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RANKING SOUTH AFRICANIGERIAINDIAKENYATANZANIA

NATIONAL AIDS CONTROL PROGRAMME (1987)GOALS:80% coverage of high risk groups90% coverage of schools and colleges by education80% awareness among rural populationReduction of transmission through blood to less than 1%Establishment of at least 1 voluntary testing counseling centre for every districtReduction of mother to child transmissionAchieving zero level increase of HIV/AIDS new infections by the year 2007.

PROGRAMME DETAILS:NACP PHASE I(1992-1999)

THE GOVERNMENT OF INDIA LAUNCHED A HIV/AIDS CONTROL PROJECT ( PHASE I ) FROM 1992 1999.100% CENTRALLY SPONSORED PROJECT FOR ALL STATES.

PROJECT OBJECTIVES:INVOLVE ALL STATES IN PREVENTION ACTIVITIES.ATTAIN SATISFACTORY LEVEL OF PUBLIC AWARENESS.DEVELOP HEALTH PROMOTION INTERVENTIONS AMONG RISK BEHAVIOUR GROUPS.BLOOD SCREENING.DECREASE THE PRACTICE OF PROFESSIONAL BLOOD DONATIONS.

IN 1992 THE MINISTRY OF HEALTH AND FAMILY WELFARE SETUP A NATIONAL AIDS CONTROL ORGANIZATION (NACO) .

A SEPARATE WING TO IMPLEMENT AND MONITOR THE VARIOUS ACTIVITIES OF THE AIDS CONTROL PROGRAMME.

ACTIVITIES OF NACO:PROMOTION OF CONDOMTREATMENT FOR STDPREVENTION OF MOTHER TO CHILD TRANSMISSION.VCTC SERVICES.ACCESS OF SAFE BLOOD.TREATMENT OF OPPURTUNISTIC INFECTIONS.ART.

BLOOD SAFETY POLICY

OBJECTIVESTO ENSURE ORGANIZED BLOOD BANKING SERVICESTO EDUCATE AND MOTIVATE PEOPLE ABOUT VOLUNTARY BLOOD DONATIONTO ENFORCE QUALITY CONTROL OF BLOOD BEFORE INFUSION

BLOOD TRANSFUSION COUNCILS SET UP AT NATIONAL AND STATE LEVEL.ONLY LICENSED BLOOD BANKS ARE PERMITTED TO OPERATE.ENSURE SAFE BLOOD COLLECTION AND STORAGE.TESTING OF EVERY UNIT OF BLOOD IS MANDATORY FOR DETECTING INFECTIONS.

ESTABLISHED BLOOD STORAGE CENTRES AT FRUS.VOLUNTRY BLOOD DONATION IS ENCOURAGED.ZONAL BLOOD TESTING CENTRES HAVE BEEN ESTABLISHED.HIV TEST KITS ARE SUPPLIED UPTO DISTRICT LEVEL BLOOD BANKS.

ACHIEVEMENT OF PHASE IAWARENESS LEVEL INSIGNIFICANT IN URBAN AND RURAL AREAS.URBAN : 70 80% RURAL 30%

NACPPHASE II(1999-2006)

AIMS OF PHASE II (1999-2006):TO SHIFT THE FOCUS FROM RAISING AWRENESS TO CHANGING BEHAVIOUR THROUGH INTERVENTIONS.PROGRAMME DELIVERY SHOULD BE FLEXIBLE, EVIDENCE BASED AND PARTICIPATORY.SUPPORT DECENTRALIZATION.ENCOURAGING VOLUNTRY COUNCELLING AND TESTING INSTEAD OF MANDATORYTO ENCOURAGE MANAGEMENT REFORMS (DRUGS AND EQUIPMENTS)

OBJECTIVESTO PREVENT FURTHER TRANSMISSION OF HIVTO DECREASE THE MORBIDITY AND MORTALITY ASSOCIATED WITH HIV INFECTION.TO MINIMIZE THE SOCIO-ECONOMIC IMPACT RESULTING FROM HIV INFECTION.

PROGRAMME STRATEGIES

1. NATIONAL AIDS PREVENTION & CONTROL POLICYIN APRIL 2002 GOVT.OF.INDIA APPROVED THE NATIONAL AIDS PREVENTION AND CONTROL POLICY.OBJECTIVESZERO TRANSMISSION RATEPREVENT FURTHER SPREAD OF THE DISEASE.IMPROVE SERVICES FOR PLWA.

CARE OF PLWAProtection of their rightsProper care and support in the hospitals and communityKeeping confidentialityFormation of self help groupsEncouragement for the participation of NGOSensitization of medical and Para medical peopleProper counseling of HIV positive mothersClinical management of HIV/AIDS

2. STI TREATMENTThe objective is to reduce STI s and there by control HIV transmission and to prevent morbidity and mortality due to STIsDevelopment of adequate and effective managementPromoting IEC activitiesComprehensive care managementIncreasing access to health care by creating new structures

2. COUNCILLING AND TESTING

Early detection of HIV by rapid diagnostic tests.Providing basic information on modes of transmission and prevention of HIV/AIDSLinking people with other HIV prevention , care and treatment services.

4. CONDOM PROMOTION

Sensitizing the clients and CSW to use condomsAvailability of low cost and good qualityGOAL:QUALITY CONTROL OF CONDOMSSOCIAL MARKETING OF CONDOMSINVOLVEMENT OF NGOS AND PRIVATE ORGANIZATIONS.

5. HIV SURVEILLANCEDIFFERENT TYPE OF SURVEILLANCE ACTIVITIES ARE CARRIED OUT TO IDENTIFY THE CASES.HIV SENTINEL SURVEILLANCE, STD SURVEILLANCE, AIDS CASE SURVEILLANCE etc

SENTINEL SURVEILLANCEMONITOR THE TRENDS OF HIV INFECTION.REGULAR SURVEILLANCE IN 1200 SENTINEL SITES.TARGET POPULATION15-45 YEARS, ANC MOTHERS, C.S.W ETC

6. TARGET INTERVENTIONS

7. SCHOOL AIDS AWARNESS PROGRAMME

8. IEC ACTIVITIES

RED RIBBON EXPRESSRED RIBBON CLUB IN SCHOOLS AND COLLEGES.ADOLESCENT HEALTH EDUCATION PROGRAMME.BEHAVIOUR CHANGE COMMUNICATION (BCC)MASS MEDIA INVOLVEMENT.

9. FAMILY HEALTH AWARENESS CAMPAIGN ( FHAC )PERIOD OF CAMPAIGN IS OF 15 DAYS AND DAYS ARE DECIDED BY THE STATES AS PER THEIR CONVENIENCE.MAINLY ADDRESSING THE REPRODUCTIVE HEALTH.

10. PREVENTION OF MOTHER TO CHILD TRANSMISSION (PMTCT)

Among 100 HIV positive women:5 to 10 infants will be infected during pregnancy10 to 20 infants will be infected during labor and delivery20 to 30 infants will be infected during breast feeding

NEVIRAPINE SINGLE DOSE TO MOTHER AND CHILD HAS BEEN STARTED FROM OCTOBER 2001.REFERAL TO PPTCT CENTRES.MODIFIED MIDWIFERY PRACTICES.SAFE INFANT FEEDING.FAMILY PLANNING SERVICES.

11.POST EXPOSURE PROPHYLAXSIS

POST-EXPOSURE PROPHYLAXIS SHOULD BE GIVEN WITHIN FOUR HOURS.THE COMBINATION OF ANTIRETROVIRAL DRUGS, ZIDOVUDINE (AZT), LAMIVUDINE (3TC), AND INDINAVIR.FOLLOW-UP OF AN HIV EXPOSED FOR 1 YEAR FOR SEROLOGICAL INVESTIGATIONS.

12. NATIONAL AIDS HELPLINE

TOLL FREE NO 1097INFORMATION AND COUNSELLING SERVICES.

PHASE III (2007 2012)GOAL:HALT AND REVERSE THE EPIDEMICS OF HIV IN INDIA OVER THE NEXT FIVE YEARS BY INTEGRATING PROGRAMMES FOR PREVENTION CARE, SUPPORT AND TREATMENT.

PROGRAMME STRATEGYPrevention of new infections in high risk groupsProphylactic treatment for HIV infected people to prevent opportunistic infectionsProviding greater care and support PLWHAStrengthening infrastructure developmentNation wide HMIS

PHASE IV (2012 2017)

Funded by global fund fight against HIV/AIDS and world bank.Main focus on: transgenderPrevention of new infectionsPPTCTReducing social stigma

PROGRAMME STRATEGIESPromotion of female condomsScaling up of second line drugs in ARTSocial protection for ending discrimination

ANTI RETROVIRAL TREATMENTHAART:CD4 CELL COUNT< 350ZIDOVUDINE 500 mgTENOFOVIR 300 mgRITONAVIR 600 mgNEVIRAPINE 200 mg

PROGRAMME ACHIEVEMENTAnnual HIV infection rate reduced up to 57%

In 2000 HIV infection rate : 2,74,000In 2011 HIV Infection rate : 1,16,000

Prevalence rate of HIV in 2000 : 0.41%Prevalence rate of HIV in 2011 : 0.27%

WORLD AIDS DAY THEME (DEC.1)GETTING TO ZERO

ZERO NEW HIV INFECTIONSZERO DISCRIMINATIONZERO AIDS RELATED DEATHS

Organizational pattern:NACOSTATE AIDS CONTROL SOCIETYDISTRICT SOCIETYICTC

ROLE OF NURSE