(For the purposes of our report, we employ the National Coalition for Cancer Survivorship definition of survivor, from the point of diagnosis onward [ 4– 8, 14, 15].) Figure 1 provides an action plan for implementing counseling recommendations.
In our setting, several factors are likely associated with late enrollment including poorly accessible diagnostics problems, low health seeking behavior, poor attendance at postnatal clinics, lack of effective community health services and poorly implemented counseling and testing services for HIV, including provider initiated counseling and home-based care testing.
Finally, one VHW noted that cultural beliefs often present barriers to implementing prevention programs: "Even when we select the right people to implement our counseling, we may still fail to do so.
Another option may be to implement group counseling sessions in order to more efficiently educate and address patients' concerns.
The office support program assisted PCPs in implementing the counseling protocol by providing in-office prompts and counseling algorithms.
Serological screening for HSV antibodies in the mother and her partner could help to plan for appropriate strategies during the delivery and implementing effective counseling.
Implementing psychological counseling for women, farmers, old age survivors and those with family member loss would be critical in mitigating the long-term risk of persistent PTSD.
Non-governmental organizations have implemented voluntary counseling and testing programs (VCT) for the general population as well as for high risk individuals [ 14].
Tertiary centres in neighbouring states have already implemented voluntary counseling and testing and/or routine HIV screening for all antenatal patients, which would serve as a bias in the study if such centres were used as control.
There were no differences between EXP and CON in the number of nurses implementing PA counseling or mean durations (minutes) of PA discussions at the first visit in MCs (range 4 13 vs. 3 10) or CCs (range 0 8 vs. 0 8).
