Re: NACP III & Re-naming VCT Centres to Red Ribbon Clubs

[Guest guest]

Dear Readers,

Rather than be looking for a new name we should be improving the performance

indicators of any VCCT's that still get customers because the standards of

counselling and support services are seriously deficient and the

confidentiality, care and support are pretty much non existent in most centres.

VCT's in the main have been infection census bureaux where the tests are done

and the numbers counted.

There is almost a complete absence of positive counsellors on the staff of most

VCT's and it is clear that such counsellors debriefed by the local NP+ members

creates the best prospects for infection proofing those that test negative and

supporting those that are determined to be positive.

Referral services for positive clients are almost non existent, sexual risk

education is seriously lacking in the pre test phase which is where most of the

good prevention strategic direction opportunities prevail. In fact I would go so

far as to say that high speed results seem to be the norm and all other aspects

of counselling for STI's and unwanted pregnancies just don't get a mention.

In the ones I visited this strategic direction is not even in the job

description. Accreditation standards for counsellors and the proper management,

debriefing and support of staff is not evident.

Recomendations to SACS for improved after-testing services do not seem to be in

place nor is there a mechanism for such monitoring and advice to influence

community support.

I am even hearing this week that in Bihar under a project that has a

mysterious acronym of MAT the BSACS is conducting secret HIV testing without the

consent of the clients to prove that the rates of infection are in fact higher

than the statistics indicate and whilst I don't doubt that they are, there are

some ethical standards lacking in such a project, whatever the motivation, and

especially if the tested patients are not informed of any status results.

I keep asking myself why that after 20 years of having access to the latest

strategic management ideas we keep getting these instances of recalcitrant

epidemiologically unsound practices emerging and worse still, they are being

kept secret until the secret leaks out and then officials dive for the trenches.

I am never sure where to direct such stories but it seems that this list at

least gets a pretty instant penetration into that part of Indian society trying

to make changes for the better.

Lets leave the Red Ribbon Peer Education clubs alone, if for no other reason

than they probably hold the key to effective behaviour change strategies in

India, and instead concentrate on improving care, support, anti discrimination

practices in all sectors, and ensure that VCCTS actually do more than just count

the number of positive tests performed.

Geoffrey

E-mail: <gheaviside@...>