Loading....
Coupon Accepted Successfully!

 

National AIDS control program phase iii (2007-2012)


First case in 1986 to 5.21 million in 2005
Focus has shifted from raising awareness to behaviour change, from a national response to a decentralized response and an increasing engagement of NGOs and networks of people living with HIV/AIDS.
  1. NACP – I (1992-1999)
    1. To slow down the spread of HIV infections so as to reduce morbidity, mortality and impact of AIDS in the country.
      1. Strengthening management capacity for HIV/AIDS control;
      2. Promoting public awareness and community support;
      3. Improving blood safety and rational use;
      4. Controlling sexually transmitted diseases;
      5. Building surveillance and clinical management capacity.
    2. Key outcomes of the project
      1. Capacity development at the state level- State AIDS Cells
      2. 50% increase in Condom distribution, 10% to50-90% in target groups
      3. Blood safety programme - Screening of donated blood; Professional blood donations were banned by law.
      4. 504 STD clinics strengthened; syndromic management.
      5. Expansion of HIV sentinel surveillance system; 140 cntrs and 180 sentinel sites
      6. Collaboration with non-government organizations on prevention interventions; and
      7. Intensified communication campaigns. Universities Talk AIDS Program.           
  2. NACP – II (2000-2006)
    1. AIM
      1. To shift the focus from raising awareness to changing behaviour through interventions, particularly for groups at high risk of contracting and spreading HIV
      2. To support decentralisation of service delivery
      3. To protect human rights by encouraging voluntary counselling and testing
      4. Evidence-based annual reviews and ongoing operational research and encourage management reforms,
  1. Key outcomes of the project
    1. 1033 Targeted Interventions (TIs) among HRGs
    2. setting up 875 Voluntary Counselling and Testing Centres (VCTCs)
    3. 679 STD clinics at the district level.
    4. Nation-wide, state level Behaviour Sentinel Surveillance (BSS) surveys were conducted.
    5. Prevention of Parent to Child Transmission (PPTCT) programme was expanded across the states.
    6. Introduction of a Computerized Management Information System (CMIS)
    7. Computerized Project Financial Management System (CPFMS)
  1. NACP – III ...To Halt and Reverse the Epidemic
     
    Goals and Objectives:
    1. Prevention of new infections in high risk groups and general population through:
      1. Saturation of coverage of high risk groups with targeted interventions (TIs)
      2. Scaled up interventions in the general population
    2. Providing greater care, support and treatment to larger number of PLHA.
    3. Strengthening the infrastructure, systems and human resources in prevention, care, support and treatment programmes at the district, state and national level.
    4. Strengthening the nationwide Strategic Information Management System.
NACP 4
  1. NACP 3 continued from 2007 to 2013.NACP 4 started from 2013 with the aims to consolidate the gains achieved so far, focus on highest risk high risk groups and bridge population, scaling up with quality assurance.
  2. Integrated Biological and Behavioural Surveillance (IBBS ) presently going on to analyse and understand HIV related behavious and HIV prevalence among key risk groups in different regions by linking behaviours with biological findings and to measure and estimate the change in HIV related risk behaviours and HIV prevalence among key risk groups, between baseline and endline for NACP 4.
{Reference IBBS module ,NACO 2014 }
  1. The specific objective is to reduce new infection as estimated in the first year of the programme by:
    1. Sixty per cent (60%) in high prevalence states so as to obtain the reversal of the epidemic; and
    2. Forty per cent (40%) in the vulnerable states so as to stabilize the epidemic.
  2. Prevention of new infections in high risk groups and general population :   
    1. Creating awareness about symptoms, spread, prevention and services available. Communication - CAU)
    2. Management of STI and RTI
    3. Condom promotion
    4. Integrated Counselling and Testing (ICT)  (provider-initiated testing and counselling of patients)
    5. Promotion of safe practices and infection control.
    6. BCC through peer and outreach.
    7. Building enabling environment.
    8. Community organizing and ownership building. (CBOs).
    9. Linking HIV related care and support services
    10. PPTCT.
    11. PEP.
    12. Promotion of voluntary blood donation and access to safe blood. 
  3. Targets:
    1. Target interventions to increase from 1030 to 2100 by 2011. 50% to be CBOs
    2. To increase condom use to 3.5 billion pieces/ yr by 2009 from 1.6 billion/ yr.
    3. To cover 50% of those with the STI symptoms and provide treatment.
    4. To raise voluntary blood donation to 90 per cent by end of the programme.
    5. ICTCs will be increased from 2815 to 4995.
  4.  Providing greater care, support and treatment to larger number of PLHA :
    1. Under NACP-II, focus was given on low cost care, support and treatment of common OIs.
    2. ART programme was launched in 2004 in 8 institutions in 6 high prevalence states and Delhi. 
    3. As on 31st May 2006, a total of 54 ART centres were functional with 33,638 patients (including 1352 children) receiving free Anti Retroviral Therapy at these centres. 
    4. However, this constitutes only 10 per cent of the estimated eligible patients
    5. 300,000 patients on ART by the end of 2011 through approximately 250 ART centres
    6. Strategy:
      1. Identification of institutions,
      2. Strengthening referral linkages for CD4 testing,
      3. Capacity building of ART teams and
      4. Procurement of ARV drugs
    7. (Priority being accorded to women & children referred from TIs and those below poverty line)
       
      Key activities
      1. Preventive
        • Develop risk reduction strategies for PLHA and their partners ;
        • Build capacity of PLHA networks ;
        • Establish linkages of TIs, ICTCs, PPTCT Centres, STD clinics with ART centres and TB clinic so that PLHA can access care, support and treatment services and behavioural communication;
        • Partner referrals through counselling; and
        • Screen TB/STI of PLHA.
      2. Managing Opportunistic infections
        • Referral linkages will be strengthened;
        • Develop guidelines and capacities for establishing standards of care;
        • Smart card system will be integrated and up-scaled to track infections in individual patients.  
    8. The staff at PHCs and CHCs will be trained through NRHM, while in district and tertiary hospitals, through the state health system.
      • Ensure transport subsidy for PLHA who are below poverty line;
      • Ensure that women have access to treatment facilities
      • Providing Care and Support for Children Infected and Affected with HIV/AIDS
      • Psycho-social and Livelihood Support
      • Nutritional Support to PLHA receiving ART
    9. Community care centers
       
      Under NACP-II, 122 Community Care Centres were set up to provide treatment for minor OIs, but more importantly psycho-social support.
    10. Services to PLHA:
  • Counselling, in particular for drug adherence;    
  • Treatment support;
  • Referral and outreach for follow up; and                             
  • Social support services
Additional 228 CCCs over the next 5 years in partnership with PLHA networks in all A and B districts, and in C districts, based on PLHA load.
  1. Treatment
    1. ARV drugs will be provided to all those who need it.
    2. Seek to achieve drug adherence rates of 95 per cent and above.
    3. Targets,
  • 250 ART centres
  • 250 CD4 count machines (existing)
  1. ART clinics established in the Departments of Medicine to provide integrated HIV services .
  2. ART centres available - at districts in cat A and
  • cat C, at districts if PLHA more      
  • cat D, medical colleges.
  1. ART centre will contain a MO, 2 counselors, lab personal (ICTC and STI) and PLHA network person.
  2. Travel reimbursement to BPL people and Tribals.
  1. Paediatric Care & Support
    1. Prevention, care and treatment of children infected or affected by HIV/AIDS;
    2.  Prevent HIV infection to newborns through PPTCT programme scale-up.
    3. Paediatric “Centre of Excellence” in each region of the country.
    4. Paediatric ART Centres will consist of a full time paediatrician, counsellor trained in paediatric HIV infection, a laboratory technician and a nutritionist
  2. External quality assurance
    • A Consultant for every 10 ART centres, or at the state level.
    1. Monitoring of ART Care by computerised MIS (provision of smart cards.)
    2. Drug Resistance Monitoring Network
    • NARI be the nodal institute and 2 reference labs with 10 sentinel labs.
    1. Innovative Financing of ART Drugs
    • Paediatric “Centre of Excellence” in each region of the country.
    • Paediatric ART Centres will consist of a full time paediatrician, counsellor trained in paediatric HIV infection, a laboratory technician and a nutritionist.
    1. External quality assurance
    • A Consultant for every 10 ART centres, or at the state level.
    1. Monitoring of ART Care by computerised MIS (provision of smart cards.)
  1. Strengthening the infrastructure, systems and human resources in prevention, care,      
    1. support and treatment programmes at the district, state and national level.
      1. In NACP I & II, the focus was mainly on the technical aspects of prevention and control and technical knowledge and skills for diagnosis and clinical management.
      2. NACP-III aims to build capacity of the programme managers at the national, state and district levels in
  • leadership and strategic management;
  • technical and communication skills of the health professionals and health care providers at
  • -all levels of care and health care organizations,
  • -CBOs and NGOs; and
  • technical, communications and counselling skills of the grass-roots level workers and functionaries of various government departments. 
  1. Training:
    1. Managerial skills
    2. Technical skills
A Training Coordination Unit will be established at NACO.
  1. Capacity building:
  • Outsource an expert agency
    1. NACO Capacity Building Unit
  • Monitoring and evaluation of Training since the beginning.
    1. Enabling Environment
  • Greater Involvement of People Living with HIV/AIDS (GIPA)
  • Reducing Stigma and Discrimination
  • Rights based approach’
  • Human Rights, Legal and Ethical Issues
  1. Monitoring & and Surveillance
  1. Strategic Information Management Unit (SIMU):
    1. to maximize effective use of all available information and implement evidence based planning
    2. Will focus on strategic planning, monitoring and evaluation, surveillance and research.
    3. will be the basis for measuring performance, analyzing variances, identifying bottlenecks, alerting the programme managers and facilitating corrective measures.
    4. Surveillance:
      1. Will focus on:  tracking the epidemic, identifying pockets of HIV infection and estimating the burden of infection in the country.
      2. Will involve: 
  • BSS and HSS including measurement of HIV incidence,
  • STI surveillance and tracking of other surrogate markers, e.g. Hepatitis B, Hepatitis C etc.,
  • AIDS case reporting,
  • HIV associated morbidity and mortality,
  •  Anti-retroviral and STI drug resistance surveillance and
  • other methods /sources of data (e.g. ongoing surveys)




Test Your Skills Now!
Take a Quiz now
Reviewer Name