The following is part of a series of project updates from the Centre for Development and Population Activities (CEDPA). The MHTF is supporting their project, Working on Integration Issues of HIV/AIDS and Maternal Health. More information on MHTF supported projects can be found here.

Written by: Mohammad Ahsan, CEDPA India

CEDPA India with the support from MHTF has undertaken an initiative to advocate for integration of HIV and Maternal Health programs and policies in India. The effort is to build consensus on strategies which will be developed to address and advocate for the issues of integration on HIV and maternal health through consultations at state and national level. CEDPA will share information related to Maternal Health and HIV/AIDS; pool technical expertise to ensure focused discussion; involve diverse multi-sectoral stakeholders and generate interest at multiple levels through public events used to catalyze action to integrate HIV/AIDS and maternal health.

So far, we have conducted a desk review of information on integrated programs and policies at national and global level. As part of this review, we have documented good practices of efforts to integrate maternal health and HIV programs by the government as well as civil society, including those implemented by the corporate sector under public private partnership. A systematic compilation of these initiatives is expected to provide evidence for replication and scale-up. We are now in the process of contacting the authors/organisations who have responded and worked on this issue to get detailed information which will help supplement in developing the compendia of best practices. Apart from following up with the authors, I have been scanning a number of reviews and technical documents. The responses that we received to our queries on HIV and MH integration programs were mostly opinions or anecdotal and not backed by evidence from evaluations or even monitoring data. Also, I could not find any case study on integration from India from these reviews. As of now, I have been able to find only few case studies. These are The Integrated Management of Adults and Adolescent Illnesses (IMAI) program, Karnataka, Karnataka HIV-RCH Integration Program and Integration of voluntary counseling and testing services, with other RCH Services, West Bengal. We are also trying to find many more cases.

To get the specific information for the best practices from the reference state, Rajasthan, we organized a meeting on 19 April 2011 with Rajasthan State AIDS Control Society (RSACs), local NGOs and RCH wing of Health Department, Rajasthan. Nodal Officer for the convergence programs from RSACs shared that Rajasthan has made significant strides in the implementation of HIV care and treatment programs. Every block has ICTC centre with counselor in-positioned. The ICTC-NRHM integration program has made noteworthy progress.100 community health centres (CHC) out of total of 368 CHC’s of Rajasthan have ICTCs. In 2010, testing percentage among registered pregnant cases under PPTCT was 86% while only 71% testing was observed among direct in labor cases. A peer counselor initiative was also started with the support of UNICEF, Clinton foundation, CRS, positive network in Rajasthan where a positive person was appointed in every district with ICTCs who do field visits and provides link between services like PPTCT, ART & PLHA.

At this time, it is required to get examples of full-integration that could include efforts such as capacity building of staff, supply management, prevention programs, testing, administrative integration, communication strategies, materials, etc. We know that a lot of initiatives are underway as a result of the NACO-NRHM convergence thrust; however, the experiences are not readily available in public domain. To get the experiences through different initiatives, we are planning to organize a consultation workshop in Jaipur in July 2011 that will create platform for NGOs, GOs and corporate to share their vivid experiences along with technical insights on integration of HIV and maternal health to improve health outcomes.

The following is part of a series of project updates from the Centre for Development and Population Activities (CEDPA). The case study come from their project, Working on Integration Issues of HIV/AIDS and Maternal Health, which the MHTF is supporting. More information on MHTF supported projects can be found here.

Written by: CEDPA

Sindhiyon Ki Dhani is one of the Muslim dominated villages in Bayatu Block of Barmer in India. The people here live in poverty amidst plenty and mostly work as laborers or as daily wagers. Here in this village people are very superstitious and attached with their tradition. Mostly people are illiterate or have only primary education and do not know about the Maternal and Child Health Nutrition (MCHN) days organized by the Health Department. They are scared that there will be side effects if they vaccinate their children. They even do not prefer any type of vaccination for pregnant women. But a male community health volunteer from CEDPA/India’s Child, Maternal and Reproductive Health Awareness Initiative (from the same village) has been successful in mobilizing the community.

After the initiation of Maternal and Reproductive Health Awareness Initiative Program (CMH), a male community health volunteer motivated them to come for the village meeting. In those meetings, Mr. Lakha Ram counseled them on child and maternal health and made them realized the importance of immunization. Now people are talking about the health issues and enquire about the health related matter in the Panchayat meeting also. The women of the village have not only inculcated the habit of practicing health and hygiene but have also become aware of ante natal check ups and post natal check ups. They also have started visiting Health Sub Centre to get the information about the health related policies and programs, like Janani Suraksha Yojana (Institutional Delivery Scheme), actually meant for them.

Click here to read a previous case study submitted by CEDPA.

The following is part of a series of project updates from the Centre for Development and Population Activities (CEDPA). MHTF is supporting their project, Working on Integration Issues of HIV/AIDS and Maternal Health. More information on MHTF supported projects can be found here.

Written by: Mohammad Ahsan, CEDPA India

CEDPA India with the support from MHTF has undertaken an initiative to advocate for integration of HIV and Maternal Health programs and policies at the state (Rajasthan) and national level. The effort is to build consensus on strategies which will be developed to address and advocate for the issues of integration on HIV and maternal health through consultations at state and national level.

So far, CEDPA India has conducted a desk review of information on integrated programs and policies highlighting replicable lessons related to services and convergence at national and global level. We are in the process of documenting best practices and case studies on the integration issues at national and global level. Queries have been posted in MHTF‘s forum under Archive for the GMHC 2010 and cross posted in HIV and MCH ( Maternal and Child Health) section of Solution exchange forum. While the response to the query at global level has not been very encouraging, but at national level we have been getting few responses. However, responses are more like comments and detailed information that we seek is missing. We are trying to contact the individuals who have responded and worked on this issue to get detailed information that will supplement in developing the compendia of best practices.

However, I think the reason for facing challenges in getting the best practices and successful cases on HIV and MH integration programs in India and specifically in Rajasthan and other states, is mainly because most of the organization have not worked on such programs on integration and neither tried to integrate their own despite of National AIDs Control Program (NACO) government order (GO) on convergence between the National AIDS Control Program (NACP) and the Department of Health and Family Welfare (DOHFW). From the desk review it is also noticeable that very few programs were piloted in different part of India but on a very limited scale.

To further aid this search, I attended a National Conference on ‘HIV/AIDS Research’ organized by the National AIDS Control Organization (NACO) in collaboration with UNAIDS at India Habitat Centre in New Delhi from 19-21 January 2011. The theme of Conference was ‘Towards Evidence-Policy linkages in HIV/AIDS Research in India. Besides serving as a national platform for exchange of knowledge, views and ideas among the researchers, program managers and policy makers in India, this National Conference aimed at providing evidences for program planning and policy formulation.. The Conference also focused on integrating preventive and therapeutic research on HIV /AIDS with the national program. It was envisaged that this scientific gathering would lead to timely and appropriate National response to the HIV epidemic and planning for the next phase of National AIDS Control Program. Although many good practices were presented at this conference, there was not much on research and evidence on integration.