The document outlines a training project conducted by Astron Hospital and Healthcare Consultants to educate Auxiliary Nurse Midwives (ANMs) in Delhi on HIV/AIDS awareness and integration with reproductive and child health services. The training included various sessions on HIV basics, stigma, and care strategies, leading to improved knowledge and referral capabilities among ANMs regarding HIV services. Recommendations for future training emphasize ongoing education and practical field visits to strengthen knowledge and service delivery integration.

1. Training of ANMs on HIV/AIDSDr. PoojaPassi

2. Training project carried out by ASTRON Hospital & Healthcare Consultants Pvt. Ltd. New Delhi

3. LayoutEvolution & Role of ANMsConcept of capacity building of ANMsMethodology Coverage of the North East districtAnalysis of Pre & Post test QuestionnairesComparative responses of ANMs- Pre-test and Post- test evaluation.Responses related to specific issues related to HIV/AIDSRecommendations

4. EvolutionMidwifery existent ever since medical services have been available to the masses.In India Bhore Committee placed foremost emphasis on preventive healthcare services right from the grass root and defined a cadre of healthcare workers called the midwives .These are selected from among the community Act as the point of FIRST contact towards access of health services .Eventually came to be known as Auxiliary Nurse & Midwives.

5. Contd.In the ‘50s and ‘60s, training courses for ANMs focused on Midwifery and Maternal and Child Health (MCH).1973, Kartar Singh Committee integrated the various functions of the health services thereby changing the role of ANMs (, 1973).1975, Srivastava Committee required the ANMs to provide child health services and Primary Curative care to villagers.Second Five-Year Plan described the role of auxiliary health workers as those activities that supplemented the contributions made by doctors for promoting preventive and curative health activities (GOI, 1986).

6. Job ResponsibilitiesThe Primary Health Center (PHC) through its Auxiliary Nurse Midwives (ANMs) and Multipurpose Workers (MPWs) at the sub center level carry out the RCH program. They deliver these preventive and promotive health services and health education.Maternal & Child Health Care in the village / community. Conducts deliveries in S/C and Home on call.

7. Contd.Identify the beneficiaries and complete necessary formalities for benefits under JananiSurakshaYojana (JSY) scheme and timely disbursement JSY benefits to eligible BPL mothers and submit utilization certificate every month for further release of funds. Family Planning motivation and activities. Identify the women, requiring help for Medical Termination of Pregnancy (MTP). Nutritional Care such as weekly IFA supplementation & Bi-annual vitamin A supplementation.

8. Contd.Organization of Health & Nutrition day in Anganwadi centre. Full coverage of routine immunization to children in time. Treatment of minor ailments and timely referral. Record of Vital events in the village. Implementation of all National Health Programmes in the community. Training for ASHA / Anganwadi Worker / Dais of respective areas.

9. Contd.Work in cooperation with PRIs/ NGOs in the village. Proper maintenance of record of Untied fund for SC development and their submission to MO I/cPHC/CHC.

10. Concept of capacity building of ANMs

11. INTEGRATIONSIMILAR GOAL: RCH and PPTCT both working on improving the IMR and MMR.The same workforce can be utilized to provide PPTCT services because of similar objectives, activities, areas, target population and deliverables in both programs.DSACS has launched an initiative in collaboration with the Delhi State Health Mission (DSHM) to create and implement HIV/AIDS training programs for Auxiliary Nurse Midwives (ANMs)

12. Methodology Training sessions undertaken for the ANMs covering all the 8 districts of Delhi. Sessions guided by a core team comprising of experts from the fields of HIV/AIDS and Public Health.The approach to training was highly participatory in nature, employing innovative means

13. Training MaterialHandouts, leaflets, flip chart, flip book and material which was easy to understand and assimilate.

16. Training SessionsSession 1: Introduction, Expectations, Pre test.Session 2: Basics of HIV/ AIDS, Myths and MisconceptionsSession 3: STIs and there management Session 4: HIV and Women, Pediatrics HIV and Care of New BornSession 5: High Risk Groups and Targeted InterventionsSession 6: Overview about Service availability

18. Training SessionsSession 7: Facilitation and Communication skillsSession 8: Session with a PLHA to discuss about issue of Stigma and Discrimination with PLHAs and their Rights. Sharing perspective of PLHAsSession 9: Role of ANMs in Integration of HIV with RCH servicesSession 10: Practice SessionSession 11: Post Test Evaluation and Training Feed back

20. Additional Topics CoveredIntegration of PPTCT with safe motherhood practices

21. Integration of “JananiSurakshaYojana” with PPTCT services

22. Developing communication & Counseling skills among the ANMs

23. Pediatric HIV/AIDS and service availability including care of new born & HIV positive mother

24. Follow up, referral and linkages with the existing healthcare services under the Public Healthcare Delivery system

25. Care & support services and linkages with safe motherhood services.

26. Coverage at a Glance (NORTH-EAST DISTRICT)

27. Expectations of the participants History of HIV infection

28. Window period in HIV infection Anti retroviral treatment

29. Rehabilitation of people living with HIV/AIDS

30. Prevention methodology for needle stick injuryAnalysis of Pre & Post test Questionnaires

32. Comparative status of awareness about Care & Support servicesImportant issues like awareness about PPTCT centers, consent for HIV testing, role of ART in HIV/AIDS and ARV prophylaxis in PPTCT appear to have achieved clarity among the ANMs as compared to the pre-training awareness levels

33. Comparative status of awareness about Preventive aspects of HIV/AIDS

34. Comparative status of awareness about Stigma & Discrimination towards PLHAs

35. Comparative status of awareness about Myths & Misconceptions related to HIV/AIDS

36. Specific issues related to HIV/AIDS

37. Knowledge about referral and linkage with PPTCT centerThis infers that now the ANMs possess adequate knowledge about the referral and linkages and in practice will be able to refer their ANCs to the center for availing the required PPTCT services

38. Significance of ARV prophylaxisThis infers that this existing workforce can now be effectively utilized in improving the uptake of PPTCT services.

39. Role of ART in care & support of PLHAsANMs now will be an effective resource to refer HIV +ve mothers, children and their families to ART centers, counsel and follow up those on treatment and hence compliment the existing efforts in reducing drop outs