Activities of National AIDS Control Programme
STD Control Programme
Objectives
Sexually Transmitted Diseases increase the chance of HIV infection by 6% to 10% and therefore the following are the objectives
Thus the treatment on STD was made accessible and available to more people.
(ii) All Government Medical Officers/Health workers are trained in Syndromic Management for STD’s.
(iii) The Table on the following page will indicate how the STD cases detected in Govt. Hospitalsdeclined in ex–Mumbai.
(iv) In Mumbai, by upscaling the STI clinics to about 6 times more than the number in year 2000, more coverage of STI patients was possible.
STD Control Programme
Objectives
Sexually Transmitted Diseases increase the chance of HIV infection by 6% to 10% and therefore the following are the objectives
- To reduce STD cases and thereby control HIV Transmission.
- Prevent morbidity and mortality due to STD’s.
Year | MSACS | MDACS | ||
Newly established STD clinics | Total | Newly established STD clinics | Total | |
1999–2000 | 34 | 34 | 5 | 5 |
2000–2001 | 0 | 34 | 0 | 5 |
2001–2002 | 0 | 34 | 0 | 5 |
2002–2003 | 19 | 53 | 9 | 14 |
2003–2004 | 0 | 53 | 10 | 24 |
2004–2005 | 8 | 61 | 1 | 25 |
2005–2006 | 0 | 61 | 10 | 35 |
2006–2007 | 0 | 61 | 0 | 35 |
Thus the treatment on STD was made accessible and available to more people.
(ii) All Government Medical Officers/Health workers are trained in Syndromic Management for STD’s.
(iii) The Table on the following page will indicate how the STD cases detected in Govt. Hospitalsdeclined in ex–Mumbai.
(iv) In Mumbai, by upscaling the STI clinics to about 6 times more than the number in year 2000, more coverage of STI patients was possible.
STI cases
Targeted Interventions
Objectives
To reduce the rate of transmission among the most vulnerable and marginalized population, hence it is the most important component of NACP – Phase II. The following table will show the progress made since 1999 i.e. the beginning of Phase II.
Year | MSACS | MDACS | Total |
1999 | 61820 | 1604 | 63424 |
2000 | 55120 | 11377 | 66497 |
2001 | 46450 | 8036 | 54486 |
2002 | 37734 | 10319 | 48053 |
2003 | 30555 | 7953 | 38508 |
2004 | 25183 | 14442 | 39625 |
2005 | 21590 | 20238 | 41828 |
2006 | 28903 | 24862 | 53765 |
2007 (up to March 07) | 8981 | 6411 | 15392 |
Targeted Interventions
Objectives
To reduce the rate of transmission among the most vulnerable and marginalized population, hence it is the most important component of NACP – Phase II. The following table will show the progress made since 1999 i.e. the beginning of Phase II.
S.No. | Type | MSACS | MDACS | AVERT | BMGF | Total |
1 | Sex Workers | 23 | 10 | 6 | 26 | 65 |
2 | Truck Drivers | 0 | 0 | 4 | 4 | 8 |
3 | Migrant Workers | 0 | 4 | 7 | 0 | 11 |
4 | MSM | 1 | 4 | 5 | 0 | 10 |
5 | MDU | 0 | 2 | 0 | 0 | 2 |
6 | SC/TG | 0 | 3 | 2 | 0 | 5 |
7 | Prisoners | 0 | 0 | 1 | 0 | 1 |
8 | Slum | 0 | 0 | 9 | 0 | 9 |
9 | Others(Composite) | 0 | 0 | 4 | 0 | 4 |
Total | 24 | 23 | 38 | 30 | 115 |
Condom Promotion by NACP
Objectives
Status of Condom in Maharashtra state during 2006
Information, Education and Communication
International Health Day Since International Health Day is observed world wide, MSACS observed this day by organising media campaign. As a part of this campaign, MSACS published an advertisement in State level as well as regionallevel newspaper.
Maharashtra Day 1st May
MSACS observed Maharashtra day by publishing media–campaign. As a part of this campaign, MSACS published an advertisement in State level as well as regional level newspapers.
1st October 2006 – Voluntary Blood Donation Day
1st October 2006 – Voluntary Blood Donation Day Camp was organized in every District of Maharashtra. On this occasion MSACS conducted awareness through Newspaper Advertisement and telecasted advertisement on the Channels like Sahyadri (Marathi), Zee TV Marathi, C TV etc.
1st December, 2006 – World AIDS Day
The most important day for the people who are working against the HIV/AIDS epidemic. This is the day for introspection and to alter the strategies if necessary, to plan the year ahead and appreciate the efforts of individuals and organizations who are working in the field of HIV/AIDS prevention. This is the day to communicate with the whole world about HIV/AIDS prevention. This year MSACS observed WAD in every district of the sate by organizing rallies, press–meets, elocution competitions for college students, conventions of CSWs, truckers etc. The advertisements were issued in various newspapers, TV channels, Radio. On mobile phone networks by SMS, 2 buses painted with prevention message played between Mumbai – Nashik for the whole month.
Career Mahotsav
To create awareness among the youth population about the menace of HIV/AIDS, MSACS in association with Pune Sanskriti Vaibhav Trust, Pune organized Career Mahotsav in Pune wherein thousands of students participated. On this occasion wide publicity campaign through exhibition stall, paper advertisements, banners, hoardings, posters, pamphlets, t–shirts and caps carrying the message of HIV/AIDS etc. were undertaken.
Tamasha Festival, Narayangaon
A competition was organized for Tamasha troupes at Narayangaon, Pune to create awareness in collaboration with the Directorate of Affairs, Govt. of Maharashtra. 100 artists from various troops participated in the competition. More than 15 thousand viewers attended the programmme.
Objectives
Status of Condom in Maharashtra state during 2006
Sr.No. | Type of Supply condoms | Requirement of Condom in lacs | Receipt of Condom in lacs | Distribution of Condom in lacs |
1 | Free supply | 400.00 | 379.00 | 138.74 |
2 | Social marketing | 50.00 | 60.00 | 10.12 |
3 | Total | 450.00 | 439.00 | 148.86 |
Information, Education and Communication
- IEC used to generate awareness, modify attitudes and change behaviour.
- MSACS has also undertaken wide awareness campaign across the State through theatre groups, folk artists, publishing pamphlets, posters, banners, television spots, radio jingles, exhibition sets, newspaper advertisements, etc.
International Health Day Since International Health Day is observed world wide, MSACS observed this day by organising media campaign. As a part of this campaign, MSACS published an advertisement in State level as well as regionallevel newspaper.
Maharashtra Day 1st May
MSACS observed Maharashtra day by publishing media–campaign. As a part of this campaign, MSACS published an advertisement in State level as well as regional level newspapers.
1st October 2006 – Voluntary Blood Donation Day
1st October 2006 – Voluntary Blood Donation Day Camp was organized in every District of Maharashtra. On this occasion MSACS conducted awareness through Newspaper Advertisement and telecasted advertisement on the Channels like Sahyadri (Marathi), Zee TV Marathi, C TV etc.
1st December, 2006 – World AIDS Day
The most important day for the people who are working against the HIV/AIDS epidemic. This is the day for introspection and to alter the strategies if necessary, to plan the year ahead and appreciate the efforts of individuals and organizations who are working in the field of HIV/AIDS prevention. This is the day to communicate with the whole world about HIV/AIDS prevention. This year MSACS observed WAD in every district of the sate by organizing rallies, press–meets, elocution competitions for college students, conventions of CSWs, truckers etc. The advertisements were issued in various newspapers, TV channels, Radio. On mobile phone networks by SMS, 2 buses painted with prevention message played between Mumbai – Nashik for the whole month.
Career Mahotsav
To create awareness among the youth population about the menace of HIV/AIDS, MSACS in association with Pune Sanskriti Vaibhav Trust, Pune organized Career Mahotsav in Pune wherein thousands of students participated. On this occasion wide publicity campaign through exhibition stall, paper advertisements, banners, hoardings, posters, pamphlets, t–shirts and caps carrying the message of HIV/AIDS etc. were undertaken.
Tamasha Festival, Narayangaon
A competition was organized for Tamasha troupes at Narayangaon, Pune to create awareness in collaboration with the Directorate of Affairs, Govt. of Maharashtra. 100 artists from various troops participated in the competition. More than 15 thousand viewers attended the programmme.
Mahotsavs by NACP
Vasant Mahotsav 06 Thane
To create and spread awareness in youth Vasant Mahotsav was organized in November, 2006 in Thane. Well known music direction Bappi Lahiri, Aadesh Shrivastava and famous poet Ashok Naygaonkar, Tyagraj Khadilkar graced the cultural show by live participation, Samnvay Pratishthan Thane organized the show.
Srujan 06 Baramati
Srujan 06: The youth festival was organized by Agricultural Development Trust, Baramati in Baramati. Street plays about HIV/AIDS awareness. Discussions about HIV/AIDS drawing competitions were organized.
Aashadhi Ekadashi Mahayatra, Pandharpur, District Solapur
As Pandharpur is one of the well known pilgrim destinations in India where lakhs of devotees visits regularly on the occasion of Aashadhi Ekadashi and Maghi Ekadashi every year which comes in the month of July and February respectively. This year MSACS conducted a massive awareness campaign in Aashadhi Ekadashi Mahayatra during 4th to 8th July, 2006.
Gokulashtami Festival
To create awareness about HIV/AIDS, MSACS sponsored a well known religious Gokulashtami Festival in Thane Districts on 16th August, 2006 organised by Sangharsh – fight of the right against wrong. Lakhs of Youths participated in the Festival. To create an HIV/AIDS awareness among Youths. T shirts with messages of HIV/AIDS were distributed, Red Ribbons were distributed, Street Plays were performed, Pamphlets distributed, Posters, Float which was designed with messages on all slides of rath was taken around in Thane City.
Navratra Utsav Festival
MSACS sponsored a religious wellknown Navratra Utsav Festival to create HIV/AIDS awareness especially amongst the youth generation in Aurangabad, Pune, Gadchiroli, Amravati, Nashik, Osmanabad, Thane etc.
Diwali Festival
Since Diwali Festival is an well known cultural festival of India on this occasion MSACS conducted awareness campaign about HIV/AIDS through Diwali issues and newspapers and electronic media. 100 Diwali issues carried the advertisement of MSACS.
Religious Campaign
MSACS organized camps at religious campaigns in association with various NGOs in Aanganwadi, Pandharpur, Solapur, Latur etc.
Workshops
Workshops for political, religious leaders at Nagpur, Latur, Sangli, Kolhapur, Washim, Osmanabad districts were organized to sensitise peoples representatives about HIV/AIDS.
National football competition 07
Abhijit Kadam Memorial Trust organized national football competition MSACS sponsored the same more than 40,000 spectators enjoyed the game.
Siddeshwar Agro–tech 07 Latur
Shri Siddheshwar Agro–tech 07 Latur has organized state level exhibition, milk competition, agro exhibition, open discussion and women meet on the occasion of Siddeshwar and Ratneshwar yatra in Latur the women meet was specially for women working in agriculture. More than 12–15 lakhs people were expected to visit this yatra.
State level street play campaign
MSACS has organized street play campaign with help of 21 drama troops in every district of Maharashtra. Each group will perform 35 shows, which will cover all the districts assigned to them. More than 700 street play shows will be organized through out the state.
Vasant Mahotsav 06 Thane
To create and spread awareness in youth Vasant Mahotsav was organized in November, 2006 in Thane. Well known music direction Bappi Lahiri, Aadesh Shrivastava and famous poet Ashok Naygaonkar, Tyagraj Khadilkar graced the cultural show by live participation, Samnvay Pratishthan Thane organized the show.
Srujan 06 Baramati
Srujan 06: The youth festival was organized by Agricultural Development Trust, Baramati in Baramati. Street plays about HIV/AIDS awareness. Discussions about HIV/AIDS drawing competitions were organized.
Aashadhi Ekadashi Mahayatra, Pandharpur, District Solapur
As Pandharpur is one of the well known pilgrim destinations in India where lakhs of devotees visits regularly on the occasion of Aashadhi Ekadashi and Maghi Ekadashi every year which comes in the month of July and February respectively. This year MSACS conducted a massive awareness campaign in Aashadhi Ekadashi Mahayatra during 4th to 8th July, 2006.
Gokulashtami Festival
To create awareness about HIV/AIDS, MSACS sponsored a well known religious Gokulashtami Festival in Thane Districts on 16th August, 2006 organised by Sangharsh – fight of the right against wrong. Lakhs of Youths participated in the Festival. To create an HIV/AIDS awareness among Youths. T shirts with messages of HIV/AIDS were distributed, Red Ribbons were distributed, Street Plays were performed, Pamphlets distributed, Posters, Float which was designed with messages on all slides of rath was taken around in Thane City.
Navratra Utsav Festival
MSACS sponsored a religious wellknown Navratra Utsav Festival to create HIV/AIDS awareness especially amongst the youth generation in Aurangabad, Pune, Gadchiroli, Amravati, Nashik, Osmanabad, Thane etc.
Diwali Festival
Since Diwali Festival is an well known cultural festival of India on this occasion MSACS conducted awareness campaign about HIV/AIDS through Diwali issues and newspapers and electronic media. 100 Diwali issues carried the advertisement of MSACS.
Religious Campaign
MSACS organized camps at religious campaigns in association with various NGOs in Aanganwadi, Pandharpur, Solapur, Latur etc.
Workshops
Workshops for political, religious leaders at Nagpur, Latur, Sangli, Kolhapur, Washim, Osmanabad districts were organized to sensitise peoples representatives about HIV/AIDS.
National football competition 07
Abhijit Kadam Memorial Trust organized national football competition MSACS sponsored the same more than 40,000 spectators enjoyed the game.
Siddeshwar Agro–tech 07 Latur
Shri Siddheshwar Agro–tech 07 Latur has organized state level exhibition, milk competition, agro exhibition, open discussion and women meet on the occasion of Siddeshwar and Ratneshwar yatra in Latur the women meet was specially for women working in agriculture. More than 12–15 lakhs people were expected to visit this yatra.
State level street play campaign
MSACS has organized street play campaign with help of 21 drama troops in every district of Maharashtra. Each group will perform 35 shows, which will cover all the districts assigned to them. More than 700 street play shows will be organized through out the state.
Promotional Activities of NACP
Media Post Advertisement Campaign
MSACS has conducted a Media Post Advertising Campaign through Post Cards, Inland Cards, Meghdoot Cards by joining hands with the department of posts, Govt. of India, these cards distributed through the Districts Post Offices all over the Maharashtra.
Calender about MSACS and HIV/AIDS prevention
MSACS has created annual calender depicting about MSACS and HIV/AIDS prevention, which is widely appreciated by general public as well as people working in this field.
Use of Electronic Media
All India Radio
MSACS has sponsored the broadcast of “Tan–man”, a Marathi play about HIV/AIDS on World AIDS Day 06 and also sponsored programme of interviews of HIV + people and TB patients. A live special program telecasted on International Drug Abuse Day 2006. Sponsored program for the students organized by Lokkala Academy.
Television
MSACS has telecast 139 television spots on VCTC, Blood Safety, STD, Stigma and Discrimination and Child Discrimination on various TV channels in Maharashtra.
School Adolescent Life Skill Education Programme (SALSEP)
Objectives
The main objective of the SALSEP is to impart life skills in teachers and students on the aspects of self and social awareness, communication and negotiations skill and decision making with regards to sexual health.
The students of STD 9th & 11th will be given 16 hours sessions a year by Nodal Teachers on sexual health. For this we have developed training material.
In Mumbai, this programme is conducted by MDACS and UNICEF through Public Health Department – MCGM, State Education Department. All secondary schools and junior colleges attached to schools have been taken up.
Media Post Advertisement Campaign
MSACS has conducted a Media Post Advertising Campaign through Post Cards, Inland Cards, Meghdoot Cards by joining hands with the department of posts, Govt. of India, these cards distributed through the Districts Post Offices all over the Maharashtra.
Calender about MSACS and HIV/AIDS prevention
MSACS has created annual calender depicting about MSACS and HIV/AIDS prevention, which is widely appreciated by general public as well as people working in this field.
Use of Electronic Media
All India Radio
MSACS has sponsored the broadcast of “Tan–man”, a Marathi play about HIV/AIDS on World AIDS Day 06 and also sponsored programme of interviews of HIV + people and TB patients. A live special program telecasted on International Drug Abuse Day 2006. Sponsored program for the students organized by Lokkala Academy.
Television
MSACS has telecast 139 television spots on VCTC, Blood Safety, STD, Stigma and Discrimination and Child Discrimination on various TV channels in Maharashtra.
School Adolescent Life Skill Education Programme (SALSEP)
Objectives
The main objective of the SALSEP is to impart life skills in teachers and students on the aspects of self and social awareness, communication and negotiations skill and decision making with regards to sexual health.
- The programme is being implemented since 1994 with NACO & UNICEF. There are 21,257 schools and since 1994 under the then programme of AIDS Prevention & Education Programme (APEP) we had covered about 20,509 schools.
- Since 2004–05 the programme is being implemented as SALSEP and have reached 5,511 schools out of targeted 8,372 in Phase I.
- State Resource Group will train the District Resource Group, who in turn will train the Head Masters and Nodal Teachers from school. Training status till date is SRG – 204, DRG – 1852 Nodal Teachers trained – 9440.
The students of STD 9th & 11th will be given 16 hours sessions a year by Nodal Teachers on sexual health. For this we have developed training material.
In Mumbai, this programme is conducted by MDACS and UNICEF through Public Health Department – MCGM, State Education Department. All secondary schools and junior colleges attached to schools have been taken up.
Blood Safety
Objectives
To ensure availability and safety of blood to the blood banks.
To create awareness and motivate people for voluntary non – remunerated blood donations. The status of Registered Blood banks including Mumbai since 1999 is as follows:
* Out of 285, 252 are functioning.
Achievements
The total collection of blood since 1999 has been remarkable and is as follows:
[All figures are for Maharashtra State including Mumbai] Due to efforts of MSACS & MDACS, the sero– positivity (unsafe blood) rate has also decreased (Table=above).
Objectives
To ensure availability and safety of blood to the blood banks.
To create awareness and motivate people for voluntary non – remunerated blood donations. The status of Registered Blood banks including Mumbai since 1999 is as follows:
S.No. | Year | No. of Regd. Blood Banks |
1 | 1999 | 225 |
2 | 2000 | 10 |
3 | 2001 | 14 |
4 | 2002 | 15 |
5 | 2003 | 8 |
6 | 2004 | 11 |
7 | 2005 | 2 |
Total | 285 |
Achievements
The total collection of blood since 1999 has been remarkable and is as follows:
Year | Blood Collection | Voluntary Collection | HIV Sero |
(in lakh) | (%) | reactivity (%) | |
1999 | 5.86 Units | 49.3 | 1.4 |
2000 | 6.49 Units | 54.29 | 1.2 |
2001 | 6.96 Units | 65.1 | 1.1 |
2002 | 7.43 Units | 66.94 | 0.95 |
2003 | 7.75 Units | 71.45 | 0.78 |
2004 | 8.34 Units | 73.56 | 0.74 |
2005 | 8.7 Units | 74.56 | 0.66 |
2006 | 9.22 | 81.3 | 0.58 |
2007 upto March | 1.11 | 81.1 | 0.54 |
Establishment of intergrated Counseling & Testing Centres (ICTC)
Intergrated counseling and Testing Centres (ICTC) provides an opportunity to access complete and accurate information on HIV/AIDS for all the segments of the population. NACO has recommended wide promotion of voluntary counseling and testing through these centers as they have been demonstrated to be effective public health strategy to prevent HIV transmission by reducing risk behabiour and increasing condom use.
Presently total 604 ICTC are functional under General, GFATM–II (PPTCT) and GFTAM – II (HIV–TB). As per annual action Plan 2006–2007, NACO has redistributed the ICTCs and now 36 ICTC are not classified under ICTC (General) category – 503 undfer ICTC(PPTCT) category and 65 new ICTC (HIV–TB) category.
Voluntary Counseling & Testing Services (VCTS)
Objectives
Following is the improvement in the performance of VCTC’s:
HIV–TB Co–ordination Activity
Objectives
Intergrated counseling and Testing Centres (ICTC) provides an opportunity to access complete and accurate information on HIV/AIDS for all the segments of the population. NACO has recommended wide promotion of voluntary counseling and testing through these centers as they have been demonstrated to be effective public health strategy to prevent HIV transmission by reducing risk behabiour and increasing condom use.
Presently total 604 ICTC are functional under General, GFATM–II (PPTCT) and GFTAM – II (HIV–TB). As per annual action Plan 2006–2007, NACO has redistributed the ICTCs and now 36 ICTC are not classified under ICTC (General) category – 503 undfer ICTC(PPTCT) category and 65 new ICTC (HIV–TB) category.
TYPE | AS ON 31–3–2007 | |
MSACS | MDACS | |
ICTC (General) | 36 | 17 |
ICTC (PPTCT) | 503 | 46 |
ICTC( HIV–TB) | 65 | 11 |
TOTAL | 604 | 74 |
Voluntary Counseling & Testing Services (VCTS)
Objectives
- To provide testing and counseling facilities to those who desire.
- To monitor the trend of the epidemic.
- To help people cope with their HIV infection through counseling.
Following is the improvement in the performance of VCTC’s:
Indicator | January to March 2007 | ||
Ex–Mumbai | Mumbai | Total | |
Total Tested | 53445 | 40442 | 93887 |
HIV Positive | 7025 | 4060 | 11085 |
% Positive | 13.14 | 10.04 | 11.59 |
Direct Walk in tested | 31001 | 26283 | 57284 |
Direct Walk in Positive | 4132 | 2862 | 6994 |
% Positive | 13.33 | 10.89 | 12.11 |
% Direct Walk in | 58.01 | 64.99 | 16.55 |
HIV–TB Co–ordination Activity
Objectives
- To make treatment services available for HIV–TB patients.
- To bring about co–ordination between VCTC–RNTCP to address the HIV–TB co–infection.
- VCTC – RNTCP (Revised National Tuberculosis Control Programme) Coordination programme was initiated in June, 2002. The Counsellors in VCTC are trained in identifying suspected TB cases to refer them to the Microscopy Centre in the same hospital. Similarly, if a person is suspected of HIV infection, he is referred to VCTC. Persons suspected of TB infection are provided with medicines under DOT (Direct Observation Treatment).
Prevention of Parents to Child Transmission
Objectives
All pregnant women attending Ante–natal clinics undergo group counselling and education before they go for pregnancy check–up. After counselling, those who are willing for HIV testing, blood sample is collected and HIV testing procedure starts. For HIV testing three types of Rapid Test Kits are used. The pregnant women who are positive in all three test kits, post – test counselling is done. During labour, one Nevirapine tablets is administered orally to these sero–positive women. The new born baby is also administered single dose Nevirapine syrup.
The performance of PPTCT programme is as follows:
Scaling up of Anti Retroviral Therapy
Government of India has decided to expand Care and Support to PLWHA by inclusion of provision of Anti Retroviral Therapy. Government of India has decided to provide Anti Retroviral Therapy for 1 Lac HIV/AIDS patients initially in a phased manner as part of 3/5 Initiative of WHO. In order to provide ART it was decided to start the programme at Medical College Hospitals and in the initial phase the faculties from Medicine, OBGY, Pediatrics, STD and Microbiologist, PSM, Chest & Tuberculosis were trained at J.J. Group of Hospital, Mumbai, which is Nodal Training Centre, recognized by NACO.
WHO has directly supplied the Antiretroviral drugs to B.J. Medical College, Pune, Government Medical College, Miraj and Government Medical College, Nagpur, NARI, Pune. Total 4 ART centers are established in Mumbai and 4 ART centers in rest of Maharashtra by MSACS.
Objectives
- To prevent the vertical transmission of HIV/AIDS from Parents to Child.
- To provide the services of counselling.
- To provide the facility of blood testing.
- If parents are found positive to provide Nevirapine to mother and child.
All pregnant women attending Ante–natal clinics undergo group counselling and education before they go for pregnancy check–up. After counselling, those who are willing for HIV testing, blood sample is collected and HIV testing procedure starts. For HIV testing three types of Rapid Test Kits are used. The pregnant women who are positive in all three test kits, post – test counselling is done. During labour, one Nevirapine tablets is administered orally to these sero–positive women. The new born baby is also administered single dose Nevirapine syrup.
The performance of PPTCT programme is as follows:
Indicator Name | January to March 2007 | ||
Ex–Mumbai | Mumbai | Total | |
Total No. of new ANC Registration & women came directly for delivery | 149465 | 29385 | 178850 |
Total No. of women counseled (Both registered and emergency) | 137889 | 28277 | 166166 |
No. of women accepted HIV test (Both registered and emergency) | 105351 | 26966 | 132317 |
No. of women found HIV positive | 853 | 244 | 1097 |
Total No. of mother – baby pairs received NVP | 326 | 92 | 418 |
Scaling up of Anti Retroviral Therapy
Government of India has decided to expand Care and Support to PLWHA by inclusion of provision of Anti Retroviral Therapy. Government of India has decided to provide Anti Retroviral Therapy for 1 Lac HIV/AIDS patients initially in a phased manner as part of 3/5 Initiative of WHO. In order to provide ART it was decided to start the programme at Medical College Hospitals and in the initial phase the faculties from Medicine, OBGY, Pediatrics, STD and Microbiologist, PSM, Chest & Tuberculosis were trained at J.J. Group of Hospital, Mumbai, which is Nodal Training Centre, recognized by NACO.
WHO has directly supplied the Antiretroviral drugs to B.J. Medical College, Pune, Government Medical College, Miraj and Government Medical College, Nagpur, NARI, Pune. Total 4 ART centers are established in Mumbai and 4 ART centers in rest of Maharashtra by MSACS.
Performance of NACP
Following table indicate the performance
The above institutions are provide Rs.1 Lac for Contingency Expenditure.Under GFATM Round III, for PPTCT plus, it is proposed to provide ART through Medical College Institutions for pregnant mothers, their children and spouse.
Care & Support: Community Care Centres (CCC)
Objectives
Following table indicate the performance
Sr.No. | Medical College | Total No of patients alive & on ART | ||||
Male | Female | TG/TS | Childern | Total | ||
1 | J.J. Hospital, Mumbai | 2588 | 1268 | 0 | 132 | 3988 |
2 | Sion Hospital | 397 | 208 | 5 | 80 | 690 |
3 | K.E.M. Hospital | 727 | 362 | 3 | 92 | 1184 |
4 | Nair Hospital | 432 | 246 | 0 | 25 | 703 |
Total (A) | 4144 | 2084 | 8 | 329 | 6565 | |
5 | PVPG Sangli | 1066 | 771 | 0 | 216 | 2053 |
6 | Sasoon GH Pune | 1098 | 812 | 0 | 238 | 2148 |
7 | Government Medical Hospital, Nagpur | 969 | 389 | 0 | 135 | 1493 |
8 | NARI | 117 | 60 | 0 | 0 | 177 |
9 | Dhule | 249 | 88 | 0 | 20 | 357 |
10 | Akola | 159 | 49 | 0 | 13 | 221 |
11 | Aurangabad | 339 | 130 | 0 | 30 | 499 |
12 | SRTR Ambejogai,Beed | 519 | 274 | 0 | 10 | 803 |
13 | Yeotmal | 184 | 69 | 0 | 14 | 267 |
Total (B) | 4700 | 2642 | 0 | 676 | 8018 | |
Grand Total (A+B) | 8844 | 4726 | 8 | 1005 | 14583 |
The above institutions are provide Rs.1 Lac for Contingency Expenditure.Under GFATM Round III, for PPTCT plus, it is proposed to provide ART through Medical College Institutions for pregnant mothers, their children and spouse.
Care & Support: Community Care Centres (CCC)
Objectives
- To have a continuum of care and support across comprehensive health care.
- To augment the efforts of Health Care System
- Access to antiretroviral treatment.
- To provide nutrition.
- Clinical Management of Symptomatic infection.
- The budget provided to each CCC is Rs. 19,48,740 yearly for 10 beds.
- We have one 50 bedded CCC in the State i.e. Bel Air Hospital, Dist. Satara since April, 2000.
- The CCC has catered to 1500 patients till date.
- 2 CCC’s are in Mumbai under MDACS jurisdiction viz.
- Sarvoday Hospital established in 2002.
- Niramay Niketan established in 2003
- 5 CCCs were established by Avert Society.
- 5 CCC proposed to be establish in 2006–07 by MSACS (Kolhapur,Ahmednagar, Thane, Chandrapur, Latur).
Drop–in–Centres
Objectives
1. Ahmednagar
2. Pune
3. Beed
4. Chandrapur
4 DIC’s are in Mumbai and funded by MDACS which are as follows,
i. Sion Hospital ii. Nair Hospital
iii. KEM Hospital iv. J J Hospital
5DCCC are proposed in 2006–07 by MSACS (Raigad, Nanded, Yavatmal, Jalgaon, Hingoli)
Functions
Objectives
To assess the prevalence of HIV infection in High Risk Group as well as general population, sentinel surveillance is undertaken every year. From 1998 to 2006, 10 rounds were conducted.
ANC Sites: HIV Prevalence has decreased in Urban from 1.25 (2005) to 0.75 (2006)and in Rural area it remain same that is 0.50 form 2005 & 2006.
STD Sites: HIV prevalence has decreased from 10.5% (2005) to 10.00% (2006).
Training
Training of officers and staff is essential for effective and successful implementation of National AIDS Control Programme. Maharashtra State AIDS Control Society conducts various training programmes at state level taking into consideration the medical and psycho–social aspects related to HIV/AIDS.
Maharashtra State AIDS Control Society is conducting following training programmes in the state:
Objectives
- To provide low cost care and support to those infected and affected.
- To provide low cost care and community outreach services.
1. Ahmednagar
2. Pune
3. Beed
4. Chandrapur
4 DIC’s are in Mumbai and funded by MDACS which are as follows,
i. Sion Hospital ii. Nair Hospital
iii. KEM Hospital iv. J J Hospital
5DCCC are proposed in 2006–07 by MSACS (Raigad, Nanded, Yavatmal, Jalgaon, Hingoli)
Functions
- Counselling to +ve people through 2 Counsellors.
- Field workers for home visits.
- Self – help group through saving – groups and thereby generating income.
- Recreational activities.
Objectives
To assess the prevalence of HIV infection in High Risk Group as well as general population, sentinel surveillance is undertaken every year. From 1998 to 2006, 10 rounds were conducted.
- In 2006, similar survey was conducted from September to November, 2006.
- The survey was conducted by MSACS in 9 STD sites (High Risk Group) 66 ANC Sites, 10 Female Sex Workers Sites, 1 Site for 15 to 24 years age group, 4 site as TB site and 1 site for Men Having Sex with Men (MSM) (Total 87 sites).
- The survey was conducted by MDACS in total 19 sites viz.9 ANC, 3 STD, 2 CSW, 1 IVDU, 1 MSM and 1 Eunuchs site.
ANC Sites: HIV Prevalence has decreased in Urban from 1.25 (2005) to 0.75 (2006)and in Rural area it remain same that is 0.50 form 2005 & 2006.
STD Sites: HIV prevalence has decreased from 10.5% (2005) to 10.00% (2006).
Training
Training of officers and staff is essential for effective and successful implementation of National AIDS Control Programme. Maharashtra State AIDS Control Society conducts various training programmes at state level taking into consideration the medical and psycho–social aspects related to HIV/AIDS.
Maharashtra State AIDS Control Society is conducting following training programmes in the state:
- Clinical Management Training of Medical Officers 200.
- Training of private practitioners. 150 according to received reports.
- Training of Counselors 385.
- Training of Lab Technician 390.
- NGO Training in condom promotion 60.
- Induction Training of NGOs 25.
- Training of NGO Medical Officers 32.
- PPTCT Team Training 500 team members.
PeopleTrained by MSACS
During the year 2003–04 following people were trained by MSACS
From April 2004 to March 2005 following people are trained
Data of training for 2005–2006 is as follows
During the year 2003–04 following people were trained by MSACS
Medical Officer | 5969 |
Nurses | 10681 |
Lab Technicians | 58 |
Field Workers | 57566 |
Counsellors | 115 |
NGO representative | 184 |
From April 2004 to March 2005 following people are trained
Medical Officer | 983 |
Private practitioners | 1846 |
Resident Medical Officers | 52 |
Nurses | 919 |
NGOs | 113 |
Refresher Training | |
Counsellors | 165 |
Lab. Technicians | 160 |
Training of trainers under PPTCT | 13 |
Data of training for 2005–2006 is as follows
1 | Training of M.O’s in clinical management | 464 |
2 | Resident Doctors | 44 |
3 | Five member team of PPTCT programme | 106 team members |
4 | Training of M.O’s in HIV–TB | 72 |
5 | Training of peer educators of PLHA organizations | 54 |
organizations | ||
6 | Training of NGOs | 51 |
7 | Training of Counsellors | 35 |
8 | Training of Lab. Tech.s | 39 |
9 | Training of private practitioners | 2200 |
Avahan – India AIDS Initiative
State Epidemic Background
Maharashtra is the second largest state in India with a population of around 100 million. It has district excluding Mumbai of which 24 have an HIV/AIDS prevalence of over 1% (as per NACO Sentinel Surveillance 2005). Further it has multiple large players – the Mumbai AIDS Control Society (MDACS), the Maharashtra State AIDS Control Society (MSACS) and the AVERT program funded by USAID, which operates in 7 districts. The AVAHAN India AIDS Initiative programme of the Bill and Melinda Gates Foundation seeks to address the need for intensified prevention efforts in Maharashtra to stem the the epidemic.
Avahan in Maharashtra
The Avahan programme in Maharashtra was initiated in March, 2004 via its grantees, Family Health International (FHI),Pathfinder International, University of Manitoba (UoM), Population Services International (PSI) and TCI Foundation Avahan’s programmes are targeted at female sex workers (FSW) and their male clients and men who have sex with men (MSM) and transgender (TG) in Mumbai / Thane and 13 other high prevalence district. Approximately Rs. 133 crores ($ 30 million) will flow into prevention programmes during a five year period.
At present, Avahan’s partner cover nearly 58,000 FSW and 10,000 MSM and TG with a full suite of prevention services (peer outreach, interpersonal communication for behavior change, condom distribution, treatment of sexually transmitted infections, community mobililzation and advocacy). In addition, nearly 110,000 truckers and about 1 million other male clients are covered through condom social marketing and STI services.
Avahan support the Maharashtra State AIDS Control Society and the Mumbai District AIDS Control Society as required through trainings, workshops and exposure visits.
Programme details and status
Family Health International (FHI): FHI, which commenced in March, 2004 has received a grant of Rs, 46 crores ($ 10.5 million) to work with around 50,000 sex workers/MSMs in Mumbai/Thane. The programme operates through 15 NGO and 700 outreach workers who have contracted the nearly 49,000 individuals to date. Every month the programme distributes around 400,000 condoms and treats 8,700 individuals through a network of 56 programme clinics.
Pathfinder International (PI) : Pathfinder, which commenced in March, 2004 has received a grant of Rs. 37 crores ($ 8.5 million) works with around 17,000 sex workers / MSMs in 10 districts of Maharashtra (Ahmednagar, Beed, Jalgaon, Kolhapur, Latur, Nandurbar, Nashik, Parbhani, Pune, and Yavatmal). The programme operates through 10 NGOs and also provide clinical services to around 3,600 FSW covered by MSACS NGOs in Pune. Pathfinder has contracted nearly 12,000 individuals through around 200 outreach workers. Every month, the programme distributes around 2,80,000 condoms and teats 2,300 individuals through 19 clinics.
State Epidemic Background
Maharashtra is the second largest state in India with a population of around 100 million. It has district excluding Mumbai of which 24 have an HIV/AIDS prevalence of over 1% (as per NACO Sentinel Surveillance 2005). Further it has multiple large players – the Mumbai AIDS Control Society (MDACS), the Maharashtra State AIDS Control Society (MSACS) and the AVERT program funded by USAID, which operates in 7 districts. The AVAHAN India AIDS Initiative programme of the Bill and Melinda Gates Foundation seeks to address the need for intensified prevention efforts in Maharashtra to stem the the epidemic.
Avahan in Maharashtra
The Avahan programme in Maharashtra was initiated in March, 2004 via its grantees, Family Health International (FHI),Pathfinder International, University of Manitoba (UoM), Population Services International (PSI) and TCI Foundation Avahan’s programmes are targeted at female sex workers (FSW) and their male clients and men who have sex with men (MSM) and transgender (TG) in Mumbai / Thane and 13 other high prevalence district. Approximately Rs. 133 crores ($ 30 million) will flow into prevention programmes during a five year period.
At present, Avahan’s partner cover nearly 58,000 FSW and 10,000 MSM and TG with a full suite of prevention services (peer outreach, interpersonal communication for behavior change, condom distribution, treatment of sexually transmitted infections, community mobililzation and advocacy). In addition, nearly 110,000 truckers and about 1 million other male clients are covered through condom social marketing and STI services.
Avahan support the Maharashtra State AIDS Control Society and the Mumbai District AIDS Control Society as required through trainings, workshops and exposure visits.
Programme details and status
Family Health International (FHI): FHI, which commenced in March, 2004 has received a grant of Rs, 46 crores ($ 10.5 million) to work with around 50,000 sex workers/MSMs in Mumbai/Thane. The programme operates through 15 NGO and 700 outreach workers who have contracted the nearly 49,000 individuals to date. Every month the programme distributes around 400,000 condoms and treats 8,700 individuals through a network of 56 programme clinics.
District Covered | NGOs | Coverage | Programme indicators |
Mumbai | AMS | 2489 FSW | 1.Individuals ever contacted:49,655 (99% of target) |
CORO | 1117 FSW | 2. Condoms Distributed per year 5 million | |
NSP | 4013 FSW | 3. STI treated per year: 131,000 | |
NSVK | 1256 TG | ||
RSP | 6134 FSW | ||
SAI | 1951 FSW | ||
Sanmitra | 2249FSW | ||
SHED | 3179FSW | ||
VKM | 4211 FSW | ||
HST | 2226 FSW | ||
Thane | Alert | 4623 FSW | |
CDI | 3117 FSW | ||
FPAI | 2922 FSW | ||
Bhiwadi | 2570 FSW | ||
Sathi | 3836 FSW | ||
SMUM |
Pathfinder International (PI) : Pathfinder, which commenced in March, 2004 has received a grant of Rs. 37 crores ($ 8.5 million) works with around 17,000 sex workers / MSMs in 10 districts of Maharashtra (Ahmednagar, Beed, Jalgaon, Kolhapur, Latur, Nandurbar, Nashik, Parbhani, Pune, and Yavatmal). The programme operates through 10 NGOs and also provide clinical services to around 3,600 FSW covered by MSACS NGOs in Pune. Pathfinder has contracted nearly 12,000 individuals through around 200 outreach workers. Every month, the programme distributes around 2,80,000 condoms and teats 2,300 individuals through 19 clinics.
Activities of NACP
University of Manitoba (UoM): University of Manitoba which commenced in late 2005, has received grant of Rs. 10 crores ($ 2.3 million) to cover around 5,200 sex workers in the three district of Solapur, Satara and Sangli. In Solapur the programme only provide Clinical services to around 2,900 sex workers covered by the Avert programme. The programme operates through around 70 outreach workers in Maharashtra and has contacted around 2,400 individuals. Every month, the programme distributes around 180,000 condoms and treats 200 individulas through 4 clinics.
Population Services International (PSI): The PSI programme, which commenced in March 2004, has received a grant of Rs. 35 crore ($ 8 million) to cover male clients of sex workers in Mumbai / Thane and 8 other district of Maharashtra. The programme is responsible for social marketing condoms, setting up a network of around 240 STI doctors to offer quality diagnosis, treatment and counseling services and for creating demand for condoms and STI services through IPC, mid–media and mass media campaigns. Each month the programme makes around 1 million inter–personal communication contacts and socially market 1.7 million condoms.
District Covered | NGOs | GSMTCoverage | Programme indicators |
Ahmednagar | Shehalaya | 957 FSW 534 FSW | 1. Individuals ever contacted: 12,444(73% of target) |
Beed | GVM | 1980 FSW 791 TG | 2. Condoms Distributed per year:3.3 million |
Jalgaon | Godavari Foundation | 580 FSW 594 FSW | 3. STI treated per year: 27,000 |
Kolhapur | MSPSS | 419 FSW 596 FSW | |
Latur | SNT | 930 FSW 409 FSW | |
Nandurbar | LSAMT | 41 FSW 519 FSW | |
Nashik | PMT | 172 FSW | |
Parbhani | SEDT | 1535 FSW 202 MSM | |
Pune | JPSD | 2575 FSW3200MSM | |
Yavatmal | GSMT | 969 FSW 204MSM |
University of Manitoba (UoM): University of Manitoba which commenced in late 2005, has received grant of Rs. 10 crores ($ 2.3 million) to cover around 5,200 sex workers in the three district of Solapur, Satara and Sangli. In Solapur the programme only provide Clinical services to around 2,900 sex workers covered by the Avert programme. The programme operates through around 70 outreach workers in Maharashtra and has contacted around 2,400 individuals. Every month, the programme distributes around 180,000 condoms and treats 200 individulas through 4 clinics.
District Covered | NGOs | GSMTCoverage | Programme indicators |
Sangli | Sangram | 2020 FSW | 1.Individuals ever contacted : 2,371 (44 % of target) |
Satara | Sangaram | 385 FSW | 2. Condoms distributed per year:1 million |
Solapur | Niramaya Arogya Dham | 2953 FSW | 3. STI trated per year : 2,500 |
Population Services International (PSI): The PSI programme, which commenced in March 2004, has received a grant of Rs. 35 crore ($ 8 million) to cover male clients of sex workers in Mumbai / Thane and 8 other district of Maharashtra. The programme is responsible for social marketing condoms, setting up a network of around 240 STI doctors to offer quality diagnosis, treatment and counseling services and for creating demand for condoms and STI services through IPC, mid–media and mass media campaigns. Each month the programme makes around 1 million inter–personal communication contacts and socially market 1.7 million condoms.
District Covered | Programme infrastructure | Programme indicators |
Condom social marketing in all district covered by Pathfinder, FHI University of Manitoba | clinics, 24,000 Condom Outlets | 1.Individual contacts per year for condom and STI promotion: 12 million. |
Satara | Sangaram | 2. Condoms sold per year:21 million |
Solapur | Niramaya Arogya Dham | 3. STI treated per year: 17,000 |
Avert Society
Transport Corporation of India Foundation (TCIF): The TCIF programme, which commenced in Mar 2004, has received a grant of Rs. 4.4 crores ($ 1 Million) to cover around 110,000 long distance truckers across four haltpoints in the state. The programme operates at Kalamboli (Raigarth), Nigdi (Pune) Pardi and Wadi (Nagpur) and has contacted over 70,000 truckers. Every month the programme, socially markets nearly 10,000 condoms directly to truckers and also treats around 2,500 STIs.
Activities of Avert Society
A Joint Project of Naco Government of Maharashtra and Usaid
Avert Society was set up in November, 2001 for managing the HIV/AIDS prevention in Maharashtra. AVERT Society was formed through a tripartitie agreement with US Government, Government of India and Government of Maharashtra. It works in close collaboration with Maharashtra State AIDS Control Society (MSACS) and Mumbai Districts AIDS Control Society (MDACS). The main aim of AVERT society is to increase the use of effective and sustainable responses to reduce transmission and prevent the spread of HIV/AIDS.
Avert Society is currently supporting over 73 projects on HIV/AIDS prevention, Work Place Intervention and Care and Support in seven districts of Maharashtra through the five strategic interventions like Targetted Intervention, Care and support, Capacity Building, Communication and Research.
Goal
The overall goal of AVERT Society is to support the Government of Maharashtra to reduce the impact of the HIV/AIDS epidemic on the social, economical and human development in India.
Areas of Intervention
Targetted Intervention Programs are implemented in seven districts of Maharashtra viz. Mumbai, Nagpur, Aurangabad, Thane, Sangli, Satara and Solapur. Care and support intervention programme are implemented in the core districts, Kolhapur and PUne. Work Place intervention programs are implemented in core districts. Nashik and Pune.
Activities of AVERT Society 06 – 07
Transport Corporation of India Foundation (TCIF): The TCIF programme, which commenced in Mar 2004, has received a grant of Rs. 4.4 crores ($ 1 Million) to cover around 110,000 long distance truckers across four haltpoints in the state. The programme operates at Kalamboli (Raigarth), Nigdi (Pune) Pardi and Wadi (Nagpur) and has contacted over 70,000 truckers. Every month the programme, socially markets nearly 10,000 condoms directly to truckers and also treats around 2,500 STIs.
District Covered | NGOs | GSMT Coverage | Programme indicators |
Kalamboli,Raigarth | BLP | 22,747 | 1. Cumulative contacts per year: 70,324 |
Nigdi, Pune | Sewadham | 29,928 | 2. Condoms socially marked per year:110,000 |
Pardi, Nagpur | IIYW | 29,466 | 3. STI trated per year : 30000 |
Wadi Nagpur | IIYM | 26,996 |
Activities of Avert Society
A Joint Project of Naco Government of Maharashtra and Usaid
Avert Society was set up in November, 2001 for managing the HIV/AIDS prevention in Maharashtra. AVERT Society was formed through a tripartitie agreement with US Government, Government of India and Government of Maharashtra. It works in close collaboration with Maharashtra State AIDS Control Society (MSACS) and Mumbai Districts AIDS Control Society (MDACS). The main aim of AVERT society is to increase the use of effective and sustainable responses to reduce transmission and prevent the spread of HIV/AIDS.
Avert Society is currently supporting over 73 projects on HIV/AIDS prevention, Work Place Intervention and Care and Support in seven districts of Maharashtra through the five strategic interventions like Targetted Intervention, Care and support, Capacity Building, Communication and Research.
Goal
The overall goal of AVERT Society is to support the Government of Maharashtra to reduce the impact of the HIV/AIDS epidemic on the social, economical and human development in India.
Areas of Intervention
Targetted Intervention Programs are implemented in seven districts of Maharashtra viz. Mumbai, Nagpur, Aurangabad, Thane, Sangli, Satara and Solapur. Care and support intervention programme are implemented in the core districts, Kolhapur and PUne. Work Place intervention programs are implemented in core districts. Nashik and Pune.
Activities of AVERT Society 06 – 07
- 38 NGOs implemented Targetted Intervention (TI) projects in seven districts in Maharashtra.
- 14 NGOs implementing Work Place Interventions.
- 23 NGOs implementing Care and Support Project.
- Regular Monitoring and Evaluation is conducted by AVERT Society to the implementing NGO projects in Maharashtra.Overview of TI Projects in Maharashtra (as on December, 2006).
Target Groups | Projects | Population covered |
Commercial sex workers (CSW) | 6 | 7000 |
Men Having sex with men (MSW) | 5 | 15000 |
Truck Drivers | 4 | 100000 |
Migrant Workers | 7 | 175000 |
Slums (Composite Group) | 9 | 225000 |
Prison | 1 | 1500 |
Target Group | 1 | 500 |
Youth | 2 | 60000 |
Street Childern | 2 | 2000 |
Care and Support Project | 23 | 16100 PLHA |
Comprehensive project | ||
(Prevention and care and support) | 1 | 48800 General Population and 1000 PLHA |
Work Place Intervention | 14 | Over 400 companies reached |
Capacity Building Institution | 2 | Implementing partners |
Total | 77 |
Other Activities of NACP
- BSS Wave III completed.
- Operations Reasearch on the Dynamic of MSM, IDUs and PLHAs completed.
- Impact assessment of MSRTC bus paintings.
- Assessment of Small Grants.
- Validation of HRG mapping in 22 High prevalent districts of Maharashtra.
- Validation of HRG mapping in 12 low prevalent districts of Maharashtra.
- 1468 NGO staff trained in various core skills.
- Manuals/Modules/Flip book developed
- “Jawan Hoon Nadan Nahin” youth campaign launched in AVERT Districts.
- BCC materials developed for youth campaign, Posters, leaflets, stickers, book marks, comic books, carom game, circus game, memory game. IT based game CDs, Song booklet by JHU and disseminated.
- MSRTC buses painted with A & B messages in the first phase and in the second phase youth messages painted.
- C & S communication campaign launched in Avert Society district (Press conference and launch in Bel Air in May 2007).
TI | WPI | C & S | |
Experience sharing Review meetings (ESRM) | 7 | 1 | 2 |
Participatory Site Visit (PSV) | 2 | 2 | 2 |
Proposal Development Workshop | 1 | 12 for Continuation | |
Induction Workshop | 2 | 3 | |
PEPFAR Workshop | 1 | 1 |