1. 
DAPCU
Appraising the DC on
Dist. level NACP-III
activities.

2. NACP-III (2007 – 2012)
Background
NACP - I (1992 - 1999) : Programme was being managed
centrally. Focus was on awareness and service
delivery units were located at rare places.
NACP - II (1999 – 2006) : Programme management
decentralized to SACS, service delivery units like TI, ICTC,
ART Centre and STD Clinic were established increasingly.
NACP – III (2007 – 2012) : Programme implementation
will be further decentralized to District and Sub-district
levels.
- Based on edidemiological / vulnerability criteria,
610 districts divided into 4 categories.
- Differential package of services planned for each
category.
- Every A and B district will have DAPCU to implement
AIDS control and prevention strategies, synchronized
with the public health infrastructure and programmes
at that level.

3. NACP – III Organogram

4. GOALS AND OBJECTIVES
To halt and reverse the epidemic in India over the next five years
Objectives :
 Prevention of new infections.
 Increased proportion of PLHA receiving Care, Support and Treatment.
 Strengthening capacities at district, state and national levels.
 Building Strategic information management systems.
Strategy for District Planning
Comprehensive package of graded services covering the entire population of the
district.
a) Saturating the coverage of three HRGs - FSW, IDU & MSM.
b) Expanding the coverage of bridge populations – Truckers and Migrant
workers.
c) Prevention among highly vulnerable population – Women, Youth & Children.
d) Prevention among the general population through mainstreaming

5. Strategy :
a) Formation of CBO and Peer led
interventions for saturating coverage
of all HRGs in urban areas.
b) NGO led interventions in rural areas
with 5000+ population.
c) Mainstreaming interventions in rural
areas with <5000 population.
.will be done by Link Worker
Scheme (LWS) by ActionAid.
• Mainstreaming HIV/AIDS in all Govt.
Depts. for environment building in
small scattered villages.

6. Service delivery at district level (A category)
Institutional Framework Public Health Infrastructure Services
MEDICAL COLLEGE
DISTRICT HEALTH MISSION ICTC
PPTCT
STD, OI, ART
DISTRICT HOSPITAL
BLOOD BANK
DOCTOR, COUNSELLOR, LT
CHC ICTC
BLOCK HEALTH MISSION PPTCT
DOCTOR, COUNSELLOR, LT STD, OI, ART
REFERRAL
24 Hrs phc
PRIVATE PRIVIDERS ICTC SERVICES, STD Control, OI
Condom Promotion
BLOCK HEALTH MISSION
Doctor, Nurse cum Counsellor, LT
SC, AWC Condom Promotion
VILLAGE HEALTH Testing Kit
COMMITTEE Care & Support
IEC
LW, ANM, MPW, ASHA
DHH - All HIV related services will be made available under one roof. This will include ICT, PPTCT, STD,OI and ART
with necessary linkages.
CHC will provide: ICT,PPTCT, STD and OI with necessary linkages to prevention and care treatment services.
PHC will be responsible for ICTC services, STD control, OI and condom promotion.
Mobile ICTC to service hard to reach areas.

7. ROLE OF DAPCU
The role of DAPCU is 3 fold.
1) Implementation of NACP strategies.
2) Convergence with NRHM activities.
3) Intersectoral Convergence

8. 2.Convergence with NRHM
a) Village level
 Village Health Committee – Orientation- Prevention-
Treatment-Care-Support
 Village Health Plan – Household survey – HIV parameter
 LW member of VHC
 Untied fund at SC – AIDS Agenda
 Orientation to ASHA, ANM, MPW
 MCHN Day - PPTCT services, nutritional support to PLHA
mother and newborn, condom supply, delivery kit, STI, TB
other OIs, ART followup – mobile lab
 Promote ANC and institutional deliveries
 IMNCI protocol – include special care for HIV +Ve infants.
Contd….

9. B) Block level
 Block Health Mission – Hospital management
committee
 Committed to IPHS
- 24 hrs. PHC/CHC be upgraded to ICTC
- Provision of LT & Counsellor at ICTC
- Centrifuge, Refrigerator, Infantometer – NRHM
- HIV/AIDS testing kits, delivery kits – SACS
- Strengthening Referral Protocol
. PPCTC / TB / STD / OI ICTC
- Monthly review meeting - Representative of TI,
Supervisor + Counsellor (ICTC).

10. (c) DISTRICT LEVEL
 Under NRHM, the District Health Action Plan
comprises the following five parts:-
 Reproductive and Child Heath Programme
 Immunization
 NRHM Additionalities
 National Disease Control Programme
 Inter-sectoral convergence, including AYUSH
 The District AIDS Action Plan will become the
sixth component of the omprehensive
Framework.

11. Dept. 3.Intersectoral Convergence Convergence activity
W & CD AWW – work on PPTCT, detect discrimination.
SHG - to support PLHA
RRC – among girls.
PR All functionaries – Orientation, Advocacy, Discrimination.
Gram Sabha – discuss HIV.
Budgetary supplement to prevention and control programme.
RD SHG + RRC – work on PLHA (Female), Integrated IEC
YA & S Promote VBD, Condom, NSS Campaign for rural youth. Train NSS (P.O.) / NYK (Co.)/Students.
Social marketing of condoms.
TOURISM Tourist spot – Condom, IEC, surveillance
LABOUR/
MINES/ IEC, Condom, Services at ESI hospital. Trade union – Orientation, discrimination Prevention, Labor – HIV in all
FISHERY training
INDUSTRY
POLICE / JAIL Support – Identifying HRG, sympathetic dealing, condom promotion in jail.
EDUCATION HIV awareness in adult education, No discrimination.
TRANSPORT
IEC, Condom vending machine, Migration route, Orientation.
BS / RS
REVENUE HIV in all Dept. training.
Municipal
Corporation & Awareness, Support through NGO and TIs for PLHAs. Mapping of HRG, Condom vending machine
normal local body.
CIVIL SUPPLY Antyodaya Cards for PLHAs.
DSW Madhubabu Pension Yojana

12. EPIDEMIC STATUS
A : WORLD
People living with HIV/AIDS 33.0 million
Adults living with HIV/AIDS 30.8 million (93.33 %)
Women living with HIV/AIDS 15.5 million (50.32 %)
Children living with HIV/AIDS 2.0 million (12.90 %)
People newly infected with HIV Per Year 2.7 million
Children newly infected with HIV Per Year 0.37 million
AIDS deaths Per Year 2.0 million
Child AIDS deaths Per Year 0.27 million
More than 25 million people have died of AIDS since 1981

13. B : India
People Living with HIV/AIDS 2.5 Million
Male Female H.R.G.
1.52 mln .95 mln .025 mln
(61 %) (38 %) (1 %)
 Prevalence rate of India is 0.34%.
 The immerging face of the Epidemic is increasingly
young, feminine & rural.
 43 % of Women have not heard about HIV/AIDS.

14. C : Orissa
People living with HIV / AIDS in Orissa 13351 (OSACS)
Male Female Child Male Child Female
4544 505 375
7927 (59.37 %)
(34.03 %) (3.78 %) (2.80 %)
Vulnerability factors :
• Large scale migration to other states in regular intervals.
• Large scale developmental projects such as, Mining industries, Hydro Electric and Irrigation Projects.
• Low literacy level especially among women.
• Rapid urbanisation and industrialisation.
• Merely parroted knowledge.
Transmission through :
Sexual 82.82 %
Blood / Blood Products 0.86 %
Infected syringes & Needles 2.72 %
ANC / PPTCT 8.80 %
Not specified 4.81 %

15. Block wise HIV +Ve
1. Bolangir (FSW, MSM, Migration)
2. Titilagarh (MSM, FSW)
3. Tureikela (Migration) /1
11
2
5 60
5
3 6
17
11 12
2
8
74

16. D : Bolangir
People living with HIV / AIDS in Bolangir 217
Death due to AIDS
Male Female Total
35
177 40
217
(81.56 %) (18.43 %)
Year wise +Ve Cases
250
217
200 2003
2004
150
102 2005
100 2006
37 38 2007
50 22
13 2008
2 3
0 Till June 2009
2003 2004 2005 2006 2007 2008 Till Total Total
June
2009

17. Delivery of Services so far :
ICTC WISE COUNSELLING & TESTING
COUNSELLING TESTING
Name of centre Male Female Total Male Female Total
ICTC - I 8887 6342 15229 5028 3196 8224
ICTC - II 2214 5486 7700 1560 4719 6279
TITILAGARH SDH 3939 3574 7513 2241 2077 4318
KANTABANJI CHC 2221 2825 5046 2152 2817 4969
PATNAGARH SDH 8679 4883 13562 180 156 336
TOTAL 25940 23110 49050 11161 12965 24126
ICTC wise +Ve Cases
250 217
200 177
150 M
95 F
100 77 81 73
40 Total
50 22
4 9 1019 15 4 19 3 0 3
0
H
H
L
H
C
H
TA
DH
DH
SD
H
SD
IC
TO
- II
-I
H
H
NJ
TC
AR
TC
AR
BA
IC
IC
G
AG
LA
TA
TN
TI
N
KA
TI
PA

18. Link Worker Scheme
Objective
Mainstreaming Interventions in rural areas with <5000 population:
• In these villages, focus will be on creating general awareness about HIV/
AIDS and STIs, and also providing referral services for STI treatment,
VCT/PPTCT, care and support. Such interventions will be done through
the link worker model
• To prevent transmission from HRG to vulnerable population i.e. women
and children.
• In Bolangir 2 lacks population will be covered under this scheme.
Implementation
• Selection of Link Worker is on process in 6 blocks.
Bolangir, Deogaon, Belpara, Loisingha, Titilagarh, Gudvela.
• Village mapping has started in Loisingha & Gudvela.

19. New Centre established
NEW ICTC Counselling
BELPARA 365
CHUDAPALI 272
GHASIAN 238
AGALPUR 68
SAINTALA 98
SINDHEKELA 470
MURIBAHAL 186
GUDVELA 127
TOTAL (8) 1824
Testing not started.
Loisingha
Khaprakhol
Deogaon
Above three centres are newly opened but staff not joined and centre may be shifted.

20. CONDOM
NAME OF AREA OF TARGET STD SOCIAL
NO. REFL TESTED +VE HOT SPOT AREA DISTRIB
TI OPERATION GROUP TREATMENT MARKETING
UTED
RYS BOLANGIR FSW, 250, 552 398 61 342 RAJMAHAL AREA, GANDHI 8837 25355
MUNICIPALITY AREA, MSM 200 NAGAR, HATISAL PARA
LOISINGHA,
AGALPUR,
CHUDAPALI
SAI TITILAGARH MSM 250 170 134 17 298 DURLA 11950 700
PATNAGARH TENDAPADAR
KANTABANJI GUDIGHAT
BANKEL
TANIA
BALIPATA
SAHARA TITILAGARH FSW 250 159 108 6 253 ULBA 19250 5560
PATNAGARH BERHAMPURA
KANTABANJI RAMPUR
RYS : Rajendra Yuva Sangha, Bolangir
SAI : Social Awareness Institution.
SAHARA : Social Association for Humanitarian Activities in Rural Areas.

21. ART Registration at Burla.
Male Female Total
Pre ART 34 19 53
On ART 25 5 30

22. Position of MBPY
No of cases No. of cases Not Death
sanctioned received traceable
140 36 19 19

23. Challenges Ahead & support needed
from dist. administration
1- To increase footfalls in ICTC
2- To ensure more no. of ART registration.
3- Convergence with NRHM and all line departments in activity &
training.
4- Coverage of all HRGs in the district
5- To address out migration
6- Strengthening the referral system
7- Liquidation of advances pending with district

24. THAN
‘Q’
ALL