Transcript AIDS 2008 PowerPoint Template

MOPDE204
Mainstreaming the Prevention of Parent to Child
Transmission (PPTCT) program with the National
Rural Health Mission (NRHM): Experiences from
Southern India
Dr. Naina Rani M (Presenting Author): Deputy Director, PPTCT-NRHM
Integration, KSAPS
R.R. Jannu: Project Director, Karnataka State AIDS Prevention Society
Dr. Reynold Washington, Chief of Party Samastha University of Manitoba
John Anthony, Team Leader Technical Support Unit, India Health Action Trust
Lakshmi.C, Admin Associate, India Health Action Trust
Acknowledgements
Karnataka State AIDS Prevention Society (KSAPS)
National Rural Health Mission (NRHM)
Department of Co-operation, Government of Karnataka
National AIDS Control Organization (NACO)
USAID, BMGF, IHAT, KHPT
University of Manitoba, Winnipeg, Canada
Background
• 1.2 million pregnancies
occur annually in
Karnataka state, South
India
• HIV prevalence in ANCs
from HIV Sentinel
Surveillance (HSS) was
0.86% in 2008
• PPTCT program in
Karnataka has worked
as a vertical program
implemented by
Karnataka State AIDS
Prevention Society
(KSAPS).
• PPTCT activities were
therefore not seen as
part of the existing
health system, and
general health resources
were not tapped
• This resulted in gaps in
HIV testing and followup for pregnant women
Methods
• An inter-departmental government directive was issued on
PPTCT-NRHM integration in 2008
• Auxiliary Nurse Midwives (ANMs; grass-root level workers
under NRHM) were given responsibilities to implement the
PPTCT Program
• Reporting was built into the regular health department
management information system
• Government District AIDS Prevention and Control Unit Officers,
and Reproductive and Child Health Officers, monitored the
implementation of PPTCT activities at district level
• Line-listings of HIV positive pregnant women were made
available to all health care providers on a “shared
confidentiality” basis after obtaining client’s consent
• Special Camps were organized to mobilize ANC for 3rd
trimester: 0.1million ANC mobilized through camps
Results
769504
796667
803551
536412
568430
215728
242021
272263
900000
800000
700000
600000
500000
400000
300000
200000
100000
0
585459
Details of PPTCT activities before integration with NRHM (April 07-Mar 08) and after integration with
NRHM (April 08 to March-09) and (April 09 to March 2010)
April-07 to March-08
April-08 to March-09
No. of ANCs Registered
No. of ANCs who received post-test counselling
• Mother-baby pair coverage
increased from 40% (2007)
to 62% (2009)
April-09 to March-10
No. of ANCs pre-test counselled- tested for HIV
April-07 to March-08
No. detected HIV Positive
April-08 to March-09
No.of MB pairs received NVP
2200
3544
4575
1617
3250
865
1118
2771
30811
Contd...
32500
30000
27500
25000
22500
20000
17500
15000
12500
10000
7500
5000
2500
0
• Uptake of testing
improved from 272,263
pregnant women tested in
2007 to 796,667 in 2009
April-09 to March-10
No.of Spouse Tested
• Approximately 9,500
ANMs and 2000 primary
care medical officers form
the program backbone
which was earlier being
done by a handful of
NGOs
Conclusion
• Integration was accomplished with the commitment
and involvement of stakeholders from the highest
levels of government to grass-root level workers, with
clear-cut roles and responsibilities.
• Wastage and duplication of resources was avoided,
which helped bring the program to scale.
• Two years’ experience has shown that mainstreaming
can achieve the scale-up of PPTCT services, by
utilizing the strengths of the existing health systems to
cater to the needs of pregnant women
• This model has now been recommended for national
replication
THANK YOU
Dr. M. Naina Rani
Deputy Director, PPTCT-NRHM Activities
Karnataka State AIDS Prevention Society
No.4/13-1, Crescent Road, High Grounds,
Bangalore-560 001.
Karnataka, India
Phone: 91-080-22201237-9
Fax: 91-080-22201373
Mobile: 098452 52052
Email: [email protected], [email protected]
Website: www.khpt.org , www.stg1.kar.nic.in/ksaps