NACP III : PROPOSED STATE PLANKERALA

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NACP III PROPOSED STATE PLAN-KERALA Dr.T.V.V
elayudhan Deputy,Director KSACS
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Kerala Scenario

• State was formed in 1956
• 1.18 of the total area of the country
• Houses 3.43 of total population
• Surrounded by TN, KA, AP
• Ranks high with respect to social Devt and Health
  indices

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Conti.

• Female to Male ratio is high
• Very high literacy rate
• Model decentralized planning implementation
  system established

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Epidemic Scenario

• First HIV was detected in 1987
• Total Number of AIDS cases reported 2003
• 619 Reported AIDS deaths
• Estimation of HIV infection 1 Lacks
• No rural-urban specificity
• Infection moved out from HR-Gen Community
• Prevalence in ANC Women 0.32
• Major factor linked with epidemic is migration

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Response Scenario

• NACP I from 1992-99
• focused on general awareness
• NACP II from 1999-2004
• focused on targeted intensive
  prevention

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Conti.

• COMPONENTS
• 52 Targeted Interventions
• FHAC 34312 Men 93332 Women
• Cross border initiatives
• IEC programme- 70 aware about all method of
  transmission
• Media initiatives
• Blood safety programme DATA

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Conti

• VCTC - 16
• PPTCT - 5
• Low cost community care for people with HIV
• Inter sector collaboration

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Critical analysis

• TI- 73 coverage of marginalized HR Population
• Only 2 IDU sites are addressed
• Reached to a stage to have specific focus on
  Migrants
• Some TIs matured to have specific strategy for
  community mobilization

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• Components of TIs- focus on qualitative up-
  scaling
• STI- services remain underused-
• Lack of -privacy,
• - supporting attitude of Health Care
  providers,
• - information on services

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• Communication aimed at attitudinal change for
  prevention of infection and effectively
  addressing stigma and discrimination could not be
  achieved as desired.
• SAEP was aimed at Govt schools and Aided Private
  Schools only.
• Despite all effective blood safety measures,
  voluntary blood donation remains 35.6
• Kerala ART programme has resulted into
  enhancement of credibility of HIV AIDS programme

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• PLWHA focus shifted from sex linked infection to
  care focused programme.

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Program Management
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NACP III Plan development process
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NACP III What we Plan ahead

• Vision for Kerala
• is a response that provides the best
• possible services for prevention and care
• Changes desired are
• serological
• behavioral
• Knowledge

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Approach of KSACS towards NACP III
Situational Assessment
Evaluation
Program Design
Implementation
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Program Management frame work
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Categories of population

• CORE groups
• MSM
• Sex workers
• IDU
• Non-CORE groups
• Truck Drivers
• Migrant population
• Prison Inmates
• Plantation, Industrial and Costal Population,
  Tribals

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Conti.

• Populations with Lower Vulnerability
• Men
• Women
• Adolescent boys, Adolescent girls
• Children

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Plan for different category of population

• Impact to be achieved
• Outcomes to be achieved
• Key Outputs for five years

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Shift in NACPIII System in Kerala PIP

• From a Project mode to a Program mode
• KSACS shift from an implementer to a Program
  Catalyst
• Strengthening District Response
• Capacity Building
• Integration of Prevention Care services
• Focus on vulnerable micro sites at district level

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Conti

• Focus on Youth, MSM IDU
• Strengthening Services
• Robust M E
• Evidence - based management

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Conti..

• TA for complimentary activities
• Flexible component
• PWHA- Network in all District and resource center
  in all district

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Conti.

• Panchayath Raj Institution to be focal point for
  planning, delivery
• Management unit to PRI
• Management unit at District

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Conti

• STI Clinics in all DH, TH
• VCTCs in all DH, GH, MCH, TH
• BB and BSU in all Hospitals up to TH
• ART 28 and high prevalence Taluk/ Villages

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Conti

• TI with focused intervention- 90 coverage of HR
  Population
• 5 more IDU sites to be covered
• Cross border initiatives for Migrants

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Conti.

• Community mobilization aimed at transfer of
  ownership
• Panchayathraj facilitated programe management
  system

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Conti..

• District level programme convergence and data
  management system
• Quality STI management system at Taluk level
  hospitals(65)

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• Communication aimed for addressing the the
  barriers of converting knowledge into practice,
  and effectively addressing stigma and
  discrimination and skill development.
• Communication scaled up to near total coverage of
  homogeneous civil groups such as students, youth,
  women, working group etc

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Conti

• Safe Blood promoters group in the community
  and institutions
• Drop in centres for affected and infected in all
  districts.

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Conti.

• Community care centers scaled upto five
• Promotion of home based care

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Conti

• Blood Safety-
• Establishing BCSU in all Govt. Medical colleges
• Strengthening existing govt. Blood Banks
• Technical support for all Blood Banks
• CD4 units in all Govt. Medical colleges

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Conti.

• VCTC
• VCTCs will be scaled up to all taluk level
  hospitals
• IVRS in all districts.
• PPTCT
• PPTCT will be scaled upto taluk level hospitals

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Thank You
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• State blood Transfusion council formed
• 136 Blood Banks modernised including 33 Govt
• Mandatory test HIV ,H BS, Ag , VDRL malaria
• Supplying test kits to blood banks
• six blood component separation units
• Doctors training
• Blood donor forums