Targetted Intervention (TI)

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West Bengal is a state in the eastern region of India and is the nation's fourth-most populous. It is particularly vulnerable to HIV infection, with the vulnerability issue varying from one district to another. 

In the districts, there are variations with varying levels of risk of acquiring and spreading the infection. Though predominantly the route of transmission is sexual, one finds that there are certain districts like Kolkata and Darjeeling, besides the sexual route, the epidemic is also driven by the injecting route of transmission. In West Bengal, the 2010-11 HSS round found an HIV prevalence of 2.72% among IDUs, 5.09% among MSMs, 2.04% among FSWs and 0.13% among pregnant women. If compared to the previous year’s figures in 2008-09 (6.90% among IDUs, 4.90% among MSM and 4.12% among FSWs and 0.21% among pregnant women), HSS 2010-11 results suggest that the trend in the epidemic continues; it is concentrated mainly in the high risk groups.

To control the spread of HIV/AIDS in the state, interventions known as targeted interventions (TIs) are being implemented among the high risk groups (HRGs) and vulnerable populations in West Bengal. Interventions among the HRGs like female sex workers, injecting drug users, transgenders, hijra and men who have sex with men and vulnerable populations like migrant labourers and truckers include (i) the provision of behaviour change interventions to increase safer practices, testing, counseling, adherence to treatment and demand for other services (ii) the promotion and provision of condoms to HRGs (iii) provision or referral for STI services including counselling at service provision centres to increase compliance to treatment, risk reduction counselling  with focus on partner referral and management; (iv) needle and syringe exchange for IDUs as well as provision of Opioid Substitution Therapy (OST).  

Overall a total of 37 TI projects are operational in the state of West Bengal in 15 out of the 20 districts of the state. The spread of TIs across these 15 districts are as follows:

Table 1: District-wise number of TIs in West Bengal as on 31-03-2015 

Sl No.

Districts

No of TIs

1

Kolkata

6

2

S 24 Parganas

4

3

Burdwan

5

4

Birbhum

1

5

Purba Medinipur

1

6 (a)

Darjeeling hills

2

6 (b)

Darjeeling plains

3

7

Jalpaiguri

1

8

 Hooghly

2

9

Nadia

1

10

Howrah

3

11

N 24 Parganas

4

12

Malda

1

13

Murshidabad

1

14

Uttar Dinajpur

1

15

Coochbehar

1

 

Total

37

Typology wise number of existing TIs along with coverage as of 31st March 2015 is as follows:

Table 2: Number of existing TIs along with proposed and actual coverage as on 31 March 2015

Typology

Actual No. of TIs as on 1st April 15

Actual Coverage

FSW

19

28,541

TG/Hizra

01

325

MSM

04

1200

IDU

03

2,011

Core Composite

01

200 FSW

      100 MSM

Migrants

03

30,000

Truckers

06

60,000

Total

37

 

 

 

 

 

 

 

 

 

In addition to the above the number of existing Source Migrant and Transit Migrant interventions in the state are-:

 

 

In addition to the above, the number of existing Source Migrant and Transit Migrant interventions in the State are:

Table 3: Number of existing source and transit migrant interventions

Intervention Type

Nos.

Transit Migrant

10

Source Migrant

05

 

OST Interventions

During the period 1st April 2014 to 31st March 2015, 12 OST centres were functional in the state. Out of the 12 centres, 11 were NGO run while the remaining 1 was run by a Government health facility in Murshidabad. The 12 OST centres are spread across Darjeeling – 9 (5 in the hills and 4 in plains), Murshidabad - 1, Kolkata – 1 & Howrah – 1, districts. All the 12 centres are implementing Buprenorphine maintenance program. Of the 11 centres that were NGO run 7 are temporary in nature and are being replaced by centres at Govt. health facilities. The remaining 5 centres are run within IDU TIs from 1st April, 2015 only one OST Centre will be in the NGO, i.e., The Calcutta Samaritans, Howrah. The rest will be transferred to government health facilities.

The 12 OST centres in both NGO and Govt. health facilities and their allotted slots are-

Table 4: OST Centres and their allotted slots as on 31/03/2015

Sl No.

Name of OST Centre

Slots

1

GUP, Siliguri

50

2

GUP, Naxalbari

25

3

BPWT, Gurung Basti

50

4

BPWT, Uttar Ektiasal

80

5

D.B. Giri Road, SPYM, Darjeeling

50

6

D.B. Giri Road, SPYM, Ghoom

30

7

D.B. Giri Road, SPYM, Mirik

30

8

D.B. Giri Road, SPYM, Kurseong

30

9

D.B. Giri Road, SPYM, Kalimpong

50

10

The Calcutta Samaritans, Howrah

80

11

The Calcutta Samaritans, Kolkata

120

 

Total Slots

645

Table 5: OST Centres at govt. health facilities (got operational from 1st Apr.,’15):

Sl.No.

Name of OST Centre

1

Calcutta National MC&H, Kolkata

2

North Bengal MC&H, Darjeeling

3

Darjeeling DH, Darjeeling

4

Kalimpong SDH, Darjeeling

5

Kurseong SDH, Darjeeling

6

Mirik BPHC, Darjeeling

7

Murshidabad MC&H (existing with 50 slots) 

 

Technical Support Unit

The National AIDS Control Organization contracted Society for Promotion of Youth & Masses (SPYM) a national level NGO to set up the Technical Support Unit (TSU) of West Bengal in late April 2014.    The main purpose of the TSU is to provide technical support to SACS in specified areas for helping it to achieve the goals and objectives of NACP IV that of prevention and treatment. The TSU in West Bengal therefore became operational from 1st May 2014. Its main mandate is to build capacities and improve and strengthen the quality of targeted interventions in the state.

After becoming operational from May 2014 the TSU has tried to improve the quality of TIs through regular handholding and onsite mentoring of TIs. Overall man days have been utilised to improve performance as well as record keeping.

 

Achievements of the TI Division

  • 100% reporting by TIs on SIMS and 31 indicators within the stipulated date.
  • 100% reporting by transit TIs within the stipulated date
  • 100% reporting by OST centres within stipulated date
  • Grading of TIs on the basis of performance. Of the 33 TIs, 3 were graded “Very Good” having scored more than 80%. 14 were graded as “Good”, 11 as average and 5 as “Poor”.
  • Fund release to TIs started based on achievements of performance indicators submitted along with bond and agreement.
  • Four TIs were discontinued during the FY 2014-’15 due to poor performance, viz., Health Vision & Research, Kolkata (FSW), Gana Unnayan Parshad, Darjeeling (IDU), Tengunia Sanskar Kendra, East Midnapore (Migrants) and Hill Social Welfare Society, Darjeeling.
  • Three Truckers TI, four MSM TI and one Core Composite TI were awarded during the FY 2014-’15.
  • TI NGOs to procure STI medicines and needle/syringes from Fair Price Shops setup at the different government health facilities.
  • Linkage of the HRGs with the nearest Govt. health facilities for STI health treatment and Syphilis testing has been initiated.