   Conduct mapping exercise to identify potential sites    and provide information on geographical areas where    migrant...
Mapping   conducted in the identified geographical areas (not the    entire taluka)   carried out at three types of loca...
KABP Survey   conducted using a standardized questionnaire    developed by ILO for workers in the    unorganized sector ...
Stakeholder analysis   conducted using in-depth interviews   Stakeholders consisted of Contractors,    Mukadams (group l...
Mapping
   In all, 86 locations were mapped (6 Nakas, 31    Construction sites and 49 Bastis)   There were 36,571 migrant constr...
12.0                        Maharashtra 11.0                        Uttar Pradesh                        Karnataka        ...
80            76     7170                                              67                               5960              ...
   Two-third of the locations had sex workers    operating nearby (brothels, etc.)   Women construction workers reported...
   General health care seeking from private    allopath (80%) and govt. facilities (28%)   Among a dozen NGOs/CBOs opera...
KABP Survey
   Three-fourth of the respondents were men   While 45% were 21-30 yrs old, 29% were 31-40 yrs    old   63% were marrie...
45                      42.74035                                                      31.330                              ...
54                        3.93                                             2.6                2.62       1.910    Naka (n=...
7060                        58.3                                           49.650                                         ...
Agree to live in the same house with                                                                             50.5    a...
14                               12.612                                               11.3               11.1             ...
Care and support information         2.1            VCT information        0.8   STI treatment information             2.9...
Required condom                                                      18.2Information on Care and support                  ...
27         25.926                          25.2                                                                  24.725242...
90      78.6                 76.980                                     74.570             65.4                           ...
Stakeholder analysis
   Key stakeholders included –    Builders, Contractors, Mukadams, NGO workers   Builders interacted with workers only o...
   Presence of substantial number of single male    construction workers who fit the definition of NACO   Mapping indica...
Rapid assessment of hiv risk and vulnerability among migrant workers
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Rapid assessment of hiv risk and vulnerability among migrant workers

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ILO, New Delhi implemented a model project on mobilizing labor unions among unorganized sector for HIV/AIDS prevention in Maharahstra. Assessment was conducted as a baseline for the intervention.

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Rapid assessment of hiv risk and vulnerability among migrant workers

  1. 1.  Conduct mapping exercise to identify potential sites and provide information on geographical areas where migrant construction workers are present, their origin and size Carryout a knowledge, attitude, behavior and practice (KABP) study to assess the level of risk for HIV infection among the migrants at the potential intervention sites, and Carryout stakeholder analysis at the identified destination sites to assess their role in reducing HIV risk among the migrant construction workers.
  2. 2. Mapping conducted in the identified geographical areas (not the entire taluka) carried out at three types of locations where migrant construction workers congregated (Nakas) /worked (Construction sites)/ lived (Bastis). Conducted using Primary Key Informant Interviews Trained NGO workers conducted mapping Information gathered during mapping included – estimated number of migrants, migration behavior, risk factors and HIV/AIDS services available
  3. 3. KABP Survey conducted using a standardized questionnaire developed by ILO for workers in the unorganized sector Conducted at 15 locations in Panvel taluka (6 Nakas, 6 Construction sites, and 3 Bastis) identified for intervention Among a sample of 380 using random sampling with PPS approach at each location Trained NGO workers conducted the fieldwork
  4. 4. Stakeholder analysis conducted using in-depth interviews Stakeholders consisted of Contractors, Mukadams (group leaders of construction workers), and NGO workers (NMS) associated with construction workers.
  5. 5. Mapping
  6. 6.  In all, 86 locations were mapped (6 Nakas, 31 Construction sites and 49 Bastis) There were 36,571 migrant construction workers in these locations Nakas had high mean no. of workers per location (783) compared to Bastis (586) and construction sites (144) No. of migrants increased by 10-15% during peak seasons (April-May, Oct.-Nov) Two-third of the migrant construction workers were men Most of the workers were from the weaker sections of the society
  7. 7. 12.0 Maharashtra 11.0 Uttar Pradesh Karnataka 51.012.0 Bihar Others 14.0
  8. 8. 80 76 7170 67 5960 525040 3330 25 2220100 % Seasonal workers % Living singly Naka Constructin site Basti Basti (NFN)
  9. 9.  Two-third of the locations had sex workers operating nearby (brothels, etc.) Women construction workers reported to work as part-time sex workers in one-tenth of the locations (mostly Nakas) More than half consumed alcohol About 1.5% of the construction workers in Basti injected drugs
  10. 10.  General health care seeking from private allopath (80%) and govt. facilities (28%) Among a dozen NGOs/CBOs operating in the area, very few provided HIV related services In less than half of the locations condoms were available (very low in Nakas and sites) Workers in only about one-tenth of the locations knew about VCT services
  11. 11. KABP Survey
  12. 12.  Three-fourth of the respondents were men While 45% were 21-30 yrs old, 29% were 31-40 yrs old 63% were married While 34% were illiterate, 25% had studied from 1 to 5 standard, 21% from 6 to 8 standard Duration in construction work varied from 1 to 8 years Only about half of the respondent reported living with their spouse currently
  13. 13. 45 42.74035 31.330 27.8 26.525201510 5 0 Naka (n=162) Construction Basti (NFN) Total (N=380) site (n=103) (n=115)
  14. 14. 54 3.93 2.6 2.62 1.910 Naka (n=162) Construction site Basti (NFN) (n=115) Total (N=380) (n=103)
  15. 15. 7060 58.3 49.650 44.740 32.73020100 Naka (n=162) Construction site Basti (NFN) Total (N=380) (n=103) (n=115)
  16. 16. Agree to live in the same house with 50.5 a family member who is +veHIV+ children should be allowed to 57.4 study in schools Willing to share a room with 44.7 someone who is living with…Willing to hold hands with someone 51.6 who is +ve Willing to share tools with co- 52.1 workers who is +ve Willing to eat food with co-worker 43.2 who is +ve Willing to use toilet used by co- 44.2 workers who is +veWilling to work alongside co-worker 47.1 who is +ve 0 10 20 30 40 50 60
  17. 17. 14 12.612 11.3 11.1 9.910 8 6 3.5 4 2.5 2.4 2 1.0 0 Naka (n=162) Construction site Basti (NFN) Total (N=380) (n=103) (n=115) % of respondents knowing at least 2 STI symptoms in women % of respondents knowing at least 2 STI symptoms in men
  18. 18. Care and support information 2.1 VCT information 0.8 STI treatment information 2.9 Condom availability 22.9 HIV prevention education 11.8 0 5 10 15 20 25
  19. 19. Required condom 18.2Information on Care and support 10.5 Information on VCTC 11.3 Information on STI treatment 10.8 HIV/AIDS education 11.8 0 2 4 6 8 10 12 14 16 18 20
  20. 20. 27 25.926 25.2 24.7252423 22.6222120 Naka (n=162) Construction site Basti (NFN) (n=115) Total (N=380) (n=103)
  21. 21. 90 78.6 76.980 74.570 65.4 61.560 52.4 53.250 46.240302010 0 % used condom in last 2 sex acts % intentinally reduced partners Naka (n=42) Construction site (n=26) Basti (NFN) (n=26) Total (N=94)
  22. 22. Stakeholder analysis
  23. 23.  Key stakeholders included – Builders, Contractors, Mukadams, NGO workers Builders interacted with workers only on financial matters (pay for work, compensation). Kept strict vigil on the premises. Contractors had a key role in hiring workers, negotiating pay, providing civic amenities at sites Mukadams being team leaders, managed and controlled workers Contractors and Mukadams were willing to support HIV/AIDS intervention by providing space and letting their workers to participate in program
  24. 24.  Presence of substantial number of single male construction workers who fit the definition of NACO Mapping indicated HIV/AIDS vulnerability – sex workers nearby, part time sex work by women workers, high alcohol consumption, some amount of drug use Poor knowledge of HIV transmission, prevention methods, and STI symptoms Lack of HIV/AIDS services in workplaces in the construction sector About half of the workers did not have favorable attitude to HIV infected co-workers Clear evidence of high risk sexual behavior, and relatively low consistent condom use Need to work closely with all the stakeholders associated with construction workers

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