Province level lacking

Province level Gapping/lacking identified on Consultation Meeting by NANGAN (August 2019)
Gapping in Province 01
Low access in ART Services, In Morang there are only 336 cases in ART out of 1600 cases
Negative impact on the PLHAs health due to not working the Viral Load and CD4 Count machine
Lack of skilled PLHIV are out of service due to the lack of equipment and skilled manpower
PLHAs death cases are also due to the low access and treatment lacking
The meeting decided to organize monthly sharing meeting with the NANGAN Coordination
manpower in PMTCT Services
PLHIV are out of service due to the lack of equipment and skilled manpower
PLHAs death cases are also due to the low access and treatment lacking
The meeting decided to organize monthly sharing meeting with the NANGAN Coordination
Gapping in Province 03
 Delay or negligence due to the lack of CD4 Services and poor economic condition of the PLHIV
 Discontinue of ART by third gender due to the stigma and discrimination
 Not getting priority in HIV Program, due to the lack of knowledge to the local bodies
 Discontinuation in the ART due to the low understanding of PLHAs on its importance
 Opportunistic diseases is increased due to the lack of nutritious food
 Although PMTCT service is available here, the service is not taken due to the expensive package on it
 Should be strict referral mechanism while going to any general treatment
 Not having HIV related program with the HIV related organizations
 Investment in IGP program is not yet success till date, due to the low trust for PLHIV

Gapping in Gandaki Province (04)
 Its low epidemic Province but concentration is in Kaski ,
 Kaski districts cases are 815 and here is no any program for labor migrants
 Installed Viral load machine at Pokhara, but it is not working
 Disturb of Viral Load machine time to time, private sector also providing VL services
 The Viral load report is not yet received from NPHL since February – medicine is continued by self decision
 There is many lacking in social part and Stigma and Discrimination
 There is minimal work in nutrition, it is not coming in time
 CSO can play supportive role to PLHIV and risk population by listening and raising their issues
 In Tanahun districts cases are 317 among them 26 are children
 Time taking 2 to 3 days for the testing – difficulty for facilitation
 It is difficult to go in ART, for those who cannot afford at least Rs 2000 to 2500
 Since <18 years CABA are getting Rs 1000/monthly but It is being very difficulty for the 18+ years
 There should also pay to the CD4 test
 There should be the provision of providing 3 months ART at a time
 CD4 Service is avaiv at District Hospital but viral load service is from Gandaki Hospital
 Blood is dropped for the testing, but the message comes in delay about the blood damaged
 CD4 machine is not functional time to time and the reagents are not coming in time
 Budget is lower and difficult to coordinate with the stakeholders eg no budget in WAD Celebration
 HIV/TB infection is also seen
 Hospital machines are dis-functional due to the outside clinic
 High S&D in HIV eg Child were restricted from the schools in Lekhnath
 No continue of Needle Syringe exchange program
 Low understanding of HIV issue at local level
 105 viral infected people are living in Kaski Jail, lack of Space and budget in Jail
 Treatment, refer and advocacy are the main component
 No PMTCT Kit available
 Positive group are doing more but there is lack of coordination
Gapping in Sudur Paschim Province (07)
 Kailali district is central place as well as the province center, thus there are many referral cases in Seti Zonal Hospital also many follow-up cases are there however the facilities for the clients is decreasing day by day
 Due to the clients visit in Kailali comes from various districts there were 2to 3 care centre and bed number was 8 but now there is lack of care centre and bed no is only 5
 Nutrition program is stopped, which were getting by the PLHIV before
 Lack of opportunistic diseases medicine for PLHAs and shortage of other medicines also especially in the pharmacy of Seti Zonal Hospital
 Lack of transportation expenses for the treatment of PLHIV
 In Kailali, there is no more Coordination, Networking and stakeholder meeting, which was held regularly before .
 Hence, this meeting recommends for the regular meeting and coordination among the stakeholders