Enhancing Mobile Populations’ Access to HIV & AIDS Services, Information, and Support (EMPHASIS) CARE New Delhi 09 April 2010
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.
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
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.
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
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
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
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
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
Where will EMPHASIS work?• Nepal-India route – Source area (Accham and Kanchanpur) – Transit area (Gaddachouki) – Destination area (Delhi and National Capital Region)
Where will EMPHASIS work?• Nepal-India route – Source area (Accham and Kanchanpur) – Transit area (Gaurifanta) – Destination area (Delhi and National Capital Region)
Where will EMPHASIS work?• Nepal-India route – Source area (Accham and Kanchanpur) – Transit area (Rupaidiya) – Destination area (Delhi and National Capital Region)
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) Source point Transit point Destination point
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
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
Key Processes – Staff RecruitmentStaff Recruitment process started in September,2009 and all staff were recruited by January, 2010. Staff Name Designation Place Essa Mohammad Rafique Team Leader New Delhi Nabesh Bohidar Manager (M-E-D) New Delhi Anju Bala Admn Assistant New Delhi Anupam Das Partnership Coordinator Kolkata Surajit Chakraborty Partnership Coordinator Bahraich Moushumi Kundu Partnership Coordinator New Delhi Jatin Juneja Finance Officer (part time) New Delhi
Key Processes – Common UnderstandingInduction 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
Key Processes – Common UnderstandingInception 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
Key Processes – Common UnderstandingNGO 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
Key Processes – Common UnderstandingCARE 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
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
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
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.
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
EMPHASIS KM Processes Discussion Transcripts Knowledge AssetsChat, Tele, Video Conf or Resources consisting ofE-forum discussion Discussion summary Recommended Documents,Blogs Consolidated Replies Websites, Contacts, Organizations…SMS, Audio, Video Final BlogGroup work Collaborative DocumentFGD, Field or Immersion Visit Reports, Guidelines, budgets ArchivesTransliteration Translated docs
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 3rd Aug’09 and ending on 2nd 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.
Snapshots of Activities in the Field• EMPHASIS team crosses the heavily guarded Indo- Bangladesh Border
Snapshots of Activities in the Field• EMPHASIS team at the Indo-Nepal Border at Rupadiya
Snapshots of Activities in the Field• EMPHASIS team at the Indo-Nepal Border at Gaurifanta
We enjoy our work too• Some amazing sights and tastes
Snapshots of Activities in the Field• Visitor to EMPHASIS – Richard Greenhalgh (chair of CARE-UK Board)
Snapshots of Activities in the Field• Visitor to EMPHASIS – Jane Adisu & Nino Gurgulia
Milestones in the First Year - India # Milestones for Year One - India Timeline Status 1 Recruitment of all staff at country and regional End Qr 2 Completed level 2 Training of partner NGOs on M&E End of Qr 4 Will be done once M&E system is developed 3 Establishment of 1 Drop in Centre in Nepal, End of Qr 3 On Schedule - Will be Bangladesh and India done by April 4 Mapping of existing service providers End of Qr 3 On Schedule – Will be completed by April 5 First capacity building session with at least 5 End of Qr 4 Will be done NGOs/CBOs each in all countries 6 First capacity building session with border End of Qr 4 Will be done security/ police in India and Nepal 7 Publication of first set of leaflets and posters in End of Qr 4 Will be done after India and Bangladesh BCC strategy is developed