most at risk adolescents in cee cis lessons learnt from programming
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Most-at-risk adolescents in CEE/CIS: Lessons learnt from programming. Anja Teltschik, UNICEF Consultant 3 September 2009. Where we started:. No political and donor priority Lack of strategic information Low service scale, scope & quality

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most at risk adolescents in cee cis lessons learnt from programming

Most-at-risk adolescents in CEE/CIS: Lessons learnt from programming

Anja Teltschik, UNICEF Consultant

3 September 2009

slide2

Where we started:

  • No political and donor priority
  • Lack of strategic information
  • Low service scale, scope & quality
  • Reluctance of civil society to address MARA issues

MARA

largely

left out

out of the AIDS

response

what strategic information revealed
What strategic information revealed:
  • A substantial percentage of IDUs, FSWs and MSM initiates risk behaviour < 18
  • Dysfunctional families
  • Street settings increase risk & vulnerability
  • MARA are diverse and intermix
  • Distinct differences between MARA & MARP
slide6

Accepting a new concept takes time

  • Sound data are critical
  • Use HIV/AIDS coordination mechanisms & strategic planning to insert MARA

In the context of:

Double standards & competing priorities =

UNICEF has to keep MARA on the agenda

slide8

A legal ‘vacuum’ affecting research + services for MARA

Major stumbling blocks

  • ‘Parental consent’ issues
  • Illegality of risk behaviour
  • NGOs limited in their service provision to minors
  • Child rescue policy – doing more harm than good?

Changes take time – find practical solutions

slide10

Methodological issues

  • Sampling
  • Recruitment
  • Language and understanding of questionnaires

Ethical issues

  • Documenting the process: tracking referrals and cases of abuse
slide12

Majority of adolescents – not at risk

Parents & families

Make systems

friendly to MARA

EVA

Sexual & socialnetworks

Pull MARA

out of risk

MARA

Do it with and not for MARA…

In the context of child & human rights…

slide13

Child protection &

social services

Health

system

HIV planning

and M&E

MARA

Child-care system

Financial

system

Education

Donors / UN

HIV-NGOs

Justice system

Youth

organisations

Humanitarian

programmes

key issues
Key issues
  • Deciding whom to partner with?
  • Deciding what may work with MARA?
  • Building response capacity (including M&E)
  • Linking MARA programming to the national AIDS response
slide17

Civil society partners

  • Daily battle with the system – demotivating
  • Winning the trust of MARA
  • Reaching the most hidden – is it possible?
  • Education, information & condoms and syringes are not enough
  • Working with families
slide18

Health care services

“We are open to all – what do you want?”

  • MARA – ‘the additional burden’
  • Youth-friendly services – not automatically MARA-friendly
  • Avoiding additional stigma + ensuring confidentiality
slide19

Getting different sectors to cooperate & be accountable

  • Building referral systems / agreeing on procedures / protocols
  • Motivating MARA to take up referrals
  • Individual case management – new approach
  • Linkages to child protection = key challenge
slide20

Understanding and working with the police and the judicial environment

  • Dealing with corruption
  • Working in a criminal milieu
  • Dealing with police harassment (MARA / outreach workers)
slide21

 Special needs of MARA living with HIV/AIDS

  • Existing services & networks – no focus on HIV+ MARA
  • Barriers to treatment access and eligibility
  • Adherence issues
  • Additional stigma and discrimination
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