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  • 1. Enhancing Mobile Populations’ Access to HIV & AIDS Services, Information, and Support (EMPHASIS) CARE New Delhi 09 April 2010
  • 2. What is EMPHASIS ?
    • EMPHASIS is a 5-year initiative funded by the Big Lottery Fund, UK
    • The programme aims to
      • reduce the vulnerability of key mobile populations to HIV & AIDS along two mobility routes between Bangladesh/India and Nepal/India by delivering focused interventions at source, transit and destination points
      • influence national and regional policies relating to safe mobility through evidence generated regionally.
  • 3. Rationale for the Project – Mobility between the three countries
    • High mobility exists between Bangladesh, Nepal and India
      • Poverty
      • high unemployment
      • political instability
      • differential economic opportunities
    • Mobility has been necessary for the economic survival of families in both urban and rural communities of Nepal and Bangladesh
  • 4. Rationale for the Project – Mobility and HIV
    • Social, economic and political factors in origin and destination countries influence the risk of HIV infection
      • separation from spouses and families
      • unfamiliar social and cultural norms
      • language barriers
      • substandard living conditions
      • exploitative working conditions
      • sexual violence
      • isolation and stress
    • These may lead mobile people to engage in behaviours, e.g. unsafe casual or commercial sex, which increase HIV risk.
  • 5. Rationale for the Project – Mobility and HIV
    • This risk is exacerbated by inadequate access to HIV services and fear of being stigmatised
    • HIV prevalence is low in Bangladesh and Nepal
    • Vulnerable mobile populations form a bridge with high prevalence areas of India
    • 66% of those tested positive in a Bangladesh centre were returnees migrants
  • 6. Rationale for the Project – Vulnerability of Women
    • Women migrant workers
      • employed in unskilled jobs
      • domestic service or entertainment sectors
      • often without legal status
      • little access to health services
      • susceptible to exploitation and/or physical and sexual violence
    • Women left behind at source sites
      • Face severe economic challenges
      • food insecurity
      • may be forced to exchange sex for food or money
      • At risk if their husbands return infected with HIV
  • 7. Rationale for the Project – Existing responses of the Govts.
    • Bangladesh recognises mobility as a major risk factor for the spread of HIV&AIDS. However, there is no programming for the mobile population in the government’s major national HIV Prevention Programmes
    • In Nepal, although legislation is in place, there is a severe lack of cohesive response to address mobility and HIV systematically and comprehensively.
    • In India, national programmes are constrained by the mandate to use national resources for the welfare of their own citizens, and do not address the vulnerabilities of citizens of other countries
  • 8. What is EMPHASIS trying to achieve?
    • Programme Goal:
      • To reduce the vulnerability to HIV&AIDS of populations mobile across borders of Bangladesh, India and Nepal and to mitigate the impact on affected communities, with a specific focus on women.
    • Programme Objectives
      • To demonstrate effective good practice models for HIV prevention, care and support for mobile populations vulnerable to HIV&AIDS across India, Bangladesh and Nepal – for replication and scaling-up.
      • To enhance capacity and contribute to government/civil society institutions and communities’ efforts to reduce the vulnerability of mobile populations and their families to HIV and to mitigate the impact of AIDS.
      • To develop evidence-based advocacy and the creation of an enabling environment supportive of reducing vulnerabilities of mobile populations to HIV&AIDS
  • 9. How will EMPHASIS do it?
    • Programme Approach:
      • The programme approach will aim to answer the question: “What approaches work with cross-border mobile populations and their families to reduce vulnerability to HIV infection?”
    • The four areas of intervention will be:
      • Test a model of cross-border services.
      • Build knowledge about the mobile populations and their families and their vulnerability to HIV infection
      • Build capacity of partners in the programme approach
      • Influence changes in relevant laws, policies, practices, beliefs, attitudes, knowledge and behaviours
  • 10. Where will EMPHASIS work?
    • Nepal-India route
      • Source area (Accham and Kanchanpur)
      • Transit area (Gaddachouki)
      • Destination area (Delhi and National Capital Region)
  • 11. Where will EMPHASIS work?
    • Nepal-India route
      • Source area (Accham and Kanchanpur)
      • Transit area (Gaurifanta)
      • Destination area (Delhi and National Capital Region)
  • 12. Where will EMPHASIS work?
    • Nepal-India route
      • Source area (Accham and Kanchanpur)
      • Transit area (Rupaidiya)
      • Destination area (Delhi and National Capital Region)
  • 13. Where will EMPHASIS work?
    • Bangladesh-India route
      • Source area (Jessore and Satkhira)
      • Transit area (Petropole and adjoining areas)
      • Destination area (Kolkata, Howrah and adjoining areas)
  • 14. Who will EMPHASIS work with?
    • Impact population:
      • Mobile population from Nepal and Bangladesh to India.
      • Both Men and Women
      • Come to India for at least three months at a time
      • Spouses left behind at source sites
  • 15. First Year of the Programme
    • Knowledge Building Phase
      • Build knowledge, information, and analysis while supporting existing services for the target group.
      • Using analysis, clarify assumptions about services for each of the two migration routes: Inputs -> Outputs -> Outcomes -> Impact
  • 16. What has happened till now?
  • 17. Key Processes – Staff Recruitment
    • Staff Recruitment process started in September,2009 and all staff were recruited by January, 2010.
    New Delhi Finance Officer (part time) Jatin Juneja New Delhi Partnership Coordinator Moushumi Kundu Bahraich Partnership Coordinator Surajit Chakraborty Kolkata Partnership Coordinator Anupam Das New Delhi Admn Assistant Anju Bala New Delhi Manager (M-E-D) Nabesh Bohidar New Delhi Team Leader Essa Mohammad Rafique Place Designation Staff Name
  • 18. Key Processes – Common Understanding
    • Induction Workshop (New Delhi-October 2009)
    • Facilitators
      • Audrey Swift
      • Andy Melendez
    • Key Outcomes:
      • Common understanding of the Programme Goals
      • Understanding of the key challenges in the programme
  • 19. Key Processes – Common Understanding
    • Inception Workshop (Kathmandu-Oct/Nov 2009)
    • Facilitators
      • Audrey Swift
      • Andy Melendez
      • Ayesha Kariapper
      • Gulshan Rehman
    • Participants: Country teams and NGO partners
    • Key Outcomes:
      • Common understanding of the Programme Goals and objectives
      • Understanding of the key challenges in the programme
      • Routes
      • Draft Country work plans
  • 20. Key Processes – Common Understanding
    • NGO pre-orientation workshop (New Delhi-Dec 2009)
    • Participants: Potential NGO partners
    • Key Outcomes:
      • Common understanding of the Programme Goals and objectives
      • Understanding of the key challenges in the programme
      • Routes
      • Process for NGO assessment
  • 21. Key Processes – Common Understanding
    • CARE Staff Induction workshop (Lucknow-February 2010)
    • Facilitators (Md. Rafique & N Bohidar)
    • Key Outcomes
      • Common understanding of the Programme Goals and objectives
      • Understanding of the key challenges in the programme
      • Routes
      • Work Plans
  • 22. Key Processes – Common Understanding
    • NGO Induction Workshop (New Delhi-Feb 2010) for NGO staff of Delhi/NCR
    • NGO Induction Workshop (Kolkata-March 2010) for NGO staff of West Bengal
    • NGO Induction Workshop – (Bahraich – March 2010) for staff of Uttar Pradesh
    • Key Outcomes:
      • Common understanding of the Programme Goals and objectives
      • Understanding Workplans and Budgets
      • Mapping Exercises
      • Understanding on HIV and mobility
  • 23. Key Processes – NGO Partners Contracted
    • As the NGO partners were pre-selected, a process of NGO assessment was carried out with all the five NGOs. (Nov-Dec 2009)
    • The NGO assessment was carried out by a team comprising of both programme staff and finance staff of CARE.
    • Draft NGO contracts were sent to BIG through the Secretariat.
    • Approval of the contracts were received in late February.
    • NGO contracts were signed from the first of March
  • 24. Key Processes – Current activities of the NGO partners
    • Mapping + Needs Assessment + Stakeholder Analysis
    • Why are these important?
      • Need to know who is coming, through which route and settling where. What is the volume of mobility.
      • Pattern of mobility
      • Vulnerabilities
      • Need for mapping data to be rigorous.
      • Need for common methodology and outputs
    • Developed a common methodology, tools and required outputs through a consultative process for destination and transit sites.
    • Status:
      • Initial discussions and mapping exercises initiated in all the program locations.
  • 25. Key Processes – Overcoming the communication divide across countries
    • Communication & KM - Ning
    • One Stop Shop
      • Chat, Forum, Tele, Google-docs, Blog, Events, Calendar, Map, Groups, Photos, videos, audios, Transliteration, Archives, Intra, Google-search, SMS-web, Wiki
    • Status
      • Started in Dec 09, Analytics show high usage
      • Will require dedicated facilitator support
  • 26. E-forum discussion Blogs Chat, Tele, Video Conf SMS, Audio, Video Discussion summary Discussion Transcripts Consolidated Replies Final Blog Group work Collaborative Document Reports, Guidelines, budgets FGD, Field or Immersion Visit Transliteration Translated docs EMPHASIS KM Processes Knowledge Assets or Resources consisting of Recommended Documents, Websites, Contacts, Organizations… Archives
  • 27. Financial Status
    • Total Budget for EMPHASIS: £ 4,999,969
    • Regional Budget : £ 2,143,821
    • Nepal Budget : £ 830,541
    • India Budget : £ 1,316,884
    • Bangladesh Budget : £ 708,723
    • Project Start date is 3 rd Aug’09 and ending on 2 nd Aug’14.
    • Fund Code PN / FC : CSD010 / CS019
    • Expenditure till Dec’09 for Care India is £ 18,811.48.
    • Have signed the MOU with 5 Sub grantees in Year 1.
    • Constraints
      • Waiting for the Foreign Contribution Regulation Act 1976 (FCRA) approval due to which we are not able to draw down the money from Care UK.
  • 28. Snapshots of Activities in the Field
    • EMPHASIS team crosses the heavily guarded Indo-Bangladesh Border
  • 29. Snapshots of Activities in the Field
    • EMPHASIS team at the Indo-Nepal Border at Rupadiya
  • 30. Snapshots of Activities in the Field
    • EMPHASIS team at the Indo-Nepal Border at Gaurifanta
  • 31. We enjoy our work too
    • Some amazing sights and tastes
  • 32. Snapshots of Activities in the Field
    • Visitor to EMPHASIS – Richard Greenhalgh (chair of CARE-UK Board)
  • 33. Snapshots of Activities in the Field
    • Visitor to EMPHASIS – Jane Adisu & Nino Gurgulia
  • 34. Milestones in the First Year - India
  • 35. THANKS http://emphasis.ning.com