Details for Reform Option "Partner Sexual Health Project, Gujarat"
Gujarat has moderate scale prevalence of HIV/AIDS and is home for about 1000 HIV positive persons. Its capital, Ahmedabad, is the 7th largest city in India with a population of around 35 lakh (3.5 million). Of them, 12 lakh (1.2 million) live in slums and public tenements, called chawls in local parlance. Most of the latter are migrant population, who have come to the city in search of the employment.
Realising that knowledge is the only way to contain the spread of HIV/AIDS, Self Employed Women’s Association (SEWA) started Partner Sexual Health Project (PSHP) in Ahmedabad. The thrust was on generating awareness and inculcating responsible behaviour.
PSHP was initiated in partnership with Lok Swasthya, a health co-operative of SEWA and Gujarat State AIDS Control Society (GSACS) in 2001. Around 20 reputed field Non-Government Organisations (NGOs) were selected and a network established for various interventions. Strategies adopted by the PSHP were to be followed by all partner NGOs.
Target areas for the interventions were chosen following a need assessment study. Based on the first study, in 2001, Behrampura was chosen and later on Asarva, Girdharnagar, Meghaninagar and Chamanpura were added, based on the need assessment conducted in 2003. The areas were chosen with the guidance and support of GSACS.
The second step was classification of high-risk groups, according to their occupation. In each community they identified community leaders by virtue of their long-standing presence in the community. These community leaders were called Peer Educators and their capacity building was done through short training programmes. The training programmes were of two days at the start, followed by monthly one-day refresher trainings by GSACS.
A two-pronged strategy was adopted for the programme.
(i) Awareness generation: through various channels like Inter Personal Communication (IPC), group discussion and street plays.
Awareness generation involved in-depth survey of the sexual behaviour of the community; it was difficult for people to freely discuss delicate issues related to sexual behaviour in a group. IPC proved a very useful tool not only to convey various methods of prevention, but also to win the trust and confidence of the community. It also helped in identifying patients of symptomatic Sexually Transmitted Disease (STD) and in motivating them to avail of medical help.
Well-crafted street plays, with relevant Lok Swasthya (public health) messages, were also performed at frequent intervals at various locations and were regularly modified in accordance with the community’s response.
Peer educators were allocated outreach areas of work and were paid INR 750 a month. Of the 26 peer educators, 18 worked as volunteers.
(ii) STD detection and treatment: With the help of well-qualified health professionals suspected cases were examined and treated free of cost by Lok Swasthya. It is a regular activity supported by GSACS as part of its programme. Patients, after being cured, are especially followed up for counselling to adopt safe sexual behaviour.
GSACS also provided IEC material and condoms.
Increased awareness and a growing trend towards responsible sexual behaviour. This is corroborated by the fact that the number of regular condom users in Behrampura increased from 275 in 2001-02 to 1527 in 2003-04.
There was a 10% organisational contribution for STD detection and training of peer educators. Support for SEWA health workers’ involvement and other health service costs were hidden costs. GSACS provided IEC material and condoms.
2001, Behrampura in Ahmedabad.
Approximately one year.
Awareness generation: Through various communication channels on modes of HIV transmission.
Promotes safe sex: Regular communication with the clientele and making services accessible promotes safe sexual practices.
Community mindset: Attitude of the community creates strong barriers to accepting facts and changing high risk sexual behaviour.
Misconceptions: Local misconceptions related to the transmission of HIV negatively influence the effect of the communication process.
Reputation: It is of critical importance the organisation be held in high esteem by the community.
Agreement with the State AIDS Control Society
Who needs to be consulted
Exisiting health facility.
State AIDS Control Society.
Sustainability is dependent on integration and convergence with other health programmes.
Chances of Replication
Replicable as there is support from State Aids Control Societies.
With so much support available from the government, as well as donors, committed organisations need to come forward to help check the menacing spread of HIV/AIDS.
Dr. Anuradha Davey, Research Consultant, National Institute of Medical Statistics, May, 2006.