The IRT Perundurai Medical College was selected as the nodal agency for providing comprehensive institutional based medical care for PLHA in Erode district. The project period was for nine months (September 2006 to May 2007). The major objectives of the program were :

• To provide training & build capacity of Health care providers in the private sector medical institutions

• To create a non stigmatizing and non discriminatory approach in the continuum of care services provided to PLHA by the HCP in the private sector

• To enable PLHA to access care at subsidized cost from private sector medical institutions

• To develop a public private partnership in providing inpatient & specialty care services for PLHA

• To establish linkages with the NGOs/CBOs/Network for effective continuum of care in private sector

The Perundurai Medical College and Research Centre is located in a lush green landscape of 350 acres, which is 20 kms west of Erode on the Erode-Coimbatore Highway. The green land and healthy environment provides an ideal setting for the location of a premier Institute for teaching and research in the field of medicine. Perundurai is in the closer vicinity of major industrial towns/cities like Thirupur, Coimbatore and Erode. The Institute being located in a rural setting has gone a long way in meeting the health needs of the socio-economically downtrodden population of the neighboring districts. This College is affiliated to the Tamilnadu Dr.M.G.R. Medical University, Chennai.

IRT PMCH, has 16, specialties, 95 regular doctors of various departments, 154 regular paramedical workers, about 100 HCPs in various cadres as contract employees. IRT PMC is one of the premier hospital providing care for PLHA of Coimbatore, Salem, Namakkal, Karur and Erode districts from the early 90s itself.

Training

• Mapping of health systems in the private sector in Erode district

• Exposure visits for the trainees

• Identification of private health care providers willing to partner for this project

• Conducting training needs assessment study among the HCPs in private sector

• Identification of core trainers and training

• Preparing a training schedule for the core trainers

• Training the participants using participatory & adult training methodologies

Clinical care

1. Provision of tertiary level clinical care for PLHA

2. Encouraging secondary level care at the private nursing homes & primary level care by the private physicians

3. Collaboration with the private sector institution

4. Partnering with nursing homes for out reach activities

5. Mobilizing resources for sustainability of the project

6. Monitoring & evaluation

7. Onsite supervision visits in the private medical institutions

8. Conducting zonal & district level coordination meetings

9. Documentation, research & dissemination

· Training

• Trained 300 private sector medical & paramedical staff in Erode district

· Onsite support

• Visits to various departments

• Fortnightly visits to the Pvt nursing homes

• Better collaboration among the various departments

· Out reach camps

• Weekly camps (done in collaboration with the private nursing home in the rural areas)

• Recognition of IRT PMCH project in the rural areas & among the private HCP.

• Increased referral to IRT PMCH

· Clinical care

• Provided outpatient clinical care for more than 700 PLHA & inpatient care for 421 cases.

• PMTCT services were provided for 113 cases & Nevirapine prophylaxis was provided for a single case.

• Initiated ART for 21 cases & ATT for 85 cases

• Improved clinical care for PLHA including assessment of comfort level

• Placement of Peer counselors had led to increased cross referrals with the positive network

• Involvement of various specialties

• Follow up of discharged patients by the coordinating NGOs

• More involvement of private nursing homes in providing secondary level clinical care for PLHA at subsidized rates.

Support from the Institute

• Centre for External Quality Assurance for samples tested at APAC VCTC

• Provided subsidy for clinical investigations for PLHA

• Mobilization of funds for sustainability

• Involvement of all departments

This nine months project had given a new dimension of collaboration in the private sector for providing training & decentralized clinical care. This model had also demonstrated certain best practices in involving PLHA, CBOs & NGOs for providing comprehensive continuum of care.

Perundurai medical college has the potential for developing into a centre for excellence for providing clinical care, bio medical research & training for medical & paramedical staff.

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