2,194,066 848,898 1,336,622 722,833 5,102,419 Sec NP IN BD
Knowledge – including HIV status, relevant laws and policies Behaviours – including drug use, sexual risk taking (including number of sexual partners, condom use), Practices – including determinants of mobility (why do people move), mobility experience (what happens to you when travelling), HIV testing Attitudes – including issues of self-esteem, auto-stigma
Epidemiology Attitudes – including Mobility and/or HIV stigma and discrimination, disaggregated by sex Practices – including influences on enabling risk taking or hindering risk reduction Policies – including government, workplace Mobility Prevalence Impact of Migration Impact of HIV and AIDS
Emphasis overview 5 10
Enhancing Mobile Populations’ Access to HIV/AIDS Information and Services (EMPHASIS) General OverviewRevised May 2010 Defending dignity. Fighting poverty.
EMPHASIS Enhancing Mobile Populations’ Access to HIV&AIDS Services, Information & SupportBIG Lottery Fund grant: £5,102,419 (BD £722,833)Duration: 5 yearsRegional portfolio: Bangladesh, Nepal & IndiaDirect Beneficiaries: 141,307Aim: To address HIV vulnerability amongst mobile populations in South Asia. Defending dignity. Fighting poverty.
EMPHASIS INDEX Flow from Nepal and Bangladesh to India Backward flow from India to Nepal andMain target groups Bangladesh Flow from Border to destination Cities Mobile workers (men & women) from Nepal and Bangladesh travelling to India Wives & families in source communitiesTarget Location1. From Accham and Kanchanpur in Far West Nepal to National Capital Region of India2. From Jessore and Sathkira in Bangladesh to Kolkata Metropolitan Area in West Bengal, India Defending dignity. Fighting poverty.
EMPHASISHIV&AIDS and Mobility in South Asia Pop ulation Exp l oitation and m ovem ent from viol ence in• Undocumented status of mobile population Bangl esh ad bord er or transit and N ep al to areas Ind ia• Political sensitivity of illegal migration• High-risk behaviour in destination communities• Women especially vulnerable to exploitation• Lack of access to health care Presence of• Spouses and families highly exposed to risk of Vulnerabl to e p op ulation HIV & STIs HIV infection having high risk behavior• Discrimination and stigma• Lack of coordinated approach to a cross-border Lack of health issue care infrastructure• Lack of data to inform interventions and other civic am enities in the b ord er zone Defending dignity. Fighting poverty.
EMPHASISCARE Piloting a comprehensive cross-border approach Working along the entire mobility continuum: source (Bangladesh or Nepal) -> transit -> destination (India) -> back to source country Setting up service networks linking into national health systems Increasing access to prevention and treatment services Action research in order to add to the strategic information available on HIV and Mobile populations towards the aim of strengthening the advocacy platform Defending dignity. Fighting poverty.
EMPHASISObjective 1: Demonstrating Good PracticesSetting up a model for good practice for accessing and providing services to mobile populations vulnerable to HIV&AIDS• Establishing service centres throughout the mobility route• Establishing a service linkage network• Increasing access to Voluntary Counselling and Testing, condom provision, advice and information• Providing uniform messages to influence behaviour changeDefending dignity.Fighting poverty.
EMPHASISObjective 2: Enhancing capacitiesEnhancing the capacity of various partners, strengthening mechanisms for consistency and facilitating linkages among service providers and organisations• Understanding gender dimensions of HIV and mobility• Raising awareness of specific vulnerabilities to HIV arising out of mobility• Supporting service providers to reach out to mobile populations sensitively• Increase the quality and access of services for mobile populations and their families• Key Targets: government agencies, health service providers, CSO service providers, PLWHA networks, research institutes and organisations.Defending dignity.Fighting poverty.
EMPHASISObjective 3: Research and AdvocacyGenerating evidence on HIV and mobility to influence national and regional policy-making.• Specific research to generate information to strengthen policy advocacy: baseline and end line studies; mapping and analysis of laws, policies and systems which frame the scope for reducing vulnerability of migrants; in- depth study on the vulnerabilities faced by mobile populations and the families; documenting good practice models.• Publication and dissemination of research findings• Policy Advocacy: briefing papers, advocacy and campaigningDefending dignity.Fighting poverty.
EMPHASISNext StepsYear one of the programme has been designated the Building Knowledge Phase.• Build knowledge, information, and analysis while supporting existing services for the sub-impact groups.• Using analysis to clarify assumptions about services for each of the two mobility routes – Assess: Inputs → Outputs → Outcomes → ImpactDefending dignity.Fighting poverty.
Key Task for theKnowledge Building Phase• Define Mobile Populations and sub-populations• Describe the Impact Population (Primary Beneficiaries)• Define the Target Population (Secondary Beneficiaries)Defending dignity.Fighting poverty.
Key Task for the KnowledgeBuilding Phase, cont.• Identify for the Impact Population in relation to HIV risk• Mapping along the mobility route of: – Key service providers – Key state and district actors (including security forces) – Risk hotspots – Resource inventory• Resource gaps analysis along the route – What services are missing – What services are insufficient – access, quality• Identify potential community human resources (including potential community leaders, volunteers, educators, mobilisers)Defending dignity.Fighting poverty.
Key Task for the KnowledgeBuilding Phase, cont.• Begin to identify potential indicators to measure: – Vulnerabilities – Determinants of vulnerabilities – Risk – Effectiveness – Capacity – Attribution• Baseline Survey of mobile workers, communities, service providers (including EMPHASIS stakeholders) and other stake holders on "HIV" and "mobility" – Including quality standards for services• Situational Analysis by source, transit, and destination communitiesDefending dignity.Fighting poverty.
Key Task for the KnowledgeBuilding Phase, cont.• Analysis of relevant laws and policies from local to regional – What laws and policies exists – How are they implemented and enforced – How supportive are they• Government engagement plan from local to regional – Within the country – Cross-borderDefending dignity.Fighting poverty.
Key Task for the KnowledgeBuilding Phase, cont.• Analysis of existing or past programmes across the route (in terms of interventions and activities – DICs, Outreach, Peer Education, etc.) – Who has done what – What has worked – What has not worked – Attribution of programmes impacting communities – Synergies with EMPHASIS – including linkages to existing programmes (e.g., C-NP Safe Passages)Defending dignity.Fighting poverty.