Health systems' responses to the roll-out of antiretroviral therapy (ART) in India: a comparison of two HIV high-prevalence settings

Figures & data

Table 1. Type of key informants interviewed in 2005 and 2009.

	Ajaynagar		Vijaynagar
Type of key informants	2005	2009	2005	2009
Type 1 key informants (programme managers, administrators and professionals)
Nodal officer – ART centre	1	1^a	–	1
Medical officer (MO) – ART	–	–	1	1^a
MO rural hospital	2	–	–	–
MO (Faculty medical college)	1	1^a	–	–
NGO director	1	1 + 1^a	4	2^a+1
PLHIV network president	1	1^a	1	1^a
Private HIV specialist	2	1^a	1	1^a
Type 2 key informants (front-line staff)
ART counsellor	1	1^a	1	1^a
Medical social worker at district hospital	–	1	–	–
TCC counsellor	–	–	1	1^a
VCTC counsellors	4	–	4	–
NGO counsellor	–	–	2
NGO social worker	1	–	–	–
NGO field coordinator	1	–	1	1^a
Total	15	8	16	10
^aKey informants who were also interviewed in 2005.

Table 2. Table showing comparative ART scenario at Ajaynagar and Vijaynagar in 2005 and 2009.

		Ajaynagar		Vijaynagar
Sr. No.	ART roll-out scenario	2005	2009	2005	2009
1	ART centre	Located in the general out patient department (OPD) of the district hospital	NGO built new hall for the ART centre on the premises of the district hospital	Located in a single room of the Department of Medicine in the district hospital	Public sector authorities accommodated the ART centre in the newly constructed building of the general hospital
2	Adult PLHIV on ART (approximately)	1000	6000	1100	5000
3	ART OPD	Once a week ART OPD	Every day OPD	Every day OPD	Every day OPD
4	ART centre coverage	Six to eight neighbouring districts	Only Ajaynagar district	Eleven districts throughout the State	Four to five neighbouring districts
5	ART centre cabins/rooms	Temporary table arrangement shared with the hospital OPD	Work of creating separate cabins (rooms) for counsellors, medical officers was underway	Room arrangement shared with the Department of Medicine staff	ART centre now well equipped with necessary cabins/rooms for counsellors, medical officer, data entry operator, etc.
6	HIV testing kits	Second and third kits for confirmation of HIV-positive status not available	Second and third kits for confirmation of HIV-positive status still not available	All essential HIV testing kits available	All essential HIV testing kits available
7	CD4 count machine	Non-functional due to the absence of technician	Functional	Functional	Functional
8	ART centre staff	Post of senior medical officer (SMO) vacant	All required and recommended staff in place	Medical officer had been delegated the responsibility of SMO and the rest of the staff was in position	All the required staff except SMO and medical officers were in place
9	ART counsellor	Not present	Present	Present	Present
10	Trained CD4 machine technician	Unavailable	Available	Available	Available
11	Treatment care and counselling (TCC) project	Not functional	TCC project under-staffed, struggling to function properly	TCC project well functional	TCC project well functional
12	Link ART centre	Not applicable	Programme was in the pipeline	Not applicable	Programme was in the pipeline
13	Paediatric ART programme	Not applicable	Programme was in place	Not applicable	Programme was in place
14	Clinton foundation paediatric initiative to support nutritional needs and transport costs of children living with HIV	Not applicable	Programme was in place, but supposed to end in April 2009; no plans reported for sustaining the programme	Not applicable	Programme was in place, plans to merge this initiative with the ongoing programme of Balasahyoga ^a
^aBalasahyoga is project in Andhra Pradesh that translates as “active support to the child”, that aims to improve the quality of life of children infected and affected by HIV/AIDS and their families by expanding the coverage of comprehensive HIV/AIDS care, support and treatment services in all the 23 districts of Andhra Pradesh.