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Program
Areas |
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HIV/AIDS Projects |
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PATHWAY |
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 The
total number of HIV cases throughout India is increasing
each year (in 2005, NACO reported 5.1 million persons
infected), and the prevalence rates in many areas,
are also increasing dramatically. Although the prevalence
rate among the general population is low in comparison
to high prevalence countries in Southern Africa,
with one sixth of the world’s population, the total
number of HIV cases continues to grow unrelentingly
in India. According to most experts, the window
of time to effectively tackle the HIV/AIDS epidemic
by prevention as well as care and support in India
is quickly running out.
PCI
India has been awarded a four-year cooperative agreement
by the Center for Disease Control and Prevention
(CDC), Atlanta under the Global AIDS Program
to implement a home-based care program for people
living with HIV/AIDS (referred to as the “PATHWAY”
Project). This project has been operational in Pune,
Maharashtra since 2001.The same model project has
been replicated and directly implemented by PCI
in Salem District of Tamilnadu. In September 2004,
PCI initiated the PATHWAY+ Program, “Comprehensive
Community and Home-Based Care and Support for People
Living with HIV/AIDS (PLWHA) in India,” which was
also funded by CDC.” The five-year continuation
program (September 1, 2004-August 31, 2009) was
designed to implement an integrated community and
home-based care and support and HIV prevention in
three sites in the high prevalence states of Maharashtra,
Tamil Nadu, and Andhra Pradesh. Through supplemental
funding from CDC, this project was expanded to three
additional project sites in the northeastern states
of Manipur (Churachandpur and Imphal) and Nagaland
(Dimapur).
PATHWAY
has trained and mobilized home-based care teams
at the project sites. The home-based care team assesses
the magnitude of the epidemic at the community level,
identifies the probable beneficiaries, conducts
a needs assessment, and develops linkages with local
health practitioners and service providers. The
program activities begin with broad-based community
sensitization and rapport-building activities conducted
in partnership with community-based organizations,
such as women’s and youth groups.
Once
a client is registered, health care and counseling
services are provided through a combination of the
mobile clinic, home visits as needed by the PATHWAY
home-based care team (medical staff, counselors,
social workers, community health workers, and peer
educators), and at a community meeting center. Services
are also provided through referrals to a network
of government and private hospitals, clinics, and
other providers which are sensitized and mobilized
to participate in the program’s referral network.
Health
care services include: prevention and treatment
of opportunistic infections, concurrent infections
such as STI and reproductive track infections;
tuberculosis screening and provision of directly
observed therapy short course (DOTS); prophylaxis,
anti-retroviral therapy monitoring; care and treatment,
self care skills training; care giving skills training;
and nutritional support. As part of the ‘continuum
of care’ approach, PATHWAY+ sites also carry out
prevention activities for the general population,
which include general community awareness programs.
PLWHA support groups and networks are formed or
existing ones are strengthened and local leaders
are sensitized to provide community support for
PLWHAs and their family members. Focused capacity
building sessions for local community-based organizations,
non-governmental organizations and other private
and government institutions to deliver prevention
and care and treatment services for the PLWHAs are
also activities of the PATHWAY+ program.
The
highlight of the PATHWAY project is that the project
model of care has been expanded and is operational
in five high prevalence states of India with ten
implementing partners. Lessons learned were presented
at the “
in June, under
XVI International Conference in Toronto in August
2006. PATHWAY has provided over 11,453 people with
voluntary counseling and testing services and over
6,356 PLWHA have received care and support services.
The project employs PLWHAs as frontline workers
as part of the HBC team, thus ensuring greater involvement
and empowerment of PLWHAs. |
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PEDIATRIC AIDS
INITIATIVE |
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 In
April 2004, the Government of India initiated its
free anti-retroviral therapy roll out scheme. As
of March 2006, the scheme has catered to around
37,000 individuals through public, private, and
non-governmental organization supported anti-retroviral
therapy centers (NACO 2006). Currently, there are
5.7 million (NACO 2006) people living with HIV in
India, mainly found in six high prevalence Indian
states: Karnataka, Tamil Nadu, Andhra Pradesh, Maharashtra,
Manipur, and Nagaland.
Based
on the Government of India’s advice to provide care
and treatment for children in India, NACO will be
supported by the Clinton HIV/AIDS Initiative in
implementing a comprehensive pediatric initiative,
so that a greater number of children living with
HIV/AIDS can benefit from the program.
Majority
of the children who were being treated were above
the age of five, as pediatric formulations to treat
children below the age of five were not widely available
through the Government of India’s free anti-retroviral
therapy scheme. The situation is further compounded
for children below 18 months as relevant diagnostics
are available only in select government establishments.
The
rationale of Clinton HIV/AIDS Initiative’s pediatric
initiative is to ensure that the majority of the
children living with HIV in India are beneficiaries
of the comprehensive, child friendly HIV/AIDS care
and treatment package.
The
comprehensive care and treatment package will include
psycho-social, nutritional, medical, and transportation
support. Clinton HIV/AIDS Initiative role will include
forecasting and procuring the pediatric ARVs for
10,000 children, linking of children living with
HIV/AIDS to the nearest anti-retroviral therapy
centers, and partnering with non-governmental organizations
providing home based care and support to children
living with HIV/AIDS. PCI was selected in April
2007 as one of the lead partners through which the
care and support components will be rolled out.
PCI has been selected as it is currently implementing
the home and community based HIV/AIDS care and support
programs in Andhra Pradesh, Maharashtra, Manipur,
and Tamil Nadu. Nagaland has extensive experience
in implementing the home and community based care
and support programs with a special focus on children.
PCI’s
role is to map non-governmental organizations working
with children living with HIV/AIDS and partner with
them. PCI is building their capacity on care and
support and linking them to the government anti-retroviral
therapy centers.
PCI
has consolidated care and support in the target
areas by building upon and integrating the project
with its existing care and support projects.
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HEALTH HIGHWAYS |
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 India
has one of the largest road networks in the world
and an estimated 2 to 5 million long-distance truck
drivers and helpers. Truckers are high at risk of
HIV due to their mobility and tendency to frequent
commercial sex workers, yet have little knowledge
about HIV and other STIs, and generally do not use
condoms.
In
1999, Project Concern International (PCI) initiated
the Healthy Highway Project to bring
about healthier attitudes and sexual behaviors among
truckers, crewmembers and the community along the
trucking routes. The project was initially funded
by the Britain’s Department for International Development,
but is now by the Rajasthan State AIDS Control Society.
At
rest-stops along a major highway in Rajasthan, PCI
peer educators engage truckers in discussions about
HIV/AIDS and STIs. Rest-stop staff, petrol pump
workers, mechanics and local private health practitioners
are trained as informal peer educators to reinforce
the work of formal peer educators.
The program has reached thousands of truckers and
transport workers with vitally-needed information,
access to condoms and STI treatment, and has succeeded
in creating peer-support for more responsible sexual
behavior. The project that began on a 30-kilometer
stretch now manages a 145-kilometer stretch of national
highway |
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HELP |
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Demographically,
India has become a young country where more than
70 percent of the population is now under the age
of 35. Out of this 33.8 percent are age 15-34. The
number of adolescents alone (10-19) is over 230
million. Thus, every second Indian is a young Indian,
but young women and men are steadily emerging as
the epicenter of the HIV/AIDS epidemic. A substantial
segment of this critical sub population are sexually
active, marry early, migrate for work in vulnerable
situations, and are exposed to negative peer pressure
and a risky environment. Nearly 33 percent of reported
AIDS cases in India are in the age group of 15-29
years, yet HIV programs for youth are scarce.
In
October 2005, PCI initiated the Health
Education and Life skills Program
(HELP), a project on youth HIV Prevention in Pune
Schools and Colleges. The project is funded by Zensar
Foundation to reduce the vulnerability of children
and young people by ensuring both girls and boys
access to HIV/AIDS prevention education services.
The objective is to raise the level of knowledge,
awareness and skills of adolescents and youth about
HIV/AIDS prevention among 8th and 9th
grade students and students enrolled in Pune colleges
during a two-year period.
The
program also contacts and sensitizes the heads of
education departments, schools and colleges. PCI
uses interactive methodology to conduct life skills
education, including HIV education, and sessions
are evaluated using appropriately designed pre and
post session questionnaires.
There
has been a significant increase in students’ knowledge
and awareness levels on HIV, pubertal changes and
the importance of physical hygiene. This project
marks the success of PCI’s partnerships with the
corporate sector in the area of youth health and
development. |
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MASBOOT |
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The
new state Jharkhand, created in 2000, suffers from
a whole range of socio-economic limitations that
may intensify the devastating effect of the HIV/AIDS
pandemic within the state. Factors include a lack
of public health infrastructure, the paucity of
the grassroots-level non-governmental/community-based/faith-based
Organizations trained in HIV/AIDS, and large tribal
and marginalized sectors of the population.
In
response to the need for building and strengthening
the capacity of the health care delivery system
in Jharkhand, in September 2005, the Center for
Disease Control and Prevention (CDC GAP) in Atlanta
awarded Child in Need Institution (CINI) and Project
Concern International/India (PCI/India) the project
named Making AIDS Services Stronger
By Enhancing Organizational Outreach
(MASBOOT, meaning STRONG in Hindi). PCI is
implementing the program in Ranchi and Hazaribagh
districts of Jharkhand in order to train and build
the capacity of government and non-government stakeholders
in the provision of HIV/AIDS services and to improve
the quality of those services in Jharkhand.
The
project conducts needs assessments, designs training
modules, and conducts need based capacity building
programs for medical, paramedical and social health
care providers. The MASBOOT Project has developed
modules of cascading level of training and a pool
of trainers which includes people living with HIV/AIDS. |
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CONTINUUM OF CARE
PROJECTS IN TAMIL NADU |
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PCI
has undertaken projects to complete the continuum
of care through linkages with relevant projects
in Tamil Nadu, thus providing holistic care and
support with PLWHAs. The projects include:
Community
Care Center
The
Community Care Center is a project implemented by
PCI with support from Tamil Nadu State AIDS Control
Society (TANSACS). It is a short term inpatient
nursing care facility, acting as a bridge between
hospital and home care. The main objective of the
care center is to deliver a continuum of care. This
involves the promotion of early detection of HIV,
focus on the effective treatment of opportunistic
infections, reduce mother-to-child transmission
of HIV and strengthen the referral services to enable
PLWHA to avail specialized services like CD4 testing
and Anti retroviral therapy when needed.
The
Community Care Centre provides 24 hours medical
care, nutrition support, counseling support, behavior
modification programs, training for caregivers,
recreational activities and referral services.
The
Community Care Centre has been playing an essential
role in the provision of comprehensive care and
support to the PLWHA in and around the district
of Salem. With the Care Centre becoming an anti-retroviral
therapy initiation centre in December 2005, much
of the activities at the Care Centre revolves around
the referrals, initiation and follows up of the
anti-retroviral therapy for the PLWHAs in collaboration
with that of the Department at the Salem Government
Hospital.
The Bill
and Melinda Gates Foundation-AVAHAN-VHS-TAI
PCI
is implementing a community driven prevention program
in Salem district reaching female sex workers and
their clients. The project is a Bill and Melinda
Gates Foundation supported AVAHAN initiative that
is funded by the Tamil Nadu AIDS Initiative. It
aims to promote behavior change and reinforce safer
sexual practices among female sex workers as well
their clients, and refers those suspected to be
infected to the PATHWAY program for home-based care.
The PCI-GFATM-TANSACS-PPTCT
The
project identifies and mobilizes antenatal mothers
for counseling and testing, providing anti-retroviral
therapy to positive mothers and children, follow-up
services for safe institutional delivery, and nutritional
support. Pregnant women are referred to the Integrated
Voluntary Counseling Centre. If a patient is found
positive, follow up activities are pursued.
GFATM III/HIV-TB
The
GFATM III is a TNSACS funded initiative through
which the state of Tamilnadu aims to increase the
demand for prevention, care and support for HIV
and TB through community mobilization and partnership
building. PCI operates this program in the district
of Salem through outreach workers, some of whom
are to be placed in the STD (Sexually Transmitted
Disease) department and Integrated Voluntary Counseling
Centre of Salem and Mettur Government Hospital,
while others coordinate in the field.
HIV Factsheet
Project Concern
International's Response to HIV Factsheet
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| © 2007 Project Concern International/India. All rights
reserved. |
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