Friday, August 23, 2013

Scaling up of STI services in the third phase of National AIDS Control Program of India


Sugata Mukhopadhyay

Issue: STIs are the major co-factors of HIV transmission. An estimated 30 million of STI episodes occur in India. The third phase of National AIDS Control Program of India targeted to reach about 10 million STI episodes annually.
Project or Activities: Designated STI/RTI clinics increased from 916 in 2008-09 to 1112 in 2011-12. 45 national and 587 state resource faculties from all states were trained on STI management by National AIDS Control Organization (NACO) of India during 2007-08. Those resource persons trained 2224 healthcare providers in 2008, 7511 in 2009, 5224 in 2010 and 6496 in 2011. 7 STI training, reference and research centres were established to augment training and research in STI case management across the country. In 2007, STI Clinics were branded as Suraksha clinic within the National Communication Strategy on STI/RTI Service Delivery. 776 STI counselors were appointed in the program in 2007-08 which was scaled up to 955 in 2011-12. Preferred private providers who treat HRGs in their localities for STIs were identified and trained on national STI treatment protocol, 5744 in 2009-10, 3891 in 2010-11 and 3942 in 2011-12. Pre-packed colour coded STI/RTI kits were provided for free supply at all designated STI/RTI clinics.
Results: 2.6 million, 6.67 million, 8.49 million and 10 million (till Jan’12) STI episodes were treated in 2008, 2009, 2010 and 2011 respectively. HRG members who had been treated for STIs showed gradual increase from 158,973 in 2007 to 632,151 in 2008 and to 1,057,577 in 2009. It was also observed that number of STI/RTI cases in HRGs declined from first to third quarter of 2011-12 by 2.5% though the clinic attendance went up to 18%. During April-June, 2011 38.5 percent of HRG had utilized regular medical check-up services of TI (Targeted Intervention) clinics which increased to 45.9% during Oct.-Dec 2011 showing improvement in health-seeking practices in HRGs. Though syphilis testing has improved but still below 40 percent against the target as country average.
Lessons learned: : India’s experience is one of the most prominent examples of scaling up of STI services through optimal resource allocation and strategic implementation of action plan of STI control.

(Selected for E-POSTER)

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