Defending dignity. Fighting poverty.

Enhancing Mobile Populations’ Access to HIV/AIDS Information and

Services (EMPHASIS)

General Overview

Revised May 2010

Defending dignity. Fighting poverty.

EMPHASIS

Enhancing Mobile Populations’ Access to HIV&AIDS Services, Information & Support

BIG Lottery Fund grant: £5,102,419 (BD £722,833)

Duration: 5 years

Regional portfolio: Bangladesh, Nepal & India

Direct Beneficiaries: 141,307

Aim: To address HIV vulnerability amongst mobile populations in South Asia.

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Flow from Nepal and Bangladesh to India

INDEX

Backward flow from India to Nepal and BangladeshFlow from Border to destination Cities

Main target groups Mobile workers (men & women) from

Nepal and Bangladesh travelling to India

Wives & families in source communities

Target Location

1. From Accham and Kanchanpur in Far West Nepal to National Capital Region of India

2. From Jessore and Sathkira in Bangladesh to Kolkata Metropolitan Area in West Bengal, India

EMPHASIS

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EMPHASIS

Exploitation and

violence in border or

transit areas

Presence of population having high

risk behavior

Population movement

from Bangladesh and Nepal

to India

Lack of health care infrastructure and other

civic amenities in the border

zone

Vulnerable to HIV

infection

HIV&AIDS and Mobility in South Asia

• Undocumented status of mobile population

• Political sensitivity of illegal migration

• High-risk behaviour in destination communities

• Women especially vulnerable to exploitation

• Lack of access to health care

• Spouses and families highly exposed to risk of HIV & STIs

• Discrimination and stigma

• Lack of coordinated approach to a cross-border issue

• Lack of data to inform interventions

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EMPHASIS

CARE 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

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Objective 1: Demonstrating Good Practices

Setting 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 change

EMPHASIS

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Objective 2: Enhancing capacities

Enhancing 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.

EMPHASIS

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Objective 3: Research and Advocacy

Generating 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 campaigning

EMPHASIS

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Next 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 →

Impact

EMPHASIS

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Key Task for the Knowledge Building Phase• Define Mobile Populations and sub-populations• Describe the Impact Population (Primary

Beneficiaries)• Define the Target Population (Secondary

Beneficiaries)

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Key Task for the Knowledge Building 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)

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Key Task for the Knowledge Building 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 communities

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Key Task for the Knowledge Building 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-border

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Key Task for the Knowledge Building 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)

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Thank You