Running Community Care Centers more of a punishment?

[Guest guest]

Dear All,

As many may be aware, grants for (Community Care Centres) CCCs from NACO are

always delayed anywhere from 3 to 6 months. This is the same story over the last

decade. As the NACO grant does not cover all the costs under the program, NGOs

that take up CCCs are expected to meet not just the resource gap that the NACO

grant does not cover, but also the amount required as per the grant.

As the in charge of running a CCC, I want to express my thoughts and

difficulties:

Without releasing funds prospectively & on time¦

a) How do we serve the PLHIV? (with quality)

How do we bargain with vendors for best prices without paying the bills for

months together?

c) How do we provide food & medicines without money on hand?

d) How do we retain our staff? (In co-ordination meetings when I

hear people debating on various strategies/mechanisms to retain their staff, I

feel like it is a joke. How practical is it to expect any staff to work without

salaries that are paid on time & without increments for years together)

Working with government is not a partnership any more; it is a mere contract,

which is one sided. CCC has to meet all obligations whether sending the

quantitative reports, SOE, attending training programs, everything, on time.

Best part of it is the Government may never want to shutdown the CCCs despite

harping on their poor performances & whether they are at all required.

The reason being is they will have no one to blame for the gaps within their ART

program.

Now they can kick the CCC to trace the LFU cases and mark them as low performing

if they don't trace out the wrong addresses that are collected by the ART

centre.

The CCC is supposed to take the rap for any of the following:

a) If someone gets HIV, CCC not doing enough Positive Prevention counseling

If someone defaults ART/ATT CCC not giving enough motivation to PLHIV

c) If PLHIV gives a wrong address CCC not tracing properly

d) If someone does not have food to eat CCC not linking to social welfare

schemes

e) If someone does not have enough documentation needed to be linked up to

government scheme CCC not trying to get them ration card/voter ID

f) If someone does not have money for travel CCC not mobilizing resources for

the welfare of PLHA

g) CCC is considered not at its best if approach roads to CCC are not good. Are

the roads also the CCC responsibility?

h) CCC will be given fewer marks if they are in the out skirts of the city,

which are far from ART centers. What a pity? So is the CCCs supposed to be in

the centre of the city where PLHA has access to many other health centers as

well, but not in a place where there is no health care facility?

i) NACO can give partial grant to CCC, but the staff should work full time only

for NACO program.

Is't NACO being unfair on these counts?

Other health programs like RNTCP which are managed by a different body of the

health ministry, has much better schemes and better process of enrolling and

tracing without indulging in any blame game.

All CCCs are feeling the heat of delays in funding. But not many want to speak

up. Some have no faith in NACO due to the absence of change.

Some are fed up with raising their voices in vain and have now reached the point

where they are now opting out of continuing with the CCC.

Freedom Foundation is one such NGO that has constantly raised its voice and is

now shutting down its CCC at Chennai because it has had enough.

Let there be a partnership rather than one sided contracts of convenience.

Regards

Madhuri

e-mail: <madhurikv_99@...>