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Mainstreaming
DIFINITIONS OF MAINSTREAMING

   Multi-sectoral response
   Joint efforts
   Ownership
                                     Internal and external
                                         mainstreaming

                    •      Development of a workplace
                           policy
   Internal
                    •      Training of staff within the
Mainstreaming              office/workplace
                    •      Provision of services related to
                           prevention, care and
                    treatment     for staff
                    members
WHY INTERNAL MAINSTREAMING ?
 Depletion of workforce                 Impact on
 Decreasing productivity                 Institutional
 Roots of stigma & Discrimination      strength
WHAT TO DO ?
• Departmental ownership : in-house advocacy,
  continuity and constant follow up action
• Analysis : Assessment of factors that put workers at
  risk.
• Workplace policy: Addresses staff needs for
  information,awareness, access to services, provides
  social dialogue.
WHY EXTERNAL MAINSTREAMING ?
 It refers to integration/incorporation of
 HIV/AIDS into the policy and programme of
 the department without compromising its
 core business.
 What to do ? * Identification of entry points and
                  incorporate into the ongoing work of the
                  department
                * Inclusion of HIV/AIDS issues into the
                   policy and programme of the department
 External         Ministry on sustainable basis
mainstreaming
Why mainstreaming?
 HIV/AIDS is not merely an health issue
 The risk factors for HIV are related to wider socio-
  economic factors, such as poverty, illiteracy, migration,
  gender discrimination, urbanisation, etc ) which are
  beyond health system
 Since only 0.3 % people are infected , separate health
  infrastructure creation is costly for the country,
 Since there is no cure, prevention is most important
 Mainstreaming is important to reach large population
  (99.7 %) who are uninfected
What do you need to ask?

How does HIV/AIDS affect your organization and
 your work?
Do the policies / norms / guidelines of the
 department focus on inclusion of interest of
 HRG/PLHIV. They should not discriminate
How can you contribute to fighting HIV/AIDS by
 limiting the spread and mitigating the impact of the
 epidemic?
Why everyone should know about
                     HIV/AIDS
                         7


 Because HIV/AIDS
 can happen to anyone in your community
 can happen to anyone in your place of work
 can happen to anyone in your neighborhood
 can happen to anyone in your family
 can happen to you




RRE-NYKS
Internal Mainstreaming
◦   Development of a policy at your workplace for prevention
    and care of HIV/AIDS
◦   Training of all staff within the office/ workplace
◦   Provision of services related to prevention, care and treatment
    for staff members.
◦   Analysing how are your polices/ programmes and schemes
    reaching PLHIV/HRGs
◦   Identification of nodal officer to sustain the effort
External Mainstreaming
◦   Expanding the prevention, care and treatment facilities
    beyond staff members to contractual workers/vendors and
    community at field sites
◦   training and sensitization of the outreach workers/staff of
    the department/ to reach larger community
◦   identification of entry points where HIV could be
    mainstreamed into the ongoing work of the organisation
◦   inclusion of HIV in the detailed programme planning and
    implementation of the ministry/department
Department of Health and Family
                   Welfare
 Possible activities
  ◦   Capacity building of health care providers to ensure that there is
      no stigma
  ◦   Sensitize all health care providers on HIV/AIDS issues.
  ◦   Ensure universal coverage of PEP Social marketing of gloves to all
      health care providers. Review the effectiveness of supply chain
  ◦   Policy guidelines to direct private sector health care organizations
      to provide services for PLWHA without stigma and
      discrimination.
  ◦   Capacity building of Infection control committee of every
      hospital.
  ◦   Institutionalize awards for best practices adopted by public /
      private hospitals on HIV/AIDS.
Department of Education


Why ?
 Youth and adolescents highly vulnerable
 Growing instances of stigma and discrimination in schools
What can be done at managerial level?
 Sensitisation and skill building of teachers and principles
  for HIV awareness and stigma reduction
 Include HIV/AIDS in the State / district level Teachers
  Training Centres.
 Include HIV/AIDS in School management manuals for
  SSA/RMSA ( Sarva Siksha Abhiyan/ Rashtriya Madhymik
  Shiksha Abhiyan)
What can be done at institutional
             level
Possible activities
 Incorporate School AIDS Education & Life Skills
  programmes in all schools & colleges.
 Facilitate incorporation of HIV Prevention
  programmes in all Non Formal Education
  Programmes
 Specialized educational courses/ diplomas/ degrees in
  universities and other institutions of higher education
 Streamline admission procedures for CSW, PLWHA
  children, or orphans affected by HIV/AIDS
Department of Women and Child


 Why?
 40% of infections are in women including monogamous
  women
 Growing feminization of HIV/AIDS : rate of infections among
  women rising faster than among men
 Violence against women is quite prevalent
 Trafficked women are at high risk

 Strategic strengths
 Existing progs. of the Department make integration easy and
  cost effective
 Existing women’s groups like self help groups/ mahila
  samakhya offer good entry points
Department of Women and Child


Possible activities
 ◦   Incorporate HIV/AIDS in all Women & Child Development
     training progs.
 ◦   Integrate HIV/AIDS in the ICDS – trainings for CDPOs,
     Supervisors, AWWs
 ◦   integrate HIV into anti trafficking initiatives
 ◦   Scale up shelter & rehabilitation homes and essential services
     for women and children affected and infected by HIV/AIDS
 ◦   Special focus on destitute & Orphan/Vulnerable Children
 ◦   Step up nutrition support for PLHA with focus on Orphan/
     Vulnerable Children.
Department of Rural Development


Why?
 Poverty and distress rural-urban migration - one of the key
  underlying causes of vulnerability to HIV/AIDS
 HIV/AIDS prevalence in rural areas fast increasing
 The culture of silence is more prominent in rural areas.
 Weak infrastructure and difficult access
 Greater stigma and discrimination due to lack of awareness and
  close social networks
Strategic strengths
 Wide outreach of rural development progs specially BPL
 integrating HIV within existing infrastructure
 Department officials at the community level have trust of
  communities as they help generate livelihoods and fight poverty
Department of Rural Development


Possible activities
 Large scale coverage of rural populations through integration
  within
       Women Self Help Groups
       Watershed Committees
       Employment Guarantee Programmes
 Incorporate HIV/AIDS in all the Rural Development training
  programmes.
 Capacity strengthening of SIRDs in HIV/AIDS to train PRIs
  on an ongoing basis
 Implementation of development schemes Economic support
  to PLHA and vulnerable populations on priority.
 Review poverty alleviation progs and strengthen activities in
  highly vulnerable districts
Ministry of Panchayati Raj
                              17
 Train all PRIs by integrating HIV module in training
  programmes .
 Issue guidelines/ directives to protect PLHIVs and affected
  households against stigma & discrimination
 protect the inheritance of widows and orphans.
 Facilitate linkages to income generation activities, nutrition
  programme, housing and welfare schemes
 to support HIV infected and affected persons on priority
  basis under special groups specially widows and orphans.
 Advise Panchayats to discuss HIV related issues relevant to
  the village in Gram Sabhas and other meetings.
 Display HIV prevention messages at Panchayat Ghars
Department of surface transport
                              18

  travel support to PLHIV for visiting ART centres/ health
   centres for treatment
  Issue directives to facilitate HIV/AIDS messages on
   bus panels / bus shelters
  Support unions to manage HIV prevention services at
   truckers halting points
  Provide counseling and testing for STI/HIV/AIDS to
   helpers and bus drivers and other related workers
  Provide HIV prevention messages and condoms/ condom
   vending machines at halting centres .


RRE-NYKS
Department of Home Affairs
                            19

Include HIV/ AIDS in the training institutions /
 programmes of all police personnel
 Sensitize them to specific vulnerabilities of High risk
 groups and victims of trafficking
Provide comprehensive HIV/AIDS services relating to
 prevention, care , support and treatment at health
 facilities meant for police personnel and their families
 Sensitize jail officials/ inmates on HIV vulnerabilities
 Link with nearest ICTC for provision of counselling
 and testing to inmates


RRE-NYKS
Department of Social welfare

Include PLHIV under National Social Assistance
 programme on priority
Consider financial support to all women living with
 HIV, irrespective of age/ marital status
 Consider financial assistance for all PLHIV ( eg
 Orissa, Delhi, Goa , Gujarat, Maharashtra etc)
Department of Labour and employment

Why ?
large number of HRG and vulnerable population in
 the informal employment
 Migrants , illiteracy , unsafe shelter conditions etc
What can be done?
 Advocacy with HR system of PSUs, Private,
  Corporate for workplace policy
 Include HIV/AIDS in their workers training system
 Include HIV/AIDS in their health services
Department of Tourism

Why- Tourists are more vulnerable to HIV . They
 may indulge in High risk behaviour and also
 become victim of high risk behaviour due to lack of
 information.
What can be done ?
 Sensitise Hotel owners, tour guides and taxi
 drivers about the risk and vulnerable factors of HIV
 Include HIV/AIDS in the training curricula of
 hotel management institutions
Railways

 Why ?
Most of the hotspots are located near railways
 stations.
 Lot of vulnerable populations thrives near railway
 stations through petty jobs.
What can be done ?
Permission to allow information booth/ hoarding
 on or around stations
Railways announcements
Inclusion of contractual staff under health services
Department of Tribal affairs

 Why – High vulnerability due to    lack of awareness and
  health facilities
What can be done
Expansion of ICTC services to health facilities in tribal
 areas , through building capacity of their service
 providers
 Inclusion of counselling and testing service in Mobile
 medical units
 Planning outdoor and mid media activities in tribal
 areas
 Including HIV/AIDS in the tribal sub plans
Department of Minor ports / inland water

 Why?
Vulnerability due to migration, and large number of
 truckers and transport worker etc
What can be done?
IEC near port areas
Inclusion of STI/HIV/AIDS in the health services
provision of counselling and testing at resting
 places, halt areas.
 Sensitisation and Capacity building of health service
  providers

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Mainstreaming presentation from manipur sacs for dapcu speak

  • 2. DIFINITIONS OF MAINSTREAMING Multi-sectoral response Joint efforts Ownership Internal and external mainstreaming • Development of a workplace policy Internal • Training of staff within the Mainstreaming office/workplace • Provision of services related to prevention, care and treatment for staff members
  • 3. WHY INTERNAL MAINSTREAMING ?  Depletion of workforce Impact on  Decreasing productivity Institutional  Roots of stigma & Discrimination strength WHAT TO DO ? • Departmental ownership : in-house advocacy, continuity and constant follow up action • Analysis : Assessment of factors that put workers at risk. • Workplace policy: Addresses staff needs for information,awareness, access to services, provides social dialogue.
  • 4. WHY EXTERNAL MAINSTREAMING ? It refers to integration/incorporation of HIV/AIDS into the policy and programme of the department without compromising its core business. What to do ? * Identification of entry points and incorporate into the ongoing work of the department * Inclusion of HIV/AIDS issues into the policy and programme of the department External Ministry on sustainable basis mainstreaming
  • 5. Why mainstreaming?  HIV/AIDS is not merely an health issue  The risk factors for HIV are related to wider socio- economic factors, such as poverty, illiteracy, migration, gender discrimination, urbanisation, etc ) which are beyond health system  Since only 0.3 % people are infected , separate health infrastructure creation is costly for the country,  Since there is no cure, prevention is most important  Mainstreaming is important to reach large population (99.7 %) who are uninfected
  • 6. What do you need to ask? How does HIV/AIDS affect your organization and your work? Do the policies / norms / guidelines of the department focus on inclusion of interest of HRG/PLHIV. They should not discriminate How can you contribute to fighting HIV/AIDS by limiting the spread and mitigating the impact of the epidemic?
  • 7. Why everyone should know about HIV/AIDS 7 Because HIV/AIDS can happen to anyone in your community can happen to anyone in your place of work can happen to anyone in your neighborhood can happen to anyone in your family can happen to you RRE-NYKS
  • 8. Internal Mainstreaming ◦ Development of a policy at your workplace for prevention and care of HIV/AIDS ◦ Training of all staff within the office/ workplace ◦ Provision of services related to prevention, care and treatment for staff members. ◦ Analysing how are your polices/ programmes and schemes reaching PLHIV/HRGs ◦ Identification of nodal officer to sustain the effort
  • 9. External Mainstreaming ◦ Expanding the prevention, care and treatment facilities beyond staff members to contractual workers/vendors and community at field sites ◦ training and sensitization of the outreach workers/staff of the department/ to reach larger community ◦ identification of entry points where HIV could be mainstreamed into the ongoing work of the organisation ◦ inclusion of HIV in the detailed programme planning and implementation of the ministry/department
  • 10. Department of Health and Family Welfare  Possible activities ◦ Capacity building of health care providers to ensure that there is no stigma ◦ Sensitize all health care providers on HIV/AIDS issues. ◦ Ensure universal coverage of PEP Social marketing of gloves to all health care providers. Review the effectiveness of supply chain ◦ Policy guidelines to direct private sector health care organizations to provide services for PLWHA without stigma and discrimination. ◦ Capacity building of Infection control committee of every hospital. ◦ Institutionalize awards for best practices adopted by public / private hospitals on HIV/AIDS.
  • 11. Department of Education Why ?  Youth and adolescents highly vulnerable  Growing instances of stigma and discrimination in schools What can be done at managerial level?  Sensitisation and skill building of teachers and principles for HIV awareness and stigma reduction  Include HIV/AIDS in the State / district level Teachers Training Centres.  Include HIV/AIDS in School management manuals for SSA/RMSA ( Sarva Siksha Abhiyan/ Rashtriya Madhymik Shiksha Abhiyan)
  • 12. What can be done at institutional level Possible activities  Incorporate School AIDS Education & Life Skills programmes in all schools & colleges.  Facilitate incorporation of HIV Prevention programmes in all Non Formal Education Programmes  Specialized educational courses/ diplomas/ degrees in universities and other institutions of higher education  Streamline admission procedures for CSW, PLWHA children, or orphans affected by HIV/AIDS
  • 13. Department of Women and Child  Why?  40% of infections are in women including monogamous women  Growing feminization of HIV/AIDS : rate of infections among women rising faster than among men  Violence against women is quite prevalent  Trafficked women are at high risk  Strategic strengths  Existing progs. of the Department make integration easy and cost effective  Existing women’s groups like self help groups/ mahila samakhya offer good entry points
  • 14. Department of Women and Child Possible activities ◦ Incorporate HIV/AIDS in all Women & Child Development training progs. ◦ Integrate HIV/AIDS in the ICDS – trainings for CDPOs, Supervisors, AWWs ◦ integrate HIV into anti trafficking initiatives ◦ Scale up shelter & rehabilitation homes and essential services for women and children affected and infected by HIV/AIDS ◦ Special focus on destitute & Orphan/Vulnerable Children ◦ Step up nutrition support for PLHA with focus on Orphan/ Vulnerable Children.
  • 15. Department of Rural Development Why?  Poverty and distress rural-urban migration - one of the key underlying causes of vulnerability to HIV/AIDS  HIV/AIDS prevalence in rural areas fast increasing  The culture of silence is more prominent in rural areas.  Weak infrastructure and difficult access  Greater stigma and discrimination due to lack of awareness and close social networks Strategic strengths  Wide outreach of rural development progs specially BPL  integrating HIV within existing infrastructure  Department officials at the community level have trust of communities as they help generate livelihoods and fight poverty
  • 16. Department of Rural Development Possible activities  Large scale coverage of rural populations through integration within  Women Self Help Groups  Watershed Committees  Employment Guarantee Programmes  Incorporate HIV/AIDS in all the Rural Development training programmes.  Capacity strengthening of SIRDs in HIV/AIDS to train PRIs on an ongoing basis  Implementation of development schemes Economic support to PLHA and vulnerable populations on priority.  Review poverty alleviation progs and strengthen activities in highly vulnerable districts
  • 17. Ministry of Panchayati Raj 17  Train all PRIs by integrating HIV module in training programmes .  Issue guidelines/ directives to protect PLHIVs and affected households against stigma & discrimination  protect the inheritance of widows and orphans.  Facilitate linkages to income generation activities, nutrition programme, housing and welfare schemes  to support HIV infected and affected persons on priority basis under special groups specially widows and orphans.  Advise Panchayats to discuss HIV related issues relevant to the village in Gram Sabhas and other meetings.  Display HIV prevention messages at Panchayat Ghars
  • 18. Department of surface transport 18  travel support to PLHIV for visiting ART centres/ health centres for treatment  Issue directives to facilitate HIV/AIDS messages on bus panels / bus shelters  Support unions to manage HIV prevention services at truckers halting points  Provide counseling and testing for STI/HIV/AIDS to helpers and bus drivers and other related workers  Provide HIV prevention messages and condoms/ condom vending machines at halting centres . RRE-NYKS
  • 19. Department of Home Affairs 19 Include HIV/ AIDS in the training institutions / programmes of all police personnel  Sensitize them to specific vulnerabilities of High risk groups and victims of trafficking Provide comprehensive HIV/AIDS services relating to prevention, care , support and treatment at health facilities meant for police personnel and their families  Sensitize jail officials/ inmates on HIV vulnerabilities  Link with nearest ICTC for provision of counselling and testing to inmates RRE-NYKS
  • 20. Department of Social welfare Include PLHIV under National Social Assistance programme on priority Consider financial support to all women living with HIV, irrespective of age/ marital status  Consider financial assistance for all PLHIV ( eg Orissa, Delhi, Goa , Gujarat, Maharashtra etc)
  • 21. Department of Labour and employment Why ? large number of HRG and vulnerable population in the informal employment  Migrants , illiteracy , unsafe shelter conditions etc What can be done?  Advocacy with HR system of PSUs, Private, Corporate for workplace policy  Include HIV/AIDS in their workers training system  Include HIV/AIDS in their health services
  • 22. Department of Tourism Why- Tourists are more vulnerable to HIV . They may indulge in High risk behaviour and also become victim of high risk behaviour due to lack of information. What can be done ?  Sensitise Hotel owners, tour guides and taxi drivers about the risk and vulnerable factors of HIV  Include HIV/AIDS in the training curricula of hotel management institutions
  • 23. Railways  Why ? Most of the hotspots are located near railways stations.  Lot of vulnerable populations thrives near railway stations through petty jobs. What can be done ? Permission to allow information booth/ hoarding on or around stations Railways announcements Inclusion of contractual staff under health services
  • 24. Department of Tribal affairs  Why – High vulnerability due to lack of awareness and health facilities What can be done Expansion of ICTC services to health facilities in tribal areas , through building capacity of their service providers  Inclusion of counselling and testing service in Mobile medical units  Planning outdoor and mid media activities in tribal areas  Including HIV/AIDS in the tribal sub plans
  • 25. Department of Minor ports / inland water  Why? Vulnerability due to migration, and large number of truckers and transport worker etc What can be done? IEC near port areas Inclusion of STI/HIV/AIDS in the health services provision of counselling and testing at resting places, halt areas.  Sensitisation and Capacity building of health service providers