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Building Consensus on the Integration of HIV and MH

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.

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