Care and Support Centres (CSC):
The overall goal of Care, Support and Treatment (CST) component under NACP IV is to provide universal access to comprehensive, equitable, stigma-free, quality care, support and treatment services to all PLHIV using an integrated approach.
Based on the recommendation and priorities of NACP IV working group on care and support, the strategy of implementation of the care and support is being completely revamped to ensure cost effectiveness and sustainability. All care and support component of NACP III CCC, DIC & DLNs are brought under one roof to provide community based care and support services.
Under NACP IV, Care & Support Centers (CSCs) are established and linked to ART centres with the goal to improve the quality & survival of life of PLHIV. The CSCs serve as a comprehensive unit for treatment support for retention, adherence, positive living, psychosocial support , referral, linkages to need-based services, and providing an enabling environment for PLHIV. This will be part of the national response to meet the needs of PLHIV, especially those from the high risk groups, and women and children infected and affected by HIV. CSCs are run by civil society partners including District Level Networks (DLN) and non-government organizations (NGOs).
Important Services Provided by Care and Support Centers:
Broadly, the following services are being provided by care and support Centres:
counselling support is provided on a wide-range of issues (psycho-social support, disclosure of HIV status, treatment education and adherence, positive living and positive prevention, nutrition, sexual and reproductive health issues such as family planning and pregnancy, discordant couples, home based care) through one-to-one counselling or couple/family counselling. Children and adolescents living with HIV are also be provided counselling services on HIV status disclosure, ART adherence, personal hygiene, eating healthy and hygienic food, coping with emotions etc. Counselling services are available at the CSC through trained counsellors and messages are reinforced in the field through outreach workers and peer counsellors.
These services include follow up of PLHIV for treatment adherence, repeat CD4 testing; tracking Lost to follow-up (LFU) & MIS cases, and motivating family members for HIV testing; reinforcing counselling messages; and providing/facilitating home-based care.
Referrals and linkages:
Another important service provided by the CSC is the establishment of linkages and provision of referrals to various service providers in the area for addressing medical and non-medical needs. The PLHIVs are also supported to access and avail social entitlements and social welfare schemes.
Advocacy and communication:
To create an enabling environment and access to services without stigma and discrimination, CSC supports the PLHIV through various advocacy initiatives at local, state and national levels. A discrimination response team is set up at the CSC level to respond to incidents of denial of services reported in the area due to discrimination. Quarterly advocacy meetings with various stakeholders and media advocacy events are planned to influence policy.
Support group meetings:
Support group formation is aimed at providing a platform for PLHIV to share their concerns and learn from each other. Regular support group meetings are organized and information on various themes are provided to build skills of PLHIV to lead quality life.
Vocational Training and Life Skill Education:
One of the important service of CSC is to provide life skill education and vocational training to the clients with special emphasis on women and youth. Theoretical aspects of life skills are incorporated into the ongoing educational and training components and the vocational training is provided through linkages with vocational training institutes under government departments as well as corporate sectors. The clients are also linked to various income generation activities available in the area.
Training on Home Based Care Services:
PLHIV and their care givers in the family are trained on basic infection control practices at home, management of general ailments and minor infections at home, and identification of signs and symptoms of health issues requiring immediate medical care. Clients are provided with information about the nearest available health care facilities and importance of good health seeking behaviour