Country Spotlight: India

Country Overview

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) has been in partnership with Solidarity and Action Against The HIV Infection in India (SAATHII) since 2002. Together, we have tested over one million women over the life of the project. The program works to prevent mother-to-child transmission in the private health sector, filling a gap expressed by the Ministry of Health (MOH). The program supports services in 364 private and faith-based hospitals spread across four high HIV prevalence states in Andhra Pradesh, Maharashtra, Manipur, and Karnataka.

Ann Summa/EGPAF

Our Work in India

SAATHII conducts trainings and roll-out of new WHO guidelines; facilitates trainings on PMTCT, early infant diagnosis (EID) of HIV, infant and young child feeding (IYCF), and community sensitization; develops job aids; provides resources and materials for service delivery; works directly with sites to plan and implement services, and provides support and TA for management of the program.

The EGPAF/India program complements the government programs by reaching unreached populations, specifically women accessing the private and faith-based maternity hospitals. The EGPAF/India program accounts for 10-20% of total coverage of PMTCT services in the private sector, and 80% of the private sector reporting in the states of Andhra Pradesh, Karnataka, and Maharashtra.

SAATHII participates in various national-level technical working groups to develop policy and guidelines; plans program implementation; chairs the national country coordinating mechanism (CCM) for the Global Fund; and works with the National AIDS Coordinating Organization (NACO), the District AIDS Prevention Control Unit (DAPCU), and the State AIDS Control Society (SACS) to elevate the elimination agenda related to PMTCT.

The public-private partnership (PPP) model is unique to the India program, and was launched in 2009 by SAATHII as a strategy for increasing cost efficiency and expanding access to PMTCT services to women attending ANC and delivering in private facilities. The model involves a three-way collaboration between a government entity (thus far the State AIDS Control Agencies in the states of Andhra Pradesh, Karnataka and Maharashtra), a private hospital, and a technical agency. The State AIDS Control Agencies offer training for nurses and lab technicians; supplies of HIV test kits; registers, and reporting materials; drugs and other consumables; and IEC materials to the private hospitals. The private hospitals benefit from the government contributions and training, and are better able to offer sustainable quality services to the population through the cost-share. The technical agency (SAATHII) acts as the liaison between the other two entities, helps negotiate the PPP agreement, provides technical assistance and organizes state-wide experience sharing meetings.  EGPAF has supported SAATHII’s costs for serving as the technical partner within the PPP.

SAATHI works with DAPCU and SACS to build their capacity in the planning and implementation of PMTCT service delivery; monitors program progress using program data; supports logistics and supply chain management; and strengthens health systems at over 500 health facilities in more than 60 districts with regard to universal work precautions, hospital waste management, confidential HIV testing and counseling, and the provision of post-exposure prophylaxis as per the national protocol.

As of September 30, 2013, EGPAF-supported programs in India have:

Key Projects in India

Healthy Mothers, Healthy Babies: Improving the Health of Pregnant Women, HIV-Positive Mothers, and Their Babies (MAC AIDS: 2012-2013)

Under this project, EGPAF and our partner Solidarity and Action Against the HIV Infection in India (SAATHII) are expanding the public-private partnership model to other districts in Andhra Pradesh in order to provide 100% coverage at all prevention of mother-to-child transmission of HIV (PMTCT) sites. SAATHII is providing technical and implementation assistance to the Andhra Pradesh State AIDS Control Society (APSACS) to establish Integrated Counseling and Testing Centers in private hospitals. The program provides comprehensive and quality PMTCT services to HIV-positive pregnant women in line with national guidelines, and develops strategies to increase the follow-up of mother-baby pairs. SAATHII also works with various governmental entities, such as the National AIDS Control Organization and the State AIDS Control Societies, to elevate the elimination of pediatric HIV agenda.

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Prevention of Mother-to-Child Transmission of HIV (PMTCT) Partnership (Johnson & Johnson: 2008-2012)

The EGPAF-Johnson & Johnson (J&J) partnership was designed to expand coverage and improve the quality of prevention of mother-to-child transmission of HIV (PMTCT) services as well as demonstrate global leadership in PMTCT by replicating and documenting best practices in 11 country programs, with additional support for clinical service programs in Cameroon, India, and Malawi. By project end, EGPAF had reached more than 2.6 million women, including over 130,000 in India, with access to PMTCT services, and succeeded in integrating PMTCT into routine maternal and child health (MCH) services by training health personnel and developing tools and job aides. In India, EGPAF worked with our local partner SAATHII in four high-prevalence states (Andhra Pradesh, Karnataka, Maharashtra, and Manipur) to provide quality and comprehensive PMTCT services at 360 sites in 58 districts. EGPAF’s work in India focuses on delivering private-sector testing and counseling in collaboration with the government through a public-private partnership (PPP). To strengthen health systems of the private health sector, EGPAF has:

  • Built the capacity of health care providers to improve supply chain management, strengthen laboratory capacity, and ensure linkages with government services;
  • Expanded community-based testing efforts in Manipur;
  • Supported the adoption of the revised WHO Guidelines for PMTCT at the national level.

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