Tamil Nadu has the highest number of documented AIDS cases, despite wide anti-retroviral therapy (ART) access and a reduction in new cases in the general population through the success of the PPTCT programs. Access to treatment is largely restricted to urban populations, and HIV positive people from rural areas, often with limited financial resources, are forced to travel long distances to access treatment, care and support services.

Karur is one of the districts with highest prevalence of HIV in the state, and an ART Center has recently been established by the Tamil Nadu AIDS Control Society. The Karur IMAI project was conceived as a way to build the capacity of health-care providers from the government institutions, though training and system-strengthening activities.

IMAI stands for Integrated Management of Adolescent and Adult Illness, and is a training package that has been developed by the World Health Organization. It has been implemented extensively in African and Asian countries. Karur is one of the first two districts selected for implementation in India, following country-specific adaptation by WHO. Adapted materials have also been translated into Tamil. SAATHII is implementing this training project based on the model of mainstreaming care and support, which it had piloted earlier in Salem district with support from APAC-VHS/USAID.

[above pic] District Collector at July 16, 2007 IMAI workshop

The assistance and support of the District Collectorate of Karur and the Tamil Nadu State AIDS Control Society (TANSACS) are gratefully acknowledged. Information about SAATHII-IMAI's initiative at Karur, can also be viewed at the Karur district website http://www.karur.tn.nic.in/aids.htm .

 Activity Area: Karur, Tamil Nadu

 Site Map:

 Objectives:

• To increase the access to quality care and treatment services to HIV positive individuals in Karur district of Tamil Nadu by mainstreaming medical care and support into the existing health care system down to the primary care centres.

• To train health care providers in acute, chronic, and palliative care, at district headquarters and subdistrict (taluk, PHC) levels, using a standardized curriculum.

• To assess health-seeking behavior among HIV positive individuals in selected urban (district headquarters) and rural areas of the proposed district.

• To strengthen the various service delivery components, fill gaps, and create a sustainable model through resource mobilization, community involvement, and networking.

• To establish sound documentation and reporting systems to consolidate information, assess impact, and facilitate replication and scale-up of the program.

  Methods and Approaches:

 Projects, key methods, and approaches include:

• Recruiting HIV physicians and nursing/counseling experts in the state and training them as facilitators for IMAI. The experts include private practitioners and staff from such institutions as SIAAP - Chennai, PSG Medical College - Coimbatore, ART Centers at Namakkal and Salem, I-TECH - Chennai, and other such institutions of repute. Facilitators have been oriented on the IMAI package by WHO national and international teams.

• Recruiting and training 30 PLHIV who function as Expert Patient Trainers  (EPT). (October 31, 2007) With the help of the EPT and resource persons from the state, 5-day training sessions are being conducted for doctors (4 batches of 20 each) and nurses/counsellors (11 batches of 20 each).

• Mr. Swaminathan 's Interview on Kodai FM. (November 7, 2007)

• A district-level planning meeting at the outset, to orient stakeholders from government administrative and health/medical departments on the project

Visit of Project Director TANSACS to Karur Nov 19, 2007

• Monthly visits to all health-care facilities to collect data on OI, STI and HIV cases, collect regular  feedback from the center staff, and identify areas of system-strengthening.

• Sub-district level coordination meetings spread  across the district to raise awareness of the project, of the need for care and support, and to mobilize  community support and resources to assist in strengthening local health facilities. Expected  attendees at these meetings will include medical/paramedical staff, local philanthropists,  charitable groups such as Lions/Rotary, elected people’s representatives, local industrialists, etc.   These coordination meetings will be modelled on good practices gleaned from SAATHII’s prior intervention in Salem district.
  
  
• Clinical Mentoring meetings at district and taluk (sub-district) levels.
  
  
• One end-of-project dissemination meeting at the district headquarters to share outputs, outcomes and lessons learned from the project.

 Staff :

Support:

 The World Health Organization (WHO) India Country Office, New Delhi, is supporting the training component of the initiative through technical and financial means.

The project is being implemented with the approval and support of the Karur District Collectorate and the Tamil Nadu State AIDS Control Society (TANSACS).

 How you can help :

SAATHII is seeking support for this project, key activity areas envisioned include developing model facilities at PHC and taluk level for sequence of care, de-centralization of ART distribution to sub-district level, etc.

SAATHII is seeking in-kind donations of weighing-machines, autoclaves, needle-destroyers, gloves, and other supplies to benefit the primary health care centers in Karur district. If you are an individual or an organization who would like to contribute, please let us know.

 Contact Information:

 For more information on this project, please email Mr. Swaminathan at swamiiyer@hotmail.com

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