PPTCT NEWSLETTER. Learn As You Go. In This Issue: Going Cellular Pg.2. Red Ribbon Express Goes to Tamil Nadu..Pg. 2. Beyond Boundaries...Pg.

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1 in PPTCT Newsletter April- May- June 2012 Issue GFATM RCC-II Learn As You Go Monitoring and Evaluation PPTCT April- May- June 2012 Issue GFATM RCC-II NEWSLETTER A Quarterly Publication of the activities and updates of the Prevention of Parent to Child Transmission (PPTCT) Programme implemented by IL&FS ETS for Global Fund. Monitoring and evaluation is one of the fundamental ingredients for measuring the success of a programme. It helps in strengthening the programme, assists in building strategy, and stimulates partnership, thus bringing accountability, transparency and effectiveness into the programme. This system cannot be perceived as the means for controlling alone but for learning as well. The PR has been carrying out various activities under this programme conducting regular visits, collecting and analyzing monthly reports, collecting quarterly financial reports, regularly meeting with stakeholders, periodically evaluating SRs by third party and very soon would be conducting independent audits for all SRs. All these activities conducted are supportive in nature where during the feedback session improvements are suggested for further strengthening the existing systems at the SR and recommendations are made for building a new system, if needed. The IL&FS ETS central team interacting with the Outreach Workers of an NGO in Bihar during its M&E visit The IL&FS ETS central team checking registers of an NGO during an M&E visit The outcome of these monitoring and evaluation activities not only gains the faith of the various stakeholders but also clarifies and refines the ultimate goal of the programme to all implementing entities. It plays a crucial role in today s environment in the light of failure by many organizations to match the funder s expectations. Thus, we collectively, the PR, all SRs, Project Coordinators and Counselors, need to proactively monitor and evaluate to achieve at least the intended impact and simultaneously strive to achieve beyond it. To do this, counselors and project coordinators need to visit the Outreach Workers under them regularly at the ICTCs, review performance along with the concerned DAPCUs, resolve issues immediately, plan and manage programme activities, provide feedback on performance of Outreach Workers, promote learning from lessons learnt. The SR head should periodically check performances and provide the necessary guidance in the intended directions to bring in efficiencies in the programme. These integrative monitoring and evaluation activities would achieve our goal thereby helping us to move on to newer areas requiring interventions. ~ Soosa George In This Issue: Going Cellular Pg.2 Red Ribbon Express Goes to Tamil Nadu..Pg. 2 Beyond Boundaries...Pg. 3 Outreach Workers SPEAK Pg 3 Whispers of a Foetus...Pg.5

2 Going Cellular! Outreach Workers make a difference one click at a time using mobile phones to track HIV positive pregnant women The PPTCT - Health Monitoring and Management System (PHMMS) application, the brainchild of IL&FS ETS has made it possible to capture data of HIV positive pregnant women and mothers and generate Resource person assisting Outreach Workers during the P-HMMS training in the State of Manipur alerts on a real time basis. The roll out of the program so far has seen the use of this application in three States namely; Gujarat, Tamil Nadu and Manipur. Training of the P-HMMS application has been initiated in Andhra Pradesh in this quarter. As of 30 th June 2012, there are a total of 659 users of the application (including Andhra Pradesh) who are thoroughly trained by IL&FS ETS. Other States are following suit to start the process. The training programme for the new States is going to take place in the following quarter. The phase wise roll out of the usage of this application expects to see PAN India coverage by the end of this year. This will ensure that there are no data misinterpretations in the reporting as data is captured at real time as opposed to the manual entry which is currently being followed. ~Shiroi Lily Shaiza Outreach Workers in Chennai during the P-HMMS Training The Red Ribbon Express goes to Tamil Nadu From way up north to far down south, the Red Ribbon Express, the train with the mission to spread awareness on HIV and AIDS finds its way to Tamil Nadu In the month of May 2012, the RED RIBBON EXPRESS travelled its way to Tamil Nadu starting from Kanyakumari on 9 th May 2012 and ended in Chennai on 28 th May The PPTCT staff got the rare opportunity to participate and get involved in this showcase event. With the support of IL&FS ETS, the PPTCT Outreach Workers with the Sub Recipients; SIAAP, Mass Action Trust in Thiruvallur district, Mithras Foundation & CHES from Chennai district, Blossom Trust (Kancheepuram district) participated in the grand event. The event was planned along with Tamil Nadu State AIDS Control Society and District AIDS Prevention and Control Unit (DAPCU). The main objective was to conduct a Rally and distribution of pamphlets by the Outreach Workers in their region as the train passed SIAAP NGO motivates people to participate in the puzzle game on HIV/AIDS their respective regions. The Outreach Workers mobilized the public to visit the train to get knowledge about HIV and AIDS and also get free testing. More than 1, 50,000 people participated in the Red Ribbon Express in Tamil Nadu. Around 100 stalls were put up by TANSACS and NGOs on behalf of Health Department during the event. PPTCT NGOs like SIAAP and Blossom Trust conducted innovative methods of spreading the message on HIV infection through participatory puzzle with questions & answers. Other PPTCT NGOs displayed the hoardings, banners regarding HIV/AIDS, distributed pamphlets and explained their activities to the viewers. Meera Foundation NGO encourages people to visit their stall while the train was on the way to Dindigul.

3 Beyond Boundaries COVER AGE Outreach Workers A heartwarming tale about how a woman was able to deliver her baby and receive support on time despite geographical boundaries. This is the case of Rashmi (Name Changed) from Ahmedabad who was tested positive in Chandlodia UHC (Ahmedabad). Rashmi s Estimated Date of Delivery was on 25 th May 2012 so she proceeded to her native place in TUN, Lasaria Panchayat, falling under Udaipur district of Rajasthan to deliver her baby. Chandlodia center's Outreach Worker Sangitaben had counseled her before leaving for Kun. Her husband was ready to go to Kun with Nevirapine tablet as they did not want to disclose her status. However, at the last moment he stopped receiving the call. After a few months, the Outreach Worker received a call on 14 th May 2012 that she has delivered a baby at 7:10 AM at Primary Health Centre Kun. The Outreach Worker informed the counselor Ms. Heena (M&E officer at Ahmedabad Municipal AIDS control society). Ms. Heena discussed this issue with State Coordinator of Gujarat IL&FS ETS who gave the contact number of the State Coordinator of Rajasthan. The Counsellor and District Coordinator of PPTCT - Ahmedabad District spoke to the Rajasthan State Coordinator. It was already 2:00 PM, and the mother still had not received Nevirapine. The State Coordinator of Rajasthan then spoke to Dr. Jyoti Meena, who supervised the delivery and got to know where the location was and how help could be given. On 19th May 2012, AM, an Antenatal Care (ANC) client was referred to Sion Hospital from Savitribai M Home in Bhandup Ward, Mumbai. A PPTCT Outreach Worker was assigned to assist the client to the hospital. However on reaching the hospital, the doctors did not agree to admit the client when they learnt of her HIV status. This matter was swiftly conveyed to the State Coordinator of Mumbai who spoke to the Joint Director of Mumbai District AIDS Contol Society (MDACS) Dr. Dilip Kadam. After his intervention, the doctors agreed to admit her. After the doctor s observation, it was found that there was a Though, KUN is in Udaipur bordering Pratapgarh district which is around 100 or more kilometers from Udaipur. It has no coverage of the PPTCT program, the State Coordinator of Rajasthan took the call of extending the support to Rashmi. Mr. Yogendra, Udaipur District Coordinator was asked to talk to the Outreach Workers in Udaipur for their availability but unfortunately all of them were on the field. Mr. Yogendra then spoke to District AIDS Prevention and Control Unit (DAPCU) and made them aware on this. Following this, the State Coordinator directed the District Coordinator to collect Neverapine and proceed to the concerned location to deliver the Nevirapine, for which IL&FS ETS would manage the expenses. District Coordinator reached Lasaria around 9:00 P.M to Dr. Jyoti s residence and delivered the Nevirapine explaining her how much of dose needs to be given. Finally, Nevirpine was given to the baby. The District has also been asked to coordinate the DBS of the child to be done at 6 weeks. At the same time IL&FS ETS would facilitate her to nearest Integrated Counselling and Testing Centre (ICTC) with the help of Rajasthan State AIDS Control Society. ~ Randhir K. Singh No Room For You A Case study from Mumbai where a woman is denied medical treatment because of her HIV Status delay in her delivery and she was referred to BMH hospital. The Outreach Worker consistently followed up with the client during this period and extensively counseled her as she felt deprived of living a normal life given her HIV status and being denied treatment in the hospital. On 23 rd May 2012, she went to BMH hospital but was denied admission again. This matter was reported to the SACS official who had to intervene again and the client was finally admitted. She gave birth on 23 rd May 2012 to a healthy baby boy. Both the mother and baby are being followed up by the Outreach Worker I am Tokali from Nagaland (Dimapur District), it s my first time working in this field. From this program I have personally learnt a lot about the importance of PPTCT program. I Have come across difficulties faced by +ve ANC woman to go for institutional delivery especially when labour pain starts at late nights and early mornings as it is very difficult to get Autos I am Boinu,working in this field, the first thing that comes to my mind is to build a very strong rapport with the client where trust will exist so sometimes makes me very sad. that it is easy to make the +ve woman avail the necessary services needed & follow up. As it also involves the infected and affected family members in the process. for transportation, even so for me to accompany them. So at those times as an ORW I could only help the baby to get NVP the next day, which My life was very limited. I was completely housewife. But when I entered in this filed. My life completely changes. I learn to travel in long areas as well as times manage. I know HIV/AIDS disease. Also I am doing HIV/AIDS awareness not only my filed work time. But also in my family life, friend s circuls, relative, neighbours - Vandana Walanju from Mumbai I am Suhoni from Nagaland (Dimapur District), Working with positive ANC/PNC cases is very different from that of working with general ANC cases. In PPTCT program I have learnt how to deal with emotions and the necessary services needed for the positive mothers and their infected family members.

4 . PPTCT Program Update As of 30 th June 2012, the PPTCT program that is being implemented by IL&FS ETS is covering 24 states and 2 Union Territories. A total of 251 districts are being covered where there are 176 Sub Recipients, 2524 Outreach Workers, 242 District Coordinators and 18 Counselors. Phase III Evaluation IL & FS ETS contracted Partners in Development Initiatives (PDI) to review the implementation of Global Fund, RCC 2 Program for PPTCT in Bihar, Chandigarh, Chhattisgarh, Jharkhand, Kerala, Maharashtra, Mizoram, Nagaland, Odisha, Puducherry, Punjab, Tripura, Uttar Pradesh and Uttarakhand. The objective of this review was to identify areas in each project, in which further improvement needs to be brought about in terms of service delivery, organizational capacity and financial management. The review, conducted in the months of March and April 2012, focused mainly on the current project period commencing from the date of signing of MOU with IL&FS ETS. The review was completed by 40 field evaluators consisting of program experts and finance experts. For more information on the evaluation results, please contact IL&FS ETS. PPTCT Refresher Trainings In this quarter, PPTCT refresher trainings were conducted and completed in the following states - Gujarat, Himachal Pradesh, Kerala, Madhya Pradesh, Mizoram, Mumbai, Odisha and Rajasthan. Training programmes have been initiated in Andhra Pradesh, Maharashtra Manipur, Nagaland and Uttar Pradesh STATES IMPLEMENTING PPTCT PROGRAMME AS OF 30 th June 2012 State Districts NGOs ORWs District Coordinators Counselors Andhra Pradesh Assam Bihar Chandigarh Chhattisgarh Delhi Goa Gujarat Himachal Pradesh Jharkhand Kerala Madhya Pradesh Maharashtra Manipur Mizoram Mumbai Nagaland Odisha Puducherry Punjab Rajasthan Tamil Nadu Tripura Uttar Pradesh Uttrakhand West Bengal TOTAL ,

5 Nutrition Programmes ACTIVITIES April- June 2012 A Support Group Meeting was conducted on 16th June 2012 with the participation of 10 stakeholders (both ANC and PNC) at the office of Walayar Valley Lions Trust - Our Partner Sub Recipient in Kerala. As many as 10 nutrition kits were distributed by the Trust. Awareness Programs A Care and Support for PPTCT mother s children was organized by our partner Sub Recipient in Mumbai - Yuvak Prathisthan on 20th June 2012 Health Workers Meetings In Gujarat, district coordinator Ms. Yogita along with ORW Ms. Veena, Ms. Parul and DLN staff organized an awareness program on HIV/PPTC at UMMID NGO. Coordinator made the participants (trainee of different courses run by the NGO) aware about HIV/AIDS/PPTCT through audio-visual and discussion. Health Workers Meeting in Bihar Refresher Trainings Role Play during the training in Himachal Pradesh Group Discussion during the training in Mizoram Training in Odisha

6 Whispers of a Foetus. A narrative written by the State Coordinator of Tamil Nadu after a personal encounter with a PPTCT client Hi mom, listen to me stop crying I am on the way to take care of you. I wonder why my mom s eyes always shed tears whenever she comes across the word HIV and its materials displayed either on the road or in the hospitals. Many times she is sitting idle and in deep thought. She was normal till the first trimester of my growth but quite recently during the first month of second trimester, she had under gone a blood test and a counselor in the Integrated Counselling and Testing Centre (ICTC), asked my mom a lot of questions. I was able to sense my mom s heart starting to beat faster and she went out of the room crying. A week after, an Outreach Worker of the PPTCT program from Thiruvanamalai district approached my mom, saying that she was sent by a distant relative who was working with the government health department and wanted my mom to come for a routine checkup. My mom prepared herself and stated walking along with the ORW. On the way the Outreach Worker introduced herself that she is HIVpositive and working with RSWS NGO for the past 5 years. She helped ANC/PNC mothers for psycho-social support, to let them be free of worries of HIV transmission to their babies. I could feel a glimmer of hope in my mom when she spoke to the Outreach Worker and after a few visits she started opening up to her. Thereafter, my dad was also tested for HIV and his result was negative. The Outreach Worker and Counselor spoke to my parents on a number of issues that I was not able to understand, but I could sense that they are about to blame my mom for the HIV infection. Two months later, my mom opened up to the Outreach Worker and Counselor started sharing a lot about her past history that her ignorance and physical relationship with her own cousin while she was working in the brick-line industries would have been the reason now for her HIV status. My mom insisted not to reveal the HIV status to her inlaws family members. The Outreach Worker thereafter convinced my dad with a lot of inputs of reason for HIV spread into our human body and promised that with due course of medical intervention, the child could be born without the infection. My mom is now happy whenever she meets the Outreach Worker and the Counsellor irrespective of her HIV status and adheres to the instructions given by them to give birth to me without the HIV infection. Mom.be happy I am on the way to take care of you ~ C. Deva All About Government Schemes for PLHIV A Handbook for People Living with HIV and AIDS In the State of Bihar, our partner, Sub Recipient, Gram Praudyogik Vikas Sansthan (GPVS) has taken a big step by publishing a handbook explicitly for People Living with HIV and AIDS (PLHA) in partnership with The United Nations Children's Fund (UNICEF) and Bihar State AIDS Control Society (BSACS). This handbook contains important information related to various Government Welfare Schemes and list of ICTC, PPTCT and ART centres in Bihar. Contact: Note: Interested persons can contact the IETS central team to get in touch with the Sub Recipient for a copy of the same. IL&FS Education Technology Services Ltd. 1st Floor, NTBCL Building, Noida Toll Plaza, NOIDA , UP, INDIA Fax : Te: