VHS – CDC PROJECT

Technical Assistance to National AIDS Control Programme-Phase IV (TA to NACP-IV).

Supported by Centers for Disease Control and Prevention (CDC).

In Partnership with National AIDS Control Organization, Andhra Pradesh State AIDS Control Society, Maharashtra State AIDS Control Society and Mumbai District AIDS Control Society.

Introduction

The Voluntary Health Services – Centers for Disease Control and Prevention, (VHS-CDC) Project, “TA to NACP-IV’, is providing technical support to the National AIDS Control Organization (NACO) in carrying out national level reviews and policy revisions on prevention, care & treatment and strategic information programmes. In line with the revised PEPFAR strategy, apart from the national level activities, the project has adopted the pivot strategy focusing its efforts on the high HIV burden cluster districts of Andhra Pradesh (AP) and Maharashtra (MH).

VHS-CDC project has undertaken strategic efforts and carried out a series of innovative activities in coordination with various stakeholders at the cluster and national levels.

Background

  • VHS entered into a Cooperative Agreement with Centers for Disease Control and Prevention, Department of Health and Human Services, United States Government to provide Technical Assistance to National AIDS Control Program

  • Goal is to strengthen strategic planning, decision making, national level reviews and policy revisions of prevention, care and treatment programs including cross cutting areas of capacity building, integration, planning and financial systems

  • Project supports strategies to maximize resource utilization by addressing gaps identified during program reviews and scaling up high impact practices

  • Project strengthens national level activities of NACO and intensely functions at cluster level, in line with revised PEPFAR approach of pivoting to six high burden cluster districts in Andhra Pradesh (East Godavari, Guntur, Krishna) and Maharashtra (Mumbai, Pune, Thane)

Focus Areas – India

  • Profiling risk of clients at Integrated Counselling and Testing Centres (ICTCs), classifying clients and linking clients (including key populations) to HIV services

  • Strengthening mechanisms to ensure all HIV positive clients (including key populations) are linked to ART centre and minimize linkage loss

  • Demonstrating models for Key Population friendly ICTC

  • Supporting the implementation of integrated PLHIV-ART Linkage System (PALS) for improved tracking of PLHIV cases and trends and demonstrating linkage across the prevention to treatment and care cascade.

  • Building human capacity to enhance counselling skills of ICTC Counsellors and strengthening linkages to treatment

  • Strengthening Partner Tracing and Testing program

  • Strengthening Prevention of Parent to Child Transmission of HIV (PPTCT) program to address gaps found in HIV testing of pregnant women, coverage of Early Infant Diagnosis (EID) and initiation of Anti Retro-viral Therapy (ART) among HIV positive pregnant women

  • Capacity enhancement and mentoring of 188 District AIDS Prevention and Control Units (DAPCU) across India through DAPCU National Resource Team (DNRT) leading to improved program efficiencies, enhanced quality of data for decision making and strengthened mechanisms for cross referrals between diagnosis and treatment facilities

  • Strengthening the Strategic Information Management Unit, basic services and care and treatment program

  • Conducting quality review of Opioid Substitution Therapy centers functioning at government health facilities

Focus Areas – Sri Lanka

  • Technical Assistance to the National STD/AIDS Control Program (NSACP), Government of Sri Lanka for strengthening the country’s response to HIV through enhancement of Strategic Information (SI) capabilities and systems in coordination with Strategic Information Management (SIM) Unit

  • Technical support to NSACP aims to
    (1) Enhance the capacities of in-country Strategic Information Management Unit team to utilize electronic and manual program data for decision making.
    (2) Improve the capacity of SIM Unit to carryout management, analysis, documentation and dissemination of summary program data reports.
    (3) Improve capacity of SIM Unit to conduct and disseminate results of operational research at national, global and regional levels.
    (4) Consultation with stakeholders on monitoring and documentation of accomplishments and sustainability plans.

PLHIV – ART Linkage System (PALS)

  • Developed PALS, a web based online – individual tracking system to improve tracking of clients across the prevention-to-care continuum cascade. VHS-CDC project has developed a module for uploading data offline.

  • VHS-CDC project in collaboration with APSACS, MSACS and MDACS has conducted the training program on PALS for ICTC counsellors, data managers and DAPCU personnel.

  • VHS-CDC project in coordination with NACO has documented the experiences of implementing PALS in the form of process documentation supported with best practices, abstracts and case studies.

  • PALS successfully completed security audit and earned a security certificate. PALS is helping the HIV program to track and manage cases across geographies, enabling data management by eliminating duplication and redundancies, facilitating to identify and track Loss to follow up (LFU) cases and ensuring data management for the PPTCT and Early Infant Diagnosis cohort.

Activities – cluster level

The project is working closely with MSACS, MDACS and APSACS and other key stakeholders in piloting the above innovations. The project personnel both at the project office and at the cluster level are coordinating with respective SACS, undertaking mentoring visits, participating in review meetings and providing strategic technical support.

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Project Director, MSACS addressing the participants in Counsellors training program

Activities – Sri Lanka

  • Facilitated the signing of Letter of Intent (LoI) between the Ministry of Health, Nutrition and Indigenous Medicine, Government of Sri Lanka and CDC/DGHT-India

  • Facilitated exploratory visits, planning meetings, consultative meetings with key stakeholders, experience sharing sessions and field visits to facilities

  • Process of developing comprehensive dashboard indicators on STI/HIV/AIDS, enhancing the NSACP website, updating Monitoring and Evaluation (M&E) plan to align with the “National HIV/STI Strategic Plan Sri Lanka, 2018-22” initiated.

  • A reference manual on “Situation Assessment of Strategic Information Management System under NSACP, Sri Lanka & Strategies and Approaches of Technical Assistance to SI under NSACP” developed and shared with NSACP, CDC and other key stakeholders.

  • Additional proposed activities in the forthcoming period include Technical Assistance for implementation of Electronic Information Management System (EIMS), developing analytical report on Strategic Information, improving capacity of SIM unit to conduct and disseminate results of operational research and documenting best practices on Monitoring and Evaluation

Key Achievements

  • Strategic Information Management Unit (SIMU), Basic Services and Care & Treatment programme of NACO: VHS-CDC project supports positions of technical consultants in NACO as part of its strategic support to NACO.

  • TA for organizing National Workshop for finalizing Risk Assessment Tool:
    VHS-CDC project has developed risk assessment tool for administering to clients at ICTCs. The tool was presented at the national workshop organized by NACO in collaboration with VHS-CDC project. A sub-committee was constituted by NACO, which reviewed and finalized the tool for implementation.

  • Extended Technical Assistance (TA) to NACO in developing plans and systems for conducting Joint Implementation Review meeting for NACP IV by involving key stakeholders including donors in selected states.

  • North East Strategy:
    Supported and facilitated development of strategic plan specific to North East region for scaling-up NACP in eight North Eastern states. Carried out systematic reviews of North East HIV/AIDS program, established priorities, identified gaps and documented challenges to tailor and strengthen response to HIV/AIDS in North East region. Conducted four multi-stakeholder North East conclaves with specific reference to People Who Inject Drugs (PWID) including Female Injecting Drug Users (FIDU) and supported state-level consultations.

  • DAPCU National Resource Team:
    DAPCU Monthly Report developed as a monitoring tool to capture the activities of DAPCU, analyze progress, track key indicators and provide feedback to DAPCU team. An innovative monthly score card was designed on key indicators to track performance and monitor effectiveness of DAPCUs. The DAPCU blog served as a knowledge sharing platform for facilitating exchange of best practices, lessons and experiences among DAPCU teams across India. DNRT offered strategic support to DAPCU Nodal Officers and key SACS officials for systematic conduct of DAPCU review meetings, addressing data quality issues and utilizing data for decision making.

  • Supported development of strategies to improve HIV-TB coordination for early detection in select northern states.

  • Provided technical assistance to NACO for conducting review of Government Opioid Substitution Therapy (OST) centres.

Publications

The project in coordination with NACO, SACS and other key stakeholders brought out the following publications:

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  • Training manual for outreach workers

  • Integrated training module for counsellors (Phase II)

  • Training manual on developing counselling skills for counsellors

  • PALS process documentation

  • Process documentation on PPTCT program outreach experiences.

  • DNRT process documentation

  • PALS offline module

  • Situation Assessment of Strategic Information Management System & Strategies and Approaches on Technical Assistance to NSACP

  • Comprehensive Dashboard Indicators on STI/HIV/AIDS for TA to NSACP, Sri Lanka