Leading transformational change: inner and outer skills
aids control pgram.pptNurses students jn
1.
2. Review the clinical facts about
HIV/AIDS
Magnitude of the problem of
HIV/Aids
Milestones of NACP in India
Goals and objectives of NACP III
National aids prevention and control
policy
Activities under NACP III
STD control programme in India
Organogram of NACP III
Roles and responsibilities of
community health nurse in National
Aids Control Programme
4. - -33.2 million people are living with HIV
- -Sub Saharan Africa region –most affected by the AIDS
pandemic
- -In India,estimated to be 2.47 million
- -Main transmission route-sexual 86%
- -The six states with the highest HIV prevalence are
Maharastra,Andhra Pradesh,Tamilnadu,Karnataka,
- Manipur and Nagaland
- -all districts across the country are classified into categories
- A,B,C,D.
- (UNAIDS,2008 Report on
- Global epidemic update)
5. 1986 –First case of HIV detected
1987-National AIDS control programme
1992-NACO,NACP I launched
1999-NACP II launched
2002-National AIDS prevention and control
policy ,National blood safety policy
2006-National council on AIDS ,National policy
on paediatric ART
2007-2011-NACP III
6. Coverage of high risk groups
Greater care,support and treatment to large
number of PLHA
Strengthen the infrastructure,system and
human resource
Strengthen the nation wide strategic
information management system
7. Reduce the incidence rate by 60 % in the high
prevalence states to obtain the reversal of the
epidemic and by 40 % in the vulnerable to
stabilize the epidemic
8. Launched in the year????????
Objectives
-Government’s firm commitment
-Generate a feeling of ownership at government
and non governmental levels
-Enabling social environment for prevention
-Decentralize HIV/AIDS control program
-Prevent women, children and other socially weak
groups from getting infected
9. Adequate and equitable provision of health
care
Overcome stigmatization ,discrimination and
seclusion in the society
International and bilateral colloboration for
research in vaccines and drugs
Ensure availability of safe blood and blood
products
Promote better understanding of HIV infection
among population
10. At the central level
Ministry of health and family welfare
Aids control department
National aids control organization
11. -State aids control society
-minister in charge of health
or the chief secretary
12. In category A and B states
District AIDS prevention and
control unit
District collector is the head
Intergration of NACP with
NRHM
13. Preventive efforts
To intergrate prevention with care ,support
and treatment
Highest priority for high risk group
General population –prevention services
Prophylaxis and management of opporturnistic
infections
Prevention of parent to child tranmission ,focus
on paediatric ART
14. Nutritional support and opporturnities
for income generation
Community care centres to provide
psychosocial support, outreach
services,referrals and palliative care
Intergrate HIV prevention into the
activities of women’s group,youth
groups and trade unions
15. Creating awareness about symptoms, spread,
prevention and services available through a
strong IEC campaign
Condom promotion
Promotion of voluntary blood donation and
access to safe blood
Integrated Counseling and Testing (ICT)
Prevention of Parent To Child Transmission
16. Management of Sexually Transmitted infection
and Reproductive Tract infections
Targeted intervention for High Risk Group and
Bridge population
Care, support and treatment services for
People Living with HIV/AIDS
17. Post Exposure Prophylaxis (PEP)
Promotion of safe practices and
infection control
Intersectoral coordination and
mainstreaming
18. Formulated for the rural areas of 187 highly
vulnerable districts
Aims at capacitating the rural community and
equipping them with HIV related knowledge
to combat the epidemic
19. Of 100 babies born to HIV infected mothers 33
may get HIV either during pregnancy,birth or
by breast feeding
Disseminate correct non judgemental
information on PPTCT
Counsel all HIV positive mothers on ways to
reduce the transmission to the baby
Administer ART to lower mother’s viral load
and act as prophylaxis for the baby
Modify the obstetric practises to minimise
baby’s exposure to HIV
20. Support safe infant feeding practices
Develop links for follow up of mother and
baby
Educate and counsel HIV mothers
-monitoring for signs of infection
-practicing safe sex
-using family planning methods
-assessing for eligibility for ART for both her and
baby if appropriate
21. Launched in 2006
Care and support to children infected with
HIV
Guideline for paediatric ART including
diagnosis of HIV in children has been
developed
Paediatric drugs are provided in all ART
centres
Free CD4 monitoring
22. Free DNA-PCR test for children upto 18
months
Liquid formulations for babies weighing less
than 5 kg
Diagnosis and treatment of OI’s
Micronutrient supplementation
Introducing Dried Blood Spot system to
transport dried blood samples
23. In 2006,Voluntary Counselling and Testing and
PPTCT merged to form ICTC
Have been established at medical
colleges,district hospitals,sub district level
hospitals,community health centres
24. ICTC and its
linkages
Access to
condoms
Early
management of
OI’s
PPTCT
TB-RNTCP
Psychosocial
support services
Community
care centres
STI services
Access to legal
services
Peer support
groups
25. TB –most common cause of death in people
with HIV
TB is treatable.Standard DOTS regimens are to
be followed (RNTCP programme)
If the patient needs ART then to consider
-when to start ART
-Which regimen to use to avoid hepatotoxicity
-NACO reccomends category I or II in HIV
infected
26. Red Ribbon Express (RRE) phase-II and follow
up plan
Multi-media campaigns in the States of North-
East‘’Red Ribbon Super Stars’’
Long format Radio & TV programs-Eg. Kyonki
Jina Isi ka Naam Hai in Doordharshan
Folk Media and IEC vans
Adolescence Education Programme (AEP)
27. The surveillance system would
include:-
(a) HIV Sentinel Surveillance
(b) AIDS Case Surveillance
(c) STDs Surveillance
(d) Behavioral Surveillance.
29. Sita 20 year old woman received a positive
HIV test 2 weeks ago.During your home visit,
You check her lab investigations that was done
recently Finds it is all within normal limits and
her CD4 count is 475.She asks “What should I
do to stay healthy?......
30. Ramu ,a 28 year old man was recently
diagnosed with advanced HIV and wasting
syndrome.He is depressed and suicidal.He has
disclosed his status only to his wife and really
does not know much about HIV.He is sure that
he is going to die…
31. A women who is 24 years ,HIV positive
,delivered her baby asks you about feeding her
baby.You have not seen her in the past ,during
her prenatal period.What points you should
keep in mind while counselling her to reduce
MTCT?
32. Key approaches to nursing care of PLHAs
A.Family centered approach
B.Multidisciplinary approach
33. Engage family in supportive care of PLHAs
Helps in the following
-PLHA able to manage own care
-help in adherence to treatment
-Increase the capacity for home based care
35. Basic care :physical ,psychosocial and
spiritual
Psychosocial :Stigma and discrimination
Education and counselling
Prevention: primary and secondary
Palliative care
Referral linkages
Treatment ,care and support(ART adherence )
Management of symptoms: OI’s,respiratory
infections,skin infections,STD’s etc
36. Management of drug side
effects
Infection control
Diet and nutrition
Psychological problem
Issues related to children
,women and pregnancy
Patient advocacy/patient
privacy
Healthy life style practices
Maintainence of records
and documentation
37. 1.Perform baseline assessment
-medical,social,sexual history
-patient’s self evaluation of how s/he is doing
-physical examination
-lab findings
38. 2.Plan care utilizing the various
approaches to care
- develop comprehensive plan of
care including all relevant
medical and nursing issues for
the particular case study
39. Primary prevention
-to prevent acquiring infection
-to prevent transmitting infection to others
-rational and safe use of blood
-offering pre and post test counselling to the
people at risk
-ANC women ,patients attending STI clinics
-Harm reduction strategies for IDU’s
41. Low socio economic status
Lack of disclosure
Lack of positive social support
Barriers to medical care
Exposure to violence at home and in the
community
Gender differences
Stigma and discrimination
42. To improve patient care and to delegate care ,nurse
should refer patients to
Other health centre’s such as PHC’s,ART centres,STI
clinics,PPTCT,ICTC and higher level hospitals
Other sources of support for patient like
-NGO’s & CBO’s
-positive network
-financial resources
-DOTS clinic
-Religious group
43. Dispensing ARV drugs
Counselling of patients
Record keeping and maintainence of patient
documents
Coordinating and tracking the referrals and
establishing linkages with various departments
Nursing care and follow up of patients
44. The candidate should be a diploma in
nursing from a recognized nursing
school/college with experience of providing
nursing care and preferably 2 years in a
public or private health institution
45. Vital signs
Follow up,medication administration
Watch out for any changes in condition
and report promptly
Counselling
Antenatal,postnatal care
Nutritional supplements as required
Maintenence of records
46. Referrals
Report on stocks of medicines and other
consumables
Maintain drug dispensed register
Case manager who provides intergrated
care of the PLHA’s case
Incharge of coordinating the outreach
workers to follow the treatment as
decided by the clinical team
47. Practice universal precaution principles
Participate in the staff meetings and provide
feedback
48. Depends on the following
Knowlegde
Understanding : Be aware of the challenges and
psycho social needs of
-YOUR patient
-YOURSELF
Confidence :Your patient will look to you for
advice ,information and support
So be CONFIDENT!!!!!