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District AIDS Prevention and Control Unit (DAPCU)

As a major structural reform, the management of HIV prevention and control programme was decentralised to district level during the third phase (2007-12) of National AIDS Control Programme-III in the years 2008-09. Using the HIV Sentinel Surveillance data (2004-2006), all the districts in the country were divided into four categories (Category A, B, C and D) based on the disease burden. As per this, there were 156 Category A and 39 Category B districts (total 195 districts) across the country (22 states) that required priority attention. National AIDS Control organization (NACO) established DAPCUs in 189 of the 195 districts to provide programmatic oversight through decentralized facilitation, monitoring and coordination of HIV/AIDS programme activities in the district.

DAPCU structure and roles:  DAPCU is the eye and ears of NACO and State AIDS Control Societies (SACS) with a cross cutting management structure that coordinates with all the HIV facilities in the district.  The DAPCU is headed by a public health officer of the rank of Deputy Chief Medical & Health Officer known as District AIDS Control Officer. S/he is supported by a team of five people hired on a contractual basis as shown in the diagram.The major responsibility of DAPCU is facilitation, monitoring and coordinating NACP activities at the district and sub- district level by integrating with the health system to the extent possible for better synergy and optimal results. DAPCUs, through active engagement of the district administration engages allied line departments and private sector in mainstreaming the programme and initiates district-specific initiatives by leveraging local resources. This helps in linking vulnerable population with various social entitlement and welfare schemes. DAPCU staff builds the capacity of the facility staff, monitor the referrals and linkages through regular supervisory visits to HIV facilities and monthly review meetings, addresses supply chain management issues through inter and intra-district transfers and make troubleshoot visits, wherever necessary.

 

DAPCU Management:

National Technical Support Unit (NTSU) at NACO has been given the mandate to manage the DAPCU programme portfolio. NTSU, with technical and funding support from Centers for Disease Control and Prevention and its implementing partner SHARE India developed a standardised training programme for DAPCU staff and trained all the staff during 2010-11. Subsequently, NACO constituted a DAPCU National Resource Team (DNRT) for continuous mentoring and management of DAPCU activities. The DNRT has experienced professionals with diverse experience in managing public health programmes and has been functioning under the continuous guidance of NTSU. The team has 12 members on board and are regionally placed for providing effective oversight to the states and districts.

Each state is responsible for managing the DAPCUs, which includes hiring and retention of staff, capacity building and providing supportive supervision and day-to-day management.  One of the senior officers of SACS, preferably, the Additional Project Director (APD), or in case, APD position is vacant; Joint Director- Basic Services is designated as the DAPCU Nodal Officer (DNO). NACO conducts periodical review of the programme using various forums. With continuous evolution of the programme and changing priorities in NACP IV (2012-17), DAPCU’s role has also evolved. To capacitate the staff to meet with the growing demands of the programme, DNRT in close coordination with NACO and CDC have developed training modules.  All the staffs are being trained in FY 2014-15 by the respective SACS using these standard training modules. DNRT, in close coordination with the DNOs in SACS make need-based visits to DAPCUs to mentor the staff and motivate them to continue with their challenging task of coordinating and monitoring of NACP activities, address the programmatic gaps to realize the programme goals and objectives.

The fact that 73% of the total HIV facilities in the country are located in the high-burden districts provides scope for a positive impact on the NACP through optimal and effective engagement of the DAPCUs.

Knowledge sharing: To promote wider sharing of knowledge within the districts, different platforms have been created. One of them is identification of successful approaches and models, documenting them as case studies and sharing them widely with all the DAPCU staff in the form of “DAPCU Series”. This practice has encouraged many DAPCUs to document and present their achievements to SACS and NACO through DAPCU Series. While it is difficult   to include all the experiences through this mode, the need for a larger space was felt. “DAPCU SPEAK” (http://dapcuspeak.blogspot.in/), is another initiative that emerged from this experience. DAPCU Speak, a moderated blog started in February 2012, is to promote sharing of DAPCUs experiences.

DAPCUs role in strengthening NACP: DAPCUs have been playing a pivotal role in strengthening the NACP and some of the achievements include:

o   More than 98% of DAPCUs are conducting monthly review meetings with district HIV/AIDS facilities staff regularly to take stock of the programme, identify and resolve system level bottlenecks to improve reporting, referrals and linkages.

o   During the period April 2013 to January 2014, 73% of the DAPCUs conducted quarterly District AIDS Prevention and Control Committee (DAPCC) meetings with District Collector in chair to review the program, engage allied departments and leverage resources to address non-health needs of PLHIV and HRGs. Some major success in this regard include procurement of cold storage units by Delhi and Odisha states, nutritional support to CLHIV in the states of Andhra Pradesh, Karnataka, Tamil Nadu and Nagaland etc.

DAPCU Resources:

Priority Districts for attention (Categorisation of districts) Details
Operational Guidelines for DAPCU (Nov 2012) Details
Training Modules for DAPCU Staff (2014) Details

DAPCU Bulletin (2014)

Details

DAPCU Monthly Reporting (DMR) Format and DMR Guidance Document(2014)

Details

DAPCU Series

Details
Related orders/guidance documents Details
DAPCU Training Report (2010-11) Details
Report on DAPCU Self-assessment (2012) Details

 

 

 

 

 

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