Reproductive & Child Health

Preventive, promotive, and curative aspects are integrated into service provisions. Static, Clinic, and mobile health care service operative since 1997. Community involvement in the prevention process.

Rights Of Children

Programs have been operated since 1998. Health and education component are perfectly blended. Right-based approach; Child-to-child Action.

Adolescent Empowerment

Preparing adolescents as future parents. Participation of adolescent girls in the intervention processes. Peer-to-peer Action through Rural Adolescents Resource Centre.

Women’s Empowerment

Addressing women’s rights. Sensitization, Skill Building Programs, Self-Help Groups, Income Generation activities, and Vocational Training Program.
In the process of intervention, the key stakeholders are children, adolescents, and women who have occupied the front seat and to a large extent have owned the programs.

To provide self-employment facilities to women and girls, one Tailoring institute is being run by OMRAH. Addressing women’s rights different sensitization and skill-building programs were organized among self-help groups. Leadership building and life skill building for women were also organized from time to time.

Disaster Management

Community Awareness and sensitization. Disaster preparedness training for specific Task Force Groups. Preparedness for rescue, relief, and rehabilitation preparation of community contingency plan

Alliance Building

OMRAH is a member of the Odisha State Advisory Group for Community Action. As a district convenor for the voice of Child Rights Odisha- Member of the Indian Network of NGOs on HIV/AIDS- Member of Odisha Voluntary Health Association- Member of Health NGO Research Network- Member of Jana Swasthya Abhiyan, Odisha.

Regular Medical checkups on a quarterly basis

Checkup was done so as to promote health-seeking behavior, reinforce preventive messages, and internal examination (proctoscopy/ speculum examination) to screen for asymptomatic STI and provide opportunities for syphilis and HIV screening.

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Bi-annual syphilis screening

All core group populations especially (FSW/ MSM/IDU) were screened bi-annually for syphilis and provided a referral to ICTC for HIV screening. OMRAH ties up with the nearest laboratory, i.e. SCB Medical College for the same within the cost provided for the test. Alternatively, the test can also be conducted free of cost at the nearest government laboratory. All HIV tests were performed only at the ICTC. Besides CBST was organized by OMRAH for HIV screening in all 9 hot spot areas.

Condom Promotion

A condom is a rubber sheath that is used on the erect penis before any sexual contact is made. After ejaculation, semen is collected on the tip of the condom. A condom acts as a barrier preventing the contact between infective secretions (semen or genital fluids, vaginal fluids) and the mucus membrane of the vagina, anus, glens, penis, or urethra.

Thus, condoms prevent the transmission of STI/HIV infection. They also act as contraceptives by the same mechanism. There are several barriers to condom usage. They are sometimes not easily available or accessible. Also, a person who buys and asks for condoms is looked upon with suspicion and stigma that he could be indulging in high-risk behavior. Most importantly, there is a lack of knowledge on the correct use of condoms and the existence of several myths and misconceptions related to condoms. Counselors, ORWS, and PEs of OMRAH doing regular counseling to the client for condom use, and myths include ‘using a condom is not manly’, ‘women do not like it, ‘condoms are sticky and oily’, ‘condoms are reusable’, ‘they tear during intercourse, and others. It’s important to explain to Injecting Drug Users the importance of correct and consistent usage of condoms.
Also, it’s important to communicate that sometimes, under the influence of a drug, a person can forget to use a condom, or may not be able to use one correctly. thereby increasing the risk of transmission of sexually transmitted infections including HIV/AIDS.

Needle syringe exchange and harm minimization for IDUs

The key objective of NSEP is to facilitate safe injecting practices by providing new NIS, safe disposal points, and education and information on safer injecting practices. Harm reduction aims to prevent the transmission of HIV by reducing the harm associated with high-risk behaviors such as sharing needles, syringes, and other equipment for preparing and injecting drugs, and unsafe sexual behaviors.

There are three tiers of harm reduction. Tier 1 includes Needle and Syringe Exchange Programmes (NSEP) and outreach. Tier 2 focuses on Oral Substitution Therapy (OST). Together, tiers 1 and 2 bring about behavior change from sharing contaminated injection equipment to safer injecting and from injecting to oral substitution. Tier 3 focuses on referrals and linkages with other services and advocacy for an enabling environment. Needle and Syringe Exchange Programme (NSEP) and Oral Substitution Therapy (OST) are integral parts of the spectrum of the harm reduction package. While NACP II focused primarily on Tiers 1 and 3, NACP III alan focuses on Tier 2 – Oral Substitution Therapy (OST).
A combination of strategies and individualization of interventions are important aspects of the harm reduction approach. Harm reduction provides a practical and flexible approach to reducing immediate drug-associated harms.

Opioid substitution

The key objective of OST is to improve the quality of life of IDUS by stabilizing them and transitioning them from the injecting mode of drug administration to noninjecting, thus preventing HIV and other blood-borne viruses. OST is a well-accepted strategy for HIV prevention under the harm reduction framework OST helps individuals avoid injecting and benefits them through improved health, better relationships, psychosocial rehabilitation, increased employment opportunities, and higher productivity.

OST is regulated under the Narcotics Drugs and Psychotropic Substances (NDPS) Act and can be dispensed only in approved centers. Eligibility criteria for admission to OST under NACP III, include
a) diagnosed case of opioid dependence with injecting the drug,
b) age over 18 years,
c) failed detoxification, and
d) willingness to provide informed consent for OST.

OST is a medical intervention and requires medical assessment and ongoing medical supervision. Steps in the administration of OST include induction after history taking and physical examination by a doctor, administration of medicines by a nurse, daily attendance at the clinic for receiving medicine (also called Daily Observed Treatment-DOT), regular follow-up by doctor and nurse, and regular psychosocial therapy with a counselor. OST also emphasizes psychosocial intervention. Family support enhances retention of IDUS to treatment and improves their chances of success. OST treatment continues till the client is stabilized psychologically and socially, stops injecting drugs, and starts working and being productive. The typical duration of OST is 9 to 12 months (some require more time). OST is a facility-based program and should be provided in addition to NSEP, BCC, general health care, and linkages with centers offering other services to IDU clients, including ART, DOTS, ICTC, etc. OMRAH also makes linkage with the above center for the betterment of IDU interventions.

Management of Symptomatic patients

We help Symptomatic patients through syndromic case management. It is expected that 30% of the core group population would suffer from an episode of STI in a year. These patients are to be identified through active outreach (peer-educator and outreach worker) and referred for treatment.

Presumptive Treatment for Asymptomatic patients

It is given to the sex workers (male and female) due to the fact that they may be harboring an asymptomatic infection due to Gonorrhoea and Chlamydia because of their high-risk behavior, they require treatment on this presumption. Kit 1 is used for Presumptive Treatment.