Breaking the chain of transmission Beean K, 12 th July UNICEF,
India
Slide 2
Brief context Good News: Reduction of over all new infections
national level by 56% Efficacious Multidrug regimen for prevention
of Mother to Child Transmission (MTCT) MTCT lees than 1%
_________________________________________ Andhra Pradesh contribute
to 20% of new infection 50% in age group 15-49, 39% women People
living with HIV in AP : 520000 Annual coverage : 70% and detecting
50% of estimated new infection Of every 100 children born in India
4.4 will die before their first birthday. untreated HIV infected
child may not 1 st Birthday
Slide 3
Work Done So Far & moving towards elimination goal PPTCT :
UNICEF key partner Early 2000 : PPTCT prog developed 2012 :
Government of India roll out efficacious multi drug for prevention
of Parent to child transmission of HIV in Andhra and Karnataka
2011-12 : 8-12 % infection among children born to infected mother
Where to by 2015 less than 5% MTCT !
Slide 4
Social Norm perspective An opportunity to strengthen MTCT in
India Health care providers discriminate Health care providers
refuse to provide treatment All people living with HIV are not
taking treatment and are still alive All children born to HIV
infected mothers are not infected with HIV Death is inevitable, so
why take treatment It is unsafe to treat infected women Loose
clients Social norm perspective has not been taken in to
consideration while MTCT programme planning, assessment or
interventions
Slide 5
Social Norm perspective An opportunity to strengthen MTCT in
India HIV infected women think that health care providers expect
them not to access services 1.Health care providers factual belief
of their safety 2.Moral judgment and attitude towards the infected
women among health care providers 3.Womens understanding of right
to life and dignity Schema: Infected women have low moral values,
no right to dignity HIV infected women do not seek health care
Health care providers refuse treatment Women do not others doing it
Do not think other women expect then to go There is a sanction to
the behavior.
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Engaging Professional bodies, Health care workers motivation,
commitment Trust relationship Integrating with Adolescent programme
and RCH Call to Action & MARPU Private partnerships, other
stakeholder Engagement at community level Leveraging Net work of
People living with HIV Existing programme+ Call to Action Strategic
Approaches
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Assessment Reference network- network analysis Comprehensive
activities for sustaining change and reporting framework Strategic
intervention Value deliberation Value deliberation discussion
forums to facilitate dialogue what is envisaged and collaboration,
trust relations, Structured, guided diffusion individual level,
groups- District to state including private sector
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Sufficient number of women believing in seeking health for
themselves and keeping their children HIV free Critical mass of
Health care professionals become change agents
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Social Network Analysis network mapping and social network
analysis needed. A another women living with HIV, a friend, high
degree node with the strongest tie Trusted professional collegaue,
senior mentor strong tie Community Health care workers bridge
between networks Counsellors can be a bridge
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How change may occur Based on assessment and social network
analysis identify referral groups, core group Professional bodies,
Union, net work of positive women, women group Identify a
influential and trusted person within core group who is trained or
can be trained Facilitate value deliberations Understand
interdepended issues, unseen behaviors and bring in a collective
understanding - willingness to change Bring the enabling
environment through correct information, knowledge, strengthening
social ties Trigger the power with in and facilitate diffusion
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How to sustain change Organize periodic deliberations continue
dialogue Recognize positive trend setters _ client friendly
Hospital, model mother Facilitate advocacy to tackle issues beyond
the norms access, supply Create an Excitement around Elimination :
Track progress and announce Loudly Enhance communication activity
at all levels as appropriate conferences, media, Television, radio
National trend setter to break the chain of transmission
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Organized Diffusion Small scale in group, individual to higher
level district state and story for country.. amplifying Creation
common knowledge discussions in homogeneous group, separate groups
Women, health workers to community Common goal There will be a
national environment translating to support the process Declaration
of the commitment Organized Diffusion- to others Sustain through
commitment amplify, sustain success story