Engagement and Training

 Recruited and deployed by Programme

 Core responsibility in care delivery
 Programme arranged 2 days core training; 40 THQs, both doctors and Charge nurse
 2 sessions per day; each 3 hours interactive session by qualified trainers
 Logistics provided ( Laptops for EMR experience)

Verbal screening
 By doctor and charge nurse
 No specific criterial ( who sent; referral etc)
 No gender related issues
 Verbal screening of all
 No record keeping
Rapid testing
 Programme selected and procured standardized rapid test kits
 No rapid test kits supply since last 6 months due to change in government ;
previously provided by programme; as per demand; without any delay or quality
issues
 Testing done at clinic by charge nurse and/or Laboratory technician.
 Recorded and reported on EMR system (after paper recording) maintained by Charge
Nurse
 Free of cost
 quarterly monitored by the programme M & E team by visiting the clinic with
documentation
 50 tested; 12-15 found reactive on daily basis.
Confirmatory testing
 PCR done at programme surveillance laboratory
 Sample collected by charge nurse at clinic on daily basis (previously was used to done
on fixed days)
 Sample Stored by charge nurse at clinic in programme provided refrigerator
 Routine sample sending; after 2-3 weeks or 200 sample together
 PCR results received within a month (via EMR system)
 EMR system to record/report PCR results
 No PCR testing fee
 quarterly monitored by the programme M & E team by visiting the clinic with
documentation
 average of 200 patients get PCR tested; 70 % found HCV positive
 Baseline assessment
 Clinical examination by doctor at clinic
 Core laboratory tests ( CBC, LFTS, RFT, Abdominal ultrasound); advised by doctor;
done at facility laboratory free of cost
 Treatment prioritization on the basis of APRI score (< 1 to start treatment), EMR
system generate the APRI score; and doctor take the decision; programme criteria
applied
 Deferred treatment (>1 APRI score); programme criteria applied; asked to visit clinic
after 6 months
 Average 80% start treatment; 20% deferred
 HCV treatment
 Doctor register the patient for treatment according to programme criteria
 Doctor provide programme recommended regimen i.e. 3 months regimen (DECLA
and SOFO ); used to be. 6 month treatment in past (RIBA and SOFO)
 programme related desk. Guide is available for the management of Hep c
 Drugs Effectively managed (storage facility, inventory, expiry )
 Provision of free of cost drugs on each follow up visit
 Recorded in EMR system and also on the patient file (kept by patient)
 Patient Education
 Both Doctor and charge nurse
 Special scenario based training of hepatitis clinic staff on patient education with
focus on both skills and knowledge
 Home take leaflets for patients available with key messages on vaccination, disease
transmission
 quarterly monitored by the programme M & E team by visiting the clinic with
documentation
 Follow-up
 Monthly follow up visit
 Core laboratory test on each follow up visit at hospital laboratory
 Clinical examination by the doctor
 Patients education about medication adherence and any treatment related
complication
 Provision of drugs on follow-up visit
 EMR system to identify absentee
 No retrieval mechanism
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