EVTHS Priority state Roll-out Mz 04-04-23.ppt

STATE: ……………………………………………
Roll out and 1st
Phase Implementation of Elimination of
Vertical transmission of HIV & Syphilis (EVTHS) Services
under NACP-V
STATE - MIZORAM

INTRODUCTION
India is signatory of WHO ‘95-95-95’ targets of EVTHS and to end AIDS epidemic by 2030.
EVTHS – one of the key objectives under NACP – V
Parent to Child Transmission is the main cause of HIV & Syphilis infection in infants/children – largely
preventable with appropriate interventions.
PTCT – contributes to about 4% of HIV infection in India.
PPTCT programme (2002) – implemented under NACP to achieve the goal of elimination of HIV &
Syphilis.
PPTCT Services – To provide access to all pregnant women for HIV diagnostic, preventive, care,
support & treatment services.
KEY OBJECTIVE – To ensure integrated PPTCT services delivery with existing RCH programme.
VISION: Women & children alive and free from HIV & Syphilis.
GOAL : To work towards elimination of paediatric HIV & improved maternal, newborn & child
health and survival in the context HIV & Syphilis infections.

GOI committed for “ Dual Elimination of HIV/Syphilis in Children” by March 2025
(EVTHS)
Process Indicator
Need to be maintained for at least 2 years
• >95% HMIS Registration of ANC
• >95% ANC know their HIV and
Syphilis Status
• >95% HIV Positive PW linked to ART
services
• >95% syphilis sero-positive pregnant
women received treatment
Impact Indicator
Need to be maintained for at least 1 Year
• <5% HIV prevalence in breast
feeding (BF) and <2% HIV
prevalence in non BF females
• <50 per 100,000 live birth
incidences of syphilis.
Data validation will start from next Financial Year

Overview of the importance of addressing mother-to-child transmission
of HIV and syphilis in India
Mother to child transmission rate - Without intervention, the overall
MTCT rate is 25-40%
10-20%
10-20%
5-10%
5-10% 10-15%
10-15%
Pregnancy Breast feeding
Delivery

Maternal and obstetrical factors that increase the risk of HIV
transmission
Recent HIV infection in the mother
High viral load, advanced HIV disease in mother
STIs
Obstetric procedures:
1. Forceps/vacuum delivery
2. Prolonged labor and rupture of membranes
3. Invasive child birth procedures
Maternal malnutrition
Conditions of breasts (sore nipple and breast abscess etc.)
 Infant-related factors that increase the risk of HIV
transmission:
1. Preterm/low birth weight baby
2. Condition of baby’s mouth (oral ulcers, thrush)
3. Mixed feeding

Risk of HIV transmission from mother to child with or without
interventions
ARV Intervention Risk of HIV Transmission from Mother to Child
No ARV; breastfeeding 30–45%
No ARV; no breastfeeding 20–25%
Short course with one ARV; breastfeeding 15–25%
Short course with one ARV; no breastfeeding 5–15%
Short course with two ARVs;
breastfeeding
5%
3 ARVs (ART) with breastfeeding 2%
3 ARVs (ART) with No breastfeeding 1%
National Guidelines for HIV Care and Treatment 2021

Overview of the HIV and syphilis epidemics in the state
DESCRIPTION INDIA MIZORAM
Total Population 1,21,05,69,573 10.97 lakhs
Male 62,31,21,843 555,339
Female 58,74,47,730 541,867
Sex Ratio 943 976
Child Sex Ratio 919 970
Estimated Adult (15-49 yrs) HIV Prevalence 0.22% 2.7%
HIV prevalence among ANC clinic attendees 0.24% 0.69%
Syphilis Prevalence (%) at ANC sites, India & States, 2019 0.10% 0.05%
Estimated Number of PLHIV Infection (Adult & Children) 23.19 Lakhs 23802
Estimated Number of Annual New HIV Infection (15+yrs.) 57,550 1549
Estimated Number of AIDS related death 51,000 192
PMTCT NEED 20,930 328

Cumulative HIV Data up to January 2023
Number of HIV detection at ICTC
General client
(since 1990)
ANC (since 2005) Total
HIV Positive 25519 2357 27876
PLHIV Death (Since 2005) 4005

Year wise detection of HIV+ among Pregnant Woman

Percentage of Year-wise detection of HIV Positive Pregnant
Woman

Number of HIV Positives by Age group

Percentage Age wise distribution of HIV+ve

Identification of key challenges and barriers to EVTHS
Key Challenges of HIV Key Challenges of Syphilis
Missed opportunities to screen PW residing in far flung
villages (low coverage areas) – lack of awareness, poor
socio-economic conditions, transportation issues etc.,
Missed opportunities to screen PW residing in far flung villages
(low coverage areas)
Non-Availability of Dual testing kits Non – availability of Dual testing kits
Cultural barriers to HIV & Syphillis testing among Bru and
chakma ethnic communities scattered in Mamit, Lunglei &
Kolasib districts.
Lack of awareness about Syphilis/Sexual Reproductive Health
Interrupted supply chain issues – Test kits, DBS test kits,
EID kit stock at NICED
Chronic shortage of Inj. Benzathine Penicillin/Inj. Procaine
Penicillin/ Inj. Crystalline penicillin
Fear of stigma & discrimination Poor health seeking behavior for STI especially among males
Non trained sub-centre staff & HWC staff on updated
PPTCT guidelines and use of Dual test kits
Limited testing facilities (NACP supported) – Mamit,
Lawngtlai, Siaha & Lunglei
Non- trained Pediatricians & Gynecologists on NACP and
lack of ownership of the programme

Analysis of the existing health infrastructure and capacity
Sl.No
.
Type of Health Facilities
Total No.
(in State)
No. SA-
ICTC
PPP
(Three Tests)
PPP
(Single Test)
F-ICTC CBS
TOTAL RUs
established
% Saturated
1 Medical College 1 2 0 0 0 0 2
2 District Hospital/Civil Hospital 8 9 0 0 0 0 9 112%
3 Sub District Hospital /Satellite 3 3 0 0 0 0 3 100%
4
CHCs/RHs (including Urban
CHC)
10 8 0 0 2 0 10 100%
5 PHCs (including Urban PHC) 57 5 0 0 52 0 57 98%
6 Prison/Jail 9 1 0 0 0 0 1 11%
7 ESI Hospitals
8
Private Nursing Homes /
Corporate Hospitals
19 2 2 15 0 0 19 100%
10 Targeted interventions NGO 33 2 0 0 0 31 33 100%
11 Non TI (LWS & VIHAAN) 11 0 0 0 0 11 11 100%
12 Mobile 9 9 0 0 0 0 9 100%
TOTAL 160 41 2 15 54 42 154

Analysis of the existing health infrastructure and capacity
(Continued…)
No. of
SAICTC
Total No.
ICTC
Counsellor
No. of Lab
Technician
No. ARTC and
Linked ARTC
No. of ARTC
Counselors
No. of ARTC
Doctors
No. HIV
Physicians in
the State
No. of
Pediatricians
No. of Gynae’s
41 41 42
14 (5 Link
ARTC)
13 12 4 31 30
No. of SC No. of ANM No. of HWC No. of HWO No. of SNCU No. of DSRC
No. of DSRC
Counsellor
SRL Lab. Tech. SRC Lab. Tech.
372 810 305 269
+Ayush 38
5 10 10 1 1

Situational Analysis: Current status of EVTHS services in the state
Year  FY 2021-22 FY 22 - 23
Estimated no. of Pregnant women 24658 20460
NHM-ANC Registration no (with %) 21484 22753 (Till Feb’2023)
No. Tested for HIV (with %) Against registration. 22964 (106.88%) 25560(112.30% March Reg. Not included)
No. Found HIV Positive (Known Case) 68 151
No. Found HIV Positive (New Case) 177 150
Total No. Found HIV Positive 244 301
No. Linked to ART (with % )*Source: ICTC data, *ART data
*AHANA Registration
177 (100%) 147 (98%)
No. Tested for Syphilis (with %) Against registration. 18490 (86.06%) 24569 (96.12%)
No Found Syphilis Positive 9 20
No. Linked to Treatment 9 20

GAPS in Coverage, quality, and accessibility of EVTHS
Services
HIV
Missed opportunities to screen PW residing
in distant villages (low coverage areas).
Leakage of reactive cases detected at
private labs not reaching confirmatory
facilities and from FICTC to SA-ICTC and from
SA-ICTC to ARTC.
Non- availability of VL testing machine
DBS sample collection done at ICTC – some
mothers unable to bring their infants on time.
PSE – private health care providers need to
be trained on EVTHS guidelines
SYPHILLIS
 Non availability of POC Dual test-kit at
the Sub – Centre Level.
 Non availability of Inj. Benzathine
Penicillin G, Procaine Penicillin & Aqueous
Crystalline Penicillin in the supply.
Lack of awareness about Syphillis among
general public (rural populace in
particular).
ILL defined testing strategies and referral
mechanism.
Lack of ownership of Syphillis by General
Health System.

EVTHS Elimination Strategies - key components of national

Strategies to improve access to and coverage of antenatal care
services
Focused ANC aims to promote the health of mothers and their babies
through targeted assessments of pregnant women to facilitate:
1.Cover/Register all the pregnant women through holistic approach in Public &
Private sector
2.Identification and treatment of already established disease. (HRP Guideline)
3.Early detection of complications and other potential problems that can affect
the outcomes of pregnancy.
4.Prophylaxis and treatment for anemia, malaria, and sexually transmitted
infections (STIs) including HIV, urinary tract infections and tetanus etc.
5.To give holistic individualized care to each woman to help maintain the normal
progress of her pregnancy and physical, mental, and social health of mother and
baby by providing education on nutrition, personal hygiene, birthing process and
family planning.
6.Counselling on danger symptoms that indicate the pregnant woman should get
immediate help from a health professional.
7.Birth preparedness.

Strategies to improve access to and coverage of HIV and syphilis testing and
counseling for Pregnant women and their partner
HIV Syphilis
• All pregnant women should have mandatory testing for
HIV in the first ANC visit itself (At the time of
registration).
• In the sub centers/VHSND level with HIV testing (Dual
testing kit/WBFPT.
• Proper counselling should be done for PW and partner.
• For High risk women repeat testing at third trimester
along with spouse/partner.
• Testing facility should be available 24*7 in the labor
room
• Saturation/engagement of all private facilities (including
Labs) with EVTHS program
• All pregnant women should have mandatory testing for
Syphilis in the first ANC visit itself (at the time of
registration).
• In the sub centers/VHSND level with Dual test/POC
testing.
• At centers where RPR is available, testing with RPR
should be done.
• High risk women - repeat testing at third trimester.

Strategies to ensure uptake of ARV prophylaxis and penicillin therapy for
HIV-positive and syphilis positive pregnant women and their infants.
HIV Syphilis
 Implementation of test and treat policy
(NACO)
 Immediate linkage with ARV of all the
PPW irrespective viral load/CD4 test
 Ensure viral load testing 32-26 week for
all the PPW
 ART Adherence counselling and
monitoring
 Ensure confirmatory test to all the
reactive PW
 The need to get their partners and
newborn babies screened and treated.
 Patient and partners should also be
educated and counselled.
 Risk reduction counseling
 A simple rule is to treat as soon as the
test for syphilis is found to be reactive.
The earlier the result of the test is
available and treatment started, the
better it is.
 Treatment should be provided to all
Pregnant women who test reactive
with the any test (POC or RPR/VDRL) so
that no case of maternal infection is
missed.
 The need to get their partners and
newborn babies screened and treated.
 Patient and partners should also be
educated and counselled.
 Risk reduction counseling,
 Condom provision enables
modification of risk behavior of
individuals is also important for
preventing re-infection.
Components of Care of
HIV-Exposed Children
Infant/Child

INFANTS born to HIV infected Mothers
Give ARV prophylaxis to HIV exposed
infants (as per the risk profile) soon
after birth and continue once daily for
6 weeks (minimum)
BREAST FEEDING
Exclusive breast feeding for
6 months
ROUTINE
IMMUNISATION as per
State Immunisation
schedule
EARLY INFANT DIAGNOSIS
(EID)
at 6 weeks,
6 months,
12 months and confirmatory
test at 18 months
CO-TRIMOXAZOLE
(Septran) for infant starting
at 6 weeks and continue up
to 18 months
Do's for Infants Birth 6 weeks 6 Months 12 Months 18 Months
Syrup Nevirapine √ √
Exclusive Breast Feeding √ √ √
CO-TRIMOXAZOLE (septran) √ √ √ √
Early Infant Diagnosis √ √ √ √
Routine Immunization as per State Schedule √ √ √ √ √
Care of HIV Exposed Infants

STRATEGIES TO STRENGTHEN LINKAGES BETWEEN ANTENATAL CARE,
HIV AND SYPHILIS TESTING, AND TREATMENT SERVICES.

Identification of key stakeholders and partners
Key Stakeholders and partners in the State for EVTHS :-
 Secretariat/Directorate of Health Services
 National Health Mission
 AHANA (NCPI+/Plan India)
 Private Medical Associations (IMA, FOGSI, IAP)
 Vihaan
 Self/index testing (PATH)
SETU/TSU (FHI 360)
 YRG CARE – Orphans & Vulnerable Children
DAPCU
 District and Block Officials

Plan for community engagement and mobilization
PPW support groups formed in 8 Districts (3 to 10 members) – engaged for peer support and
motivation.
To mobilize pregnant women to access services (routine ANC services/ Family Planning services/ HIV
related services/ social protection schemes).
To provide psychosocial support to newly detected positive pregnant women).
Engaging infected/affected persons from the community in NACP – EVTHS Programme.
Strengthening DLN and SLN/ CSS – to achieve the objective of EVTHS :
 Peer counseling/positive living
 Regular support group meeting
 Treatment literacy
 Address stigma & discrimination
Mass-Media Mid-Media activities.
Special health camps at high load district, blocks and high load site.
Community mobilization meeting of positive pregnant women at district level.
Orient through IEC on Women’s Day and World AIDS day to key population group.

Timeline for implementation of the EVTHS elimination programmes
(Major Activities)
Indicators/activities Timeline to be complete
Orientation of CHOs/ANMs (Testing & Reporting – Community based) May 2023
State EVTHS Core committee meeting under Principal Secretary Bi-annual
Orientation & Consultation of churches/faith leaders in four Priority Districts Quarterly
Re-Orientation of PHC/CHC/DH Medical officers & DACO’s Bi-annual
District EVTHS Committee Quarterly
Strengthening of District EVTHS meeting May & June
Training of FOGSI & IAP & IMA State Branch June & July 2023
Training of Labour room staff on New EVTHS Update Bi-annual
Training of ART staff on New EVTHS Update Bi-annual

Monitoring and Evaluation framework
Objective Performance Indicators Means of
Verification (MoV)
Source of
Denominator
Task Required Responsibility
ANC registration of all PW
at the 1st
Trimester
No. of ANC registered
against estimation
HMIS HMIS Monthly report review
and analysis
BSD, M&E,
AHANA
Screening of all PW at the
1st
Trimester
No. of ANC screen against
registration
HCTS Report &
HMIS
HMIS Monthly report review
and analysis
BSD/NHM
Early diagnosis & Early
linkage to Services
Total PPW Identified &
Linked to treatment
HCTS report ICTC & ARTC
(AHANA)
Monthly report review
and analysis
BSD/NHM
EID & 18th Month
Confirmatory test
EID & 18th Month
Confirmatory test
ARTC Report
/PPTCTC/AHANA
ARTC (AHANA) Monthly report review
and analysis
Treatment retention &
Adherence amongst all
PPW (New & Known)
No. of PPW New & Know
(identified as general)
ARTC Record /
AHANA
ARTC (AHANA) Monthly report review
and analysis
Engage all Private sector
facilities
Private Sector
Engagement
PSED BSD & AHANA MSACS/AHANA Assessment of Private
sector and Signed MoU
with SACS
BSD/AHANA
Data Validation and
Performance review
Quarterly review meeting BSD

Trimester - wise testing
Indicators 2021 (April)-22 (March)
April-22 – March-23
# PW found HIV Positive 177 150
# PW identified positive in the first
trimester
98 72
# PW identified positive in the second
trimester
50 36
# PW identified positive in the third
trimester
12 31
# PW identified positive in DIL 9 7
# PW identified positive as PNC 8 4

Assessment of State Situation
Indicators 2021-22 Apr22 –March23
No. of positive deliveries 220 271
No. of positive deliveries conducted in institution 204 (92.72%)
266 (98.15%)
No. of live births 205 267
No. of HIV exposed newborns administered ARV prophylaxis within time 202(98.52%) 267(100%)
No. of HIV exposed newborns breastfeed 150 (73.17%) 193 (72.28%)
No. of HIV exposed newborns eligible for first EID 200 (97.56%) 234(99.03%)
Out of the above, for how many sample was drawn within 2 months 137 (68.5%) 190 (72.66%)
Out of the above, for how many sample was drawn within 2-6 months 52 (37.95%) 19(08.20%)
No of HIV exposed infants in the PPTCT who have completed 18 month 199 (99.5%) 200 (69.75%)
Out of the above how many have undergone 18 months confirmatory test 189 (95%) 152 (75.32%)
Out of the above how many was HIV Negative 187(98.9%) 147 (96.72%)

Policy & Regulatory Framework related to EVTHS
Universal testing coverage as per MOHFW guideline
HIV & Syphilis screening/testing is mandatory for all the
Pregnant women as per NACO guidelines.
Test & Treat Policy
Follow all the prevention protocols by staff
To avoid Stigma & Discrimination and keep confidentiality of
positive pregnant women, strictly adhering to HIV Prevention &
Control Act. 2017.

EVTHS Programme: Current Status
EMTCT - THREE 95’S (FY - 2021-22) - HIV
87.12% 93.13% 100%
95% of all estimated
HIV +ve pregnant
women are alive and
on ART
pregnant women
needing PMTCT know
their HIV status
pregnancy registered at
ANC and have at least 1
ANC Check-up

EVTHS Programme: Current Status
EMTCT - THREE 95’S (April 22 – March23) - HIV
111.19% 125% 98%
95% of all estimated HIV
+ve pregnant women
are alive and on ART
pregnant women needing
PMTCT know their HIV
status
pregnancy registered
at ANC and have at
least 1 ANC Check-up

HMIS ANC Registration against estimated Pregnancy
(Apr-Aug 2021)
<=25% 26-50% 51-75% 76-95% >95%
# of district
Name of Districts
Lunglei (92%)
Siaha(91%)
Mamit (90%)
Serchhip (90%)
Lawngtlai (86%)
Aizawl (85.35%)
Kolasib (86%)
Champhai (85%)
Major
Challenges/gap
State average :
Key Gaps (95-95-95):
EMTCT Progress – First Process Indicator April 2021 - March 2022

HMIS ANC Registration against estimated Pregnancy
(Apr-Aug 2021)
<=25% 26-50% 51-75% 76-95% >95%
# of district
Name of Districts
Lunglei (103%)
Aizawl (105%)
Kolasib (106.29%)
Mamit (110%)
Serchhip (114.11%)
Lawngtlai (117%)
Siaha(120%)
Champhai (135.04%)
Major
Challenges/gap
State average :
Key Gaps (95-95-95):
EMTCT Progress – First Process Indicator April 2022 - March 2023

HIV testing of Pregnant women
against HMIS ANC registration (Apr-Aug 2021)
<=25% 26-50% 51-75% 76-95% >95%
# of district
Name of
Districts
Serchhip (48%)
Siaha (55%)
Lawngtlai (56%)
Mamit (66%)
Kolasib (92%)
Lunglei (94.24%)
Aizawl (159%)
Champhai (106%)
Major
Challenges/gap
1. Limited testing
facility across the
districts.
2. Absence of
Gynaecologist for
more than 1 year
3. Lack of awareness
& health seeking
behaviour amongst
the minority
community.
1. Limited testing facility
2. Absence of MO in some
areas
3. Transportation facility
4. Lack of awareness &
health seeking
behaviour amongst the
minority community.
5. No testing from private
sector
1. Lack of health
seeking behaviour
amongst the PW
2. Limited testing
facility
3. Convergence with
Private sector and
Private clinic needs
to improve
State average :
EMTCT Progress – Second Process Indicator April 2021 – March 2022

HIV testing of Pregnant women
against HMIS ANC registration (Apr-Aug 2021)
<=25% 26-50% 51-75% 76-95% >95%
# of district
Name of Districts Lawngtlai (62.36%)
Mamit (76%)
Siaha (81.23%)
Lunglei (96%)
Kolasib (146.25%)
Serchhip (150%)
Aizawl (155.18%)
Champhai (160.11%)
Major
Challenges/gap
2. Absence of MO in some
areas
3. Transportation facility
4. Lack of awareness & health
seeking behaviour amongst
the minority community.
5. No testing from private
sector
1. Lack of health seeking
behaviour amongst the
PW
2. Convergence with
Private sector and
Private clinic needs to
improve
State average :
EMTCT Progress – Second Process Indicator April 2022 – March 2023

EMTCT Progress – Third Process Indicator
FY APRIL 21- MARCH 22
51-75% 76-95% >95%
Champhai (100%)
Kolasib (100%)
Serchhip (100%)
Lunglei (100%)
Lawngtlai (100%)
Siaha (100%)
Aizawl (100%)
Major Challenges or Gap :
FY APRIL 22- MARCH 23
51-75% 76-95% >95%
Mamit (82%) Champhai (96%)
Kolasib (100%)
Serchhip (100%)
Lunglei (100%)
Lawngtlai (100%)
Siaha (100%)
Aizawl (100%)
Major Challenges or Gap : Transportation issues
Poor socio-economic conditions

SYPHILLIS COVERAGE
EMTCT – THREE 95’S – (FY APR 21 – MAR 22) - SYPHILLIS
87.12% 86.06% 100%
Adequate treatment
coverage of Syphilis-
seropositive PW at
>95%
Coverage of Syphilis
testing among PW at
>95%
ANC-1 coverage
(at least one visit)
at >95%

SYPHILLIS COVERAGE
EMTCT – THREE 95’S – (April 22- March 23) - SYPHILLIS
111.19% 120.08% 100%
Adequate treatment
coverage of Syphilis-
seropositive PW at
>95%
Coverage of Syphilis
testing among PW at
>95%
ANC-1 coverage
(at least one visit)
at >95%

SYPHILLIS
INDICATORS Apr 2021-Mar 2022 Apr 2022- March-2023
No. of Pregnant Women tested for Syphilis 18490 24569
No. of Pregnant Women diagnosed for
Syphilis
9 20
No. of Syphilis reactive pregnant women
received treatment
9 20
No. of Infants exposed to Syphilis 9 20
No. of exposed infants received treatment 0 0
GAPS POSSIBLE SOLUTION
Inadequate supply of Syphillis test kits POC Dual test kit for HIV & Syphillis can be supplied up to
Sub Centre level
Non- availability of Benzathine Peniciilin G,
Procaine Peniciilin and Aqueous Crystalline
Penicillin G in the supply
To include these commodities in the CMSS supply and
need to include them in the Essential Drugs List.

ESTIMATED PPW VS. IDENTIFIED PPW
Districts Estimate
(FY 2021-22)
Identified
(FY 2021-22)
Estimate
(FY-2022-23)
Identified
(FY-2022-23)
Aizawl 184 122 (66.30%) 161 149 (92.54%)
Kolasib 30 27 (90%) 30 28 (93.33%)
Mamit 30 16 (53.33%) 25 19 (76%)
Lunglei 35 22 (45.71%) 30 29 (96.66%)
Champhai 32 16 (50%) 32 33 (103.12%)
Serchhip 27 14 (62.5%) 20 19 (95%)
Lawngtlai 24 15 (62.5%) 15 13 (86.66%)
Siaha 22 13 (59.09%) 15 11 (73.33%)
Total 384 245 (64%) 328 301 (92%)

ESTIMATED PPW VS. IDENTIFIED PPW (GAPS & SOLUTIONS)
GAPS
1.For FY 2021-22, Estimated PPW is 384 and identified
is 244 (Gap- 10.47%) and for FY Apr 22-Dec. 22,
Estimated PPW is 284 and identified is 227 (Gap-
20.08%)
2.Estimation of PPW maybe higher than actual (over-
projection)
3.Missed opportunities to screen PW residing in far flung
villages (low coverage areas) – due to lack of awareness
to get screened or inability to access screening facilities
4.Leakage of reactive cases detected at private labs not
reaching confirmatory sites
5.Limited facility for ANC screening especially in rural
areas.
SOLUTIONS
1.Mechanism for sharing of pregnant women sub-centre
line -list has been established - This is to ensure universal
screening of all PW registered at all sub-centre for HIV &
Syphilis
2.Correct estimation needed to reduce the gap
3.Strengthening of Mobile ICTC mobility funds to quickly
navigate unreached areas
4.Strengthening of private sector engagement
5.Organised Health camps on quarterly basis to reach out
peripheries and low testing districts

VL TESTING (STRATEGY, GAP, AND SOLUTION)
STRATEGIES GAPS POSSIBLE SOLUTION
1. VL Sample collection
at the ARTC on
Specific dates given.
2. VL camps held as per
request and approval,
supported by Share
India.
3. VL Collected sample
were sent out of the
state by
courier/flights.
Non- Availability of VL testing machine in Mizoram.
Successful Transportation of VL samples are solely based on
flight availability (E.g: unforeseen weather conditions, flight
cancellations, pandemic etc hampers transportation).
Since sample collection is scheduled twice weekly in some
districts, and since most Positive women are daily labourers, it is
not feasible for them to approach the ARTC on the scheduled
date.
Since VL testing services are catered through ARTC’s which are
located at District hospitals, it is a cumbersome exercise to
mobilize PPW for viral load testing between 32 to 36 weeks of
pregnancy.
Financial dependency to the family, transportation issues and
fear of disclosure to family has also been one of the major
reasons.
Viral Load Machine for the
State.
Plan for sample collection at
the door for PPW 32-36
weeks base on needs of PPW.
Expansion of VL Collection
facility at all Link ARTC.
Allocate emergency fund
for PPW who face financial
problem for VL testing.

EID (STRATEGY, GAP, AND SOLUTION)
STRATEGIES GAPS POSSIBLE SOLUTION
1. Collect and
send DBS
samples of
Babies between
2- 6 weeks of
age for HIV-1
PCR at ICTC
(Follow EID
Algorithm
under EVTHS
Guideline.)
1. Delay of Result, and most of the results are not
shared. Hence, negative impact on the
subsequent EID test.
2. Shortage of Kits supply and other consumables.
3. Successful Transportation of samples are solely
based on flight availability (ex: unforeseen
weather conditions, flight cancellations,
pandemic etc hampers transportation).
4. Non- Availability of testing machine in Mizoram.
5. Since EID testing services are available at ICTC’ s
which are based at the District Capital,
therefore, it is challenging for mother to travel
such distance with their infant babies.
1. Proper coordination with the
Testing Agency and fix TAT for
the results. (Either the result is
positive or negative, it should be
shared).
2. Uninterrupted supply of Kits and
other consumables.
3. Arrange emergency package for
Mother who reside in far flung
villages and who are facing
financial challenges for
transportation to reach service
centres.

Identification of key resources and infrastructure needed to
support EVTHS elimination
 Adequate fund for continued capacity building of the stakeholders and staff.
 Availability of adequate staff at all the facility level.
 Adequate and timely supply of Kits and consumables.
 Adequate and timely supply Drugs – ARV, Bnz./Penicillin, CPT, NVP,
Zidovudine .
 Availability of Viral Load Machine for monitor of VL and to attain viral
suppression for all PPW.
 Expansion of ARTC/Link ARTC.
 Linkage of PPW on the same day of HIV/AIDS detection.

Priority Actions for a Coordinated Approach

ROAD MAP for EVTHS in Mizoram
Sl.No. Actionable Stakeholders Timeline Remarks/Challenges
1 Capacity Building - MO’s, ANMs,
HWO, FOGSI, DACO, IAP,
MSACS, NHM, NCPI+ AHANA, PATH,
District CRG, DAPCU
April - June Orientation on New
EVTHS update
2 Re-orientation of ICTC staff & Lab
tech, ARTC Staff.
MSACS, PATH, DCRG June -
August
3 State Advisory Review Committee Principal Sec., MSACS, NCPI+ AHANA,
NHM, DC Aizawl, DHME, DHS, FOGSI,
IMA, IAP
Quarterly
4 Supply Chain management Supply and Procurement Division, online
Orientation with Staff
April
5 Partnership (PPP) MSACS, NCPI+ AHANA & Private
Hospitals
April - June
6 Implementation of new EVTHS
Guidelines across the districts
NACO, Mizoram SACS, NHM and
EVTHS partners
April - June
7 ANC Health Camps NCPI+ AHANA, BSD SACD/MICTC, SC Quarterly in
5 priority
Dist.

ROAD MAP for EVTHS in Mizoram Contd...
Sl.No. Actionable Stakeholders Timeline Remarks/Challenges
7 Target based approach for
priority district
MSACS, 4 Districts Priority states,
DEMTCT, DC, NCPI+ AHANA, DC etc.,
Quarterly
8 District EMTCT Committee NCPI+ AHANA under Guidance of SACS,
DCRG,
Quarterly
9 Coordination meeting MSACS - NHM, NCPI+ AHANA, ART,
ICTC, CST, STI Division , IEC, TI, DAPCU
etc.,
Monthly/
Quarterly
10 Outreach & CBS NCPI+ AHANA, VIHAAN, LWS and TIs April - June
11 Church Leaders Consultation MSACS & NCPI+ AHANA Quarterly
12 VHSND at SC level NCPI+ AHANA & MICTC Monthly
13 PMSMA at PHC Level NCPI+ AHANA, ICTC/MICTC, MO etc., Monthly

49
An HIV Free Generation
Thank You

EVTHS Priority state Roll-out Mz 04-04-23.ppt

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