AN

Organizational
REPORT
ON
NATIONAL AIDS
CONTROL
ORGANISATION
(NACO)

SUBMITTED TO SUMBITTED BY

PROF. MRS ANNEY AVARACHAN MS. MANISHA

VICE PRINCIPAL MSc. NSG 1ST YEAR

HFCON HFCON
EDUCATIONAL VISIT
The term “field trip” has been known for decades in many sectors and it is a common
term used in worldwide schools. It seems that a field trip is a favourite part of both
teachers and students who are keen in learning and discovering.

EDUCATIONAL TRIP
A field trip or excursion is a journey taken by a group of people to a place away from
their felid trip usual environment. In education, field trip are defined as visits to an
outside areas of the normal classroom and made by a teacher and students for purposes
of first hand observation.
The students activities planned via various educational field trips, various days and
festival celebration has long been a major part of the education programming for both
young and adults.

Students activities can be integral part of the instructional program. Well planned
students activities play a vital role in enriching the learning experience of students.
Numerous research studies in science education have documented significant increase
in participant’s factual knowledge and conceptual understanding after participation in
well- planned students activities.
Students learn essential life skills like team work, planning and implementing various
student’s activities. The classroom environment does not promote sufficient
engagement with the content; there is a need to look outside the classroom for other
resources that can enhance curriculum effectiveness.

IMPORTANCE OF EDUCATIONAL VISIT:

 Educational visit help students to learn through visual experience.

 Educational visit can be an interesting way to explore new things.

 They help in educating children on complex topics.

 Students get idea on concepts through live examples.

 Educational visit must be made compulsory in schools, colleges.

General objectives for student teacher-
After field trip, the student teacher will be able to :
1. Gain the skill in organizing the field trip for students.
2. Co-ordinate various activities required to arrange for the visit.
3. Gain skills to maintain interpersonal relationship.
4. Motivate the students to learn in realistic educational procedure.
5. Gain confidence and self-esteem while organizing the field trip.
GENERAL OBJECTIVES FOR STUDENTS
After the field visit trip, the students will be able to:
 Obtain knowledge on National AIDS control
 Know about the organizational set up and its functions.
 Describe the physical set up of National AIDS Control organisation
 To describe the development of the organization and its source of funding.
 Gain knowledge about the diagnosis tests, treatment modalities and prevention
of AIDS.
STRUCTURE OF THE EDUCATIONAL VISIT
 Obtain knowledge on National AIDS control
 Know about the organizational set up and its functions.
 Describe the physical set up of National AIDS Control organisation
 To describe the development of the organization and its source of funding.
 Gain knowledge about the diagnosis tests, treatment modalities and prevention
of AIDS.

STRUCTURE OF THE EDUCATIONAL VISIT

As the requirement of the Nursing education curriculum it was the requirement of
M.Sc. Ist year students to organize an educational visit for the undergraduate students
to enhance the knowledge of the students and gain confidence in organizing the
educational visit for the same. It was a team work and contribution were given by each
and every member of the Obstetrical and Gynaecological Nursing Ist yaer students.
DRAFTING PERMISSION LETTER AND FINALISATION OF VISIT DATE
An official letter for seeking permission was drafted to the National AIDS Control
Organisation, Department of Health & Family Welfare, Government of India, 6th &
9th Floor, Chanderlok Building, 36, Janpath, New Delhi, India ., Pin:- 110001.by
Holy
Family College of Nursing explaining about the objectives of the visit and need the
curriculum. Therefore, we visited the centre and availed the permission with Mrs Neha
Of NDTBC to confirm the date.

On 13th January 2020 the NDTBC, New Delhi granted permission for all the listed
students from different courses to visit the NDTBC. The date decided for the visit was
24th January 2020. The total number of students were 48 students.

VISITING DATE

- 24TH January 2020

CONTRIBUTORS FOR THE VISIT

 Ms.Anuradha
 Ms. Lovely Tomer
 Ms. Manisha
 Ms. Yamini

With the consultation of the teachers, Mrs Anney Avarchan, the teacher for the
Nursing Education and Ms. Jeena, class coordinator of B.Sc 2nd year students the dates
are fixed for visit was 24th January 2020 as it is suitable and convenient for the centre.
The vehicles were arranged with the help of Mrs. Anney Maam and the students are
informed about the visit.
PREPARATION BEFORE VISIT

 Ms Jeena, class teacher of B.Sc 2nd year was informed prior to the visit to adjust
the schedule of the students and permission was taken from them for the same.
 Transportation facilities were arranged for the visit on the scheduled date.
 A class was conducted for B. Sc 2nd year students. Objectives of the study was
discussed in the class. A study material was prepared and teaching session was
conducted on the day of the visit at 7:30 am to 8:00 am regarding NDTBC,
New Delhi.

INSTRCUTION FOR THE STUDENTS

Respective students given were informed about the visit.

 The general instruction was given to them to wear decent clothes.

 Wear ID cards
 Carry small notepad and pen
 Not to use cell phones in front of the patient.
 Avoid talking to the patients and entertain them.
ON THE DAY OF THE VISIT

On around 8:30 am attendance was taken and again the instruction were repeated for
the students. All the students headed towards the bus at 8:30 am and reached NACO,
New Delhi at 10 am.

All the students then reached NDTBC and proceed towards the auditorium of the
NDTBC, New Delhi as according to the instruction given by Miss Neha.

At 10 am Miss Neha had a session regarding NACO, then proceeded forward to the
orientation and physical layout of the centre.
Sessions were taken accordingly about the National Tuberculosis Control Programme.

PROGRAMME SCHEDULE OF THE DAY

 Orientation to NACO
 NACP IV
 Targeted intervention
 Blood transfusion services
 IEC
 Care support and treatment
 Lab services
 Strategic information management
 HIV and TB
 Prevention services
ABOUT ORGANISATION

NATIONAL AIDS CONTROL ORGANISATION

INTRODUCTION

National AIDS Control Organization is a division of the Ministry of Health and Family Welfare that
provides leadership to HIV/AIDS control programme in India through 35 HIV/AIDS Prevention and
Control Societies.
In 1986, following the detection of the first AIDS case in the country, the National AIDS Committee
was constituted in the Ministry of Health and Family Welfare.
As the epidemic spread, need was felt for a nationwide programme and an organization to steer the
programme. In 1992 India’s first National AIDS Control Programme (1992-1999) was launched, and
National AIDS Control Organization (NACO) was constituted to implement the programme.

VISION AND MISSION

NACO envisions an India where every person living with HIV has access to quality care and is
treated with dignity. Effective prevention, care and support for HIV/AIDS is possible in an
environment where human rights are respected and where those infected or affected by HIV/AIDS
live a life without stigma and discrimination.
NACO has taken measures to ensure that people living with HIV have equal access to quality health
services. By fostering close collaboration with NGOs, women’s self-help groups, faith-based
organisations, positive people’s networks and communities, NACO hopes to improve access and
accountability of the services. It stands committed to building an enabling environment wherein
those infected and affected by HIV play a central role in all responses to the epidemic – at state,
district and grassroot level.
NACO is thus committed to contain the spread of HIV in India by building an all-encompassing
response reaching out to diverse populations. We endeavour to provide people with accurate,
complete and consistent information about HIV, promote use of condoms for protection, and
emphasise treatment of sexually transmitted diseases. NACO works to motivate men and women for
a responsible sexual behaviour.
NACO believes that people need to be aware, motivated, equipped and empowered with knowledge
so that they can protect themselves from the impact of HIV. We confront a stark realty – HIV can
happen to any of us. Our hope is that anyone can be saved from the infection with appropriate
information on prevention. NACO is built on a foundation of care and support, and is committed to
consistently fabricate strategic responses for combating HIV/AIDS situation in India.

NACO envisions:
 Building an integrated response by reaching out to diverse populations.
 A National AIDS Control Programme that is firmly rooted in evidence-based planning.
 Achievement of development objective
 Regular dissemination of transparent estimates on the spread and prevalence of HIV/AIDS
 Building an India where every person is safe from HIV/AIDS
 Building partnerships
 An India where every person has accurate knowledge about HIV and contributes
towards eradicating stigma and discrimination
 An India where every pregnant woman living with HIV has the choice to bring an HIV free
baby into the world
 An India where every person has access to Integrated Counselling & Testing Centres (ICTCs)
 An India where every person living with HIV is treated with dignity and has access to quality
care
 An India where every person will eventually live a healthy and safe life, supported by
technological advances
 An India where every person who is highly vulnerable to HIV is heard and reached out to

POLICIES AND GUIDELINES

The spread of HIV/AIDS from the high risk groups to general population and from initial hot spots
to new areas in India underlines the need for a comprehensive National AIDS Control Policy to
effectively control the epidemic in the country.
Among the preventive services are awareness generation, condom promotion, prevention of parent to
child transmission, increasing ICTC services, promotion of voluntary blood donation and access to
safe blood. The policies also have guidelines on targeted Interventions (TIs) for high risk groups like
injecting drug users (IDUs), men having sex with men (MSM), female sex workers (FSWs) etc.
Apart from this, policies have extensive guidelines on the management of common opportunistic
infections, malignancies among adult/adolescent PLHA and operational guidelines for ART centres
to standardise ART services across the country. The National Policy on Blood Banks ensures
adequate supply of safe blood and blood components.
NATIONAL AIDS CONTROL PROGRAMME IV

India’s AIDS Control Programme is globally acclaimed as a success story. The National AIDS
Control Programme (NACP), launched in 1992, is being implemented as a comprehensive
programme for prevention and control of HIV/AIDS in India. Over time, the focus has shifted from
raising awareness to behavior change, from a national response to a more decentralized response and
to increasing involvement of NGOs and networks of PLHIV.

In 1992, the Government launched the first National AIDS Control Programme (NACPI) with an
IDA Credit of USD84 million and demonstrated its commitment to combat the disease. NACP I was
implemented with an objective of slowing down the spread of HIV infections so as to reduce
morbidity, mortality and impact of AIDS in the country. National AIDS Control Board (NACB) was
constituted and an autonomous National AIDS Control Organization (NACO) was set up to
implement the project. The first phase focused on awareness generation, setting up surveillance
system for monitoring HIV epidemic, measures to ensure access to safe blood and preventive
services for high risk group populations.

In November 1999, the second National AIDS Control Project (NACP II) was launched with World
Bank credit support of USD 191 million. The policy and strategic shift was reflected in the two key
objectives of NACP II: (i) to reduce the spread of HIV infection in India, and (ii) to increase India’s
capacity to respond to HIV/AIDS on a long-term basis. Key policy initiatives taken during NACP II
included: adoption of National AIDS Prevention and Control Policy (2002); Scale up of Targeted
Interventions for High risk groups in high prevalence states; Adoption of National Blood Policy; a
strategy for Greater Involvement of People with HIV/AIDS (GIPA); launch of National Adolescent
Education Programme (NAEP); introduction of counseling, testing and PPTCT programmes; Launch
of National Anti-Retroviral Treatment (ART) programme; formation of anointer-ministerial group
for mainstreaming; and setting up of the National Council on AIDS, chaired by the Prime Minister;
and setting up of State AIDS Control Societies in all states.

In response to the evolving epidemic, the third phase of the national programme (NACPIII) was
launched in July 2007 with the goal of Halting and Reversing the Epidemic by the end of project
period. NACP was a scientifically well-evolved programme, grounded on a strong structure of
policies, programmes, schemes, operational guidelines, rules and norms. NACP-III aimed at halting
and
reversing the HIV epidemic in India over its five-year period by scaling up prevention efforts among
High Risk Groups (HRG) and General Population and integrating them with Care, Support &
Treatment services. Thus, Prevention and Care, Support & Treatment (CST) form the two key pillars
of all the AIDS control efforts in India. Strategic Information Management and Institutional
Strengthening activities provide the required technical, managerial and administrative support for
implementing the core activities under NACP-III at national, state and district levels.

The capacities of State AIDS Control Societies (SACS) and District AIDS Prevention and Control
Units (DAPCUs) have been strengthened. Technical Support Units (TSUs) were established at
National and State level to assist in the Programme monitoring and technical areas. A dedicated
North- East regional Office has been established for focused attention to the North Eastern states.
State Training Resource Centres (STRC) was set up to help the state level implementation units and
functionaries. Strategic Information Management System (SIMS) has been established and nation-
wide rollout is under way with about 15,000 reporting units across the country. The next phase of
NACP will build on these achievements and it will be ensured that these gains are consolidated and
sustained.
BASIC SERVICES
The Basic Services Division of National AIDS Control Organisation provides HIV Counseling and
testing services for HIV infection, the critical first step in detecting and linking people with HIV to
access treatment cascade and care. It also provides an important opportunity to reinforce HIV
prevention. The national programme is offering these services since 1997 with the goal to identify as
many people living with HIV, as early as possible (after acquiring the HIV infection), and linking
them appropriately and in a timely manner to prevention, care and treatment services. The
introduction of ART services for people living with HIV/AIDS in 2004, gave a major boost to
Counseling and testing services in India.
The HIV Counseling and testing services include the following components:
 Integrated Counseling and Testing Centres (ICTC)
 Prevention of Parent-To-Child Transmission of HIV (PPTCT)
HIV/Tuberculosis collaborative activities
The Basic Services Division through Integrated Counseling and Testing Centres (ICTCs) provide
HIV counseling & testing services, Prevention of Parent to Child Transmission of HIV (PPTCT)
services and HIV-TB cross referrals. These services have linkages with TI NGOs/CBOs and outward
linkages with ART centres, outreach services, peer support services, OI management and home
based care. NACP-IV envisages integration and scale-up of service delivery to sub-district and
community levels through existing infrastructure in the public and private sectors.
BLOOD TRANSFUSION SERVICES
Blood is an intrinsic requirement for health care and proper functioning of the health system. NACO
has been primarily responsible for ensuring provision of safe blood for the country since 1992.
NACO supports a network of 1131 blood banks across the country in over 600 districts and strives to
achieve accessibility to adequate quantity of safe, quality and affordable blood and blood components
to the needy.
Government of India adopted the National Blood Policy in April 2002 which aims to develop a
nationwide system to ensure easy access to adequate and safe and good quality blood supply.
Supreme Court judgment of 1996 for CWP 91/1992 mandated creating of National Blood
Transfusion Council and removal of professional blood donation. National Blood Transfusion
Council (NBTC), the apex policy making body for issues pertaining to blood and plasma is a part of
National AIDS Control Organization.
Accordingly, through all phases of the National AIDS Control Programme, a comprehensive,
efficient and total quality management approach has been adopted towards strengthening Blood
Banks and Blood Transfusion Services. NACO has taken number of steps towards the modernization
of blood banks in the country by providing the critical inputs for ensuring provision of safe blood for
the country. During this time HIV sero-reactivity among blood donors also declined to 0.14% in
NACO supported Blood Banks. Availability of Blood has increased to 10.8 million blood units in
2015-16.
NACP IV Targets: to be achieved at end of NACP IV

Cumulative Number of Blood Banks 1300

Total number of Blood units Collected 90 Lakh Units

Percentage of Voluntary Blood Donation 90%

Number of Blood units converted to Blood 80%

Components

Key strategies:
 Assessing blood needs and requirements of the country.
 Increasing regular voluntary non-remunerated blood donation to meet the safe blood
requirements of the country.
 Promoting component preparation and availability along with rational use of blood in
healthcare facilities.
 Capacity building of health care providers.
 Enhancing blood access through a well networked centrally coordinated, efficient and self
sufficient blood transfusion service.
 Establishing Quality Management Systems to ensure Safe Blood.
 Building implementation structures and referral linkages.

CARE, SUPPORT AND TREATMENT

The care, support and treatment needs of HIV positive people vary with the stage of the infection.
The HIV infected person remains asymptomatic for the initial few years; it manifests by six to eight
years. As immunity falls over time the person becomes susceptible to various opportunistic infections
(OIs). At this stage, medical treatment and psycho-social support is needed. Access to prompt
diagnosis and treatment of OIs ensures that PLHAs live longer and have a better quality of life.
Under NACP–II, focus was given on low-cost care, support and treatment of common OIs. Apart
from further improving the availability, accessibility and affordability of ART treatment to the poor,
NACP- III plans to strengthen family and community care through psycho-social support to the
individuals,
more particularly to the marginalised women and children affected by the epidemic, improve
compliance of the prescribed ART regimen, and address stigma and discrimination associated with
the epidemic.
To achieve this objective, 350 Community Care Centres are planned to be set up during the
programme period (2007- 2012) in partnership with PLHA in high prevalence and moderate
prevalence districts. These centres will be established based on the epidemiological profile and
PLHA load of the districts, and linked to the nearest ART centre. The centres will provide
counselling for drug adherence, nutritional needs, treatment support, referral and outreach for follow
up, social support and legal services. State AIDS Prevention and Control Societies will ensure access
of high risk groups to community care centres through linkages between TIs and the centres.
By strengthening local responses, NACP–III seeks high levels of drug adherence (>95 percent) and
compliance of the prescribed ART regimen. This approach to care, support and treatment also creates
awareness about the prevention of HIV infection and, thus, is a very significant part of NACP–III in
achieving NACO’s mission of containing and reversing HIV/AIDS incidence in India.

Care and Support for Children

Approximately 50,000 children below 15 years are infected by HIV every year. So far, care and
support response to these children was at a very minimal level. NACP–III plans to improve this
through early diagnosis and treatment of HIV exposed children; comprehensive guidelines on
paediatric HIV care for each level of the health system; special training to counsellors for counselling
HIV positive children; linkages with social sector programmes for accessing social support for
infected children; outreach and transportation subsidy to facilitate ART and follow up, nutritional,
educational, recreational and skill development support, and by establishing and enforcing minimum
standards of care and protection in institutional, foster care and community-based care systems.
IEC AND MAINSTREAMING
Information, Education & Communication
Communication is the key to generating awareness on prevention as well as motivating access to
treatment, care and support. With the launch of NACP IV, the impetus is on standardising the lessons
learned during the third phase. Communication in NACP IV is directed:
 To increase knowledge among general population (especially youth and women) on safe
sexual behaviour
 To sustain behaviour change in at risk populations (high risk groups and bridge populations)
 To generate demand for care, support and treatment services
 To strengthen the enabling environment by facilitating appropriate changes in societal norms
that reinforces positive attitudes, beliefs and practices to reduce stigma and discrimination
Key Activities
Mass Media Campaigns: An annual media calendar was prepared to strategize, streamline and
synergise mass media campaigns with other outreach activities and mid-media activities. NACO
released campaigns on voluntary blood donation, condom promotion, sexually transmitted infections,
stigma and discrimination amongst healthcare providers and PPTCT on Doordarshan, cable and
satellite channels, All India Radio and FM radio networks. To amplify the reach of mass-media
campaigns innovative technologies were also utilised like dissemination of advertisements through
movie theatres.
Long Format Programmes
The State IEC teams conducted various long format programmes like phone-ins and panel
discussions on HIV related issues through regional networks of All India Radio and Doordarshan.
These programmes reached out to a large audience.
Advertisement through Newspapers
Newspapers have good recall value on the day of event, and also reach out to a larger number of
readers. Both NACO and SACS release advertisements in newspapers to disseminate information
and create awareness.
Outdoors
Outdoor activities like hoardings, bus panels, pole kiosks, information panels, and panels in railways
and Metro trains were implemented by the State AIDS Control Societies, condom social marketing
organisations of NACO and under link worker’s scheme to disseminate information on HIV
prevention and related services. NACO has developed a well-coordinated plan involving different
agencies to avoid duplication of activities.
MID MEDIA
Folk Media and IEC Vans
Folk media engages audiences using their own cultural contexts. Previous years have witnessed
carefully thought-out national folk media campaign planning including script-writing workshops to
ensure synergy between key messages and elements of folklore into the performances. A mix and
match of seven thematic areas and the popular folk forms was used for the roll-out. The messages
were vetted by the technical experts in NACO for accuracy, effectiveness and consistency.
Folk media also used efficiently to piggyback on events organised in States during major festivals
like Navratra, Durga Puja, Ganesh Chaturthi, Pongal, State specific big fairs and important cultural
occasions reached out to readily available large gatherings in urban and semi urban areas.
YOUTH
Adolesence Education Programme
This programme runs in secondary and senior secondary schools to build-up life skills of adolescents
to cope with the physical and psychological changes associated with growing up. Under the
programme, sixteen hour sessions are scheduled during the academic terms of classes IX and XI.
SACS have further adapted the modules after State consultations with stakeholders, such as NGOs,
academicians, psychologists and parent-teacher bodies. This programme is being implemented in
31States and till date more than 50,000 Schools have been covered.
Red Ribbon Clubs
The purpose of Red Ribbon Club formation in colleges is to encourage peer-to-peer messaging on
HIV prevention and to provide a safe space for young people to seek clarifications of their doubts
and on myths surrounding HIV/AIDS. The RRCs also promote voluntary blood donation among
youth. About 14,000 clubs are functional and are being supported for these activities; which
includes 459 RRCs started in 2014-15

LAB SERVICES
Laboratory Services Division
Universal and routine access to quality assured HIV related laboratory services are made available
through the activities of Laboratory Services Division. It is recognized that work related to laboratory
services are not confined to HIV testing, but are overarching and have an impact on other
interventions included under prevention, care, support and treatment, STI management, blood safety,
procurement and supply chain management. Emphasis on quality assured laboratory service delivery
is important to the success of NACP.
To ensure quality of HIV testing under the NACP, NACO has an External Quality Assessment
Programme administered to all HIV testing laboratories. The HIV testing laboratories are arranged in
a tiered manner with apex laboratory (NARI, Pun) at the very top. 13 National Reference
Laboratories (NRLs) and 117 State Reference Laboratories (SRLs) form the two subsequent tiers of
the laboratory framework and are involved in supervision of testing in all peripheral testing centers
(ICTCs).
The testing activities of 272 CD4 testing laboratories, 6 laboratories for testing under EID
Programme and 10 Viral Load Testing Laboratories under the NACO umbrella are supervised by the
Laboratory Services Division

Major activities of Laboratory Services Division:

 Framing guidelines for HIV testing, Quality in HIV Testing, Enumeration of T lymphocytes
and Laboratory guidelines for Early Infant Diagnosis
 Accreditation of HIV testing Laboratories.
  Establishing and improving Quality Management Systems in CD4 testing laboratories, STI
laboratories and ICTCs.
 External Quality Assurance Programme for HIV testing laboratories
 Consortium for ensuring kit Quality in NACP
 Testing Services in National Programme on Early Infant/child less than 18 months Diagnosis.
 CD4 testing for initiation and monitoring of patients on antiretroviral therapy (ART)
 Viral Load testing for second line ART
 Training of laboratory personnel.
STRATEGIC INFORMATION MANAGEMENT
India’s success in tackling its HIV/AIDS epidemic partly lies in how India has developed and used
its evidence base to make critical policy and programmatic decisions. Over the past 15 years, the
number of data sources has expanded and the geographic unit of data generation, analysis, and use
for planning has shifted from the national to the state, district and now sub-district level. This has
enabled India to focus on the right geographies, populations and fine tune its response over time.
The National AIDS Control Programme recognizes that rigorous and scientific evidence is central to
an effective response and hence, having a strong Strategic Information management was a high
priority agenda under NACP. Under NACP, it is envisaged to have an overarching knowledge
management strategy that encompasses the entire gamut of strategic information activities starting
with data generation to dissemination and effective use. The strategy will ensure
High quality of data generation systems such as Surveillance, Programme Monitoring
through SIMS and Research & Evaluation;
Strengthening systematic analysis, synthesis, development, Data Analysis and dissemination
of Knowledge products in various forms;
Emphasis on Knowledge Translation as an important element of policy making and
programme management at all levels; and
Establishment of robust evaluation systems for outcome as well as impact evaluation of
various interventions under the programme.

STI/SRTI SERVICES
Sexually transmitted infections (STI) rank among the top five conditions for which sexually active
adults seek health care in the developing countries. As per the community based STI/RTI prevalence
study (2003), over 6% of the adult population in India suffers from one or the other STI/RTI episode
annually. There is enough evidence to suggest that early diagnosis, treatment and management of
STI/RTI including inducing behavior change through education amongst the target groups will
reduce transmission of STI/RTI and HIV (Lancet 1995; 346:530-536). Failure to diagnose and treat
STI/RTI at an early stage in women of reproductive age group may result in serious complications
and consequences, including infertility, fetal wastage, ectopic pregnancy, ano-genital cancer and
premature death, as well as neonatal and infant infections. Presence of a STI/RTI in the sexual
partner increases the risk of acquisition of HIV from an infected partner by 8-10 fold Effective
control of STI/RTI is a strong and most cost effective strategy for reducing/preventing transmission
of HIV.
Control of STI/RTI is an important component of the NACP; during NACP IV, the programme
aimed to provide universal, comprehensive and standardized quality STI/RTI services at all health
care facilities to all population groups with special emphasis on HRG population and vulnerable
groups, including women and adolescents through convergence with NHM and by involvement of
private sector.
NACO through its network of 1160 designated STI/RTI clinics (situated at government health care
facilities at district level and above) is providing free standardized STI/RTI services. These clinics
have been branded as “Suraksha Clinics” and provide sexual & reproductive health services.
Standardized training to the medical and paramedical personnel based on syndromic case
management approach is being provided and counseling services from trained counselors are made
available at these clinics. Colour coded syndromic drug kits and RPR test kits are being centrally
procured and supplied to these clinics.
Laboratory support for STI/RTI has been strengthened through a network of 10 regional STI
Laboratories and 45 state reference centre. The function of these centres are to provide validation of
Syndromic case management by doing etiologic testing, antibiotic susceptibility testing for
Gonococci, EQAS for syphilis and conduct operations research providing evidence to the
programme.
STI/RTI services are also being expanded though effective integration with the RCH-II programme,
NACO and RCH division have jointly drafted technical guidelines on management of STI/RTI so as
to ensure uniformity of service delivery across all facilities. Private sector has been meaningfully
involved through identification of 3400 preferred private providers to give services to the high risk
group population served through TI projects.

CARE SUPPORT CENTRES

The overall goal of Care, Support and Treatment (CST) component under NACP IV is to provide
universal access to comprehensive, equitable, stigma-free, quality care, support and treatment
services to all PLHIV using an integrated approach.
Based on the recommendation and priorities of NACP IV working group on care and support, the
strategy of implementation of the care and support is being completely revamped to ensure cost
effectiveness and sustainability. All care and support component of NACP III CCC, DIC & DLNs
are brought under one roof to provide community based care and support services.
Under NACP IV, Care & Support Centers (CSCs) are established and linked to ART centres with the
goal to improve the quality & survival of life of PLHIV. The CSCs serve as a comprehensive unit for
treatment support for retention, adherence, positive living, psychosocial support , referral, linkages to
need-based services, and providing an enabling environment for PLHIV. This will be part of the
national response to meet the needs of PLHIV, especially those from the high risk groups, and
women and children infected and affected by HIV. CSCs are run by civil society partners including
District Level Networks (DLN) and non-government organizations (NGOs).
Important Services Provided by Care and Support Centers:
Broadly, the following services are being provided by care and support Centres:
Counselling Services:
counselling support is provided on a wide-range of issues (psycho-social support, disclosure of HIV
status, treatment education and adherence, positive living and positive prevention, nutrition, sexual
and reproductive health issues such as family planning and pregnancy, discordant couples, home
based care) through one-to-one counselling or couple/family counselling. Children and adolescents
living with HIV are also be provided counselling services on HIV status disclosure, ART adherence,
personal hygiene, eating healthy and hygienic food, coping with emotions etc. Counselling services
are available at the CSC through trained counsellors and messages are reinforced in the field through
outreach workers and peer counsellors.
Outreach services:
These services include follow up of PLHIV for treatment adherence, repeat CD4 testing; tracking
Lost to follow-up (LFU) & MIS cases, and motivating family members for HIV testing; reinforcing
counselling messages; and providing/facilitating home-based care.
Referrals and linkages:
Another important service provided by the CSC is the establishment of linkages and provision of
referrals to various service providers in the area for addressing medical and non-medical needs. The
PLHIVs are also supported to access and avail social entitlements and social welfare schemes.
Advocacy and communication:
To create an enabling environment and access to services without stigma and discrimination, CSC
supports the PLHIV through various advocacy initiatives at local, state and national levels. A
discrimination response team is set up at the CSC level to respond to incidents of denial of services
reported in the area due to discrimination. Quarterly advocacy meetings with various stakeholders
and media advocacy events are planned to influence policy.
Support group meetings:
Support group formation is aimed at providing a platform for PLHIV to share their concerns and
learn from each other. Regular support group meetings are organized and information on various
themes are provided to build skills of PLHIV to lead quality life.
Vocational Training and Life Skill Education:
One of the important service of CSC is to provide life skill education and vocational training to the
clients with special emphasis on women and youth. Theoretical aspects of life skills are incorporated
into the ongoing educational and training components and the vocational training is provided through
linkages with vocational training institutes under government departments as well as corporate
sectors. The clients are also linked to various income generation activities available in the area.
Training on Home Based Care Services:
PLHIV and their care givers in the family are trained on basic infection control practices at home,
management of general ailments and minor infections at home, and identification of signs and
symptoms of health issues requiring immediate medical care. Clients are provided with information
about the nearest available health care facilities and importance of good health seeking behaviour
TERMINATION OF THE VISIT

The visit ended at 12:30 pm. All the students were boarded to the bus and attendance
were taken in the bus. Everyone was back to college at 2:00 pm.

INSTRCUTION TO THE STUDENTS AFTER THE VISIT

Reports regarding the visit has to be written and submitted to concerned students
teacher.
Evaluation criteria of the reports were provided to the students.
Marks of the students have to be submitted to the concern teacher.

EVALUATION CRITERIA

The report writing was done and the students were provided with the criteria for
evaluation.
The students were marked according to the criteria and the list of the students were made
and the record was handed over to the concerned teacher.
The students prepared the report and submit to us on time. The report was the detailed
outline of the educational visit and the students shares their experience.

EVALUATION PERFORMA FOR THE OBSERVATIONAL REPORT

TOTAL
S.No. CONTENT MARKS
1 Introduction of the students 1
2 Objectives of the visit 1
3 Organogram 1
4 Physical Set up 1
5 Staffing Pattern 1
6 Activities conducted in the institution 1
7 Observation 2
8 Summary and conclusion 1
9 Presentation and Punctuality 1

TOTAL SCORE ……………

TEACHER SIGNATURE……………
SUMMARY AND CONCLUSION
The visit was successful with the effort of the team. The visit was enriched with
immense knowledge. The objectives of the visit were fulfilled related to the students
and the student teacher. The students shown full interest and enthusiasm in the
educational visit. The students can apply this knowledge in their future and this can
also help them in academics.

We are very thankful to Mrs. Anney Avarachan, Vice Principal for providing such a
wonderful opportunity for organizing the visit and helped us in gaining the confidence
in arranging the visit and controlling the group. The visit has enhanced the level of
confidence and positive attitude in the students and student teachers. We expressed
our heartful gratitude towards her.