Koshish a European Commission-funded programme, strengthens civil society organizations and networks— specifically those representing and working with PLHIV and other marginalized groups like MSM, transgender, sex workers, and people who use drugs—to effectively advocate for policies and strategies on sexual and reproductive health (SRH) and rights for PLHIV in India. Through coalitions, partner organizations develop and implement state and district-level efforts, affirming the principles of empowerment and meaningful partnerships as core elements of effective advocacy.
Increased capacity and advocacy supported through Koshish will support the realization of rights of PLHIV and help address dynamics that limit PLHIV access to SRH interventions. Alliance India leads this project in India; In Maharashtra the project is being implemented in partnership with NMP+ and Mamta.
District level Partners in Maharashtra.
In Maharashtra a total of 5 districts are covered under the project. NMP+ covers 3 districts where as MAMTA covers 2 districts.
Districts covered by State Level Network (SLN) & State Level Partner (SLP)
|State Level Partner/Network||District Covered||Type of Organisation||Name of the Organisation|
|NMP+||Ahmednagar||District level Organisation||Network of Ahmednagar by People Living with HIV. (NADP+)|
|Ahmednagar||Key Population Organization||Snehalaya|
|Kolhapur||District level Organisation||Network of Kolhapur by People Living with HIV. (NKP+)|
|Kolhapur||Key Population Organization||Maitra Organization.|
|Thane||District level Organisation||Network of Thane by people Living with HIV.|
|Thane||Key Population Organization||Adiji Sanstha.|
|MAMTA||Nagpur||District level Organisation||Sanjeevan Bahuuddeshiya Sanstha DLN|
|Nagpur||Key Population Organization||Manav Vikas|
|Amravati||District level Organisation||Adhar DLN|
|Amravati||Key Population Organization||Bhagyoday|
Civil Society Organizations.
|State Level Partner/Network||District Covered||Name of the Civil Society Organisation|
|NMP+||Kolhapur||Jeevan Jyoti Sanstha|
|Amravati||Jeevan Vikas Sanstha|
|RTM SAP Mandal|
Staff at State Level Network.
1. Mr. Manoj Pardesi – Project Director
2. Mr. Vinod Jambhale – Technical Support Officer.
3. Mr. Vijay Bhende – Advocacy Officer.
4. Ms. Monali Jagtap.
- State Level Collation meeting.
2. District Level Events. Doctors Day.
3. Task force group
4. Community Consultations.
5. District level Advocacy.
State level Advocacy Plan.
State level Advocacy Plan was made during fifth coalition meeting held at Nagpur on 23rd August 2012. All twenty CSOs participated in the meeting.
State level advocacy plan is developed on the following issues: –
- Cesarean delivery of HIV positive ANC’s should be essential to reduce the chances of HIV transmission from mother to her child
- PAP smear test for cervical cancer should be compulsory for KPs and PLHIV who are taking ART.
3. To review existing training modules of MO and counselors in order to see if SRHR issues are included if not included advocate for including the SRHR issue by making them aware of the importance of the issue
Report on Pap smear testing
Koshish is an initiative to advocate for policies and strategies on reproductive and sexual health rights for Persons Living with HIV in India. Through coalitions, partner organizations in Maharashtra develop and implement state and district-level efforts, affirming the principles of empowerment and meaningful partnerships as core elements of effective advocacy in five districts viz. Nagpur, Amravati, Kolhapur, Ahmed Nagar and Thane.
During our work with PLHIV, we have come across higher incidence of cervical cancers. It is well researched that HIV positive women are five times more at risk of acquiring Cervical Cancer than HIV negative females. As the supply and availability of ART has increased, it has given greater hope to positive women to live healthy and longer life. With these increased chances of survival and long life, it is critical that these women also lead healthy lives without the fear of morbidity and mortality. Cervical cancer is one such danger that needs immediate redress. However, an early detection of cervical cancer is possible and can be managed through PAP SMEAR test
During community consultation meetings at district level, information on cervical cancer was provided by the field officer and demand generated by the participants for early detection.
In all implementing five districts of project Field officers met with civil surgeon and Dean. From all the meetings they came to know that referral is not provided to WLHIV and in Amravati district Cyto pathologist is not appointed.
A small study was made by the field officer at district about how many women living with HIV and FSWs are referred for PAP smear testing. The number was very less according to the reporting of field officers.
Issue of PAP smear test and its importance was discussed in coalition meeting with the CSOs and with field officers. It was decided by the coalition that we need State specific data on cervical cancer, camps will be organized for screening of cervical cancer and prepare a one page note and share it with decision makers.
Contributing to State Advocacy agenda:-
Testing camps are organized to collect data from all 5 districts and it will utilize as evidence for State level advocacy and also to draw the attention of decision makers towards issue of cervical cancer.
At present the Pap smear test has not been carried out in ART centres in Maharashtra despite being provisioned in the National Guidelines. By including this test at these centers, the chances of survival of positive women would increase many-fold.
Coalition will requestto include Pap smear test as a mandatory test for all PLHIV women at least once in a year. This will help in increasing their chances of survival with a long and healthy life.
- Research and data were collected from National AIDS research institution (NARI, Pune ) and organize testing camps to collect district level data.
- It was planned to celebrate Doctors Day to thank and appreciate Doctor’s for their services towards PLHIV to increase awareness and boost their confidence and encourage other doctor’s community with the involvement of government authorities to achieve multifold benefits (includes pap smear testing, safe delivery at taluka level etc) by celebrating Doctors day.
- Draft a request letter with primary and secondary data for referral of WLHIV through ART centers.
- Request letter will be present to key official of SACS and NRHM
Collection of data was done from counselors, medical officers, after this it was planned to put a written request to the key official regarding initiating “ Pap Smear Test” on World AIDS day after honoring key officials from Civil Hospital
On 30 November 2012 a common activity was planned at all five districts as a next step in pap smear testing advocacy. Our district field officer along with their staff members and board of director visited to civil hospital honored the civil surgeon, ART HOD, ART medical officer, Art and ICTC counselors, care coordinator, PPTCT counselor with a small trophy and certificate for their support to the SRHR project. After the small program, IEC material developed on cervical cancer and a request letter for initiating pap smear testing was given to civil surgeon. Interaction with all the team helped to bring a positive outcome at all the districts.
Civil surgeon agreed to start the PAP smear testing.
- At Ahmednagar the team agreed to set a camp on 1st and 3rd Saturday of every month. Testing for 25 women was agreed by the CS at every camp.
- In Thane, civil surgeon agreed to arrange the camp for 30 women in monthly camp.
- Civil surgeon of Kolhapur assured to organize camps in the month of March.
- In Nagpur Indian cancer society giving their support for organizing camps.
- In Amravati district Civil surgeon appointed cyto pathologist and circulate the circular for routine PAP smear test.
|Name of District||No of tested WLHIV||Remark|
|Nagpur||18||7 tested positive|
|Ahmadnagar||29 (Two camps)||Nil|
|Kolhapur||Tuesday and Saturday|
|Amravati||Cyto pathologist is appointed in this month|
Next Action Plan:-
- To conduct an advocacy event in March 2013 with the decision makers at NRHM and SACS for conducting the PAP smear test mandatory of every WLHIV on ART once in a year.
- Follow up with district decision makers for organizing testing camps.
Pap smear testing camp and motivating women’s for testing in Thane.
Candle Light Memorial Day Advocacy Event