Link Workers Scheme

What is Link Workers’ Scheme? To whom is the program targeted?

The ‘link worker’ is a concept by which a rank of middle-level health care workers are trained to become the second important line of defence against HIV/AIDS.

They are believed to be especially important in rural India to reach out to high-risk groups and vulnerable population with information, knowledge, skills on STI/HIV prevention and risk-reduction.

The link worker forms a credible bridge between the patient and the doctor, and the patient and society, and helps build a community-centred HIV care model. TANSACS is creating a strong cadre of such link workers across the state.

This scheme aims to increase demand generation, service utilization by strengthening referral linkages and community mobilization to address issues of stigma and discrimination among core group and peole living with HIV/AIDS (PLHA) in the rural areas.

What are the activities in the Link Workers Scheme?

	The link workers help establish referral and follow-up linkages for various services, including treatment for STIs, testing and treatment for TB, ICTC/PPTCT services, HIV care and support services including ART.
	They help create an enabling environment for people living with HIV/AIDS and their families, reduce stigma and discrimination against PLHAs through interactions with existing community structures/ groups, like Village Health Committees (VHC) Self Help Groups (SHG) and Panchayati Raj Institutions (PRI).
	They help promote and dispense condom use among high-risk groups.
	The high risk groups, identified through these link workers scheme, are linked with the NGOs implementing TI in the respective districts, for promoting behavior change and for linking with other services.
	Mapping of the districts done for the identification and selection of villages. Based on this, link workers are selected and the implementation of the programme in the selected villages are carried out.

Tamil Nadu’s achievements

Under the GFATM project Round VII (Global Fund against AIDS,TB and Malaria), a separate budget and a secretariat for this has been earmarked. The Link Worker programme is being implemented in Tamil Nadu by APAC-VHS in three phases

Phase I - Preparing community and local systems in select rural/ urban areas
Phase II - Strengthening community structures and responses
Phase III - Handing over integration into health system and exit

APAC has helped create a rank of link workers in four district of Tamil Nadu i.e., Trichy, Namakkal, Theni and Salem in the year 2008-09, identifying a core group through NOGs. All the staff are in position in these 4 districts.

NACO has extended the programme to 0 more districts in Tamil Nadu during 2009-10. The districts are – Madurai, Tiruvannamalai, Nilgiris, Karur, Erode, Coimbatore, Villupuram, Vellore, Kanchipuram and Dharmapuri. Seven high-risk districts have been identified and the training of link workers completed

Action Plan for Expansion of LWS in Tamil Nadu in 2010-1011
	Target as per AAP 2010-11
Implementing districts	22
DRP	44
LWS	840
Supervisor	88
HRG covered	60% of mapping population in Yr-1 districts, 40% of Yr -2 districts, 20% of Yr-3 districts
Vulnerable coverage	60% of mapping population in Yr-1 districts, 40% of Yr -2 districts, 20% of Yr-3 districts
HRG for HIV test	60% of mapping population in Yr-1 districts, 20% of Yr -2 districts, 20% of Yr-3 districts
HRG for STI test	30% of mapping population in Yr-1 districts, 20% of Yr -2 districts, 10% of Yr-3 districts
Village Information Centres	1,867
RRC	483
Condom Depot	1,820

In 2010-11, TANSACS and APAC will jointly focus on

	Capacity building of the LWs
	Mid-media campaign in the districts
	Creation of condom depot and one Information Centre per district
	Addition of other components as state level initiative - like TB/HIV treatment convergence, other health and social issues
	Strengthen Monitoring & Evaluation