India
EGPAF has been in partnership with Solidarity and Action Against The HIV Infection in India (SAATHII) since 2002. Together, we have tested over one million women over the life of the project. The program works to prevent mother-to-child transmission in the private health sector, filling a gap expressed by the Ministry of Health (MOH). The program supports services in 364 private and faith-based hospitals spread across four high HIV prevalence states in Andhra Pradesh, Maharashtra, Manipur, and Karnataka.
The EGPAF/India program complements the government programs by reaching unreached populations, specifically women accessing the private and faith-based maternity hospitals. The EGPAF/India program accounts for 10-20% of total coverage of PMTCT services in the private sector, and 80% of the private sector reporting in the states of Andhra Pradesh, Karnataka, and Maharashtra.
The EGPAF/India program has been in existence since 2002 working with a consortium of local NGOs. The program is managed jointly by EGPAF and a key local partner, SAATHII, which also plays the role of an implementing partner. The current EGPAF/India goal is to reduce pediatric HIV infections and HIV-related morbidity and mortality among women, children, and their families by providing high-quality, comprehensive PMTCT services. EGPAF works with SAATHII to achieve its goal in-country.
The objectives identified through this partnership include the following:
- Fill key gaps in PMTCT coverage in high-prevalence states and districts, primarily in the private sector. Focus on Andhra Pradesh, Maharashtra, Karnataka and Manipur.
- Maximize the number of HIV-positive pregnant women reached via outreach, referral networks, and community counseling and testing.
- Strengthen technical capacity for the delivery of high-quality PMTCT services.
- Analyze, document, and share program experience nationally and internationally.
- Develop, and help partners develop, new donor partnerships to sustain existing services, and if possible, continue expansion.
(Photo: EGPAF, 2009)
Program Implementation Click to view
SAATHII conducts trainings and roll-out of new WHO guidelines; facilitates trainings on PMTCT, early infant diagnosis (EID) of HIV, infant and young child feeding (IYCF), and community sensitization; develops job aids; provides resources and materials for service delivery; works directly with sites to plan and implement services, and provides support and TA for management of the program.
Advocacy Click to view
SAATHII participates in various national-level technical working groups to develop policy and guidelines; plans program implementation; chairs the national country coordinating mechanism (CCM) for the Global Fund; and works with the National AIDS Coordinating Organization (NACO), the District AIDS Prevention Control Unit (DAPCU), and the State AIDS Control Society (SACS) to elevate the elimination agenda related to PMTCT.
Public-Private Partnership Model Click to view
The public-private partnership (PPP) model is unique to the India program, and was launched in 2009 by SAATHII as a strategy for increasing cost efficiency and expanding access to PMTCT services to women attending ANC and delivering in private facilities. The model involves a three-way collaboration between a government entity (thus far the State AIDS Control Agencies in the states of Andhra Pradesh, Karnataka and Maharashtra), a private hospital, and a technical agency. The State AIDS Control Agencies offer training for nurses and lab technicians; supplies of HIV test kits; registers, and reporting materials; drugs and other consumables; and IEC materials to the private hospitals. The private hospitals benefit from the government contributions and training, and are better able to offer sustainable quality services to the population through the cost-share. The technical agency (SAATHII) acts as the liaison between the other two entities, helps negotiate the PPP agreement, provides technical assistance and organizes state-wide experience sharing meetings. EGPAF has supported SAATHII’s costs for serving as the technical partner within the PPP.
Health System Strengthening Click to view
SAATHI works with DAPCU and SACS to build their capacity in the planning and implementation of PMTCT service delivery; monitors program progress using program data; supports logistics and supply chain management; and strengthens health systems at over 500 health facilities in more than 60 districts with regard to universal work precautions, hospital waste management, confidential HIV testing and counseling, and the provision of post-exposure prophylaxis as per the national protocol.
Projects In Progress Click to view
Healthy Mothers, Healthy Babies: Improving the Health of Pregnant Women, HIV-Positive Mothers, and Their Babies
(MAC AIDS: 2012–2013)
Under this project, EGPAF and our partner Solidarity and Action Against the HIV Infection in India (SAATHII) are expanding the public-private partnership model to other districts in Andhra Pradesh in order to provide 100% coverage at all prevention of mother-to-child transmission of HIV (PMTCT) sites. SAATHII is providing technical and implementation assistance to the Andhra Pradesh State AIDS Control Society (APSACS) to establish Integrated Counseling and Testing Centers in private hospitals. The program provides comprehensive and quality PMTCT services to HIV-positive pregnant women in line with national guidelines, and develops strategies to increase the follow-up of mother-baby pairs. SAATHII also works with various governmental entities, such as the National AIDS Control Organization and the State AIDS Control Societies, to elevate the elimination of pediatric HIV agenda.
Completed Projects Click to view
Prevention of Mother-to-Child Transmission of HIV (PMTCT) Partnership
(Johnson & Johnson: 2008–2012)
The EGPAF-Johnson & Johnson (J&J) partnership was designed to expand coverage and improve the quality of prevention of mother-to-child transmission of HIV (PMTCT) services as well as demonstrate global leadership in PMTCT by replicating and documenting best practices in 11 country programs, with additional support for clinical service programs in Cameroon, India, and Malawi. By project end, EGPAF had reached more than 2.6 million women, including over 130,000 in India, with access to PMTCT services, and succeeded in integrating PMTCT into routine maternal and child health (MCH) services by training health personnel and developing tools and job aides.
In India, EGPAF worked with our local partner SAATHII in four high-prevalence states (Andhra Pradesh, Karnataka, Maharashtra, and Manipur) to provide quality and comprehensive PMTCT services at 360 sites in 58 districts. EGPAF’s work in India focuses on delivering private-sector testing and counseling in collaboration with the government through a public-private partnership (PPP). To strengthen health systems of the private health sector, EGPAF has:
- Built the capacity of health care providers to improve supply chain management, strengthen laboratory capacity, and ensure linkages with government services
- Expanded community-based testing efforts in Manipur
- Supported the adoption of the revised WHO Guidelines for PMTCT at the national level
(Photo: EGPAF, 2009)
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India Program Highlights*
- Provided more than 1.3 million women in India with critical PMTCT services.
- Became the first and largest private-sector PMTCT program in India (formerly called the India CTA Program), and has become a major PMTCT presence and influence in four high-prevalence states.
- Provided HIV education to more than one million women via HIV counseling that occurs throughout antenatal care visits, both for HIV-negative and HIV-positive women.
* Data cumulative from program start through September 30, 2012.