Policy shift in battle against AIDS

CHENNAI AUG. 26. In a significant shift in policy, the Tamil Nadu health department has decided to provide micro-solutions to the HIV/AIDS epidemic, tailored to the needs of `high-risk' districts.

The programme will be launched in districts where HIV prevalence is above one per cent — Namakkal, Tirunelveli, Madurai, Theni and Vellore — according to the Tamil Nadu State Aids Control Society project director, K. Deenabandu.

While in Namakkal, Tirunelveli, Madurai and Theni it will be implemented by the TNSACS in co-ordination with Family Health International, the collaborator for the Vellore project is the United Nations Children's Fund.

Sentinel and behavioural surveillance studies will be conducted initially to identify the problems and assess needs, peculiar to every district. The survey has commenced in Namakkal and will soon begin in the other districts.

``The district-centric approach is essential at this stage of the battle in Tamil Nadu. We have realised that the problems vary from area to area — the nature of the epidemic is different, the causal factors are different, the high-risk groups vary and therefore, the solutions should also be different'', says Mr. Deenabandu.

For instance, while the high-risk group in Namakkal are truckers, in Tirunelveli, the epidemic spreads through a migrant population. As part of its district-specific targeted intervention programme, Madurai intends incorporating awareness modules on HIV/AIDS in driving schools, through regional transport offices.

Once the assessment is completed, IEC (information, education, communication) campaigns will be planned and a support package to take care of prevention and cover health and emotional care needs finalised. Short-stay homes, community care centres and `drop-in' centres for persons living with HIV/AIDS will also be established in taluks and run with the aid of the Positive Persons Association. Three `Positive Living Centres' have been planned for Namakkal district.

Service extended to taluk hospitals

The Prevention of Mother-to-Child Transmission project, now being implemented only in the headquarters hospital, will be extended to the taluk hospitals as well. A health continuum will also be established, wherein links will be established in such a manner as to channel provision of medicare to persons living with HIV/AIDS, wherever they go for help.

A proposal to establish a district-level administrative mechanism, like the AIDS Control Society, to decentralise operations and promote a ``bottom-up'' approach, is under consideration.

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