7835.pdf
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GOVT OF KARNATAKA
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PHASE-II OF NATIONAL ADIS CONTROL PROJECT IS SCHEDULED TO BE
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IMPLEMENTED FROM 1st APRIL 1999 IN KARNATAKA. THE PROJECT
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IMPLEMENTATION PLAN IS PREPARED AND HEREWITH PRESENTED.
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THE PROJECT IS PREPARED AFTER DISCUSSION AND CONSULTATION HELD WITH
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THE EXPERTS, VARIOUS RESOURCE PERSONS, NACO PROJECT DIRECTOR. CONSULTANTS
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OF THE WORLD BANK. TECHNICAL LIASON OFFICER AND INSTITUTIONS INVOLVED IN
CARE AND SUPPORT OF HIV / AIDS PATIENTS IN THE STATE.
A REGIONAL WORKSHOP WAS HELD IN BANGALORE FROM 1st
TO 3rd SEPT. 1998
IN WHICH PROJECT DIRECTOR. NACO AND STATE REPRESENTATIVES AND
REPRESENTATIVE NON-GOVERNMENTAL ORGANISATIONS, PARTICIPATED AND
DISCUSSED ABOUT THE STATE P.LP.
THIS IS THE FINAL P.LP. PREPARED KEEPING ALL THE GUIDELINES OF THE WORLD
BANK, and NATIONAL AIDS CONTROL ORGANISATION.
GOVERNMENT OF INDIA.
WE THANK ALL THOSE WHO HAVE HELPED IN PREPARING THIS P LP REPORT
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G>'- 1
( DR. P.N. HALAGI )
MEMBER SECRETARY
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KARNATAKA. STATE AIDS PREVENTION SOCIETY
BANGALORE-9
dated 7TH
DECEMBER 1998
BANGALORE
P2
EXECUTIVE SUMMARY OF THE PHASE II AIDS CONTROL
PROJECT:
AIDS Control Programme which at present implemented
Prevention Society will be geared
by State AIDS
up to face the challenges of HIV/ AIDS epidemic
threatening round the comer with the financial support of World Bank, Government of
India, and Technical guidance of NACO.
The state is prepared to launch the II phase of
AIDS Control Project. The deficiency observed during the implementation of I Phase
AIDS Control project have been thoroughly analysed and discussed
with experts,.
administrators, and NGOs and draft PIP for Phase II Project is
prepared. It is
suggested to give high priority for specific intervention project both at High risk and
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Low risk groups with key role of NGOs in AIDS
Prevention and control. -The
Surveillance and blood safety measures
capacity
building
implementation
and
modern
will be strengthened, priority will be given to
programme management
principies.The
plan under Phase II AIDS CONTROL PROJECT -
Project
1999 - 2004
is
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prepared for Karnataka State keeping in view of cultural and social factors of the state
and the activities will be implemented
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on a time bound basis in all the five years of the
projecr period. The intervention amBng commerical sex worker, and devadasi system
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prevailing areas will be taken up involving active non
which are already having experience in this task.
governmental organisations
The truck routes perticularly
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highways where truckers from other states from Maharashtra. Tamilnadu. Pandicherrv.
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Kerala, Goa, Andhra Pradesh, which are bordering the state with high prevalance of
HIV/STD infection particualry in Maharashtra, Tamilnadu, Goa,
Andhra Pradesh, are
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passing though Karnataka state and hence this
area needs effective intervention
programmes. Accordingly dedicated non governmental organisations will be involved
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under Truckers project and monitoring and
supervision activities under this
component will be intensified in all the five years of the project period and care will be
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taken to check the cross border spread of HIV infection
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Diseases among the High Risk Groups.
and Sexually Transmitted
The Information, Education and Communication materials will be developed based on
the socio cultural factors prevailing in the state covering all the four revenue divisions
i.e., Banagaiore division , Mysore division, Belgum
division, and Gulbarga division.
The state Highways and other transport network will also be covered for awareness
creation on healthy
life styles and AIDS/STD Prevenition and control.
To create
awareness among the General community including Highschools and Colleges, the co i
operation and co
ordination-of all medias print. Electronic and folk medias .will be
utilised effectively. The components under AIDS prevention and control particular^.
programme
management,
HIX'
Serveillance.
AIDS
Case
Serveillance.
Sexualh
Transmined Disease Ser^eiliance. STD Control including strengthening of STD Clinics
page. 4
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Blood safety, Voluntary testing and counselling, training. Information, Education and
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Communication and targetted interventions among high risk and low risk groups will
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be given priority during Phase II AIDS Control Project.
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H The Karnataka State AIDS Prevention society is established and registered under
Karnataka societies Registration Act 1960 during December 1997.
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Karnataka is expected to achieve ail success in the implementation of II Phase AIDS
Control Project.
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PROJECT
--------- -JAUON PLAN :
££2^ctdescription;
Background (Situati,
on Analysis)
Karnataka has a ;v
Census). Current estimates
esti
(1997) oft^XhSnTws sute^'
so" °off 45
Population
45 mi,li°n ('99!
the population in the state i:
— is 50 million. '
^he population ( ~ ”
divided into two districts Viz’
Bangaiore whlch 1S
through primary health ccare centres (160!), commuX Slth Ce7"
076). ln addition there
“
a number
Private nursing homes h"
h°Spita,S
Medical Institutions which
cater to the populate. The cr^de Birth Set,ChOrPorate
Death
eath Rate is 7.3 per sample registration s^
---•'ey^chis.ehhelo.th^X^^^
Indian CounirofM^l^^ Was
mi
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in ’
^foTeX^7^ G°,danCeof
established in the Deoartm R^arch (J-!™8U987. and c
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t e AIDS Survetllance Centre, was
Bangalore. The
Hospi^^
lore Medical College
r
^d action initiated foZ/'Z dUnns
Fro"HIV
7-. c
1 ne State AIDS C 11
in
Cx-x
.
.
“t:,he s* d“™«'»
Subsequently
thefinancial
ft
BboVSfet^Pr^
6"^ with the
—e! was
<,fBto»d * _ “”
““ c—
,ankjng system in the State
Cases 1S being reported every year.
z oS:—“"
^z°™X“d
“d -Maj
or Achievements in Phase 1
1 Mood Safety
T«™
sZaeLh"f'X
Govmmen, Sra„ and
of 51 Blood Ba„ks ZchZ,“k'"
Licensed Blood Banks (8 1) in th
SeCt°r have been modernized
^0 T,a„sfus,„„ Copood’dX'^ ““ ■” Z»”' B1P0P
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2. Surveillance
Until 1992 Surveillance for HIV infection was carried out in the State at the Dept. Of
Microbiology, Bangalore Medical College, Victoria Hospital under the ICMR guided
programme Since 1992, two more AIDS Surveillance Centres were established at Department
of Neuro-virology, National Institute Of Mental Health and Neuro Sciences (NIMHANS)
Bangalore and at Depanment of Microbiology, Kasturba Medical college, Manipal. Sentinnel
Surveillance was initiated in 1'the State among STD
---- patients in 1994 and ANC cases in 1996.
At present Sentinnel Surveillance is being carried out att seven STD clinics and one AnteNatal. Clinic across the State. In addition. Five new C__
Sentinne! Sites have been approved by the
NACO recently (three ANCs, one STD clinic and
—J one Drug Deaddiction Centre) and
Surveillance will be initiated at these sites soon.
3. NGO activities
The State has been fortunate to be endowed with highly committed NGOs which have
initiated and earned out excellent work in various spheres of HI V/AIDS, some of which has
been trend-setting for the entire country Viz. :
(i) Intervention among Commercial Sex workers of Bangalore. Unlike other Metropolis and
major cities in the country. Bangalore does not have an organised Red Light District. Yet an
NGO from Bangalore has been able to make significant progress in understanding the
dynamics of commercial sex work and initiate and continue various HIV prevention programmes for the sex workers since 1993. Similarly is Belgaum Dist. Known for C.S.W, an
N G.O-called BIRD’S (Belgum Integrated Rural Development) project is involved in awamess
and educational activities including condom promotion to the clients.
(n) Care and Support has been the primary of focus of three NGOs in Bangalore which have
been catering to the health needs of PLWHAs. These NGOs have establfshed good liaison
among themselves as well as with major Government and Private hospitals in the city.
Counseling has been given a major focus by all these three NGOs. One of them is a large
centre (60 beds) devoted to HIV/AIDS as well as substance abuse and is serving as one of the
model centres for the country.
(iii) The Well Women’s Clinic Concept. Realizing the vulnerability of women in HIV/AIDS
epidemic an NGO in Bangalore has taken the initiative of setting up a Well Women’s Clinic
with a view to increase the accessibility of services to women who are vulnerable for HIV
infection through a “holistic care” approach. This clinic caters to the health needs and focuses
on earlv detection and management of Reproductive Tract Infections' ifalso offers counseling —services The success of this three year old venture has inspired another NGO to extend this ’
concept to several areas across the entire city-a major project termed "Suraksha”
(iv) The NGOs, Doctors from Major hospitals caring for PLWHAs and the State AIDS cell
have together recently constituted an informal forum called '‘AIDS Forum Karnataka” (AFK).
This torum will facilitate monitoring of intervention activities. Care and Support. 1EC
activities in the field of HIV/AIDS. AIDS forum is organising awamess programme for the
general public on 1 * of every month at public places.
(v) Truckers programme: An NGO in Bangalore has initiated an awareness
awareness and
and prevention
prevention
programme for truckers and their helpers at Bangalore and Mangalore. This program has
been successfully implemented since 1994.
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clinics across the Qfn*
Vanous districts have been *
—
me “ “"XX
-ases under STD surviehaj^es.
5+~IEC activities
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those sponsored by the 'state A^ne Undertaken during Phase I ’
were ;- developing TV sn t
$
35 we^
soonsn
^tate*
Eluded
Donation Day celebration^ de^l
J‘nS'eS’ World AIDS da NG?S TheSC activities
activjues; NSS sponsnr^ ’ C eloPln8 Street plavs in
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Voluntary Blood
Programmes.in schools conX^rf .progra'n'nes in collegTnSo^811^6, Folk Media
^ed representatives ’and Jl a
-d Sensitfi^n
aW—s
^ore has set up a HOT^pS e
Members
the Di^r PS C°nduCted for
- ^Jdaining_activities
0^1 * * ""—
Specialists, Medical’otEce^o^STD % °f ^^^ent and PriX
Heaith
^lg-^gggQ-d-irLthe country
pnonty accorded by
spread m the State
• w setting up the Karn; '
““’^"AlDSfteventaS^
commitment and the
prevention of HIV
of Karnataka
current situation
ts noticed that there IS a
d
Page. 8
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For mstance. Sentinel Survetllance data obtained from seven STD clinics across the state have
shown HIV prevalence as high as 30% and there has also been a slow but steady increase in
the infection among antenatal mothers (0.5%in 1996 to 1.75% in 1998) Several Hospitals are
reportmg mcreasmg numbers of AIDS cases m recent times and it is Ldent that Hmh ijsk
behaviour is preva ent almost in all Districts of the State as well as the major Cities fike
Be'8w
REVIEW of PAST EXPERIENCE :
Apart from the significant contributions and
progress made by the State AIDS Cell
and other agencies including NGOs there were several lessons learnt
Karnataka by the end of
Phase I and they are listed below under various headings :
i
1 ?nS,tr^eff0,1S haVe beCn PUt int° Creatin8 awareness both by the
Se .MDS
m
dAIDS C
35 We “ thC NG°S working in the field, yet the socio-cultural and reeionaJ
rXer
110^
"Zf07Va?°UHdeVe,
Pa7°fS “
°f the ofState
HaVe br°Ught f0rth the fo,,owmg .Eg
field
'meXions Vs
culture specific, purpose specific
mtcrvmtions Vs general awareness needs) messages (ii) a need for the development of
vuX.
°" {ar (ii) n,““8“ fOr W0"“ “d
i
isd s"c““Miy
:
tS<,“™i""“dyd!"m Sitl"rly'"" Ms,i"e for volun,“y "d
p"ox>S™£“^
“s,"“ "“y «■' ••
Ibree centres ere in.de,tt.te for . iJS "ITe
Moreover all t„e three testmg/Stirveillmce centres which have been catering to the dLtnostic
needs are located m the Southern part of the State
magnost.c
: Specific
to
proS'fXXr tCOnCemS °f PLWHAS-
clinicaJ
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and counseling is being
faciZs
TT tOme
‘n the SUte there is “ ur8ent need '0 expand these
facilities especally due to the rapid spread of HIV dunng the last two to three years resulting
accessible^all PlZa^Z™3? 'kX5 ^‘h"8
muSt be
cessible,to all PLWHAs and preferably -under one roof which wouTd avoid unnecessary
XZtheXt PL7
b<i ,nV°IVed m Van°US aCtivitieS and decisi0n mabng bod’S - '
would
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lnclud,ng Provldmg membership in the State AIDS Society. Such a move
would serve to empower the PLWHAs
Wood Safety
dunne
Phase I Yp^nHmber
'"T P6™™8 t0 BI°Od Safety haVe
been covered
oerfot
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issues couPd not g.ven sufficient attention dunng Phase I Viz (1) the
nof bXTuaTed
6 “ b'0°d
^"^"ed dunng the Phase could
n ]■
efficient emphasjs was not placed on the rationale of using blood
Viet * V CMntr0 °fnbl0°d banks •vil1 be imPlemented in state, the Microbiology department of
>ctona Hospttal Bangalore will be identfied as referral center for quality conrtol assurance.
Page. 9
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Program Management The lack of an AIDS control Society until recently has lead to the
delay in sanctioning of funds for the various activities of the Sate AIDS ceil. The lack of
Adequate Staff in the State AIDS cell was another major factor for delay in implementation of
some components of the programme. Similarly, the delay in supply and procurement of
appropriate training materials and modules resulted in a lot of hardship for the various training
programmes as well as IEC activities. The lack of Advocacy within the top Governmental
Sectors also was a major deterrent to the programme.
Intersectoral Co-ordination : This was one area which was not paid much attention during
Phase I due to various administrative and human resource constraints. As a result
Governmental sectors perceived HIV/AIDS as a special issue under the Department of Health
and not as a developmental issue . It also resulted in lack of Co-ordination with NGOs
working in the field leading to a feeling of neglect amongst them
LIMITATIONS IN IMPLEMENTATING THE PROJECT
1. Supply of drugs on time and continuety of care and treatment
The provision of drugs and other consumables are to be provided to the Centres/Hospitals
On time. The procedural formalities will delay the procurement of itmes. Hence there is a
need to simplify the procurement procedures.
• 2. Laboratory diagnosis facilities for voluntary' testing in all Districs.
The existing three voluntary blood testing centres, two at Bangalore and one at Manipal is
inadiquate to provide testing and counselling facilities for the entire state and hence there
is a need to establish voluntary testing and counselling facility in all Distric level Hospitals
and Major Hospitals.
3. Lack of full participation by NGO’s.
There is a need to identify and select dedicated NGO’s to take up awamess activities on
HIV/AIDS/STD Control activities and also for care and support In the 1 Phase project it
is expreanced that majority of NGO’s become dropout after the receipt of first instalment
of grants and most of them have not submited the expenditure statement and utilisation
certificate along with the apprisal cenificate from the respective District Health and FW
Officers. And most of NOG’s have not complited the original project complitly and
r qualitatively
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Treatment and counselling facilities
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I here is a need to provide drugs and counsumbles with provision of trained counsellers at
al! District Hospitals and Major Hospitals for tratment of oppenumstic infections among
people leaving with HIV/AIDS, which was not provided in the Phase 1 project
5. (dear Poficy guidelines on testins.
The existing HIV testing policies needs to be spell out property and the HIV test Kits
should have highest specificty and sensitivity. There is a need to monitor the private
diagnostic laboratories where they use different kinds of test kits which donot have
uniformity in testing procedures. There is a need for standred guidelines and policies for
the entire cuntory for HIV testing procedures.
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KEY ISSVES TO BE XODRKSSEI) IN PH ASE II OE THE PROJECT :
1. Ln teryen tie ns
Understand the dynamic', -n Commercial Sex work within the various pans of the state
and evolve appropna.c strategies for intervention among sex workers
• To set up intervention programmes for other vulnerable populations in the State (IVDUs,
.. MSMs. Devadasis etc )
• To replicate the Well Women’s Clinic Concept which has been successful in Bangalore so
as to increase access of health care to women, which in turn would lead to early detection
and management of reproductive tract infections.
• The above intervention of CSW’s will be taken up with the help of identified NGO s
alleady working for the area specific intervention projecs.
•
2. Care and Support.
• To evolve low cost community based Care and Support programmes that can be easily
replicated in the various parts of the State
• To be accountable to PLWHAs and to institutionalise them in the programme
3. To increase NGO involvement and community participation, especially in the Districts for
intervention and Care and Suppon projects. NGO participation will be on an kequal
partnership1 basis with the State AIDS Prevention Society so as to facilitate better Co
ordination.
4. To strengthen STD services by providing training to doctors in Syndromic management of
STDs at the Taluk level hospitals
5. To further strengthen the Sentinnel Surveillance system and Voluntary testing facilities as
well as Monitoring the Blood Safety Programme
6. Decentralisation of the programme to the District level by setting up District level Societies
In hiuh prevelent areas in Mangalore. Belgaum and Bellary.
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7 To^set up an aggressive Advocacy programme within and outside the Governmental
framework m order to facihtate [hter-Scctorai Co-ordination
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PROJECT DEX ELOPMEM OBJECTIVES
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The etfori^io teauce HIV transmission to continue, main tocus is given on High risk
groups, low risk groups to "educe the spread of H1B infection, reduce the impact ot AIDS.
Morbidity. Mortalitx. Socio-Economic Problems and depletion of Wealth and to Strengthen
Capacity Building to fight challenges posed by HIV/A1DS Epidemic. In Karnataka State
Intervention Programmes among Devadasi system is prevailing in Belgum and other Northern
part of the state is planned to be stepped up. The National Highways bordering Maharashtra,
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Goa,Tamilnadu, AndhiaPradesh and Kerala where large number of Truckers will be travelling
and moving across the border including coastal areas, and heance there is need to check cross
border HIV/STD infection in the community In addition the other transport network is also
planned to be taken care of involving NGO’s for awarness creation activities and treatment
facility for S.T.D. cases among the highway transport staff
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[PROJECT STRrXTEGIES/COMPONENTS
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COMPONENT I
Targetted Intervention Among High Risk Groups
Sex worker Protection. RTI / STI Programme, Condom Promotion.
Men Having Sex with Men Protection, Migrant Workers Protection,
Women workers Protection, and Truckers Project.
Continuation of Strengthening of STD Clinics.
COMPONENT II Targetted Intervention Among Low Risk Groups.
Blood Safety Programme. Voluntary Testing and Counselling.centres?
And Information. Education and Communication
COMPONENT
in
Surveillance,
Programme Management, Institutional Strengthening,
Operational Research & Research and Development.
Training FiX)gramme.
COMPONENT IV
Low Cost Community Care Centres,
Care and Support.
IT
COMPONENT V
.. Inter Sectoral Collaboration.
IMPLEMENTATION ARRANGEMENTS
The Karnataka State AIDS Preventauon Society is established and registred as per the
Karnataka State Society Registration Act I960 during December 199" and is Currently
functioning as a society with Head quarters in Bangalore. The society is an independent and
autonomous authority vested with full executive and financial powers.
The society as an apex body, the general body where the chief Screatary of the Government
of Karnataka is the chairmen and which is responcibal for administration and management of
the affairs of the society.
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The executive commuil&eof the society is responsible to the general body for efficient running
of the affairs of the society which will meet once in a month or frequently if necessary for
monitoring and supervision of various activities under AIDS Prevention and control with
financial powers. The president of executive commtiftR^is the secretary to Government of
Karnataka Health and Family welfare Department. The member secretary of the society will
be the project Director for AIDS Control project and he will be responsibfttfor day to day
management affairs ot the society and chief executive of the society.
The Pattern of staff suggested in the organogram by the world bank / NACO for Phase II
AIDS Control Project 1999 - 2004 will be create</filled up shortly in due course.
The Criteria for selection of NGO’s for implementation of various activities under Targetted
Intervention Projects will be followed as per the guidelines already provided by NACO. The
Karnataka State have already formed a District Level committee under the chairmenship of the
District Deputy commisioner with District Health and FW Officer of the Districts as member
secretary of the District level committee where in the project proposals of the NGOS Will be
scrutinized and short listed in the district level committee and will be forwarded to state AIDS
prevention society for scrutiny and consideration by the NGO Advisor and officers of the
society which in turn submit the proposals to the executive committee for obtaining approval
and sanction for relase of grant in aid financial assistance to NGO’s for implementation of their
projects in the respective areas. Further a thorough monitoring and supervision of NGO
activities will be taken up by the district committee and also by State AIDS Prevention
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Society.
ORGANISATIONAL
ARRANGEMENT
FOR
IMPLEMENTATION
OF
ACTIVITIES through AIDS Prevention Society at the State Level and to provide technical
advise to Dist. Level. Block level Hospitals on safe Blood, testing and Counseling, STD
Services. Surveillance, Clinical care, and to implement targeted interventions, including
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condom promotion and Sex Education.
’ >. . The
Specific Responsibilities will be entrusted to the implementing agencies.
guested by NACO. Govt, of India will be followed and action will be taken to
Organogram sug_
fillup alf^he posts in the Karnataka State AIDS Prevention Society as per the Organogram
The Dist. Nodal Officers for AIDS at District Level and other fonctionanes. the Disf
Health and FW Officer and District Surgeons/Medical Superintendents/Medical Officer 1/c of
Blood’Banks and STD Clinics will be suitably advised on implementation ot vanous activities
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SUMMARY OF IMPLEMENTATION PROGRAMME
Major components and activities to be implemented under the project in Karnataka are as
follows.
COMPONENT I: TARGETED INTERVENTIONS AMONG HIGH RISK GROUPS
Targeted Intervention Projects will be planned to be taken up with active involvement of
selected active NGOs giving emphasis to creation of awareness, education, IEC, STD Control
and promotion of condoms among High Risk Groups. CSWs, MSM, migrant workers, women
STD patients and truckers.
Depending on the prevailing risk behaviour groups in the State, intervention project
will be taken up in all the Districts and major cities. This will be area specific and group
specific intervention specific. The type of interventions planned in Phase II for Karnataka are
listed below:
- 1. Sex worker protection.
’2. Protection of women workers.
3. Reduction of STIs amongst women.
4. Protection of migrant workers.
5. Men having sex with men.
" 6. Awareness and prevention among truckers.
7. Continuation of strengthening of STD Clinics.
The intervention among substance abuse will a part of intervention strategy in all the above
sub components.
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Component 1
SEX WORKER PROTECTIOX
Sub Component
Targeted interx ention among sex workers
Primary- Objective
Behaviour change amongst sex workers leading to
reduction in the risk of HIV infection
Secondary- Objectives
1. To undertake a mapping of the sex industry in
Karnataka leading to a district and city-specific
understanding of the dynamics and behaviour of sex
workers and their clients
2. To understand and define Safer Sex Negotiation skills
To undertake district and city-specific Behaviour
Change Communication Strategies leading to the
promotion of safe sex and STD treatment-seeking
behaviour amongst sex workers and their clients
4. To reduce the vulnerability of sex workers to social
and legal factors by undertaking a proactive strategy
to assist government and non-govemment institutions
in understanding and dealing with sex workers in
their special circumstances
Strategy
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The programme will commission a mapping of the sex
industry in Karnataka with the assistance of nodal and
academic agencies such as the Institute of Social &
Economic Change, Bangalore , and FEVORD-K
(Federation of Voluntary Organisations in Rural
Development-Kamataka)
The programme will involve behavioural scientists and
sex workers to define practical Safe Sex Negotiation —
SkilK
•. The programme will involve applied communication
specialists and behavioural scientists in the
formulation of manuals that will allow HIV AIDS
interventionists
to
plan
area-specific
BCC
programmes
• The programme will
undertake
sensitisation
workshops with elected representatives, bureaucrats,
enforcement officials. NGO representatives and the
media to bring about a more secure environment for
sex workers leading to effective H1V/AIDS control
and prevention interventions.
•
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Component 1
PROTECTION OF WOMEN WORKERS
Sub Component
Targeted intervention for women labour-intensive industiial
units in the unorganised sector - eg: garment factories /
tailoring units
Primary Objective
Reduction of vulnerability to sexual exploitation leading to
reduction in the risk of HIV infection
Secondary Objectives
I. To undertake a mapping of all woman labour-intensive
industries in the unorganised sector in Karnataka leading
to a district and city-specific understanding of the needs
and vulnerability of women in these situations
2. To understand and define mechanisms which reduce
women’s vulnerability to sexual harassment in the work
place
Strategy
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To undertake industry-specific interventions leading to the
reduction of sexual harassment and vulnerability to HIX' .
infection of women workers in the unorganised sector.
The programme will commission a mapping of all woman
labour-intensive industries in the unorganised sector in
Karnataka with the assistance of nodal and academic
agencies such as the Institute of Social & Economic
Change. Bangalore. Shramik Vidyapeeths. and Trade
Union Federations.
The programme will involve behavioural scientists, lawyers.
HRD specialists, trade unionists and women workers to
define mechanisms that will lead to reduction in sexual
harassment of women in the work place.
The programme will involve behavioural scientists, lawyers.
HRD specialists, trade unionists.and women workers in the
formulation of industry-specific leading to the reductron ot
sexual harassment of women workers in the unorganised"
sector, and their vuinerabilitv to HIX’ infection
The programme will undenake sensitisation workshops with
industry representatives, trade unionists, labour officials,
enforcement officials. NGO representatives and the media to
bring about a more secure environment tor sex women
workers in the unorganised sector leading to effective
HIV/AJDS control and prevention interventions.
Page. 16
Component 1
REDUCTION OF S TIs AMONGST
WOMEN
Sub Component
targeted intervention to
transmission in women
Primarx- Objective
To develop a package of educational, syndromic and
clinical STI/RTI services that will provide women a non
stigmatising environment and allow them greater
capability to protect themselves from the risk of HIV
infection
Secondary' Objectives
1
reduce the risk of HIV
To create a replicable and gender-sensitive model of
STI/RTI services, involving the concept of a Well
Women's' Clinic that allows women to openly access
services without stigma
2. To promote STI prevention/treatment as an HIV
preventative measure amongst women and their
spouses in a manner that is gender-balanced, culturally
sensitive and acceptable
Strategy
•
•
Because 60% of all STIs in women are asymptomatic,
and because of cultural factors that does not lend
itself to a safe sex negotiation environment, there is a
need to reach out to the larger society of women
including housewives. The programme will promote a
package of STI/RTI services which because of its
reproductive health framework will allow women to
access the clinics without fear of stigma. The clinics
will also function as district nodal training centres for
syndromic management of STIs.
B\ focusing on reproductive tract infections, rhe
•’programme \xill reach out to women with information
about S Fl and HIX -AIDS in a manner that is
culturallx sensitive As part of ns extension sen ices,
the programme will also focus on male reproductive
health and sexual education to create an environment
which both educates males, and makes them willing
partners to responsible behaviour
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Page. 17
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Component 1
PROTECTION OF MIGRANT
WORKERS
Sub Component
Targeted intervention for migrant workers • eg
construction workers, hotel workers, dock workers
Primary Objective
Behaviour change amongst migrant workers leading to
reduction in the risk of HIV infection
Secondary Objectives
1
To undertake a mapping of all migrant worker
activities in Karnataka leading to a district and city
specific understanding of the needs and vulnerability
of migrant workers in these situations
2. To understand and define Safer Sex Negotiation skills
Strategy
3. To undertake - district and city-specific Behaviour
Change Communication Strategies leading to the
promotion of safe sex and STD treatment-seeking
behaviour amongst migrant workers
• The programme will commission a mapping of all
migrant worker activities in Karnataka with the
assistance of nodal and academic agencies such as the
Institute of Social & Economic Change, Bangalore.
Shramik Vidyapeeths, and Trade Union Federations
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Page. 18
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The programme will involve behavioural scientists and
sex workers to define practical Safe Sex Negotiation
Skills
The programme will involve applied communication
specialists and behavioural scientists in the
formulation of manuals that will allow HIVZAJDS
interventionists
to
plan
area-specific - BCCprogrammes
Component 1
MEN WHO HAVE SEX WITH MEN
PROTECTION
Sub Component
Targeted intervention among Men who have sex with
Men
Primary Objective
Behaviour change amongst Men who have sex with Men
leading to reduction in the risk of HIX' infection
Secondary Objectives
1. To undertake a pilot study in Bangalore leading to a
city understanding of the dynamics and behaviour of
Men who have sex with Men (MSM)
4
2. To undertake city-specific Behaviour Change
Communication Strategies leadmg to the promotion
of safe sex and STD treatment-seeking behaviour
amongst Men who have sex with sex
l
3. To reduce the vulnerability of men who have sex with
men to social and legal factors by undertaking a
proactive strategy to assist government and non-.
govemment institutions in understanding and dealing
with sex workers in their special circumstances
4. To promote the formation of a CBO
(
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Strategy
•
The programme will commission a pilot study of Men
who have sex with Men in Karnataka.
•
r
The programme will involve behavioural scientists and
Men who have sex with Men to define practical Safe
Sex Negotiation Skills
• . The programme.will involve applied- communication
specialists and Men who have sex with Men in the
formulation of IEC materials that will allow
H1V/AIDS interventionists to plan area-specific BCC
programmes
• The programme will undenake sensitisation
workshops with elected representatives, bureaucrats,
enforcement officials, NGO representatives and the
media to bring about a more secure environment for
Men who have sex with Men leading to effective
HIV/AIDS control and prevention interventions.
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Page. 19
1
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AIDS Awareness and Prevention Program among Truckers in Karnataka
Overall Goal:
To improve the accessibility to sexual health services for truck drivers &
their helpers, who traverse the State of Karnataka.
(
SPECIFIC OBJECTIVES:(1) To educate the target group about HIV/AIDS & to remove the misconceptions
regarding the same prevailing among them.
(2) Services for prompt detection & treatment of sexually transmitted diseases should be
made available to the target population.
(3) To educate them about proper use of condoms which should be promoted as one of
the most important measures in preventing the spread of this disease. '
(4) Condoms free/branded should be made accessible to the target group at all the halt
points & places with high concentration of CSWs.
STRATEGY FOR 5 YEARS:1st Year:(1) An advocacy Meeting to be conducted to sensitise & inform all the authorities at the
district level under whom this project is going to function regionally.
- 2 Months
(2) To identify ideal halt points for intervention throughout Karnataka
- 2 Months
(3) To identify Governmental & Non Governmental Organisations in the respective regions
for planning & implementing the Programme.
- 2 Months
(4) Sensitive & motivate all the partner Organisations by involving them right from the
planning process in the Project.
- 7th Month
(5) A Workshop to be conducted for developing Project Proposals for all the partner
organisations.
Sth & 9th Months
(6) Proposals to be scrutinized <& approved by the Society: 10th Months.
(7) Proposals to be approved & partner Organisations to be contracted for implementation
of the Programme 10th Months.
"................................................................................ .
2nd Year:(8) In the Pilot phase i.e 1st Year 10-12 Organisations could be contracted
(9) With the lessons learned in the 1st Year & to remove & expand the services. man\
other organisations'could be brought into the network based on the need for the same
3rd Year:(10) By the end of 2 years, the partner organisations involved in the pilot phase would have
completed one year in the project & other Organisations required to cover all the truck drivers
& helpers throughout Karnataka would have been contracted. The No. of such organisations
to be contracted will be based on the No. of points identified as ideal halt points for interaction
in Karnataka.
Page.20|
(11) Periodical training programmes would be conducted in the 1st, 2nd & 3rd Year to
update the knowledge .& skill? of partner NGQs in IEC, BCC, Svndromic approach for
5 IDs, Condom promotion & Social marketing of the same & Administration & Accounting.
(12) Concerned authorities in the district level should be involved in planning, implementing
6 evaluating the progress in the Project at all levels.
(13) In the 3rd Year, the focus should be more on behavioural change communication &
counseling with quality based intervention.
4th Year & Sth Year:(14) The 4th & Sth Year should be devoted for sustainability.
INDICATOR OF PERFORMANCE:(T) No. of truck drivers interacted with in each month at the specified halt points.
(2) Their level of knowledge about H1V/AIDS assess by random survey at the end of 1st
Year should have improved compared to that at the beginning of the project.
(3) The No. of persons using condoms should increase shown by an increase in the demand
for freely supplied as well as the popular brands sold in the shops.
(4) An increase in the No. of truck drivers visiting the health centres in the halt points for
STDs.
(5) No. of drivers seeking treatment in the earlier stages of STDs should improve.
(6) The No. of drivers who come for follow up should improve.
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MONITORING & EVALUATION:-
As mentioned earlier the district level authorities should be involved right from the planning
stage up to the periodical monitoring
of the activities of partner organisations in their region. The society at the state level should
appoint external consultants who would visit the partner organisations periodically in order to
give a feed back on their activities to the society. The society at the state level should conduct
a Meeting at least once in 6 months consisting of the Consultants, representatives from district
level society, representatives of the NGO Advisory Committee, members of the Technical
Advisory Committee & members of the state level society. This opportunity should be utilised
to review the progress, to identify any constraints & to plan for further strengthening of the
Programme in future.
~
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EVA EL ATION
Each project panner will send a Quarterly Report of the Project to the state level society &
the society based orTthese reports & indicators as mentioned above will do an evaluation once
in 6 months. Independent evaluation by an outside agency will be taken up.
CONSTRAINTS:-
(
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(1) Truckers are highly mobile population so follow up is very difficult.
(2) Most of them are illiterates or semi literates.
(3) Most of them are alcoholics or drug addicts (Opium) which influences their sexual
behaviour.
Page. 21
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COMPONENT NO. II
TARGET ! ED INTERVENTIONS AMONG
LOW RISK GROUPS
BLOOD SAFETY PROGRAMME
which mainly focusses" on complete BloodTransfusio^ SaTetr'anT^du'ctTorHI V
transmission through Blood and Blood products
The Programme aims at <encouraging voluntary Blood donation Movement. The
Karnataka State has established the State"Blood Transfitsmn
-------------1 council during July 1996 and
is made functional
J A t_ _
C* .
T'X •
«
^r-.
—.
Centres at Karnataka Institute ot Medical Sciences Hubli and M R Medical Collette
?Ur'nS
SeCOn,d kyear Of the proJect 10 ensure the availability of services in the
entire State on a regional basis and are attached to Medical Colleses The unit cost
nerThTw VdR t°^
Prrthe eX,S'inS pattern ofNACO- and 'he costing IS reflected as
per the World Bank Guide lines vide annexure.
2. ZONAL BLOOD TESTING CENTRES:
the Pm' t Th eX1Stlng Ten Zonal Blood testin8 Centres will be continued in the II Phase of
e Project. The equipments have already been supplied by NACO during the I - Phase of
dTTacTTa'T601 T hT861
SUpP''eS
consumable^ is worked out as
comnonlm
T
refleCktefl ,n the Prescribed formats. The funds required for salary
mponent is worked out as per the pay and scale of the State Pattern.
3. Modernisation of Blood Banks
F™ ---- --x
fhe tunas required for Laboratory supplies anc consumable-. Salaries o<
Laboratory-Techmcrans (Technical Assistants) >s worked out as per the exKtmu YACO
Guideunes and States pay scale and cadre etc. and is reflected in the annexure
H D ^le train'n° ot Personnel working in the Blood Banking svstem is reflected under
ase-II Project and a nominal operational contingency expenses is also worked out and
shown in the annexure.
p.
The detailed break-up costing is worked out vide annexure.
Page.22
number ot units collected, number of units transfused, number of components requested,
number of components issued, number of HIX infections, number of voluntary donations,
performance in quality assurance program
The institutions responsible would be all licensed blood banks in the government sector as well
as those in the private sector which have been strenuthened under Phase 1 bv the State AIDS
Cell Blood Safety
(
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Objective, (i) To monitor the use of blood and emphasise the need for rational use of blood
and blood components.
(ii) To meet all requirements of the state through voluntary donation.
(nil To establish quality control of blood banking system in co-ordination with Druss control
department
Strategies:
It is proposed that by the middle of Phase II. each of the 27 districts of the state would have
one modem blood bank, with component separation facilities. This would be the nodal point
for blood collection, testing and component separation, from where the requirements of the
entire district would be met through distribution centers. All district blood banks in the state
would be-monitored using the following parameters:
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Additional output supported under various other projects
1
Building facilities and maintenance and supply of equipment and repairs and maintenance
is taken care under World Bank Assisted Karnataka Health Systems Development Project
Blood Bank intelligence system is already established in the state with the suppon of
Drugs control Department in Karnataka which will monitor licensing and other blood
banking system
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\ ohintary I esting and Counseling Centers
OB.JFX LIVES
FO PROVIDE VOLUNTARY TESTING AND COUNSELING
FACILITIES AVAILABLE'AT EACH DISTRICT IN THE STATE
PROPOSAL
. At present there are only three Voluntary Testing Centres in the State
and they are located m the Southern pan of the State- two in Bangalore and one in Manipal
The total number of Districts in the State are 27 and therefore It i
---------- .. is proposed to start 25
additional centres during the II Phase. to ensure atleast one voluntary testing center is
established tn each district and counsellors in these voluntary testing centers will be entrusted
to NCOS These centres will provide Voluntary Confidential testing^ Pre and Post Test
Counseling, and testing for diagnostic purposes. All these centres will be linked one Nodal
centre in the State (Either BMC or NIMHANS) which would conduct monthly qual.ty control
assurance tests bs dispatching coded samples, Anv centre which does not perform
satisfactorily in the quality assurance programme will be tarueted for tramins and correction of
errors. Each centre would have one Medical Officer, one Technician and one Counselor and
shall be provided with lab and counseling space, ELISA readers. Pipettes. Multichannel
f ipettes, ELISA washer. Centrifuge. pH meter. Stirrers. Glass ware and diagnostic kits for
■testing purposes
Institutions responsible Medical College Hospitals (Microbiolottv Depanments) or District
Hospital Laboratones or NGOs
■ Activities to be undertaken : Recruitment of staff, training of technicians and counselors
(preferably PLWHAs as counselors), provision of condoms, provide counseiina. provide
confidential testing, positive networking and Quality assurance testing.
Time frame Year I - 10 centres. Year II - 10 centres. Year III - 5 centres
Assessment Parameters ' Appointment of Staff and equipment of Laboratones. Number of
subjects availing testing facilities. Number of individuals counseled, number of HIV tests done.
Quality assurance results, number of persons followed-up. number of persons refereed to other
centres,'NGOs..Number of persons given information about HIV. Care and Support
Risks
Sufficient number of persons may not avail facilities at all the centres, breach of
confidentiality and poor follow up
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Page.24
COMPONENT II: INTER\ EN PIONS AMONG LOW RISK CROP PS
I EC & SOCIAL MOBILISATION :
Information, education and communication cuts across various components and interventions
IEC in the first phase has been general and difluse, and has been partly successful in raising
awareness. Now there is a need for systematically designed IEC that addresses the needs and
concerns of specific populations and groups. Earlier IEC efforts focused on providing
information and raising awareness Although this needs to be sustained, future IEC strategies
need to be culture and location specific, context-based, and aimed at promoting behaviour
change. For behaviour change to occur, “correct” knowledge and positive attitudes have to
reinforced, and most importantly, conducive, enabling and supportive environment created
Therefore, one of the major aims of IEC is to mobilise specific groups, communities and the
society in general to become aware, sensitive and participate actively in the design and
implementation of the programme. In other words, create a sense of ownership and
accountability. For this to occur advocacy is essential. Specific locally suited IEC materials
will be developed keeping the local socio cultural factors and culturally acceptable to the
cumfhumity.
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IEC
The IEC component will aim towards promoting behaviour change, this will include provision
of information in a positive, sensitive way, in keeping with the needs and concerns of
particular communities, e.g. CSWs, MSMs. PLWHAs. in a form that is understandable and
acceptable to them.
<
The key to successful IEC efforts lies in not only the content of the communication but also
the media "mix” used, and how effective it is in reaching particular segments of society. For
instance, it is well known that mass media is well suited to raising awareness, but to bring
about behaviour change there is need for interpersonal communication and interaction.
Electronic and print media may be effective in urban areas, but a different strategy, consisting
of folk media -jathas. melas. street plays, may have to be adopted in rural areas. Infotainment
and merchandising may be particularly useful in reaching urban youth. IEC is not a one time
activity IEC' efforts have to be sustained over time-.- evolve to -meef-chanainu concepts Then
again, these have to be backed b\ interpersonal communication, ranging from peer education,
intensive counseling to training- Electronic media can also be interactive, the voice response
svstem is interactive and also has provision tor personalising inputs with the inclusion ot
.jjMjnseling Similariv. videos mav be useful for developing skills, eg correct condom use.
videos can be combined with-discussions that allow tor clarifications and modifications to suit
particular settings and situations Effective IEC raises expectations and creates demands It is
imperative that these be met with the provision of goods and services, such as condoms and
health care
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IEC strategies have to be designed taking into consideration the local culture and
circumstances, accessibility and credibility of the media. Pre-testing to ascertain the
effectiveness of strategies and messages before large scale implementation is crucial.
Monitoring of implementation and process evaluation with feed back to programmes is
necessary for making mid-course corrections and modifications. Finally, innovative ways of
evaluating behaviour change is needed. Thus, formative, process and outcome evaluation has
to built into the EEC programme.
(
For providing guidance and resource to the design and monitoring of the EEC programme a
IEC Expert Panels at the State and district levels need to be set-up. Panel members may be
drawn from the field of development communication, public health, and include experts from
intervention components. District level panel should include experts, familiar with the local
culture and ethos, as well as district level implementors.
Social Mobilisation
For the behaviour change strategy to be successful, an enabling environment is crucial, for this
involvement of the society is essential. Mobilisation of good will, a sense of vulnerability,
responsibility and the will to participate and act is fundamental. Behaviour change can be only
sustained in a supportive atmosphere, for this there needs to be a change in the social climate,
for instance women can take up decision making roles if social structure and economic roles
enable them to do so.
Advocacy will be the key strategy for social mobilisation. Advocacy to mobilise the support of
policy and decision makers at the state, district and grass root levels, who have the power to
make changes in programmes, laws, and influence attitudes is of the utmost importance. As
HIV/AIDS issues touch up broad social and development concerns these will be linked so that
HIV/AIDS becomes a part of the regular programmes. New scientific and epidemiological
information, lessons from other intervention will inform the development of advocacy
strategies as they develop.
Errorts wall be made io draw in the commercial media- cinema, T. V ? and print to depict
HIV/AIDS issues in a responsible way. Private and public media sectors, and the corporate
sector will be encouraged to participate and contribute to the IEC programme.
Key Activities
Activities will includeAdvocacy for policy and decision makers
Awareness campaigns to be reviewed and strengthened
Interactive Voice Response Systems in 5-6 cities
IEC directed towards grass root functionaries and organisations e.g. panchayats, mahila
mandals, youth clubs
• Counselor training and support
• IEC for Work Place based interventions
• IEC for interventions with “high risk” and “low risk” groups
• Operation research to support IEC and Advocacy
Page 26.
•
•
•
•
KARNATAKA STATE AIDS CONTROL PROJECT
Phase -II ( 1999-2004 )
COMPONENT- III
Component - III of the project consists of surveillance, institutional strengthening an
training, operation and research & programme management. Under component - 3 World
Bank suggested orgonogram for medium sized state is adopted and the staffing patem
suggested will be created and filled up, in addition to secretarial supporting staff which
includes drivers. Group D assistants & others.
The staffing pattern suggested will be filled up on a selection cntreria who are already
working under the project with due experience.
And the orgonogram technical and nottechnical staff will be filled up adopting the state cardre pay & scale and the secretarial
assistance and other staff on contract basis will be filled up on a contract basis with a fixed
salary on a need based terms and conditions.
The posts will be filled up on a need based basis without any rigid condition based^previous
field experience under AIDS Prevention & Control activities. The posts of NGO Advisor
and Consultant EEC will be filled up on a contract basis with a fixed salary . In addition the
consultancy services will be considered wherever it is required subsequently as per the
World Bank guidelines.
(
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The existing 13 HIV Sentinel Sites will be continued during the second project and an
additional 7 sites will be considered during first year of the porject ( 1999 - 2000 ). These
sites including 3 STD Clinic, 3 ANC Clinic and 1 Drug Deadiction centres.
STD Clinics ANC Clinics Drugs Deadiction Centre.
1—HIV Sentinel Sites existing
2. N<w Sites Proposed
8
4
1
3
1
c
And another 6 HIV sentinel sites i.e. 3 STD Clinics & 3 ANC Clinics will be considered
during the 2nd year of the project ( 2000 - 2001 ), during 3rd year ( 2001 - 2002 ) 4 New STD
Clinic and 3 New ANC Clinics will be considred iin identified high pnonty area The costing
and other budgeUYequiremem is worked out on ;the basis of earlier guidelines of NACO?
Govt, of India. STD Disease surveillance will be planned in 4 centres during 1* year of the
poiject and will be continued during 2nd ,3rd , 4th & 5th year.
The surveillance activities will be taken up to know the trends of HIV infection prevelance
among high risk groups and low risk groups over a period of time to plan for future preventive
strategies. The Sentinel sites are identified duly considering al! the areas of the State. The
costing towards equipment’s, consumables. Training Honorarium etc., are worked out
based on the previous guidelines of the NACO.
Page.27.
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The Training programme is planned to provide institutional strengthening for the following
categories of Staff in the entire State.
1. Faculty Members of Govt. & Pvt. Med. Colleges.
2. Faculty Members of Health & F.W. Training Centres, and ANM & LHV Training
centres.
3. Faculty Members of Dental Colleges
4. Doctors.
5. A. N.M s. ( Auxilary Nurses Mid-Wife )
6. M.P.W s ( Multi purpose workers )
7. L.H.V S' ( Lady Health Visitors )
8. B. H.E s ( Block Health Educators )
9. Staff Nurses.
10. Dental Doctors.
(
The Training Programme will be taken up at State Level, Regional Level and District
Level.
rd
year of the project a refresher training programme will be taken up during the
3 and 4 year of the project period. The costing towards the expenditure involved in the
training programme is worked out on the basis of previous guidelines of NACO, Govt, of
India.
The District level AIDS Control Society, will.be established on a priority basis in high
prevelance areas of the following 3 District.
1. Mangalore
( Dakshina Kannada )
2. Belgaum.
3.
Rellary.
The Deputy commissioners of the District will be identified as Chairman of the District
AIDS Control Society and the District AIDS Control Society and the District Surgeon
Medical Superintendent of District Hospital will be identified as Member Secretary- and a
nominal honorarium^ and other contigencies expenditure, provision is reflected vide Annext*!f
necessary-the expansion of establishment of District AIDS control society w ill be considered in
the subsequent years of the project in other districts.
The unit cost worked out is nominal and the State AIDS prevention society will monitor
the activities of the District Societies and also the remaining areas of the state about the
implementation of various activities.
Page 28
The Unit cost of the budget requirement for the entire porject of 5 years^wise is reflected
in the annexure as per the guidelines of the NACO.
The orgonogram and the pattern of staff suggested in the second project is relfected vide
annexure.
The equipment will be proecured by NACO following LCB procedures. And wherever
consumables and other sundry items are required the state AIDS prevention society will
follow LCB procurement as per world bank guidelines.
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ORGANOGRAM FOR AIDS CONTROL SOCIETY IN MEDIUM SIZED STATES
(Rajasthan, Karnataka, Gujarat, Orissa, Kerala,Assam, Punjab, Haryana, Corportaion of Delhi & Mumbai)
[ Projecfbirector |
I
_______
Additional Project Director
(Trageted Intervention)
1
[
J
JD(IEC)- Tj
JD (Surveillance,
Training)
—|DD(Surv, Tn
->
DD(STD)
rJD(BS) I
Durg
Inspector
I
ADMN.
OFFICER
Treasurer
Establishment
Officer
AD(STD) ]
->
DD(VTC)
NGO *
Advisor
►
Audit
Officer
----- —___
Accounts
Officer
Monitoring &
Evaluation
[AP(vtc)‘1
AD* (Coun
-selling)
>
Statistical
Officer
Statistical
Asst(2)
j
j.
Procurement
Officer
Purchase
Asst.
Store
Keeper
Contracts
Officer
'»
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COMPONENT IV: CARE AND SUPPORT
affectOXue'toH'lWATD^C^ S!Snifican' thrust on Care and Support for infected and
^Xe 2e X si L7 r
T " 7'11
Sr0W,n8 ep,demic’ the centraIity of prevention
(■
health maintenance^ ,
C
SenSe
encomPass lhe spectrum starting from
settines will be exnln
^H"8 '"neSS (aCUte and chronic)- Health care
settings will be explored and mvolved to respond to the ever increasing care demands and
bT fe aft eXl
/‘
" 3 ,OnS
The
of care
Z in
c±o SOn
aftCr iIlneSS (Eg TB and °ther opportunistic infections).
X moveTn t
from home
XdiTl umts X S
bC C°ntinUed aS h°me
“S™ complemented bv
toItfZ aX^^SV
7 l0ng Stay homes- hospices, self help groups leading
DarXouS t
P 7 tHe ,nV01” of people living with HIV and AIDS ,1
S
k determining the nature of care that is needed. This can also include affected
family members and other individuals.
anectea
very important component of the care continuum. At this point it needs to be strongly.stressed
that counseling is a process and not
an event, as is some times conceived hence adequate
provisions needs to be incorporated.
mant/ 7
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SUpP°rt’ therefore there are elements
as, clinical
S
' nUrSlnS
COUnsellng- home
hospice care, acuon to protect individuals
from iscnminatory practices, services for meeting social support needs
It is important to look at existing health care system an accommodatine changes with in the
systems to respond appropriately to address the health care needs
i J of people living with HIV /
AIDS. It is imperative that the different levels work well together
■ to provide a continuum of
care which is comprehensive and holistic.
The efficient functioning of the holistic care continuum depends on :
/’ h7CeSS
health
reference between hospitals, testing facilities, blood
s- ■ Os. CMBOs. Doctors other paramedical staff. Government Bodies
Uepanments. companies (corporate public sector undertakings) etc
b. Process / procedures for referral of people with HIV / AIDS and the.r families for soc.a!
upport (apart rrom the above mentioned there is a requirement to tram, facilitate and
support other \GOs. mst.tutions. rmssionary organisat.ons to prov.de the infrastucture
taciliry and suppon .
C) peTn^0' °f
by aPProPn^e personnel and facilitating on gome training as
boration and Coordination between and among
among Government
Government agencies Non
o eminent and private sector responses in health, social and community based care
activities.
PageBO
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Complementary to care is support, “support for people living with HIV and their families"
This can be interpreted as social support, economic support, support for positive living,
support towards enabling and sustaining productivity there by reducing the care burden on
the state. Much of this can be achieved by involving community groups, community
organisations and spontaneous groupings of people living with HIV/AIDS. Hence, support in
the context of care provides a social safety net for the infected, e. g. legal support, support
needed because of spouses death or due to destitution, support for children orphaned due to
parents death ( home and education), support for vocational training and skills development
to sustain income, job opportunities in compassionate grounds, support for reintegration of
individuals in broken families. Care ensures recovery form illness and support provides for
rehabilitation in pursuit of a quality of life.
-- By strengthening the existing care facilities in various district head quarters, both in
government sector non Government sector, non government and. private sector the first step
to ensure access to care for opportunistic infections will be established (Note : The above
mentioned strategy should be also equally incorporated in the urban sector )
Various levels of training for care providers in theafore said sectors will be conducted
to standardise care procedures and promote quality service and ethical practices in providing
care for people living with HIV/AJDS.
For effective treatment programme drugs that will be used for treating opportunistic
infections including TB will be made available to NGOs, CBOs, Government care settings and
other non governmental institution that provide care for PLWH/A.
Hospital care will be in the form of interim care and acute care and not as institutional
care that will be for prolonged duration. Hence, all care providing centres will engage in out
reach training for promoting home care program with adequate emphasis on social
restructuring and ongoing support. This will be in conjunction with non-govemment and
private^sector agencies
Current community based care programmes will be examined to explore the scope of
involving
government functionaries, other NGOs. CBOs and other institutions
in
incorporating HIV care in their programmes.
With in the care and suppon programme, a nutrition component that will enable
care gives to provide nutrition information, nutritional product support for PLWH/A to
' promote well being ill be added.
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There is evidence that there is an
increasing trend of infection among pregnant mothers
Under
A7Tfzxthe guidance of the NACO,' 3 ^ieraPeut’c intervention program that will provide for
AZTtoposmve pregnant mothers will be examined and implemented m a phased manner.
successor' nrPnUlm°nary tube^'osis is emerging as the twin epidemic and there are
successtu!
programmes to deal with TB at the community level, hnkaue with those
programmes and instituting new Anti TB initiatives will
minimise the morbidity due to HIV
and TB Drugs for treating PTB will be i.._J_
made available through vanous care outlets and
proper monitoring to minimise drug resistance to TB will be part of the
initiative. Revival
of the diarrhea will be one of the out reach home
care initiatives thereby avening possible
morbidity and mortality.
The concept of hospice care has been well established in Karnataka
and the State can
take pnde in being the first to do so “Freeedom
T
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Foundation Trust" an NGO has been
dealing with alcoholism drug addiction and HIV /AIDS ~~
J . The above mentioned organization
have been pioneers in this area it is now considered to be the ideal model to be replicated
I in
other pans of the country. Though the institution and the model
can be upgraded and
supported recently two other NGOs Samraksha and Snehadan
have staned the same in a
small way. Similar kind of mini facilities
-------- > can be incorporated in other parts of the states
SI nificance of vanous approaches in clinical care will be encouratted and successftil initiatives
will be replicated.
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COMPONENT \ : IN TERSEC FOR A L CO-ORDINATION
Iritersectral collaboration with Public and Private Sector
Health Sector Plays an important part in any community based intervention programs,
for successful implementation of AIDS control project other related sectors like education.
Urban Development Women and Child welfare Prisons and Jails Social Welfare labor play a
great role incarnating the sperfez intervention strategy. The first phase of the AIDS control
project lacks. This Component effective intersectional condition between different core
Departments and between Government and Private is really needed. It is suggested to have
representatives of these sectors at the State level and district level and it is suggested to form
subcommittees at different implementation levels like District. State and Corporation areas.
The role of each sector will be specifically defined The same also applied to copying the
representative of NTO's Who have successfully implement AIDS control project in the cost 2
to 5
-Private Sector is an important component especially in this state as large work force is
engaged in this activity this includes private factors, other establishments like. Industries.
Urban Industnes. Private sectors and Junior colleges etc..
Public sector Under taking employ a large man power in Karnataka like HAL, IIT,
BEL/ITI. HMT. BHEL. BEML and it’s planed to develop a strategy for awareness relative in
contraption with the management. Educational Department especially secondary Education,
will be involved in awareness activities and to train the teachers and peer educators
i
4
The strategy to implement sector specter activity will be planned both at state level and
district level as per to need. This component of Intersectral coloration with public and private
sector is expected to cost Rs 5.36 crores. The phasing of the activity is enclosed with details
of costings and calculations is enclosed wide annexare
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h
procurement plan
In <he Karnataka State AIDS prevention society procuring the equipments, vehicles,
furnitures, consumables, stationanes, etc., which are not supplied by NACO by
adopting the purchase procedures of NACO vide their letter dated 23-09-1992. The
tender notification is made in leading daily newspapers and the formalities of
procurements are followed as per NACO guidelines.
For S3 D ( hmes/ Blood Banks the equipments are supplied by N ACO and the
consumables of Blood Banks and STD Medicens to STD Clinics. Further a technical
committee will be formed by the society and the procurements procedures for items
costing around Rs. 15 lakhs the method of local competitive bidding will be followed and
for items costing above Rs. 15 lakhs the method of National bidding will be followed and
for itmes costing less then Rs. 10 lakhs the method of calling sealed quotations from
minimum three or four local firms will be followed.
L nder Phase II AIDS Control Project the procurement load will be considerable and
hence will be handled by qualified trained staff and the technical committee for
procurement process will scrutinise ail procedures for local shopping. National
Competitis e bidding and local competitive bidding. The annual maintenance contract
for equipments will be arranged by the Karnataka state AIDS'Prevention society for all
(he equipments including those already supplied by NAC O after the expiry of NACO s
contract.
I he eixii v^orks undet Phase II project are minimum and relat^to renovation and
extension facilities for counseling facilities STD Clinics,and also at voluntary testing and
counseling centers., 1 he new construction under civil works are already being taken up
underworld bank assisted Karnataka Health System Development Projects.
Page.34
The maintenance of the buildings are under taken by Public Works Department of the
State Government out of Slate Funds.
The local consultants are proposed to be employed on honorarium not exceeding
Rs. Fifteen thousand per month by the Karnataka State AIDS Prevention Society
which will be done bv fixing guidelines and apAeempnfanri
j
appointment by the executive committee of the society duly advertising in leading daily
newspapers, fixing of guidelines qualifications, age etc. For selection ofNGO’s for
targetted interventions the NACO Guidelines already existing will be followed.
In Karnataka state District Level committee under the chairmanship of the Deputy
commissioner of the district with District Health and Family Welfare officer as Member
Secretary is already formed in all the District.
Step. 1 .
These District Committees will short list and scrutinise the project proposal of
NGO’s and forward to Karnataka State AIDS Prevention Society.
Step. 2
Subsequently the Karnataka State AIDS Prevention Society' officials will
examine and scrutinise the project and will be submitted to the executive committee.
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Step. 3
The executive committee of the society will examine for giving approval and
sanction of the grant in aid.
Step 4.
I he financial assistance to MrO’s vs ill be released in the form ol Hrant in aid b\
obtaining grant in aid bills and payees receipt with an agreement on a indicia! stamp
paper. The funds will be released in two or three instalments.
*
4
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MONITORING AND EVALUATION OF PHASE II AIDS
CONTROL PROJECT 1999 - 2004
The monitoring will be done by Karnataka State AIDS Prevention Society.
f
•
Monthly monitoring will be taken up and will be reviewed in the executive
committee meeting and general body of the society.
Monitoring of the activities under all the components will be done bv an expert
committee under Karnataka State AIDS Prevention society.
'
mon,tonng of a«ivities including the grants received from NACO and
World Bank will be monitor by the accounts wing of the society and also by
identified Charted Accountant/ Accountant General.
I
•
Quarterly financial expenditure statement will be submitted to NACO and World
Bank.
•
An independent agency will be identified and entrusted for periodical evaluation of
the Phase II AIDS Control Project.
Performance indicated will be developed for different component of the Phase 11
Project.
World Bank Mission review will be taken up once in six month by World Bank or
NACO.
Mid-term review will be taken up by the World Bank some time in December 2002.
•
Monthly monitoring formats will be computerised showing both physical and
financial activities undertaken in the Phase II project.
•
Project completion report will be submitted after six months after completion of the
Phase II project. ■’
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ANNEXURE - I
IMPLEMENTATION ACTIVITIES DETAILS
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COMPONENT I
TRAGETTED INTERVENTIONS
•• J
AMONG HIGH RISK GROUPS.
Sub component:- Sex workers Protection Programme
Secondary Objectives :
Level of
Implement’n
State AIDS
Society
Process
establishment
of Terms of
reference for
the study in
consultation
with AIDS
Interventionists
, NGO bodies,
enforcement
agencies,
concerned
government
departments
1
Sub-Process
Identification and
selection of an
appropriate
research institution
implementor
')
Inst resp
for Implim.
Activities to be undertaken
Researchers
Selected
Research
institution
I.
il.
I
III.
Iv.
v.
vl.
vll.
vili.
lx.
t
I
Page 37
I
■J
setting up of ToR
Identification of research
Institution
pilot study in 1 urban/rural
district
analysis of findings
revision of ToR
implementation of State study
presentation of findings and
recommendations to a
Professional Review Body
Publishing of report
Dissemination of report
Time
frame
Yr 1
Assessment
Parameters
■
systematic district mapping of
the sex Industry in Karnataka
identification of sexual
Interests of clients
understanding of the
economics of the sex
Industry
Identification of special
interest groups: transsexuals,
MSM, Devadasls etc
identification of area-specific
key behavioural factors
determining the nature of the
sex industry
Risks
lack of
Cooperation
from members
of the sex
Industry and
enforcement
agencies
researcher
insensitivity to
sex worker /
client
behaviours
)
COMPONENT I
Secondary Objectives :
2
Level
of
Implement’n
Process
NGO
establishment of
Terms of
reference for the
study in
consultation with
behavioural
scientists, sex
workers,
transsexuals.
MSM and NGOs
Involved with
AIDS
Interventions
To understand and define Safer Sex Negotiation skills
Sub-Process
Identification and
selection of an
appropriate
research
institution
Implementor
Researchers, sex
workers and
NGO field staff
1
I
Inst resp
for
Implim.
Activities to be undertaken
Selected
Research
institution
i.
ii.
iii
iv
v.
vi.
vii.
viii.
ix
setting up of ToR
identification of research institution
pilot study
analysis of findings
revision of ToR
implementation of study across all
groups requiring Safer Sex
Negotiation Skids
presentation of findings and
recommendations to a Professional
Review Body
Publishing of report
Training workshops to Implement
report recommendations
Time
frame
Yrl
Assessment
Parameters
identification of all
groups requiring Safer
Sex Negotiation Skills
identification and
understanding of
existing factors that
constrain Safer Sex
negotiation
understanding of the
skills required for Safe
Sex negotiation
Trainings undertaken
Field testing of skills
learnt and used
Risks
socio
economic
factors which
make Safe
Sex
Negotiation
an alien
concept
lack of
support and
understandin
g from pimps
I madams
researcher
insensitivity
to sex worker
/ gender
realities
I
Page 38
j :(
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—
COMPONENT I
Secondary Objectives :
3
To overtake district and < ^ng to the promotion of safe
workers and their clients
■5“-™“S==KS~~....
Level of
_122£lemenrn
Process
1 Brothel/
Lodge/
Street /
Community
Education and
Promotion of safe
behaviours
Sub-Process
Inter-personal ~ ;
communication
condom promotion
and health care
referrals
,m Piementor
NGO :
~
counsellor I
coordinator, field
Inst resp
.for Implim.
Activities7o~be
concerned
staff, anta
Peer educators
Time
frame
coordinator, 2 field staff and w
Peer educators to work with 200
Yrl-Y^
sexkad S Undersfreet-based
sex trade conditions
II
III
iv
»
undertaken
NGO
v
vi
vii
Recruitment of 1 Counsellor /
~ator 2fieW staff and to
P^e educators to work with 500
sex workers in brothels
Assessment
Parameters
ordinators trained and
working in field
Number of field educators
trained and deployed
Number of peer educators
trained and deployed
Training for NGO counsellor / co
ordinator, field staff and peer
educators
Development and product,on of
BCC materials
Outreach travel for educat,on
Number of condoms
distributed and used
|ransPorta"on/storage
and distribution
y
STD education/referrals
Number of Sex Workers
counselled
sex worker-related BCC
materials developed and
produced
Number acce:•ssing STD
services
Page.39
PRisks-
^^beToTCounsellorTcoT
lack
of
empathy
amongst
staff
lack of Peer
Educators
Peer
Educator
turnover
inconsistent
Condom
supply
-^WHONeNT
I
Seco.ndarV Objectives ■
4
/ ^Ver3f^~
Uglfilernenvn
>03
deal|ng Wrth sex
^rker8
J,0 redPce th
^olnerg^iijj
stra<egy to
workers
Process
“ds'llsatlon
'Wdwhops
and IEc
J S^-Process ' ,m'Piementor
■---------
-- ----------
iS?
55a^l>'
^
rh
S
'"st resp
^LL^PIim.
hgo
^mandates
to
/ responb
/ Sensit/\M/V
Io I he
/ special1 ^^S-ances
-—
n9 a Proactive
" “"“"•'aMtag
and dea'ing with
1 ' fede''XhoX,<S,IOps
hal s« 'vorke,s
Jlye m
sex
, Actl^Toi-~---
X^Pdertaken
Ofd|nator/
KSAps
:° o'd'natof
iii
^ime^
J[3me
/ pSsess^eni
Siarneters
Re^s^i~b^~
^acyo,indi^
sr£9^have
)
Risks
SO/NGO
Monties to
pad|cipa(e
I
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■
COMPONENT I
Sub component
l
Secondary Objectives :
Level of
Implement’n
Process
District NGOs/
DSAS
establish
qualitative
STI/RTI
services for
women
STI / RTI SERVICES
1
To create arcepHcab'e
"
and gender-sensitive model of STI/RTI services,
involving the concept of a Well Womens
Clinic, that allows women to
openly access services without stigma
Sub
Process
implementor
establish district
training and
extension
services for
syndromic
management of
STIs
Dfslncl
team
STI/RTI
I
i
lnstresP
for
Implim.
NGOs
/
DSAS
Activities to be undertaken
recruit and train 1 coordinator +1
Woman Doctor +1 counsellor +1
lab technician +1 community
organiser to provide STI/RTI
services to 20 women/day
li
identify site for clinic, preferably
within District Hospital premises
ni
equip clinic with required
Instruments and lab materials
iv
provide a structured environment
in which all women have access
to education while waiting, and
counselling Immediately after
consultatlon/examlnatlon
v
practice DOTS for first Intake of
medicines.
VI
Because of the average cost of
Rs 350/womanAreatment arrange
for free medicine support for an
effective service, leading to
providing demonstratlonAralning
services to other medical
practitioners In the district
Vli. provide referrals as necessary
Viii. conduct monthly Planning and
Training services for syndromic
____ management of 'STIs/RTIs
Page.41
I
Time
frame
Assess
ment
Parameters
Yrl-YrS
•
•
•
establishment of
district training
and service
units
provision of
package of
STI/RTI
services
no of women
accessing these
services and
followed up
Planning and
training
sessions held
no of other
medical facilities
supported in the
district
referral links
established
Risks
clinic space may not be
available in the District
hospital premises
cost of treatment makes
replicability without access to
free medicines difficult
finding suitable Woman
Doctor
poor repeat attendance
lack of interest from
management of existing
health services
a
COMPONENT I
Secondary Objectives : 2
I
Level of
Implement’n
Process
District NGOs/
DSAS
establishment
of promotional
activities
___ i__
Sub-Process
development of
appropriate IEC J
materials for both
women and men
Implementor
Inst
resp
for
Implim.
Activities to be undertaken
Time
frame
RTI/STI
Team
I
NGO
i.
YH-YrS
ii.
I
establishing referral
links
Page 42
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preparation and production of
IEC materials
awareness programmes with
men and women on women and
male reproductive health, sex
education, STI/RTI symptoms,
and services available
Assessment
Parameters
No of IEC materials
designed, produced,
distributed
No awareness
programmes held
No women accessing
clinic
No spouses
counselled, referred
Risks
lack of participation
cultural factors not
overcome
spousal support not
available
4
COMPONENT I
Sub component:- MSM PROGRAMME
Secondary Objectives :
1
To undertake a pilot study in Bangalore leading to a city understanding of the dynamics and
Behaviour of Men who have sex with Men ( MSM )
Level of
Implemenfn
Process
Sub-Process
implementor
Activities to be undertaken
Inst resp
for Implim.__
NGO
establishment
of Terms of
reference for
the study in
consultation
with AIDS
Interventionists
NGO bodies,
gay activists
Identification and
selection o( an
appropriate NGO
Researchers •
Selected
NGO
I
it
in
iv
v
VI
VII
VIII
IX
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Page.43
setting up of ToR
identification of research
institution
pilot study in 1 urban district
analysis of findings
revision of ToR
implementation of study
presentation of findings and
recommendations to a
Professional Review Body
Publishing of report
Dissemination of report
Time
frame
Assessment
Parameters____________
Yrl
•
•
•
systematic city mapping of
MSM in Bangalore
identification of sexual
interests of MSM
identification of area-specific
key behavioural factors
determining the vulnerability
of Men who have sex with
Men to the risk of HIV
transmission
Risks
lack of
Cooperation
from MSM
researcher
insensitivity to
MSM
Negative legal
environment
COMPONENT
I
Secondary Objectives :
2
leading to the
who have sex witl^Men
Level of
Implemen
1 Street /
Community
Process
Sub-Process
Education and
Promotion of safe
behaviours
Implementor
Inlei persun.ii
commilmcation
N( io/
• •oun iellor /,
condom pinmoh. ■<
and health r.Ht.
referral’s
oordmator/.field
skiff and
Peer educators
treatment-seeking' behaviour
Inst resp
Activities to be undertaken
J^fJmplim.
■ • —— ------ — ______ _
NGO
concerned
Recruitment of 1 Couns^T
coordinator. 2 field staff and 10
peer educators to work with 100
MSM under street-based
conditions
ii
ls
til
I
IV
v
VI
Training for NGO counsellor / co
ordinator. field staff and peer
educators
Development and production of
BCC materials
• Outreach travel for education
Condom transportation/storaoe
and distribution
STD education/referrals
amongst Men
Time
frame
TCP
rr o p
■ YrS
Assessment
Parameters
Number of Counsellor / crT
ordmators trained and
working m field
Number of field educators
trnmed and deployed
Number of peer educators
trained and deployed
MSM -related BCC materials
developed and produced
Number of condoms
distributed and used
Number of MSMs counselled
Number accessing STD
services
Page.44
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C9
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Risks
lack
of
empathy
amongst
staff
lack of Peer
Educators
Peer
Educator
turnover
inconsistent
Condom
supply
>. »
COMPONENT I
Secondary Objectives :
3
...... with sex
Level of
Implemen
Process
Sub-Process
Government and
NGO Institutions
dealing with MSM
sensitisation
workshops
and IEC
help.ng GO and’ ’
NGOs Io adapt
•heir mandates to
respond
sensitively to the
special
circumstances
that MSM live
[ under
Secondary Objectives :
4
Level of
Implemen
Process
NGO
Identify
leadership
Provide training
Implemento
r
ng67^
Inst resp
for Implim.
NGO
Co ordinator/
Activities to be
undertaken
Time
frame
Risks
sensitisation workshops
redefining workshops for
existing Institutional
mandates
Advocacy of Individual
cases
Assessment
Parameters
Yrl- Yr$
conr.istent and positive
access to MSM
environments
Refusal by
GO/NGO
authorities to
participate
Activities to be
undertaken________
Time
frame
Assessment
Parameters
Risks
Yearly, as
per
project
cycle
Number of persons ■
provided skills
Documention for registration
prepared
CQO registed
NGOs not
willing to
iniatate
Inappropnate
members form
group_______
I
II.
HI
l
To promote formation of CBOs
Sub-Process
Implementor
Formation of
support groups
Inst resp
for Implim.
NGO functionary
Peers *
NGO
i
Skills training
ii.
iii.
iv.
i
Page.45.
No of Instrtutlon/NGOs that
have adapted themselves to
dealing with MSMs In their
special circumstances
t
:(
Meetings for consensus
Formation of care group
CBO formation
COMPONENT I
Subcompoment:-
MIGRANT WORKERS
Secondary Objectives :
PROTECTION PROGRAMME
1
workers in these situations
.Level of
Implement
State AIDS
Society
Process
establishment of
Terms of reference
for the study in
consultation with
migrant workers,
Industry
representatives,
trade unionists, the
labour department,
lawyers, activists ,
NGOs working with
AIDS
Sub-Process
_ 1
9
h
Karnataka leading to a
needs and vu|nerability of migrant
rirr^FernentorTlnst resp
Activities to be undertaken
for Implim.
RPlAT-Imn
selection,1 n!
of an
'
migrant workers
appropriate
research institution
Selected
Research
institution
i. •
ii
iii
iv.
i
vi.
vil.
I
viil
IX.
i
Page.46
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setting up of ToR
'
Identification of research institution
pilot study migrant labour-intensive
ndustries in the unorganised sector
In 1 district
analysis of findings
revision of ToR
Implementation of State study
presentation of findings and
recommendations to a Professional
Review Body
Publishing of report
Dissemination of report
Time
frame
Assessment
Parameters
Yrl
3-6mths
•
•
systematic district and
industry-wise mapping
of migrant labourintensive industries in
Karnataka
identification of needs
and vulnerabilities of
migrant workers,
especially women
Risks
lack of
Cooperation
from
management of
these industnes
researcher
insensrtn/rty to
migrant worker
realities
COMPONENT
I
Secondary Objectives :
2
i
To undertake district and city-specific Behaviour Change Communication
Strategies leading to the promotion of safe sex and STD treatment-seeking
behaviour amongst migrant workers
Level of
Implemen
Process
Sub-Process
Implementor
Inst resp
for Implim.
Activities to be undertaken
Time
frame
Assessment
Parameters_____
Risks
1 Migrant
worker
sites
Education
and
Promotion
of safe
behaviours
Inter-personal'
communication,
condom promotion
and health care
referrals
NGO
counsellor /
coordinator, field
staff, and .
Peer educators
NGO
concerned
i.
Yrl- YrS
Number of Counsellor /
co-ordinators trained
and working in field
lack of empathy
amongst staff
I
ii
in.
iv
v
vi
Recruitment of 1 Counsellor /
coordinator, 2 Held staff and 10 peer
educators to work with 250 migrant
workers
Training for NGO counsellor / co
ordinator, field staff and peer educators
Development and production of BCC
materials
Outreach travel for education
Condom transportation/storage and
distribution
STD education/referrals
Number of field
educators trained and
deployed
Number of peer
educators trained and
deployed
migrant worker-related
BCC materials
developed and
produced
Number of condoms
distributed and used
i
Number of migrant
workers counselled
Number accessing
STD services
Page 47
i
lack
of Peer
Educators
Peer
Educator
turnover
inconsistent
Condom supply
COMPONENT
I
Sub component: - WOMEN WORKERS
Secondary Objectives :
1
PROTECTION
programme
To undertake
unorganised
understanding of the
Level of
Implement’n
State AIDS
Society
Process
establishment
of Terms of
reference for
the study in
consultation
wrth women
workers.
Industry
representative
s. trade
unionists the
labour
department
lawyers,
women
activists
NGOs
working with
AIDS
........
SubProfcess
Identification
and
selection
an
appropriate
research
institution
implementor
R esearchers^
’■'•'omen workers
Inst resp
for
Implim,
Activities to be undertaken
rAssessmeiT
*frame
Selected
Research
institution
i.
ii
in
i
vni
ix
)
J
Page.48
I1
:l
G
f-
O
“
'—-
°f resear‘;h instilution
PM study women labour-intensive
unorganised sector
iv
v
vi
vii
I
i
setting up of T^R
4*
45*
analysis of finding:s
revision of ToR
implementation of State stud’
presentation of findings and '
recommendations to a Profess1Onal
Review Body
Publishing of report
Dissemination of report
Yrl
(3-6mths)
t
Risks
_ Parameters
•
I
I
i
I
I
i
I •
systematic district
and industry-wise
mapping of women
labour-intensive
industries in the
unorganised sector in
Karnataka
identification of needs
and vulnerabilities of
women workers
lack of
Cooperation
from
management
of these
industries
researcher
insensitivity
to woman
worker
realities
V ■
COMPONENT I
*
Secondary Objectives : 2
To understand and define mechanisms which reduce women’s vulnerability to sexual
harassment in the work place
Level of
Implement'n
Process
Sub-Process
Implementor
Inst
resp
for
Implim.
KSAPS
establishment of
Terms of
Reference for a
study to
understand and
define
mechanisms to
deal with sexual
harassment In
consuttation
with women
workers.
Industry
representatives,
trade unionists,
the labour
department,
lawyers, women
activists, .
NGOs working
with AIDS
Interventions
Identification and
selection of an
appropriate
research institution
Researchers,
committee
members
Selected
Research
Institution
II.
ili
Iv
vi.
vii.
vill
lx
I
Page. 49
Activities to be undertaken
setting up of ToR
identification of research Institution
literature survey
presentation of options to
committee members
operationalisation of recommended
mechanisms
piloting of mechanisms with
volunteer Industries
presentation of findings and
recommendations to a Professional
Review Body
Publishing of report
Training workshops to Implement
report recommendations
Time
frame
Yrl
Assessment
Parameters
identification of
existing legal,
social
mechanisms
understanding of
the use and
limitations of these
mechanisms
pilots undertaken
Trainings
undertaken
Risks
nonacceptance by
management
lack of support
and
understanding
from woman
workers
researcher
insensitivity to
women worker
I gender
realities
COMPONENT-
I
Sec^ary Objectives .
3
-
L^veToF^"
’rHplement'n
^en laboui
'^tensive
,ndU8trles In
the
uhorgarilse<l
sector
Process
°' '*ornen8LJPportive
^anlsrn at
»fiop floor lave.
-
Section
Sub-pjrocess
Inst reap
for
JOWn.
ma0agement/
3r,r”“
Participative
worker
'^sentatlves
Processes
NGO-------concerned
I.
Time
frame
n«W s^an^ 1 Coordinator. to
I
/V.
V
^ucatomP^r/repre6entatlve
/
Scc XanT 8nd produc,i°n of
O^reaS
^lerials
/
STD^catton/re°e™sCafjOn
/ 2tUrnber°f field
Number of
/
Risks
trained and wortrir,'nators
lack
’—v
field
^°hong in
/
of
management
“norganl8ed sect^^9 in the
i
HI
^S8es^77
parameter8
Yn- Yr5
^^^^^Pcatora to
ii.
n °f sexual
Workers jn the
ur women
^^presemanve
SSX1"’-™
I 'aCk
Support
of
Apathy
amongst staff
^al hurdles |n
following
up
sexual
harassment
cases
/
/
I Wort<ers coun,.^
I No of sexual
i
!5S2‘c"^<
p3ge.50
i
I1
J.
r
. ' -
S
’’
.
r e
;
»
*.
___ __
©
I
COMPONENT I
SUB COMPONENF: Truckers Awareness Program^
Basic Objectives : i. To Educate Truckers about IIIV/AIDS and remove misconception
2.
To Provide senice for prompt detection and treatment for STD/RTI
3.
Educate Truckers about proper use of condoms
4.
To pros ide condoms to I nickers Across the State free of cost.
Level of
Implementation
Process
Sub-Process
linplementer
State &. District
Identifv
NGOs
identify ZHAl .1
Points across
High wass
K1 \ P S/I).:A.P S
& NGO
I
In\ ilc proposals
from NGOs /
CBOs
Scrutinise
Proposals
5 l/>
GC
i
GT
Go
Instn.
Rcsp. For
Implm
NGOs /
CBOs
Activities To be
Undertaken
Time Frame
Identification ofNGOs
Identification of Halt
points
Training and recruitment
of stall by NGOs/CBOs
Providing STD services
along Highways
Pres iding Medicines and
condoms
Preparation of reinvent
I IT' material and conduct
Perodic training for staff
Y! to Y5
Assessment Parameters
Risks
Number of Truckers
contacted KAP Studies
among truckers
Truckers arc
mobile,
No change in
behaviour.
No followup
Number of Truckcrs
availing STD Sen ices
Number of STD
Service points
functional on Highways
Number of condom
supplied
Number of Truckers
reporting for folowup
"I
OG
f
I
J
COMPONENT I
Sub component:Basic Objectives:Level of
Implementation
KSAPS
DAPS
NGO
Substance Abuse
'
Process
INDENT 11 Y
NGOs
tot^tngc leading to
,
Sub
|) roc css
! Implementer
Fstabli^l]
j N(i()s
the need
----- 1
m
Disincis
DAPS
rcduclion of HIV/AIDS infection
Institution
Activities to be under taken
Responsible for
Implementation
NGO/
(’BO
Establish centrc/units across the
state
•
i
•
I
i
Page 52
' ,1
I
r- r.
Recruit train and employ staff
Provide medicine and
consol!ing services
I
i
Time
Frame
Mcntifv N(iOZ(TK ) responsible
I KSAPS
I
among abusers
Provide networking and rcfcral
services with other agencies
•
Provide (raining to other
agencies
•
Creating peer systom for
implementation
Mobilisation of Social support
Assessment Parameter | Risks
•
Y! to
Y5
No. of persons
•
availing sen ices JC
No. of NGO/CBO
units established & j
active.
Feed Back from
implementing
agencies about the
component
Recovery rate from
sub-stance abuse
and incidence of
safe sex behaviour
Involvement and
feed back from
positive people
Number of subjects
on follow up.
Rc lapse
Mas not
avail
sen ices
Cominunitx
insensitivity
Marginalisa
lion of
posi live
people
‘.V
COMPONENT - II
‘ Sub Component:Basic Objectives :
Level of
-Implementation
State Level
Process
Identify
Blood Banks
to provide
Blood
Component
sepcration
facilities at
State Level
& other
places
TARGETTED intervention
among low risk GROUP
B’ood safety programme.
Blood Con.ponent Seperatio/. Centre
To emphasize rational use Of blood.
Sub-Process
Implementer
Intiatc
procurement
procedure for
supply of
Equipments
and
Consumbalcs
K.S.A.P.S and
Major Hospital
Blood Banks
en
Identify
Technical
staff. Blood
Bank Officers
Technical
Assistants
Install
equipment to
make
functional
M^oTHospitaTTl^
* Pccurments of staff
& Medical
Training of Blood Bank
Colleges
Officers and Technicians
•
Supply of Consumables for
Component sepcration.
•
storage and distribution to
pcripharal centres.
•
Conduct tests for HIV and
other Blood borne
pathogens
Time
Frame
Y1 to Y5
AswssmeiirpI^^7T
•
Number of
Componant
sepcration carried
out.
•
j-
Page. 53
j
j.
•
Number Transfused.
•
Number Distributed
to peripheral centres
No. of Training
programmes
conducted and No.
trained.
Providing Training &
information on rational use
of Blood and Blood
products in the District.
i
No. of Units
collected
Number of HIV &
other infection
detected
Risks
Lack of
suppl ly of
consumables
on time.
COMPONENT II
: BLOOD SAFE! Y PROGRAMME
Sub Component:
ZONAL BLOOD I ESTING CENTRES
Basic Objectives:- To prevent HIV transmission thr?!lKh Blood
Level of
Implementation
State le\-el &
Regional Level
Process
Identify
Blood
Banks to
provide
Z.B.T.C
Facilities
Sub process
•
- To emphasise rational use of BLOOD
Implcmentcr
I
initiate
procedures for
supply of
Equipment and
■consumblcs
K.S.A.P.S&
Hospitals with
ZBTC Facility
Institution
Responsible for
Implementation
Major Hospitals
Activities to be under
taken
Statc/Dist./
Medical
colleges
•
Training of staff
•
Supply of
consumables
Recruit SUIT
To identify
Technical staff
Conduct tests for
HIV and other Blood
borne pathogens
I
Blood Bank
format to be
Supplied
Review activities of
Blood Banks linked
to ZBTCs both Govt,
and private Voluntaty
Blood
Banks
•
1
. .1;__
Page. 54
J
il
___
..
Time
Frame
Conduct Voluntary
blood donation
camps, collection /
storage/.
_
Y1 to
Y5
Assessment
Parameter
Risks
Number of
Units
collected
Lack of
supply of
consumables
on time.
Number of
Blood units
distributed
Number of
Blood Borne
disease
delected
Non-co
ordination of
private
Voluntary
Blood Banks
J
COMPONENT II
BLOOD SAI I Ia BROGRAMME
■S..b Compon,,,, - M„,iri„„ . ......... .
Basic Objeciivcs - lb
my
liansiuissioii through Blood-to
Lex el of
Im|)lementation
Process
I Sub process
Implementer
‘I
State Level &
District Lex el
Identify
Hospital to
- Provide
blood Bank
facilities at
State lev el
District Lexel
and
Block Lexel
places
Initiate
procurement
procedures for
supplx of
KSAPS&
Majo^/Dist
I lospital
ensure safe Blood transfussion
Institution
Activities to be under
Responsible for
taken
Implementation
Major/Dist7BhdT ?
Recruit StalT
Level Hospitals
•
Training of Blood
Bank officer /stafT
consumables
cquifxincnK
through Voluntary Blood donation
rime Frame
VI to Y5
Supply of
consumables/
equipments
•
Collection / storage
and distribution
•
Conduct Voluntan
Blood Donation
i
j
Lack of
supply
consumblcs
&
equipments
on time
Number of
voluntan
Blood
Donation
camps
conducted
Conduct tests for
HIV and other
Blood borne
pathogens
Page. 55
Number of
units
collected &
distributed
for
transfusion
Risks
Number of
Blood borne
diseases
detected
Camps
' ,1
Assessment
Parameter
!
__ L
COMPONENT 11
VOM M AIO TESTING AND COUNSELLING CENTRES.
Objective:Secondary
siiqj. mid
senses for HIV in each districi of'Kaniaiik-i
T To provide confidentialtE-’test
mg and coulftclling services
“-------------------- —1
Objectives
2.
3.
Level of
Implementation
Process
State Level
Establish
qualitative
HIV testing
and
counselling
facilities
&
District Level
To facilitate networking ol positive people in the districts
To supplement and strengthen S I l/RTI interventions
Subprocess
Mniplemcnter
Establish/
strengthen
District
laboratories
and
integrate
with Di
STl/RTI
• K S A PS
District
Volumaiv
testing team
Institution
Responsible
for
Implcmention
District
Hospital
’/Medical
Activities to be undertaken
I
College
I
2
3
4
sen ices
5
6
7
I
X.
10
Page 56
’ .1
i
j
Recruit and train VTC team
in testing and confidentiality
(I Medical Officer + I
technician)
Identify site for VTC Lab
(preferably within districi
hospital/ medical college
Adapt existing facilities
Equip the VTC Labs
Provide confidential testing
facilities
facilitate networking of
Positive people at district
level
provide trainings on
universal precautions for
HCWs
Provide appropriate referrals
Participate in Slate Quality
Assurance Programme
Develop and produce VTCspccific I EC materials
Time Frame
Assessment
parametres
Year I -Year 5
•
No of patients
tested
Yr I = It) Dts
Yr2
K) Dts
Yr3 = 5 Dis
Yr3-5 = 25 Dis
Operational
Services
mav not
•
No patients pre
test. post-test
counselled
•
No of Universal
Precautions
trainings held
Ik ‘
•
Assessment of
VTC quality and
confidentiality
though feed btick
from Positive
people
»
No of Positive
People groups
established
►
No of Positive
People facilitated to
access serv ices
Risks
accessed
uniform!)
space ma
not be
available
COMPONENT II
s
Sub
component: - I.E.( .
Basic Objectives
Level of
Implementation
Statc/Districts
and Blocks
INI’ORMATION; EDUC ATION
AND COMMUNICATION
I.
2- I o (lex clop positive mc;c,4iA
— —1 disseminate IIIV/A IDS
Sub process ,
Iniplcmcntcr
Process
materials for HIV/AIDS/STD
awareness
..........
j
____________________
Identify
a.
agencies
for
developing
IEC
materials
b
c
d
Identify agencies
for each Medias
(Print. Electronic
and Folk)
J,
KSAPS &
DAPS.
1
Time
Frame
Implementation
NGOs/CBOs
DHFWOs
I.
Cont.aclion
c\cvniton io
NG()/pn\ He
agencies
I
I
Yl to
Y5
Recruit IEC consultants
3.
Development of IEC
4.
Conduct training progi
rammes
for NGO/CBO
3. Feed back from
positive people
S
Distribution of materials
Broadcasting / Telecasting /
staging nodal activities
4. Number and type of
materials de\eloped
materials
6.
Contract material Dcxelopmcnt
7.
Field testing of materials
developed
8
Involve positive people
(PLVVHA) for awareness
9.
I
i
j
Plan lor KAP studies
2. Feed back from
communiu
■VNo. of district
committees and NGO
formed
6 No. of positive
people involved
7. No.of KAP studies
conducted.
activities
Page 57
1 Quality of material
developed
2.
Identify NGO
and other
partners
I ormation ol
stale <X: Dist
I c\el
Committees
m\ol\ ing. N( it )\
Set up committees state and
Dist. Level
Assessment
Parameter
------- - - ________
------ ---- -
Risks
-Fear based
messages
Misconception
-Lack of rcspons<
from /'NGOs /
public in the
Districts
COMPONENT II
SUB COMPONENT:- Characler buildinj;. Seuial Education and H1V/AIDS Awareness
Basic Objectives : - To Provide value educalidn to proinote Safer sexual behaviour among the adolescent and youth
Level of
Implementation
Stale & District
Process
Sub-Process
linplcnicntcr
Instn. Resp. For
Imp by
Training of
Teachers
acrosslhe
State
Conducting
training of
Teachers
I
NGOs / Trained ~
Teachers teams
•
K.S.A.P.S
NCiOs
Pro\ iding
curiculum
Educational
Institutions
I
Invohc NCi( )s
linohc
Education
Dept and
Institutions
I
Activities To be
Undertaken______
Identify NGOs for
Training Teachers
Time
Frame
Y1 to
Y5
AsscN.imen( Parameters
Number of Teachers
trained / No. of Schools
implementing
programme.
Incorporation of
curiculum into
school syllabus.
No. of peers involved.
No. of IEC materials
developed and
distributed
Promoting ParentTeachers. student Teachers activities.
•
Creating peer
system leading to
implimcntalion
Community out
reach.
Development of age.
Gender, target
specific kits for
implementation
(IEC material)
Page 58
i
i
I
■J
I
Type of Training
imparted
Undertake studies to
asses impact of training
(Sexual behaviour) &
Substance abuse.
l ypc of curricluation
Developed
Risks
a)
Misconsccptions
about HIV/AIDS
b)
Rigidity among
tcachcrs/Institution
c)
Resistance
to C hange
COMPONET III
SUB-COMPONET - Surveillance
OBJECTIVE-To
Ixwel of
Implcmention
State level
District level
asess trends of HIV infection Io plan for luture preventive strategies.
Process
Sub-
Plan HIV
Sentinel
Surveillance
in High risk
& low risk
groups
Procm •
Identify HIV
Sentinel
sites,
workout
budget
requirement
Implementors
Karnataka
Statc'AlDs
Prevention
Sociclv
i
Idcntih
testing ,
Laboratoris
Institutions responsible
for implcmentation
Major Hospitals. Disl
Hospilals.Mcdical
Colleges. Premier
Institutions.
Activities to be taken up
Idcntifysitcs with Higli Risk Groups & Low Risk
Group Population.
Provide equipments. Consumables to Sentinel
sites, and Testing Laboratories/ Visit to Sites.
Organise training to pcrsonel engaged in Sentinel
Surveillance work. Providing reporting formats
Methodology:- Following HIV Sentinel
Surveillance protocol of NACO with unlinked
unnonymous testing procedures, sample size of
250-400 for High Risk & 400 for low Risk group
for the period of 6 to 8 weeks
i
Analysis & feed Back:- Sruvcllancc reports to be
received immediately alter the survey.
Data interpretation & analysis.
Issue feed back
Follow up action:- To use data to plan for future
strategy for AIDS Prevention & Control
I
Pngc 59
Time
Frame
Y1 to
Y5
Two
rounds
of
Survey
in all
the HIV
Sentinel
sites
each
year.
Assessment
parameter
Frequent visit to
sites and
Testing
Laboratory and
supers ision of
work during the
survey
Trends of HIV
Prevalence in
different sites
and populations
groups.
Follow up
action
RISKS
1 Lack of
supervision
2. Delay in
Commence
mcnl
3. Lack of
interest by
staff in the
sites
4. Delay in
reporting
5. Absence
from work
COMPONENT HI
I
I
SUB COMPONENT: Programme management
Basic Objectives
To provide Technical and Management support for planning and implementation of AIDS control programme in karnataka state
Strenthenmg of Karnataka State AIDS Prevention Society.
Level of
Implementation
State Level bv
KSAPS
Process
Sub-Process
Implcmcntcr
Placement of
Staff &
Provision of
infrastructure
Identification
of posts and
creation of
posts.
K.A PS
I
Selection &.
Appointment
of staff as per
organogram b\
Deputation
from (lost X:
also by
contract mil
basis
Instn. Resp.
For Implm
KAPS /
DHS/
DME.
Activities To be Undertaken
Time
Frame
1)
Selection & appointment of
staff as per organogram
Number of staff in
position / Vacancy etc...
2)
Training of Staff
Number of staff Trained
3)
Purchase of office furniture
and office Equipment (one
time)
4)
Purchase of vehicle & POL
maintenance
Yl to Y5
5)
Telephone, Fax, E-mail '
Computer, etc., procurement /
installation
6)
Preparation of Annual action
plan & Budgeting etc..
I
Page. 60
I
Assessment Parameters
!
Vcihiclc / furniture /
equipment purchased .
installed and made
functional
Physical tragets and
financial tragets and
achievements as per
implementation plan
Risks
Lack of
dedication and
timely
attention and
action by staff
( Both
Technical and
managerial
staff)
COMPONENT-III
SUB COMPONENT -
PROGKAMMF MANAGEMENT/establishement
Basic objectives:- To decentralise the proeps:
>
I
Level of
Implementation
District lex cl
Process
Set up
District
level
Society
Sub process
Rianna and implementing AIDS Control Aetivitie, in High HIV Prevalent District,
linplcmcnter
Registration
of District
Socicis
DlStlKl
Deputy
*!
( oininissioncr/
DAPS
Institution
Responsible for
_! mjil cm c n t a t i on
Di st. Deputy
Commissioner /
DAPS
Activities to be under taken
•
Time
Frame
Prepare Bye-1 a us and Register
the Socict\
•
Appointment of project
Director
Mamber / Secretary and others.
•
payment of Honorarium
•
1
Placement &
training of
stafT
OF DISTRICT LEVEL AIDS PREVENTION SOCIETIES ( DAPS )
Yl
Y5
Yl to
Y5
Training of stafT
Yl
•
Prepare plan for specific
activities
Yl
toY5
I
!
Page <>l
Number of staff
Trained
Yl to
Meet POL & Travel cost
/Contingency Expcnces
I
Number of staff in
position/Vacancy
etc..
Yl
•Selection of Secretarial
assistance staff and pa\ ment of
Honorarium
I
Assessment Parameter
•
Risks
Frequent
Transfer of
Deputy
Commissionc
as they arc
IAS officers
Vchiclc/fumiturc/
Equipment
Purchased
Installed and
Lack of
competent
staff
made functional
Lack of
response b\
NGOs and
other Depts..
Physical targets
and financial
targets and
achievements
( OMPONENT - III
Programme Management
Subcomponent: Inter Departmental
Basic objective
Level of
Implementation
Director AIDS
Prevention
Society in 6
Districts.
< o oi (liantjon
To hate a ( iniidinated
Process
response to IIIV/AIDS Prevention A Control.
Sub-Process
Implementer
I
Formation
of District
AIDS
Prevention
Committee
Qualit) rexicu
meeting
District level
sociciv/committcc
& NGOs
Institution
Responsible for
JlTJlIP/pcntaiion
District levlel
socicty/committcc
Activities To Be
Undertaken
Women & Child
Development
Deportment
J
I
I
I
NGO Co-ordination &
.specific activitcs to be
taking .
Formation of District
I
committee other
Deportments & NGOs
Time
Frame
V I to
Assessment
Risks
Parameters
Selection
performation
indicotors
l.ack of
participating
in the
meeting
Review of MIS.
Lack of coordinationg
among oilier
Deportment
& NGOs
J
I
Page.62
1 I
i
■i
i
*
COMPONENT III
Subcomponent:- Programme management
BASIC OBJECTIVES: To have effective DATA on Management of AIDS CONTROL PROGRAMME
Level of
Implementation
Karnataka State
AIDS Prevention
Society
Process
Development
and
implementation
of management
information
system
Sub process
I
Identify and select
priority areas for MIS
such as reporting;
formats of
I STD Clinic
2 Condom issued
3 Blood Banks
4 Scro-Snrvcillancc
re|X)rt
5 Sentinel
i
Sun oil lance ■
report
AIDS Case
Sun cil lance
report
x
9
NGO formal
f raining
L \pcndihiie
MMR
' I1
Page. 63
I
;<
[ Implementor
Project Director
KSAPS/Tcchni
cal officers
Institution
Responsible for
Implementation
Karnataka State
AIDS Prevention
Society
Activities to be
under taken
Time
Prepare reporting
formats
Yi to Y5
Print and supply
Analysis of
reports and
remarks, feed
back
To mcc^
contingency and
Office expenses.
Frame
Assessment
Parameter
Risks
Number of MIS
formats received
Mo n th ly/Quarter ly
Reviews taken up
Incomplete
reports
Feed Back reports sent
Delay in
submission
/receipts of
reporting
formats
COMPONENT III
7'^
Subcomponent:- Programme management, Monitoring & Evaluation
Objective:- To assess Progress/ Impact of the implementation of various activities on AIDS Prevention & Control.
■I-—. —----------- -- --------------
Level of
Implementation
State level
Regional
Level.
Process
Sub process
Study of
process and
impact
evaluation
•
Set-up
internal
evaluation
sub
committee
Institution Responsible for
Implementation_________
• Karnataka state AIDS
Prevention society.
|lmplcmerttcr
Karnataka
Stale AIDS
Prevention
Society
Independent evaluation
agency & Rcscrch
Institution.
I
Idcntifj
independe
nt external
Agency to
lake up
evaluation
I
Activities to be under
taken______________
• Review of activities by
Technical Officers of
K.S.A.P.S. and
Review of Activities
records, Registers al
KSAPSZ Field level
Centres/ NGO
activities by Extcnial
independent
evaluation Agency
Review of reports.
Time
Frame
• End of
Y2 &
End of
each
year
from
Y2 to
Y5
Assessment
Parameter
• Number of
Evaluation
study takenup.
Number of
Review
meeting on
Evaluation
report and
Action taken.
Follow-up
measures.
Monitoring of
Performance
Indicators.
Page. 64
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Risks
Lack of
Competency to
take up
evaluation work
Cost factor and
Timely
completion of
evaluation by
cxleranal
independent
evaluation
Agency.
It may be
difficult to
assess impact in
First 2 years.
COMPONENT ! 11
SUB COMPONENT - TRAINING
Management
Level of
Implementation
State level.
Regional level.
District level.
Proccs
Organise &
Conduct
Training
Programme
5k,"S
"’C S'-ffOn A'DS Prevc'lti'’n and Control including STI) control/AIDS Case Diagnosis and
Sub proce.s.se.s
Implementor
Identfv
Institution to
conduct
Training
Karnataka
state AIDS
Prevention
Societx
Institution Responsible
_ Jor Implementation
I
Procurement
of Training
Materials.
Modules.
Printing and
suppl)
Karnataka Slate
AIDS Prevention
Socicty/NIMHANS/
Medical
collcgcs/Hcalth
&FW Training
Centres.
Activities to be under
taken__________
•
•
•.
VI lo Y3
•
Identify Category of
staff to lx? trained
Refresher
Training
I
J
Pre-test Post-test
Questionair during
training session
Number of visits by
officers of KSAPS &
TOTs Core-Members
during training
session
in Y4
Workout number to
lx? trained &
Number of Balches
to be trained
No. of session to be
taken up
•
Work-oul Budge!
Issue directions for
holding training
session and
Deputation order /
Circular
Page 65
Training load to be
assessed
Identify target group
for training
District Training
Teams
Slate l.cscl/ Disi
Level and
Regional Level
Assessment Parameter
Prepare Training
schedules
•
LHV/ANM Training
Centres.
Prepare
training
schedule &
guidelines
Time
Frame
•
•
Number of training
dun ng each year
No. of training
session held for each
year &. No. of
catcgon' trained.
Number of refresher
training session
conducted
Number trained
catcgon wise.
Risks
Lack of
avalability of
Training
modules in time
Lack of
Participation of
core trainers
Lack of
participation b\
trainees
Lack of
Coordination b\
training centre
COMPONENT
IV
LOW COST COMMUNITY CARE
Secondary Objectives :
1
CENTRE / CARE AND SUPPORT.
isychosiciarcale aZ^^^T'03 t0
mediCal, nursing and
=—
Level of
Implement’n
Process
State AIDS
Society/NGOs
esybalish HIVspecific services
Sub-Process
establish district
training and
extension services
implementor
District C&S team
I
Inst resp
for Implim.
Activities to be undertaken
KSAPS/
NGOs
i.
ii
III.
iv.
v.
vi.
vii
recruit and train 1 coordinator +1
counsellor +1 nurse +1 community
worker team to manage 64
PLWHAs/week (10 clinic ♦ 24 home
based ♦ 20 hospital outreach + 10
respite) +1 nurse + 2 care assts + 1
house parent +1 cook as hospice
staff
psychosocial and emotional support
nursing support
medicine support
out-patient facility
tertiary (hospital) links
hospice
viii. community, material and financial
support
ix.
x.
I
Page.66
' J
referrals as necessary
Planning and Training services for
other care providers
Time
frame
Assess
ment
Parameters
Risks
Yr1-Yr5
•
lack of
interest from
management
of existing
health
services
•
•
»
•
establishment of
district units
provision of
package of
services
no of PLWHAs
supported and
followed up
Planning and
training
sessions held
no of other care
facilities
supported in the
district
referral links
established
existing policy
emphasis on
prevention
may lead to
lower priority
tor care
COMPONENT IV
Secondary Objectives : 2
to deal with the effects of
Level of
Implement’n
NGOs
PLWHAs
and
Process
establishment
of self help
groups
Sub-Process
motivating and
identifying suitable
motivated PLWHAs
willing to take
responsibility
Implementor
PLWHAs
I
Inst reap
for
Impiim.
Activities to be undertaken
NGO
I.
ii.
group formation
physical space and conducive
environment for group meetings
Hi. group facilitation
Iv. sharing and emotional support
v.
Identification of PLWHA Issues
VI. resolution of PLWHA problems
vii. represntatlon of PLWHA Issues
vlii. education on Positive Living
ix. institutional funding for SHG
programmes
1
Time
frame
Assessment
Parameters
Yr1-Yr5
No of SHGs
formed
No PLWHAa
members
mutual
support
issues
Identified
issues
resolved
Issues
represented
programmes
undertaken
links wfth
network of
positive
people
1
i..
Page. 67
Risks
lack of
participation
loss of
confidentiality
Incompatibility
hostility from
larger society
Component
- V :
Inter Sectoral Collnboratidh
Sub Component: - Inter Departmental Co-ordination (Govt, and Public Sector)
Basic Objectives:- Two sort out specifijp issues and to co-ordinate implementation activities
Level of
Implementation
Process
Slate Level &
District Level
Formation of Slate
Level and Dist.
Level Committees
Sub process
Implementation
Identify Depts /
Public sector,
under taking.
education. Urban
Development.
Social Welfare.
Labour. Women
8: Child
Development.
NGOS./HAI..
IIT. BEL. H I
HMT.BEML
BHEL. NGEF
L&T industries &
factories etc
Project Director
K.S.APS&
officers.
Projects Director
D.A.Pi.S.
Officers
Institution
Responsible for
Implementation
Activities to be
under taken
Setting up the
/committees
Involve
positive
people
KSAPS
&
DAPS
•
Quarterly
meeting.
Review the
issues,
follow-up
action.
Address for
co-ordiantion
of each sector
to implement
the required
activities
Page. 68
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I
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Time Frame
Yl to Y5
Assessment
Parameter
Risks
Number of
review
meeting held
in each year
Absence of
Members of
the
Committee
Feed Back
from positive
people
Lack of Co
ordination
Action taken
on each
meeting out
come
Number of
specific
issues
resolved.
Delay in
timely
action.
;■
»«
L
(
V
(
f
(
t
ANNEXl'RE n
BUDGET
i.
i
DETAILS
KSAPS
PIP
PHASE II AIE£ CONTROL PROJECT '1999 - 2004
KARNATAKA
TOTAL SUMMARY
Rs. In Millions
YEAR 2
YEAR 3
YEAR 4
YEAR 5
TOTAL
IC
RC
54.712
73.790
80.437
67.505
64.911
341.355
337.665
3.690
55.540
47.277
45.876
233.662
187.967
45.695
YEAR
COMPONENT
I
1
I
COMPONENT
II
31.843
53.126
COMPONENT
III
46.979
48.917
35.301
30.735
25.556
187.488
137.288
50.200
COMPONENT
IV
17.061
22.943
31.329
29.147
28.769
129.249
125.249
4.000
COMPONENT
V
8.195
11.570
12.590
10.742
10.503
53.600
47.800
5.800
TOTAL
158.790
210.346
215.197
185.406
175.615
945.354
835.969
109.385
PERCENTAGE
16.80
22.25
22.76
19.61
18.58
100%
88.42
11.58
i
09
to
KSAPS PIP
PHASE II AIDS CONTROL PROJECT
1999 - 2004
KARNATAKA
TOTAL SUMMARY
Rs. In lakhs
YEAR 1
COMPONENT
COMPONENT
COMPONENT
COMPONENT
COMPONENT
TOTAL
PERCENTAGE
I
II
III
IV
V
547.12
318.43
469.79
170.61
81.95
1587.90
16.80
YEAR 2
•YEAR i 3
p7.90
804.37
531.26
555.40
489.17
353.01
YEAR 4
YEAR 5
TOTAL
IC
RC
675.05
649.11
3413.55
3376.65
36.90
458.76
2336.62
1879.67
456.95
307.35
255.56
1874.88
1372.88
502.00
291.47
287.69
1292.49
1252.49
40.00
105.03
536.00
478.00
58.00
1756.15
9453.54
8359.69
1093.85
18.58
100%
88.42
11.58
472.77
'lt
229.43
313.29
115.70
h25.90
2103.46
2151.97
22.25
22.76
i
O
i
t
I
i
•J
107.42
1854.06
19.61
I
I
i
Position: 1294 (4 views)