,  February 25, 2018

Enhancing Migrant Populations' Access to HIV and AIDS Services, Information and Support (EMPHASIS) is Committed to: Universal Access - Continuum of Prevention to Care                                                                                                                                         Promoting Women's Empowerment                                                                                                                                         Dignity and Safety of the Mobile Populations

    
    

EMPHASIS Project a ‘best practice model

EMPHASIS Project, CARE has recently been highlighted by UNAIDS in Bangladesh as a ‘best practice’ model. In the recently released Country Progress Report for Bangladesh which has been produced by UNAIDS with the National AIDS/STD Programme of the Ministry of Health and Family Welfare, Government of Bangladesh, as the main coordinating body, EMPHASIS is one of seven projects identified as good initiatives.

 

(Please see below the information on EMPHASIS from the UNAIDS Country Progress Report)

 

Addressing HIV vulnerability among Cross Border Mobile Population

 

Cross‐border movement into India has become a necessity for economic survival of people living in bordering  areas  of  Bangladesh.  EMPHASIS  (Enhancing  Mobile  Population’s  Access  to  HIV  &  AIDS services, Information and Support) is the very first ground breaking 5 years (Aug 2009‐Aug 2014) sub‐ regional initiative by CARE India, Bangladesh and Nepal funded by BIG Lottery Group of United Kingdom. The project works with highly vulnerable groups who are largely poor, with low literacy rate coming from rural Bangladesh and end up migrating to cities (specially at Mumbai and Delhi) in India with dreams and hopes of better jobs to support their family back home.

 

The baseline study identified the major push factors of cross border mobility are lack of employment and poverty at source; pull factors are more employment opportunity, higher wages, recreation opportunities, and peer pressure etc at destination. Unknowingly the mobile people fall into HIV & STI risk: men meet their sexual need unsafely at destination, women become involved in 51 sex trade for endurance at destination or in the course of mobility they are abused / harassed by power people at source and destination. This continues as frequent phenomena for years and it acts as driving force of stigma towards them (Ref: Baseline study of EMPHASIS Project).

 

The major objective of the intervention is to test model to reduce HIV vulnerabilities of the undocumented migrant population and their family members to demonstrate model intervention for future replication. Three areas for intervention were identified: creating access to information and services, enhancing capacities of service providers, research and advocacy. Strategies include:

 

Obtaining Broker’s assistance to reach cross border mobile population

 

The approach to reach impact population (IP) at transit areas is to reach them through brokers at the place they are stopping over during their travel, a place where no one is going to find them. After one year implementation at selected border areas, outreach was built on trusting relationships with the brokers and reaching Ips with necessary HIV & service access information at locations selected by brokers. The outreach activity at transit has been established from field learning that People from different districts choose this transit for safe undocumented trespass and sometimes takes a stopover close to the land port to secure a safe time for the trespass. Migrants sometimes bring their family to villages near the porous border area. The outreach activity through contact with the broker is thus successful as it doesn’t have any implication of facing law enforcement agency harassment.


Self Help Group of Wives of Migrant´s left at home to reduce stigma and discrimination related to HIV

and Cross Border Mobility

 

A group of women left at home (Self Help Group) were brought together to try to address financial constrains in the absence of their husbands and they initiated the community action (ie. participated in family counseling and community sensitization) to reduce family violence and social stigma on them and the returnee females with the help of EMPHASIS. Community referral to services for the returnees and migrant´s family was another action point. It resulted to reduce violence and stigma against women left at home & returnee females of 22 families and they started to be reintegrated into family and community. Service access increased that was documented through qualitative evidence of STI services consumption by returnees and migrant´s family.

 

Capacity building of the health service providers to increase service access for the cross border mobile population

 

93 Health service providers ( Government and nongovernment) at Jessore and Satkhira (two border‐ lying districts) were trained on Syndromic Management of STI, HIV/AIDS and Migration, Voluntary Counseling and Testing (VCT), Advocacy and Communication and HIVAIDS care and rational use of ART. This capacity building initiative resulted in increased service access of the bordering people. Formal MoU could  not  help  activating  effective  referral  but  increased  knowledge  after  training  of  the  service providers facilitated them to render services to the clients. It was evident that the female clients were frequently referred to the gynecologist for any kind of STI and RTI related sign/symptoms; but after having the STI management training many of the male doctors and medical assistants also felt confident to treat clients.

 

(For the entire report:

http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/201

2countries/ce_BD_Narrative_Report[1].pdf)

 

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