Integrating RCH and HIV Services for Preventing Mother-to-Child HIV Transmission
"Learn about the integrated approach of Reproductive Child Health (RCH) and HIV services to prevent HIV transmission from mother to child. The strategy includes universal HIV testing for all ANC cases, collaboration with stakeholders, public-private partnerships, and robust monitoring systems."
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INTEGRATION OF RCH INTEGRATION OF RCH- -HIV SERVICES HIV SERVICES GOAL To prevent HIV transmission from mother to child. OBJECTIVES Universal coverage of HIV Counseling and Testing for all ANCs Integrating existing systems for Institutional deliveries Track and address HIV infection in children (upto 18 months) STRATEGY Collaborate with all stake holders Ensuring cashless institutional deliveries for HIV +ve Public-private partnerships for expanding coverage Robust systems for monitoring to ensure timely & quality services
Roles and responsibilities Roles and responsibilities NRHM Providing the services of RCHOs & their Staff & periodic review. Financing of incentives for: Service providers of HIV +ve deliveries under Yeshaswini Scheme ASHAs who mobilizes HIV +ve ANCs KSAPS Collaborate with NRHM & Dept. of Co-operation to kick -start the model Capacity Building on the model to all KSAPS, NRHM & Others Provide necessary kits and drugs. Dept. of H&FW Directions issued for integration of activities Ensured RCHOs constant involvement TSU of KSAPS Preparation of Operational Guidelines, IEC materials Monitoring, Site visits, Supervision and feedback.
Process for kick Process for kick- -starting Integration Integration starting Pioneer model: entirely owned and managed by the State Joint Government Order issued on 19/05/08 by Mission Director NRHM & Principal Secretary, Department of Co-operation, Govt. of Karnataka for cashless delivery of HIV+ve pregnant women in Yeshaswini Network Hospitals. All district level officers (RCHOs, DTOs, DPMOs) briefed on the Operational Guidelines of PPTCT programme.
Activities of Integration Activities of Integration All 2nd Trimester pregnant women are being mobilised to PHCs by ANMs/ASHAs on Thursdays (ANC check-up day at PHCs). Counselors and Lab. Technicians from DH & TH to visit the PHCs to cover all pregnant women in the 2nd Trimester on Thursdays. Reimbursement of charges to Yeshaswini Network Hospitals borne out of NRHM funds @ Rs.5500 for ND & Rs.10000 for C-section. As on 31/03/2013, under Yeshaswini Scheme, 3410 ANCs have been delivered in Yeshaswini Network Hospitals, out of which 2841 were normal deliveries and 569 were C-Sections.
Challenges Challenges - - met met Worked in a mission mode - organised camps and provided outreach testing facilities to cover backlog. Regular DAPCU meetings to build rapport between RCH, HIV and TB staff working at the district level Line-listing of all HIV positive ANCs in MasterRegisters Samples for CD4 testing drawn at PHCs for ANCs unable to reach ARTs with CD4 reports being handed over at every monthly meeting
Key elements of the programme Key elements of the programme Clarity of roles and responsibilities Cost-effective and sustainable model: No additional man power recruited for PPTCT Programme. All components of PPTCT integrated into the existing RCH activities Horizontal approach- joint ownership rather than a vertical programme.
Universal Access to HIV Counselling and Testing after Integration 1200000 1012366 1000000 795160 784795 800000 Integration commenced on 19/05/2008 568430 600000 400000 242021 200000 0 2007-08 2008-09 2009-10 2010-11 2011-12
No of ANCs detected HIV+ 4000 3549 3500 2951 3000 2604 2377 2500 Nos 2000 1500 1000 500 0 2009-10 2010-11 2011-12 2012-13 YEAR
No of CD4 tested 2500 2246 1921 2000 1758 1718 1500 Nos 1000 500 0 2009-10 2010-11 2011-12 year 2012-13
No of ANCs eligible for ART 731 800 710 693 700 535 600 500 NOS 400 300 200 100 0 2009-10 2010-11 2011-12 2012-13 YEAR
No of ANCs intiated ART Treatment 661 700 600 517 461 500 355 400 NOS 300 200 100 0 2009-10 2010-11 2011-12 2012-13 YEAR
PERCENTAGE OF NO OF ANCs INTITIATED ART TREATMENT AGAINST ANCs ELIGIBLE FOR ART 100.00 90.42 90.00 72.82 80.00 66.52 66.36 70.00 PERCENTAGE 60.00 50.00 40.00 30.00 20.00 10.00 0.00 2009-10 2010-11 2011-12 2012-13 YEAR
