In India, less than 30% of the estimated 43,000 positive pregnant women receive PMTCT services. Low coverage is mainly attributed to unavailability of these services in the large and diverse private (for-profit and non-profit) health sector, which handles 44% of institutional deliveries through thousands of facilities. In order to reduce this coverage gap, SAATHII, with funding support from Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Johnson and Johnson (J&J) and MAC AIDS Fund has been complementing government efforts by implementing the country's largest PMTCT program since 2002 in the private sector. A consortium of seven NGO partners in four high prevalence states of Andhra Pradesh, Karnataka, Maharashtra, and Manipur implements the program at 381 private health facilities spread across 58 districts. SAATHII, as a national coordinator to EGPAF, provides technical, programmatic, and financial assistance to these seven NGOs (Please refer to Annexure 1 for the partner profiles and their geographical coverage). The biggest change for the India program during 2009 came from the increased involvement with the government initiative to support PMTCT in the private sector under the public-private partnership (PPP) model.
Accomplishments so far :
- Number of Pregnant Women Reached with Counseling and Testing: 1.2 million
- Number of HIV+ Preganant Women Reached with PMTCT Services: 6,541
- Number of Health Care Providers Trained: Over 18,000
In an effort towards saturating coverage in the private sector, this program proposes to expand its services to an additional 200 private health facilities in 32 new districts in the implementation states and Tamil Nadu through the PPP model in 2012. This program will help decrease the coverage gap by 15-20% in the private sector in the operational districts by reaching 416,816 pregnant women with HIV testing and counseling services and 1,350 HIV+ pregnant women with PMTCT services. Concurrently, SAATHII will assist the National Program in rolling out combination ARV prophylaxis in both public and private sectors in the four states.
Synopsis of the program over the 10 year period:
The program over the ten year period made remarkable contributions to the implementing sites by strengthening health systems and improving the quality of the program. The progam also made significant contributions to the national government by joining hands in the PMTCT expansion, as explained below.
- Health system strengthening on:
- HIV diagnosis using National Protocol
- Universal Work Precautions
- Hospital Waste Management
- Post-exposure prophylaxis
- Supply chain management
- Reporting to the government
- Quality PMTCT program implementation through
- Institutionalizing counseling for all pregnant and lactating women
- Counseling on nutrition, SRHR, hospital follow-up for all pregnant women
- Infant feeding counseling as per the revised WHO guidelines
- Effective linkages with public health facilities for ART initiation, infant diagnosis and pediatric care
- Home-based care for provision of ante-natal and post-natal care for HIV+ women
- Forming support groups for retention of mother-baby pair
- Access to family planning services including safe abortion
- Contribution to the national PMTCT program coverage:
- 3% in testing of pregnant women
- 6.1% in positive identification
- 6.4% in serving positive pregnant women with PMTCT services
- 40% of private sites reporting to the national government
Currently, SAATHII is assisting various state governments in translating the goal of "Elimination of Pediatric HIV" into action through a rapid scale up in the private sector and transition to efficacious regimens in both public and private sectors.
- Freedom Foundation
- Freedom Foundation
- Asha Kirana
Hebal, Andhra Pradesh
- Swamy Vivekananda Youth Movement
- Bapuji Child Health Institute and Research Centre
- Tamil Nadu MGR Medical University
Chennai, Tamil Nadu
- Asha Foundation
- Children Aid and Research Trust (CART)
Annexure 1: EGPAF – SAATHII Program Partners:
Asha Kirana: Asha Kirana is a Community Based Organization (CBO) dedicated to providing un-stigmatized Comprehensive Care Continuum to people living with HIV/AIDS and Prevention of Mother to Child Transmission (PMTCT) services in four districts of Karnataka state since 1997. Asha Kirana Hospital, a 25-bed facility established in November 2004, networks with multidisciplinary health care professionals in order to bring together research and state-of-the-art treatment for HIV / AIDS and opportunistic infections.
Bapuji Child Health Institute: Bapuji Child Health Institute is a tertiary care academic institute and a major referral pediatric hospital situated in the districts of Davangere and Haveri in the state of Karnataka since 2003. As part of the EGPAF Indian PMTCT program, BCHI provides a full range of PMTCT services to clients from urban, semi-urban and rural areas. Actively involved in the field of HIV/AIDS, tThThe institute has collaborated with 13 other public and private partners to provide HIV/AIDS services, showcasing an exemplary public-private partnership.
Freedom Foundation: Established in Bangalore in 1992, Freedom Foundation is a non-profit organization that offers a wide spectrum of services including treatment and residential care for those dealing with alcoholism, drug abuse and AIDS. From its Andhra Pradesh office, the organization operates in the districts of Hyderabad, Ranga Reddy and Medak. In Karnataka, the organization operates in the districts of Bangalore, Bellary, Siruguppa, and Udupi. Freedom Foundation’s PMTCT program has initiated the first support groups functioning within the PMTCT sites.
PRAYAS: Prayas is a non-profit organization working in the areas of health, education, energy, parenthood and community development since 1994. PRAYAS covers the districts of Pune, Sangli, Solapur, Kolhapur, Satara, Jalna, and Ahmednagar in the state of Maharashtra. Since September 2002, EGPAF India has been supporting PRAYAS in implementing a PMTCT program in urban and rural sites in districts of western Maharashtra. PRAYAS is an important referral center for care of people living with HIV from all over the state of Maharashtra and other neighbouring states. The organization significantly contributes to the development of education material for variety of audiences.
Swami Vivekananda Youth Movement: Swami Vivekananda Youth Movement (SVYM) is a non-profit development organization working in the areas of health, education and community development in Mysore, Karnataka. For the last 23 years, SVYM has offered a whole range of HIV/AIDS related services, focusing on all modes of transmission of HIV infection and providing comprehensive preventive, curative, and linkages to rehabilitation centres. SVYM is the only non-medical college that has been recognized as a Regional Resource Training Centre in Karnataka. It has established India’s first and only free ART Centre in collaboration with government and private sector partners. The organization has PMTCT centers running in the three districts of Mysore, Hassan and Dakshin Kannada.
Solidarity and Action Against the HIV Infection in India:
Solidarity and Action Against the HIV Infection in India (SAATHII) is a
registered non-profit organization in India, founded in 2000, working to
expand access to quality HIV/AIDS prevention, care, support and treatment,
and sexual and reproductive health (SRH) services in India. Headquartered
in Chennai, SAATHII operates in nine states of the country with offices in
Hyderabad, Kolkata, Bhubaneswar, Jaipur, Imphal and Nagpur. As the
national coordinator for EGPAF India PMTCT Program, SAATHII provides
technical assistance to EGPAF funded partners for their capacity building
activities. Specific assistance to partners includes grant and financial
monitoring, conducting need-based trainings, on-site and desk-level
technical and programmatic assistance. Additionally, SAATHII serves as a
technical assistance agency to NACO/SACS to expand their coverage in the
private sector through Public Private Partnership (PPP) in Andhra Pradesh