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Global Fund project Newsletter Jan - Mar 2009 PFI |
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P-ACT News
PFI
Volume 1/ Issue 3
January- March 2009
From the Desk of the Executive Director
The engagement of People Living with HIV (PLHIV)
is important for a country to achieve the universal goal
of access to prevention, treatment, care and support.
NACP III mentions that a strong partnership with
PLHIV networks need to be developed to create an
enabling environment by addressing issues of stigma,
discrimination, legal and ethical concerns. Keeping
this in mind, the Government of India has adopted the
policy of ‘Greater Involvement of People living or
affected by HIV/AIDS’ (GIPA). It is envisaged
that by involving PLHIV in programme development,
implementation and policy-making, the relevance,
acceptability and effectiveness of programmes will
improve. It needs to be recognized that the networks
play a significant role in implementation of HIV
programs, not just as beneficiaries but as proactive
partners.
A. R. Nanda
Executive Director
Population Foundation of India
Message from the Project Director
The HIV/AIDS pandemic demands mobilization and
collaboration at community, national and international
levels. The involvement of PLHIV into HIV/AIDS
program makes it inclusive and holistic. Peer Educators
share the same life experience as that of key population
group and hence act as credible sources of information
for behaviour change. Peer education can take place
on a street corner, at a social club, in a bar, in a bus
station, in a factory or any other place where people
feel comfortable. Peer Educators play a significant
role in expanding and accelerating access to care and
support services for People Living with HIV/AIDS.
Thus, they form a major component of HIV/AIDS
program and with proper training and capacity building
they become the real change agents.
Dr Mary Verghese
Project Director
Population Foundation of India
A vow to adhere
Akash is an eleven year old orphan on Anti-Retroviral therapy. He lives with his grandparents. He was taking ART from Satara Civil Hospital in
the state of Maharashtra. Akash’s grandfather was unable to take Akash to Satara for collecting his monthly ART medicines due to old age and
health problems. As a result, Akash defaulted and started having health problems. His grandfather was worried. He approached the DLN at
Satara. The counselor at the DLN explained to them the importance of taking ART regularly. Akash went with his grandfather to Satara to restart
his ART treatment. Akash now takes his ART on time and has promised to never miss the dose. DLN also informed them about the
Balsangopan Yojana, a government scheme to provide education support to children and referred him to ‘Adhar Grah’, a care home to take care
of his needs.
A new horizon
Thirty three year old Rita Devi came to know of her status in 2001 when she was tested positive along with her husband. After knowing her
status, her in-laws threw her out of the house. Her only solace was that her children were tested negative. This motivated her to start her life
afresh for the sake of her children. She came in touch with Sushma Devi, an outreach worker from Nai Asha Community Care Center in
Mokama. Sushma counseled her and guided her like an elder sister. With her support, Rita visited the Nai Asha and took proper treatment.
Today she is keeping well and regularly follows up for care and nutrition at the Community Care Centre. She expressed her wish to work with
the sisters at the centre. Sushma motivated and trained her. Initially she visited homes with Sushma during her field visits and now goes on her
own to nearby villages. She feels at home at the Community Care Centre and loves all the staff as her family members. She is thankful to all the
members for supporting her in her difficult times. Today, she is a successful outreach worker and takes care of her children.
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Programme Updates
Awareness rally at Magh Mela
The auspicious Magh Mela is an annual religious event and it is so
called as it falls in the Magh period (January-February) on the occasion
of Makar Sankranti. A large number of local people and tourists
participate in this mela. It starts on a full moon day and lasts for 15
days and attracts thousands of pilgrims who come for a holy dip in
Sangam.
With the support of Population Foundation of India, UPSACS,
UNICEF, INP+, DACC (Allahabad), Uttar Pradesh Welfare for People
Living with HIV/AIDS Society (UPNP+) organized a silent rally
‘Magh Mela HIV/AIDS Awareness Campaign’ at the Magh
Mela, Allahabad. The objective of the rally was to spread awareness
and information about HIV/AIDS by the positive people among the
general population. The aim was to reduce stigma and discrimination
and motivate PLHIV to actively participate in awareness generation.
The theme of the silent rally was: “We Live a Healthier Life, We Prevent
New HIV Infections”. Spiritual Saint Sri Sri Murari Das Ji Maharaj
(Rishikesh, Haridwar) and Dr. S.A. Mishra (AIDS Officer, Allahabad)
inaugurated the rally. Mr. Merrajudin Khan, .I.A.S., Chhetriya Prachar
Officer, Ministry of Information & Broadcasting, Government of
India, was the Chief Guest at the inauguration.
Around eighty positive
people from different
districts of Uttar Pradesh
participated in the rally.
They distributed IEC
material,
leaflets,
brochures to a large
number of people
including pilgrims,
maintenance personnel,
Awareness rally at Magh Mela,
Allahabad
shop keepers, police, members of National Social Service (NSS) and
health department staff among others. The PLHIV who participated
in the rally also discussed about HIV/AIDS with people who were
unable to read the IEC material. The rally sensitized the general
population about HIV/AIDS and provided an opportunity to interact
with PLHIV.
International Women’s Day
Women Forum at Tamilnadu Networking People with HIV/AIDS
(TNNP+) in collaboration with the state unit of Population
Foundation of India (PFI), Tamil Nadu, organized a special event on
20th March 2009 for Women’s Day. The theme of the event focused
on the contribution of women as prime caregivers. There were around
sixty participants from the District Level Women Forum and the
State Women Forum. The hallmark of the event was to make women
realize the importance of providing care to the women living with
HIV/AIDS and enable them to access services available from the
government. This event provided a platform to bring women together
to share achievements and highlight their current social, economical
and health needs. Dr. Jegatheswari, the Medical Officer from the
Department of Microbiology, Rajaji Medical College and Hospital
shared that though stigma and discrimination has reduced, the reach
is limited and that women living with HIV/AIDS are still highly
discriminated and neglected in the society. She expressed her desire to
work towards awareness generation and reduction of HIV. She
emphasized that reduction of transmission among children would
result in healthy future generation.
IEC Orientation Program
While interacting with the
PLHIV at the grass root
level, the peer educators felt
the need for a
communication tool to
disseminate
correct
information about HIV/
AIDS. Keeping this in mind,
PFI developed an IEC kit. It
consists of a diary for peer educator, two flip books on ‘Living with
HIV/AIDS’ and ‘Managing HIV/AIDS’ and four leaflets on HIV/
AIDS. These materials are used in outreach, support group meetings
and interaction meetings of PLHIV. These materials are in six
languages English, Hindi, Tamil, Telugu, Kannada and Marathi.
Members of the networks wholeheartedly appreciated the efforts of
PFI in bringing this well designed informative kit to the reaches of
PLHIV even at the taluka/block level.
The State and Regional units of Population Foundation of India
had organized orientation workshops for IEC in their respective
states and regions on the content and methodology of using the
IEC kit. Participants in these workshops members include members
from District Level Networks, Positive Living Centres, Treatment
Counselling Centres, Comprehensive Care and Support Centers and
Community Care Centres.
Exposure Visits
An exposure visit to Manipur was organized for the Round 4 ACT
Program state unit offices of Maharashtra, Tamil Nadu, Karnataka,
and Andhra Pradesh of PFI. The team visited Manipur from 27th
January to 1st February, 2009. The purpose of the visit was to
understand the links between the Injecting Drug Users (IDU) and
HIV/AIDS, the role of District Level Networks, Positive Living
Centres and other NGOs in addressing the socioeconomic and health
needs of IDU- PLHIV. The team visited SASO, Kripa Foundation,
Bishnupur PLC, Shalom-NGO, Manipur SLN, RIMS-TCC and Imphal
East District Level Networks. The visit provided an opportunity to
understand the cross cutting issues associated with IDU-PLHIV and
the mechanism adopted to improve ART adherence and IDU
rehabilitation.
Doctors’ Training
A four day doctors’ training
on HIV/AIDS manage-
ment was organized and
conducted by Engender
Health Society along with
St. John’s Medical College,
Bengaluru, Karnataka from
March 18th to 21st, 2009.
Doctors from service delivery points across the six high prevalence
states participated in the training. The training was conducted as per
the WHO curriculum for doctors training. To make the training more
participatory and to give the participants hands-on experience, St.
John’s Medical College- a hospital based institution was chosen as the
training site. St. John’s Medical College is a NACO accredited training
centre for conducting doctors training on ART as part of GFATM
Round VII project. Participation of doctors was excellent in the
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entire training program. They were very enthusiastic and eager to
learn more. They felt that the participatory methodologies and training
was more clinical and case based and addressed their current needs.
They interacted with the faculty; many of whom are senior clinicians
treating PLHIV. One of the doctors said “We had the opportunity to
obtain information which are very useful and relevant to our practice”.
State Level Program Coordination Committee
Meetings
The fourth State Level Program Coordination Committee meetings
under the Global Fund Round 6 Program were organized with SACS
in the states of Gujarat, Rajasthan, Chhattisgarh, Madhya Pradesh,
Bihar, West Bengal and Uttar Pradesh. The progress of the program
was shared and plans for the next quarter were finalized for the
respective states in consultation with the SACS.
Financial Management Workshop
A Regional Workshop on Financial Management was held at
Kathmandu, Nepal between 29 and 31 March, 2009 organized by
The Global Fund. The participants from Principal Recipients as well
as Sub-Recipients of The Global Fund HIV/AIDS programs on TB,
HIV and Malaria were oriented on performance improvement, legal
compliance and management of sub recipients. The workshop involved
presentations, exercises and group discussions. The participants were
oriented further on EFR Applications, financial reporting, budget
management process, analysis and review, linkage to programmatic
performances, co-financing and audit procedures. The Global Fund
invited Senior Grants Manager, PFI, Mr S. Vijayakumar to make
presentation on Sub- Recipient Management. The session also included
a workshop on variance analysis linking both program and finance.
CMIS Trainings at Community Care Centres
Computerised Manage-ment Information Systems (CMIS) has been
developed by PFI for the
Community Care Centres.
Trainings were conducted
for the Round 4 ACT
Program in Bangalore and
Dimapur for the
Community Care centres
CCC CMIS Training Participants in
Ahmedabad 27-29th Jan-2009
of Freedom Foundation,
St.Joseph’s HIV/AIDS
Care Centre, Meetei
Leimarol Sinnai Sang
(MLSS), Moreh and Development Association of Nagaland on CMIS.
The PFI-PMU also organized training programs on Computerized
Monitoring Information System (CMIS) for Community Care Centres
under the Round 6- PACT Program during January-March 2009. Staff
from 44 CCCs under CBCI and HLFPPT was trained in CMIS. The
CCCs trained include 5 in Uttar Pradesh, 4 in Madhya Pradesh, 4 in
Rajasthan, 9 in Gujarat, 5 in Bihar, 5 in Orissa, 4 in Chhattisgarh and
8 in West Bengal.
Reviewing quality of care at Community Care Centres
Population Foundation of India conducted a study on the quality of
care provided at the Community Care Centres (CCC) set up by its
partners, CBCI and HLFPPT under the PACT Program. The purpose
of this study was to examine the quality of services provided at the
CCCs, from the perspective of clients, family members, and service
providers. The study was conducted at 4 CCCs in the states of Gujarat,
West Bengal, Uttar Pradesh and Madhya Pradesh. The results of the
study were disseminated to partner organizations and PFI regional
units on 20th January 2009.
The following were the recommendations of the study:
• The role of the care centres need to be redefined, so that the
centres can reach out and harness their maximum potential
• Family members are a significant source of support and care for
the clients, and centers have to systematically plan their
involvement in care, for sustainability beyond the care centre.
• Counseling needs to go beyond the primary information giving
role and to offer clients the space to articulate and ease their
deeper stress and concerns. The capacity of the counselors needs
to be built up accordingly.
External MIS Audit
PFI conducted external MIS Audit with the help of Indian Institute
of Health Management Research, Jaipur. The audit was conducted to
check the reliability of the data recorded in the reports with regard to
their accuracy and consistency. The audit also checked the validity of
the clients by verifying the authenticity of enrollment of PLHIV. The
audit results were disseminated to partner organizations and PFI
regional units, on 21st January 2009.
The following were some of the recommendations suggested for
improving MIS formats
• To develop formats in Hindi as all the District level Networks
visited were from the Hindi speaking states
• To institutionalize the system of providing feedback on monthly
reports to improve the quality of performance
Potential for Impact Analysis of the ACT Program
To understand the potential for impact of the ACT program in the
lives of the PLHIV, a study was commissioned by PFI and conducted
by Catalyst Management Services. The study was conducted in the
states of Andhra Pradesh, Tamil Nadu, Maharashtra and Nagaland. A
strategy analysis exercise was conducted at the national level to
summarise the analysis from the field and also to draw overall
conclusions. Results of the study were disseminated to the partners
in the Round 4 program on April 14, 2009.
The study concluded that the program is making a difference in the
lives of PLHIV in terms of providing them with psycho- social
support, coming to terms with their status and behavior change
communication. As summed up by PLHIV participants during FGD
in Andhra Pradesh (Krishna), treatment has increased life span,
improved health and reduced opportunistic infections. It has given
the PLHIV the courage to get on with their lives and the belief that
they can also live a normal life and support their children.
Continuum of Care for Injecting Drug Users (IDUs)
including IDUs Living with HIV, in Imphal City:
Current Situation, Needs and Gaps
To move towards the goal of having continuum of care for IDUs
(including those living with HIV) in Imphal city, a study was conducted
with the following objectives:
To assess the current situation of the various drug- and infections-
related medical/non-medical services (Govt./NGOs/CBOs/
PLHIV Networks/Private sector) available for IDUs, including
those living with HIV, in Imphal.
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To identify gaps in existing prevention/care services and identify
unmet and emerging service needs.
A mixed methods (qualitative & quantitative) study design was used
for the study. A survey was conducted using a semi-structured
questionnaire among 36 agencies (NGOs, CBOs, government hospitals,
private clinics and laboratories) in Imphal city about the type of
services they offer to IDU- PLHIV. Focus group discussions, in-depth
interviews (with IDUs, targeted intervention and drug de-addiction
program staff) and key informant interviews (with health care
providers and NGO leaders) were conducted. The findings and
recommendations of the study were shared with key stakeholders in
a dissemination workshop that was held on April 16, 2009.
The key recommendations from the report include
strengthen coordination among NACO-supported IDU
prevention/treatment programs, and Ministry of Social Justice
and empowerment (MSJE)supported rehabilitation/detox
programs
develop guidelines for enrolment of clients in the various
treatment modalities (community-based detox, home-based
detox, residential rehabilitation program)
ensure referral to the next level of care after detoxification
establish long-term vocational training programs that are useful
to and in-demand from the clients
ensure adequate supply of different sizes of syringes and needles
to meet the needs of drug users who use different drugs (Heroin
and ‘SP’)
address the barriers to antiretroviral treatment (including second-
line ART) and Hepatitis-C treatment (need for national action
plan on Hepatitis-C diagnosis/treatment);
ensure that specific needs of female IDUs (drop-in centres,
child care services) are met in de-addiction centres
ensure available social welfare schemes (income generation
programs, microcredits and small loans) in the State Department
of Social Welfare also cover IDUs and people living with HIV
develop guidelines on when and how to refer IDUs from one
service to another service
scale-up the availability of residential detox/rehabilitation
centres.
Orientation of Service Delivery Points
PFI Regional Coordination Unit - Madhya Pradesh had organized a
one day orientation cum coordination meet of all the service providers
at the Hotel Ashoka Lake View, Bhopal. This meeting was chaired by
the Project Director MPSACS, Mr. Omesh Mundra, IAS. The basic
purpose behind organizing this meet is to orient and establish effective
coordination among all the different service providers and the stake
holders working in different parts of the state. The aim was to orient
all the participants on the role and the objective of the Global Fund
and the way it is operating at the country level and internationally.
Special emphasis was given on the role of Community Care centers
under the NACP-III. It was planned to establish district level
coordination committee for all the districts where ART, CCC are
functioning. A similar state level meeting along with the SACS, PFI
and HLFPPT was organized on 12th February 09 in Lucknow, Uttar
Pradesh. It was chaired by the Project Director, UPSACS. The SACS
officials present in the meeting provided guidance and inputs in
formulating strategies to smoothen coordination among the various
service delivery points for better access and uptake of services by the
PLHIV.
ART- CCC Coordination Meeting
Coordination meetings between the Community Care Centers and
ART Centres were conducted for the PACT Program in the Round 6
states to increase the coordination between the two service delivery
points. The meeting addressed the need for proper coordination so
that all PLHIV initiated on ART are referred to CCC and sharing the
list of Lost to Follow Up (LFU) and missed cases on ART for retrieval
to the ART centre is streamlined.
Indian Network for People Living with
HIV/AIDS
Chennai
Ph: 044- 22254670-74
Freedom Foundation
Bangalore
Ph: 080- 65966445
With Contributions from:
Partners
Confederation of Indian Industry
Gurgaon
Ph: 0124- 4014060-69
EngenderHealth Society
New Delhi
Ph: 011- 26851948/49/50
Hinduathan Latex Family Planning
Promotion Trust
Noida
Ph: 0120- 4673673
Catholic Bishops’ Conference of India
New Delhi
011- 23344474
Population Foundation of India - Regional and State Offices
Population Foundation of India
B- 28, Qutab Institutional Area
Tara Crescent, New Delhi- 110016
Ph: 011- 43894100, Fax: 43894199
E-mail: popfound@sify.com
Website: www.popfound.org
PFI- Andhra Pradesh
Ph: 040- 65999770
E-mail: pfiapsco@yahoo.com
pfiapsco@gmail.com
PFI- Tamil Nadu
Ph: 044- 24329074
E- mail: pfichennai@gmail.com
PFI- Karnataka
Ph: 080-41285706
E-mail: pfibangalore@gmail.com
PFI- Manipur
Ph: 0385-2445072
E-mail: pfimanipur@rediffmail.com
PFI- Maharashtra
Ph: 022- 65029710
E-mail: mahapfi@gmail.com
PFI- Nagaland
Ph: 03862- 234009
E-mail: popfound_nagaland2yahoo.co.in
PFI- Rajasthan
Ph: 0141- 2210680
E-mail: pfirajasthan@gmail.com
PFI- Madhya Pradesh
Ph: 0755- 2550647
E-mail: pfi.madhyapradesh@gmail.com
PFI- Uttar Pradesh
Ph: 0522- 2353838
E- mail: pfiuttarpradesh@ gmail.com