| 4. In which ways is the initiative creative and innovative?
4. Innovation of the Government of Pasuruan is purely of an initiative that has never been done in other areas by strengthening the commitment of the officers in the field both officers in Bangil General Hospital nor the Environment of Public Health Office level service puskesmas are directly related to people living with HIV, it shows concern and sincerity duty to take risks close to the patient.
When the first VCT/CST clinic stands, some patients are always asked repeatedly about his condition, how to take the medicine, the side effects of drugs, and the problems facing patients with their families.With the business card of clinic officers VCT/CST must be ready for Calling and texting by people who needed.
The purpose of the provision of this number as a media consulting and counseling regarding: 1).Explanation of how to take the medicine, if not understand when to be briefed on the service; 2).The side effect that occur in each type of ARV.3).The condition and development of the body with reception ARV 4).ARV correct storage method.5).Schedule the next visit. 6).The rest of the drug if any.7) the Society can inquire about HIV/AIDS dan Antiretroviral drugs problem.8) Empowering communities with the coordination of Social Service.
| 5. Who implemented the initiative and what is the size of the population affected by this initiative?
Innovation ODHALink PLUS initiated by the Government of Pasuruan in order for the prevention and treatment of HIV/AIDS sufferers is increasing every year.
ODHALink PLUS implemented by Bangil General Hospital and Health Service via Satellite-district health centers as networking of Bangil General Hospital and also received support from some of the cross-sector and private parties, namely Community leaders, religious leaders, NGO (NGO, WPA,KPA).
In the implementation of this innovation many people who get beneficial including for:
a. People with HIV/AIDS (PLWHA) itself, with innovations odhalink they feel comfortable, underserved, more confident because it turns out there are concerned, their privacy is maintained, to take his medication could be monitored.
b. ODHA Family; with ODHA family, Odhalink services asissted when taking the drug, more families know and understand how to access information and care for people living with HIV
c. Society; with Service Odhalink, society more easily obtain information about what is HIV/AIDS, how it is passed so that people understand, care about, at least in patients with stigma and discrimination of ODHA
d. Non Government Organization (NGO) such as the Society of Social Institutions, Citizens Concerned AIDS; Odhalink with the service they are easier to map PLWHA, cooperate in serving the community and people living with HIV with beneficial activities
e. Officers odhalink that health workers will gain new knowledge, new information from the community and people living with HIV, inner satisfaction closer and understand the patient's condition.
f. Stakeholders, with Odhalink stakeholders understand the condition. situation and information on the development of HIV/AIDS in the Pasuruan Regency, so they can do the planning in the form of policies and funding for service development of HIV/AIDS in Pasuruan.
| 6. How was the strategy implemented and what resources were mobilized?
A. Financial Resources
In carrying out the activities of PLWHA link would require that the cost of the activities can be run well and smoothly. Below is a supporter of funding, starting from the beginning of clinic VCT/CST stand.
1. Procurement cards are for Bangil General Hospital wears budget costs
2. The cost of each officer Pulse Rp. 50,000/month and budgeted through Bangil General Hospital.
3. To transport a motorcycle delivery service officers wear when return.
4. High acces activities both in hospitals and health centers BANGIL financed through the budget and BLUD.
B. Human Resources
a. Bangil General Hospital
Team of VCT/CST Clinic consists of specialist doctors, general practitioners, paramedics and support personnel as executor VCT/CST Clinic. Support from the Department of Health and KPA (AIDS Commission) as an institution that has always supported and supports a wide range of activities related to HIV/AIDS. NGOs among others from Paramitra, Sadar Hati, Wamapara (transgender community) who helped usher in high-risk patients to want to do the examination VCT, even willing to be the PMO (Supervisory Drink Drugs) and fetch medicine for ART patients who can not take medication.
b. Satellite Health Center
Health workers trained, certified VCT, PITC, and there are some doctors who already CST
The number of doctors in health centers trained VCT SDH there were 20 doctors and officers who have been trained PITC everything in health centers totaled 33 officers.
Technical resources used are:
Mobile and each vehicle executing on VCT/CST Clinic in communicating with the patient as well as the time of the delivery order.
High Acces activities using the facilities provided by Bangil General Hospital, KPA and the Health Department.
• Online message including the creation of the group Friends of ODHA
• Delivery service (closer access ART) to people living with HIV sufferers by officers from Bangil General Hospital. The development by the establishment of four satellite health centers from 33 health centers existing in Pasuruan regency geographically is now reaching all access services, namely in Prigen, Grati, Purwosari and Gempol which will be increased to ART Health Center by Satellite:
- Grati Health Center serves the District of Grati, Lumbang, Nguling, Lekok, Ngopak, Rejoso
- Purwosari Health Center District Area serves Purwodadi, Purwosari, Sukorejo, Rembang, Wonorejo
- Prigen Health Center District Area serves Prigen aand Pandaan
- GempolHealth Center District Area serves Gempol and Beji
• High Access (ODHA empowerment, counseling, mobile VCT, KDS Youth through Cak and Yuk Pasuruan Organization, social gathering,
• Evaluation conducted by the District Health Office and the Provincial once every 1 year and by AIDS Subdit Ministry of Health RI every 2 times a year through data validation.
Evaluation mechanisms reporting of patient data, the patient's condition, using a path that Siha report (routine reports done by officers specially bersertifiksi as reporting and Recording), while the monthly inspection of ODHA can be implemented by health workers in Health Center.
The health workers do monitor every 1 month after the health condition of the development of the use of drugs with a visit or regular meetings.
If the complaint is found additional or complication of other infectious diseases, which if the disease can not be handled by health workers in health centers to hospitals then immediately refer Bangil General Hospital or to a designated referral hospitals.
| 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
7. Government of Pasuruan was the initiator of the program odhalink plus commissioned to manage and coordinate the activities Odhalink, identify the location of high risk in Pasuruan, collect, move and utilize resources effectively, ensure budget allocation/funding for HIV/AIDS from the source local-source as well. together with the Health Department with a role as coordinator of the satellite health centers and hospitals in cooperation with the Coordinating antiretroviral drugs as well as the improvement of people living with HIV Referral hospital with infection or additional complaints (opportunistic infections).
Organization/institution Non Government (National AIDS Commission and NGOs) play an important role and are recognized as equal partners in the response to HIV/AIDS to reach out to people living with HIV and the group, with special needs, among others, youth, religion, women, professionals who typically do not or difficult to reach by government officials, so that the KPA and NGOs assist in the implementation of Odhalink plus to help provide information to the public also facilitate the monitoring and observation of PLWHA
Plus ODHALINK implementation will involve various stakeholders:
a. Local Government of Pasuruan
b. Bangil General Hospital
Through VCT/CST clinic health service related to diseases caused by HIV/AIDS. VCT clinic serves patients who want to know, consultation and examination before he is known infected or not infected with HIV and CST clinics serve with care, support and provide ARV treatment.
c. Pasuruan District Health Office
- Through four satellite health centers from 33 health centers existing in Pasuruan regency geographically is now reaching all access services, namely in Prigen, Grati, Purwosari and Gempol which will be increased to Puskesmas Initiation of ART by Satellite Health Center
Role of NGOs to help realize ODHALINK PLUS as a bridge on ODHA patients with services in hospitals and health centers.
| 8. What were the most successful outputs and why was the initiative effective?
8. With the ODHALINK PLUS innovation will provide an outcome that can be seen as follows:
a. Increased patient visit PLWHA in health facilities in hospitals and health centers (in 2012: 15; in 2013:48 : in 2014: 133 in 2015:164 in 2016:214)
At the beginning of messaging communication service only between patients with officers now there are 16 people living with HIV who formed the group "Friends of the CST", 35 HIV-positive people who entered as a member of the KDS (Peer Support Groups "Healthy One Heart") where they can open status their HIV to others.
When people living with HIV do not need every month to Bangil General hospitals, they were able to save between Rp. 22.000 to Rp. 60.000 for money transport. The money they can use to buy basic necessities of daily.
a. The spread of information about HIV/AIDS that is true, then more and more organizations and other groups who dare to assist people living with HIV with the formation of the WPA (AIDS Care Residents) at the district level, the HIV Ambassadors Circle of Cak and Yuk Pasuruan
b. In 2012, pediatric HIV services are still referred to RSSA Malang but currently (December 2016) there have been 16 children who received HIV care in Bangil General Hospital
b. The provision of skills for families of PLWHA
This is consistent with the SDGs program number 1
Increased economically valuable skills to reduce poverty in poor and vulnerable populations ,ODHA families get the help of sewing machines and training of Social Services so that now they can increase revenue
c. The provision of a comprehensive health care for all ages
This is consistent with the third SDGs program
The success of treatment and support personnel in the provision of antiretroviral drugs for people living with HIV couples who eventually gave birth to a baby that is negative, it is in accordance with the third SDGs particularly decrease neonatal mortality rate and end the AIDS epidemic
d. Provide educational information about the prevention and transmission of HIV / AIDS in schools and communities
This is consistent with the fourth SDGs that ensure a decent quality education and inclusive and encourage lifelong learning opportunities for everyone.
e. Making policy ODHALINK PLUS No. 72 Year 2016
Establishment of Satellite Health Center boosted policy Satellite Health Center No. 9 2016.
| 9. What were the main obstacles encountered and how were they overcome?
9. Pasuruan District Government in implementing ODHALINK PLUS innovation
a. General public
The persistence of stigma and discrimination in society
How to solve this problem by means of persuasion or approach, provision of information, education and continuous
There are still many people who do not understand and care for HIV disease so many cases Dropout, depression and suicide
The fix approach to care and support from staff and family
c. Relevant agencies
The persistence of stigma, discrimination, and do not care about the transmission of HIV/ AIDS
How to cope with counseling, information through mass media
• There is still a negative stigma in society = provision of correct information about the modes of transmission and prevention of transmission of HIV
• The difficulty of transportation access (fees, transportation, escort) patients to hospitals as referral Bangil General hospital ARV Pasuruan = closer access to antiretroviral therapy in outlying health centers with satellite formation
• At a minimum number of officers who have been trained in counseling = held in-house training in the district of Pasuruan
• Lack of financial support = support CSR of the companies in the District. Pasuruan
Cross-sectoral cooperation is not maximized = increasing support and good cooperation with the government sector, private, and community.