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)
Source
point
Transit
point
Destination
point
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
17. Key Processes – Staff Recruitment
Staff 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
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. EMPHASIS KM Processes
Discussion Transcripts Knowledge Assets
Chat, Tele, Video Conf
or Resources
consisting of
E-forum discussion Discussion summary Recommended
Documents,
Blogs Consolidated Replies Websites,
Contacts,
Organizations…
SMS, Audio, Video Final Blog
Group work Collaborative Document
FGD, Field or Immersion Visit Reports, Guidelines, budgets Archives
Transliteration Translated docs
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 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.
28. Snapshots of Activities in the Field
• EMPHASIS team crosses
the heavily guarded Indo-
Bangladesh Border
34. 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
