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Anjana Das STI Capacity Building

Community-centered Clinical Services: Case Studies and Lessons Learned from Implementing Key Population Programs in India. Anjana Das STI Capacity Building. Scale and Scope of Avahan Program. 10 Years = USD $376 million 2004 – 2013 Phase 1 – Scale-up 2004-2009

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Anjana Das STI Capacity Building

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  1. Community-centered Clinical Services: Case Studies and Lessons Learned from Implementing Key Population Programs in India Anjana Das STI Capacity Building

  2. Scale and Scope of Avahan Program 10 Years = USD $376 million 2004 – 2013 Phase 1 – Scale-up 2004-2009 Phase 2 – Transition 2009 - 2013

  3. STI service delivery structure

  4. Community Led- Approaches for Clinical Service Provision Community participation guidelines for planning, implementing and monitoring services in Avahan COGS & CMP • Training and supporting peer outreach workers • Establishing service committees e.g. STI, care and support • Appointment of community members in clinic staff positions Phase 1 (2004-2009) Scale-up Refined with learnings • Preparing CBOs to lead STI program components • Service committees increasingly led by community non-peers Phase 2 (2009-2013) Transition

  5. Documenting Community-centered Clinical Services: Case Studies and Lessons Learned • Document innovative approaches used in resource-constrained settings • Share good practices and lessons learned • Strengthen capacity of KP programs elsewhere Purpose Intended audience • Primary: KP program implementers • Health officials, donors, policy makers • Replicability and scalability • Demonstrated improved outcomes • Relatively simple processes • Acceptable and accessible by KPs Case study selection criteria

  6. List of Thematic Areas/Chapters • Community-led Approaches for Clinical Service Provision • Customizing STI Service Delivery Models • Sexually Transmitted Infections (STI) Care and Treatment • Continuum of Care • Clinic Management Systems • Sustainability and Transition

  7. Lessons Learned • Increased clinic utilization • Has the potential to lead to a change from an externally-led to a community-led program Community Participation Service Delivery Models • Tailored to KP typology and local resources • Improved accessibility • Static + outreach clinics cost-effective in large urban areas • Standardized guidelines and SOPs • Regular quality monitoring and use of data improved services • POC tests increased syphilis screening STI Care and Treatment

  8. Lessons Learned (2) • Demand generation and HTC at outreach clinics led to four-fold increase in HIV testing • Primary HIV care & support, TB screening provided on-site with referral linkages for higher-level care Continuum of care • Capacity building mechanisms for clinic staff ensured quality of services • Stock management systems for drugs and other commodities prevented stock-outs and wastage Clinic Management Systems • CBOs should be involved in transition planning, post transition support necessary • Early planning for sustainable mechanisms for clinical services Sustainability and Transition

  9. Acknowledgements andKey References • Bill & Melinda Gates Foundation • Implementing agencies • Our community members

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