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Community Care Centers
Bhoruka Public Welfare Trust has been opened 10 bedded Community Care Centers (CCC) in the following places:
1. Guwahati, Assam with support from ASACS, started from July 2008.
2. Another CCC will be established at Jalpaiguri district, West Bengal with support from Catholic Bishop’s Conference of India (CBCI) within January 2009.
The Community Care Centers (CCC) are playing a critical role in enabling PLHA to access ART as well as providing monitoring, follow-up, counselling support to those who are initiated on ART, positive prevention, drug adherence, nutrition counselling etc. The monitoring of PLHA who do not require ART yet (Pre-ART care) will also be a critical function that needs to be carried out by CCC.
Community Care Centre (CCC) is a place with facilities for out-patient and inpatient treatment where a PLHA receives the following services:
All PLHA started on ART (at the ART center), will be sent to the CCC for a minimum of 5 days of inpatient care where the following action will be taken:
a. PLHA without OI should be placed separately from PLHA with OIs.
b. Medical monitoring for side effects and tolerance to ART regimen and/or stabilization of OIs as initiated by the ART centre/higher level facilities
c. Verification of patient address: The ART centre will verify the address of all PLHA being enrolled at the ART centre. In case of PLHA whose address could not be verified, the CCC will be informed of the same. The outreach worker at the CCC will undertake home visit to verify the address. The home visit will be undertaken with informed consent of the PLHA regarding time, day and person to be contacted.
d. Follow-up home-visits to ensure home care and to monitor well-being and treatment adherence.
e. Preparing family and/or spouse for acceptance of test status of PLHA, counselling for supervised administration of drugs, home based care etc.
f. Psychosocial and counselling support on drug/treatment adherence, patient education, nutrition counselling, positive prevention including consistent use of condoms, reproductive health counselling for HIV-positive women and couples etc.
g. In case of PLHA requiring stay for over five days, discharge of PLHA would be determined by the treating physician.
Treatment of OIs.
Following assessment at the ART centre, PLHA who do not require ART, will be followed up for pre- ART care such as routine regular monitoring of CD4 testing and other medical concerns. The PLHA will also receive psychosocial support and counselling, treatment literacy, positive prevention etc.
i. ICTC for confirmation of HIV status in patients with unconfirmed or unknown status, spouses and family members of PLHA etc.
ii. PPTCT for care of HIV-positive pregnant women
iii. Paediatric HIV services/ART centre for children living with HIV/AIDS for routine monitoring including growth, HIV/PCR diagnostic testing, immunization, prevention and care of opportunistic infections, assessment for ART initiation etc.
iv. ART Centre for the CD4 test and other laboratory investigations and if required, initiation of ART at the ART Centres
v. Medical facilities for specialised services as required.
vi. DOTS for treatment for TB.
vii. Other services as required e.g. welfare-legal services, harm reduction programmes for IDUs, peer support networks etc.
i. Consultation of illnesses related to HIV/AIDS
ii. Treatment of OIs
iii. Counselling for adherence and Home Based Care (HBC)
i. Outreach facility for PLHA who required home care or additional psychosocial support.
ii. Counselling for Home Based Care (HBC)
An ICTC has been set-up within the CCC at Guwahati. This will offer HIV testing to:
• Spouse and children of PLHA
• HRGs
• Clients reporting to the CCC with TB
• Any client referred to the centre.
• Direct walk-in clients seeking a HIV test.
The CCC will provide the range of PPTCT service to:
• Pregnant women referred to the CCC
• Spouse of PLHA
• Positive pregnant women
• All PLHA should be counselled for risk reduction
• Condoms should be made available at the CCC
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