Eight years of Care and Support for PLHIV
PFI managed program funded by the Global Fund
The "3 by 5" initiative, was launched by UNAIDS and WHO in 2003. The initiative aimed at providing antiretroviral treatment (ART) to 3 million people living with HIV/AIDS in low-and middle-income countries by year 2005. It was a step towards the goal of making universal access to HIV/AIDS prevention and treatment accessible for all who need them as a human right. To meet the target, India launched its free national ART programme in April 2004 with financial support from the Global Fund. To improve access to ART and improve the quality of life of PLHIV, care and support is inevitable. The Global Fund invited proposals from Civil Society Organizations to support the national programme. Population Foundation of India (PFI) felt that the HIV situation in India needed to be looked at in conjunction with the organization’s larger vision of working on issues related to reproductive health and population stabilization. PFI became the first civil society Principal Recipient (PR) of the Global Fund grant in India in 2005. PFI managed the care and support program under Round 4 (HIV), Round 6 (HIV) and consolidated Round 4 (HIV) program under Rolling Continuation Channel (RCC 1). The program ended in March 2013 covering a span of eight years providing quality care and support services to PLHIV and building the capacity of individuals and institutions.
Improve the survival and quality of life of people living with HIV/AIDS and reduce HIV transmission.
Program Coverage, Sub-Recipients and Fund Status
|Grant||Period||Number of states covered||Number of Sub-Recipients||Amount signed (in USD)||Fund Received during period(in USD)||% of fund utilized against fund received|
|Round 4||April 2005 – March 2010||6||7||18,209,481||16,788,642||97.66|
|Round 6||June 2007 – March 2010||8||8||11,664,745||11,660,264||94.41|
|RCC 1||April 2010 – June 2013*||19||217||33,136,867||18,958,526||105.0**|
|Total||April 2005 – June 2013||63,011,093||47,407,432||99.80|
* The grant closure period of April-June 2013 is included.
** Opening balance as on April 1, 2010 from R4 and R6 was not included in fund received.
Strategy and Achievements
The strategy was to provide ART at all public teaching and district hospitals through the NACO programme while the care and support services were to be provided through civil society partnerships. The care and support services were offered to PLHIV through various types of institutions as well as through outreach.
- 220 District Level Networks of PLHIV (DLNs) and 75 Community Care Centres (CCCs) were set up and strengthened
- 447,645 PLHIV were provided various types of care and support services
- 20,263 children were provided educational support
- 7 corporate health facilities started providing ART under PPP model. The Corporate ART Centers are unique models of PPP, where e corporate houses and NACO partnered to provide access to care and treatment. The corporates provided infrastructure and human resources and NACO provided ARV drugs, HIV test kits, reagents and training to the staff
- 17,600 DLN staff and other PLHIV were trained on peer education as Master Trainers
- Various training curricula related to ART adherence, Peer Education, Sexual and Reproductive Health, Facilitative Supervision were developed
- Various oversight and grant management systems were put in place to improve the program efficiency.
Direct Management of care and support program
Owing to certain exigencies, PFI had directly managed the care and support program during RCC 1 period that lasted about three years. Under the direct management, PFI signed grant agreements with 213 DLNs in nine states to ensure the continuity of services despite several challenges. The direct arrangement necessitated quarterly disbursements, programme management with limited human resources and building the capacity of DLNs without comprising the overall programme implementation. During the direct management, PFI signed 1,700 MoUs, received 9,000 quarterly reports and 11,000 monthly reports, and conducted 20 integrated reviews covering programme, finance, grants and M&E management in the nine states.
Ernst & Young conducted an assessment of the direct management in June 2012. Few excerpts from its report:
- DLNs were appreciative of the systems and support provided by PFI. They were unanimous in their appreciation of the handholding and round-the-clock support, as well as prompt resolution provided by the state office. They credit PFI with building their capacities and enhancing their self confidence.
- Trainings and the systems that had been established had given DLNs the confidence of being implementers and accountable for their own programmes.
- DLNs preferred working directly under PFI for long-term implementation of the programme.
- Findings of the study underline the significant efforts of the PFI team in building the capacities of the DLNs and ensuring seamless service delivery across the nine states.