Rapid Assessment among migrant workers in Construction Sector on HIV/AIDS Risk and Vulnerability in
Raigad dist., Maharashtra
Shankar Talwar (Ph.D.)Consultant
ILO, New Delhi
25 November, 2008
Objectives of the assessment
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.
MethodologyMapping 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
MethodologyKABP 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
MethodologyStakeholder analysis conducted using in-depth interviews Stakeholders consisted of Contractors, Mukadams (group leaders of construction workers), and NGO workers (NMS) associated with construction workers.
Findings
Mapping Size estimation and migration behavior HIV/AIDS risk factor HIV/AIDS services aware and used
Estimating size
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
Where do migrant construction workers come from?
51.0
14.0
12.0
11.0
12.0
Maharashtra
Uttar Pradesh
Karnataka
Bihar
Others
Migration behavior
% Seasonal workers % Living singly0
10
20
30
40
50
60
70
8071
22
76
67
52
25
59
33
Naka Constructin site Basti Basti (NFN)
HIV related risk factors
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
HIV/AIDS related services
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
FindingsKABP Survey Background characteristics of the respondents Knowledge of HIV transmission and
misconceptions Knowledge of prevention methods Attitude towards HIV+ co-workers Knowledge of STI symptoms in women and men Awareness of HIV/AIDS services at workplace,
and services received Sexual risk behavior Condom use
Background characteristics of respondents
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
% knowing all 4 routes of HIV transmission*
Naka (n=162) Construction site (n=103)
Basti (NFN) (n=115)
Total (N=380)0
5
10
15
20
25
30
35
40
45
26.5
42.7
27.8
31.3
* Sex, blood, mother to child, and needle/syringe
% endorsing all 4 misconceptions of HIV transmission*
Naka (n=162) Construction site (n=103)
Basti (NFN) (n=115)
Total (N=380)0
1
2
3
4
5
1.9
3.9
2.6 2.6
* Using toilet, mosquito bite, touching, sneezing nearby
% knowing any 3 HIV prevention methods*
Naka (n=162) Construction site (n=103)
Basti (NFN) (n=115)
Total (N=380)0
10
20
30
40
50
60
70
32.7
58.3
49.6
44.7
* A, B, C, sterilized needle, M-C treatment, safe blood
Attitude towards HIV+ person (%)
Willing to work alongside co-worker who is +ve
Willing to use toilet used by co-workers who is +ve
Willing to eat food with co-worker who is +ve
Willing to share tools with co-workers who is +ve
Willing to hold hands with someone who is +ve
Willing to share a room with someone who is living with HIV/AIDS
HIV+ children should be allowed to study in schools
Agree to live in the same house with a family member who is +ve
0 10 20 30 40 50 60
47.1
44.2
43.2
52.1
51.6
44.7
57.4
50.5
Knowledge of STI symptoms in women and men (%)
Naka (n=162) Construction site (n=103)
Basti (NFN) (n=115)
Total (N=380)0
2
4
6
8
10
12
14
2.5
1.0
3.5
2.4
9.9
12.6
11.3 11.1
% of respondents knowing at least 2 STI symptoms in women
Awareness of workplace HIV/AIDS services (%)
HIV prevention education
Condom availability
STI treatment information
VCT information
Care and support information
0 5 10 15 20 25
11.8
22.9
2.9
0.8
2.1
HIV/AIDS services received in workplace (%)
HIV/AIDS education
Information on STI treatment
Information on VCTC
Information on Care and support
Required condom
0 2 4 6 8 10 12 14 16 18 20
11.8
10.8
11.3
10.5
18.2
Sex with anybody other than spouse (%)
Naka (n=162) Construction site (n=103)
Basti (NFN) (n=115)
Total (N=380)20
21
22
23
24
25
26
27
25.9
25.2
22.6
24.7
Condom use and partner reduction
% used condom in last 2 sex acts % intentinally reduced partners0
10
20
30
40
50
60
70
80
90
78.6
52.4
65.461.5
76.9
46.2
74.5
53.2
Naka (n=42) Construction site (n=26)Basti (NFN) (n=26) Total (N=94)
Findings
Stakeholder analysis
Role of stakeholders
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
To sum up .. 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