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Dear Friends,

Would like to share the below points related to District AIDS Prevention Control Unit (DAPCU).

1. What are the problems involved in manning the DAPCU, building their capacities, and delegation of administrative and financial powers ?
·         In some places DAPCU office set up is not up to the mark and the infrastructure is very poor, with congested office space. Moreover, the delay in provision of telephone and internet facility due to various reasons, has affected its initial start-up;
·         Unfilled vacancies: Some posts in DAPCU offices are still vacant. Like that of Messenger -Group D;
·         DPOs are unable to visit peripheral units because of more responsibilities and most of the time goes in reporting and responding to mails from the State itself;
·         Difficulty in collection of SOE from peripheral units – No proper co operation from clerks, office superintendents neglecting ICTC work, and so on.

2. The relationship with DM or Collector and District Health Society, their relationship with SACS and NACO.
It has been noticed that in many places Deputy Commissioners (Collectors) and DHOs are very co operative, interested and support the DAPCU work. Like for example: Mysore and Davangere in Karnataka. However, some Collectors are overburdened with their work responsibilities and are members of various boards and committees, which make them unavailable during DAPCU/District Level meetings. The relationship has been good so far.

3. Are the present guidelines prepared taking into account the existing institutional arrangements or does it require modifications?
It certainly requires modifications. Nevertheless, in bureaucracy, the policies are always made at the higher levels and they have to be executed by the machinery at the lower level. There is no participation of the implementers in formulating the policies. To site an example provision of less amount for vehicle hiring than the practical need, as this amount has to accommodate also the TA/DA for M and E Assistant. 
Moreover, there is no provision of TA/DA for local Lab Technicians and Counsellor. In addition, DAPCUs also feel that they are not given a free hand to  depute LTs and counsellors at DAPCU level.

4.What are the examples of integrated public health services that the DAPCU can follow to integrate the NRHM, RCH and TB control services with HIV prevention and care?
For the programme on prevention of parent to child transmission of HIV infection (PPTCT) under NACP-III, NACO and Karnataka SACS has been integrated with the Reproductive & Child Health Programme under National Rural Health Mission of the Department of Health & Family Welfare Services since May 2008.

A joint GO was issued on in May jointly by the Mission Director, NRHM and the Principal Secretary, Department of Co-operation. The Reproductive & Child Health Officers (RCHOs) concurred that it was their primary responsibility to ensure that all women and children are healthy and free from all infections including HIV. This ownership of the programme facilitated the integration of activities and helped mainstream HIV activities with NRHM.

Based on the G.O, all the Districts commenced HIV testing of all Antenatal cases who are in their II trimester of pregnancy following NACO’s Protocols. ANMs were made responsible to mobilise ANCs to the PHCs on Thursdays, which is the regular ANC checkup day. The district tuberculosis officers, district supervisors appointed by KSAPS and the district programme officers under KHSDRP have been involved and have extended full co-operation to the RCH Officers in preparing micro-plans and putting up the rotational calendars for the ICTC counsellors and lab technicians to visit the PHCs on Thursdays for counselling and HIV testing. HIV positive pregnant women were registered with the Yeshaswini hospital of their choice in their district or outside and the complete reimbursement for their delivery would be done to the Yeshaswini Hospital by NRHM. Currently, 330 hospitals are included in the Yeshaswini network. These include 38 Government Hospitals and 292 Private Hospitals all over the State with three hospitals of the Apollo Group in Hyderabad and Secunderabad are included for patients from Northern Karnataka especially from Gulbarga and Bidar.

It has also been planned to integrate mobile ICTC services with the mobile health services that are being launched under KHSDRP and NRHM shortly, so that ICTC services can be provided at places where it could be utilized for testing HRGs. These  consists mainly of temporary settlers and for congregations who run or visit local fairs or shandies on fixed days regularly and many other such groups who find it inconvenient to visit ICTC at a fixed location or do not wish to be identified when visiting an ICTC. These mobile health clinics would also treat STIs and distribute Condoms.

5. What are the challenges faced in extracting, reporting and analyzing the data at DAPCU level?
Difficulties in obtaining in real-time information from peripheral units,
The higher agencies keep asking for one or other report frequently, so much so that DAPCUs need to prepare them as and when required which takes a lot of time to collect the data.

(With due acknowledgement to DPO, Mysore, Karnataka).

Warm regards,

Poornima B.S.
Technical Support Unit to Karnataka SACS (KSAPS),
Bangalore.

poowonder@gmail.com

 

 

 
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