which
was facilitated by The Global Fund Secretariat with
input from technical partners. This training workshop
aimed to strengthen the M&E capacity of Principal
Recipients and the Sub Recipients to best utilize the
Performance Based Funding system of The Global Fund.
The workshop had an interactive focus and covered
performance-based frameworks and The Global Fund
reporting requirements, M&E Plans and M&E systems
strengthening. The Workshop was attended by
representatives of PFI, CBCI and HLFPPT. Dr. Phanindra
Babu, PFI made a presentation on best practices
in M&E.
South and West Asia Grant Implementation &
Management Meeting in Colombo, Sri Lanka from 10–12
November, 2008. Participants from the South and West
Asian countries participated in this three day regional
meeting. The meeting was inaugurated by the Hon’ble
Minister of Health, Sri Lanka Mr. Nimal Siripala De Silva.
From PFI, Dr. Mary Verghese, Mr. S. Vijay Kumar, Mr. Subrat
Mohanty and Mr. Bijit Roy participated. In this meeting
disease specific overviews were presented for AIDS,
Tuberculosis and Malaria and important discussions on
disease specific guidance on effective scaling -up and
best practices took place.
SAARC Second Conference on “Working Together
to Fight against TB, HIV/AIDS and Respiratory
Diseases” was held on 15th to 18th December 2008
at Kathmandu, Nepal. The Conference highlighted
the achievements and challenges of TB and HIV/AIDS
control, while emphasizing partnership building
among different sectors involved in the control
measures. From PFI, Ms. Rashmi Sharma presented
a paper on “Treatment Adherence -Involvement of
PLHIV” at the conference.
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Lessons Learned
Regular meetings and program reviews at district level helps in establishing effective coordination and better
program implementation.
Number of PLHIV tested positive at the ICTC and being registered at the ART centres needs to strengthened.
Coordination with different stakeholder at district level is important to optimize outreach activities for follow
up of PLHIV.
Efforts have been made in reducing stigma and discrimination by DLNs through advocacy. PLHIV experienced
better acceptance in the community and family. Much more still needs to be done in this area.
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4.9 Page 39 |
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Financial Report
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5 Pages 41-50 |
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Photo Credits
Indian Network for People Living with HIV/AIDS (INP+)
Freedom Foundation
EngenderHealth Society (EHS)
The Confederation of Indian Industry (CII)
Population Foundation of India (PFI)
With Contributions from
Mary Verghese
S. Vijayakumar
Subrat Mohanty
Phanindra Babu Nukella
Rashmi Sharma
Aparna G.
Milan Rana
Sanjeev Ranjan
Piyali Sarkar
Rohini Gorey
K. Balasubramanian
Everista Kapu
Archana Oinam
A.S. Kulloli
Vikas Panibatala
Alwin Leone Das D.
Vitsiatho Nyuwi
Vijaya P. Kanase
Prasad Kumar A.
Yumnam Sanjoy Singh
Neela Santhi
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POPULATION FOUNDATION OF INDIA
B-28, Qutub Institutional Area
Tara Crescent, New Delhi-110016
Telephone: 011- 43894100, Fax: 43894199
E-mail: popfound@sify.com
www.popfound.org