M & E AND RESEARCH SURVILLANCE

Tailoring the HIV surveillance system to the pattern of the epidemic in a country. Behavioral surveillance for collection of information on risk factors and practices, STIs, etc. Making best use of other sources of information to increase understanding of the HIV epidemic and the behaviors that spread it. Better use of surveillance data to plan prevention and care interventions, improve national response and to measure impact.

Sentinel Site is defined as "a designated service point/facility where blood specimens  & relevant information are collected from a fixed number of eligible individuals from a  specified population group over a fixed period of time, periodically, for the purpose of  monitoring the HIV epidemic.

Surveillance is defined as an ongoing, systematic collection, analysis, interpretation and dissemination of data regarding a health related event for use in public health action to reduce morbidity and mortality and to improve health.

To monitor trends in prevalence of HIV infection over time To monitor the distribution  and spread of HIV prevalence in different population subgroups and in different  geographical areas To identify emerging pockets of HIV epidemic in the country

To estimate and project burden of HIV at state & national levels. To support programme  prioritization and resource allocation.To assist evaluation of programme impact. Advocacy.

Groups covered under HSS High Risk Groups: FSW, MSM, TG & IDU Low Risk Population: Pregnant women attending ANC Clinics.

Pregnant women represent the sexually active segment of general population, and hence taken as proxy for monitoring HIV among general population. Unlinked Anonymous Testing strategy is possible only at those clinics where testing and blood specimen collection is done routinely. At ANC clinics, routine blood specimen collection is done for Syphilis and Hemoglobin testing, a part of which can be used for HIV testing Pregnant women represent a more homogeneous group than persons attending any other clinic/ OPD Pregnancy, being physiological, does not introduce any bias in HIV prevalence which other illnesses/ diseases may introduce due to underlying factors common to HIV Facilities for antenatal care are available across the country at different levels of health care system and hence are feasible for implementation.

Ensures the supply of all consumables and release of funds required for surveillance to the sentinel sites Provides site code, sub-site numbers to all sites along with allocation of sample size in case of composite sites Ensures availability of operational manuals, wall charts, data forms, stamps/ pre-printed stickers, etc. Ensures training of the personnel involved at all the sentinel sites and testing labs in the state Ensures sensitization of  NRHM officials/ CMOs/ Supdts. of hospitals from general health system about HSS Ensures adequate HR and infrastructure at sentinel sites Monitors surveillance through supervision visits and regular coordination.

Responsible for all arrangements and activities for HIV surveillance at the site. Attends trainings conducted for surveillance by the SACS Conducts a pre-surveillance on-site training for all staff Correctly identifies the eligible respondents as per the inclusion criteria and ensures consecutive sampling Ensures that sample number is not linked with individual's identity thus maintaining unlinked anonymous testing Ensures adherence to standard operating procedures (SOP) by the site staff while collecting, processing & storing blood specimens Monitors progress in sample collection on daily basis Checks filled forms every day for completeness, discuss issues, if any, with concerned staff, guide them and sign the filled forms Arranges for transport of blood specimens under proper cold chain along with sample transportation sheet (STS) to HSS Testing Laboratory Ensures that results of routine tests are provided to the respondent subsequently Contacts nodal person at SACS for any clarification/ problem regarding staff, availability of the listed consumables, user manuals, flow charts, data forms and stamps/ pre-printed stickers or any other methodological issues.

HIV Sentinel Surveillance is defined as "a system of monitoring HIV epidemic among specified population groups by collecting information on HIV from designated sites (sentinel sites) over years, through a uniform and consistent methodology that allows comparison of findings across place and time, to guide programme response."

Assists the site in- charge in identifying the eligible respondents Fills the data form for the eligible respondents as per the instructions given Ensures unlinked anonymity by seeing to it that data form does not carry any personal identifiers Ensures that the filled data form and the respondent reach laboratory technician for blood collection Ensures proper storage of data forms and weekly transport of data forms to RI Assists the site in-charge in the overall implementation of surveillance at the site.

Verifies the completeness of data form before taking blood specimen; refers back to nurse / counselor immediately if any field is missing or illegible Collects blood specimen following universal safety precautions Separates sera from blood specimens, labels and store them as per SOP Takes care and precautions to avoid damage to specimens (haemolysis, contamination, leakage etc.) Takes the lead in storage, packing and transportation of blood specimens every week and in their documentation, under the supervision of the site in-charge Strictly follows instructions for labeling and ensures appropriate labeling of specimens for routine testing and surveillance Strictly adheres to all the prescribed bio-safety measures.