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      Integrated counseling and HIV testing centers of Delhi: An evaluation

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          Abstract

          Background:

          HIV counseling and testing services are a key entry point in prevention of HIV infection, treatment, and care of people with HIV. Evaluation of counseling, testing, and referral services help to increase the effectiveness, efficiency, and quality of services delivered by providers by improving any deficiencies in availability, accessibility, and acceptability of testing and counseling services. The objective of this study was to evaluate the integrated counseling and testing centers (ICTC) in New Delhi.

          Materials and Methods:

          The evaluation study was conducted among ICTCs during 2014–2015. Twenty ICTCs of New Delhi were selected on the basis of population proportion to the size of clients catered. The study tool was pretested structured tool for evaluating HIV voluntary counseling and testing (VCT). The evaluation tool consists of an assessment of components including the availability of infrastructure, laboratory services, referral services, and staff availability. Counseling sessions were also observed for assessing content and quality. Means and proportions were calculated.

          Results:

          Twelve (60%) ICTCs had dedicated counseling rooms ensuring privacy for the clients. Waiting space was reported to be adequate in 16 (80%) ICTCs. Space within counseling room was observed to be adequate in 8 (40%) ICTCs. Counselors of both sexes were present in 12 (60%) ICTCs. Both external and internal quality assurance was observed in all ICTCs. Standard operating procedures were followed in 15 (75%) ICTCs. On observation of the counseling sessions, it was found that 67.4% of male counselors and 67.2% of female counselors addressed all the issues of content of counseling.

          Conclusion:

          ICTCs lack waiting area and adequate space in counseling room and required staff personnel. Records maintenance and laboratory quality control maintained by ICTCs were found to be adequate. The counseling rooms lack privacy that may compromise the confidentiality of clients. Few components of counseling need improvement.

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          Most cited references7

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          Performance evaluation of PPTCT (Prevention of parent to child transmission of HIV) programme: An experience from West Bengal

          Background & objectives: Prevention of parent-to-child transmission (PPTCT) services are an integral part of National AIDS Control Programme and their critical appraisal is necessary for improving quality care. The present study was conducted to evaluate the performance of PPTCT services in West Bengal during April, 2008 - March 2009 and April 2009 - March 2010 and identify gaps in service delivery for making suitable recommendations. Methods: Data were collected from the Computerized Management Information System and validated by cross-checking records at each district. Focus group discussions (FGDs) were conducted among programme managers, counsellors and antenatal women attending the Integrated Counselling and Testing Centres. Performance indicators and outcomes of FGDs were analyzed. Results: The proportion of antenatal women tested declined in 2009-2010 from 2008-2009 (64.3 to 63.8%). Proportions of counseled cases also declined (72.5 vs. 68.4%). HIV positivity rates among those tested were 0.13 and 0.14 per cent, respectively in two years. Proportion of mother-baby pairs receiving nevirapine prophylaxis was increased by 5 per cent. Medical colleges, and category A districts having high HIV prevalence provided better services. Follow up services of HIV-exposed birth cohorts were grossly unsatisfactory. Interpretation & conclusions: Gaps were identified at each step of service delivery for which capacity building, improvement of infrastructure including laboratory services and ensuring emergency labour room testing up to the sub-district level were imperative. Outsourcing follow up services to other community based organizations may also be considered.
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            An assessment of the Zimbabwe ministry of health and child welfare provider initiated HIV testing and counselling programme

            Background Provider-initiated HIV testing and counselling (PITC) is widely recommended to ensure timely treatment of HIV. The Zimbabwe Ministry of Health introduced PITC in 2007. We aimed to evaluate institutional capacity to implement PITC and investigate patient and health care worker (HCW) perceptions of the PITC programme. Methods Purposive selection of health care institutions was conducted among those providing PITC. Study procedures included 1) assessment of implementation procedures and institutional capacity using a semi-structured questionnaire; 2) in-depth interviews with patients who had been offered HIV testing to explore perceptions of PITC, 3) Focus group discussions with HCW to explore views on PITC. Qualitative data was analysed according to Framework Analysis. Results Sixteen health care institutions were selected (two central, two provincial, six district hospitals; and six primary care clinics). All institutions at least offered PITC in part. The main challenges which prevented optimum implementation were shortages of staff trained in PITC, HIV rapid testing and counselling; shortages of appropriate counselling space, and, at the time of assessment, shortages of HIV test kits. Both health care workers and patients embraced PITC because they had noticed that it had saved lives through early detection and treatment of HIV. Although health care workers reported an increase in workload as a result of PITC, they felt this was offset by the reduced number of HIV-related admissions and satisfaction of working with healthier clients. Conclusion PITC has been embraced by patients and health care workers as a life-saving intervention. There is need to address shortages in material, human and structural resources to ensure optimum implementation.
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              Operational guidelines for integrated counselling and testing centres

              (2007)
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                Author and article information

                Journal
                J Family Med Prim Care
                J Family Med Prim Care
                JFMPC
                Journal of Family Medicine and Primary Care
                Medknow Publications & Media Pvt Ltd (India )
                2249-4863
                2278-7135
                Jul-Aug 2018
                : 7
                : 4
                : 791-795
                Affiliations
                [1 ] Department of Community Medicine, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India
                [2 ] Family Welfare Training and Research Centre, (Ministry of Health and FW, Govt. of India), Mumbai, Maharashtra, India
                [3 ] Department of Community Medicine, VMMC and Safdarjung Hospital, New Delhi, India
                Author notes
                Address for correspondence: Dr. Vinoth Gnana Chellaiyan, Department of Community Medicine, Chettinad Hospital and Research Institute, Kelambakkam, Chennai, Tamil Nadu, India. E-mail: drchellaiyan@ 123456gmail.com
                Article
                JFMPC-7-791
                10.4103/jfmpc.jfmpc_128_17
                6132007
                41f68247-aa83-4a07-a90c-f2923d2e9c37
                Copyright: © 2018 Journal of Family Medicine and Primary Care

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

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                evaluation,hiv counseling,integrated counseling and testing centers

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