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Avahan PRINCIPLES AND EXPERIENCE ON COMMUNITY INVOLVEMENT. July 23, 2014. Sameer Kumta Senior Programme Officer. agenda. Avahan overview Why community mobilization? How community mobilization is critical for HIV prevention? Data from programs Lessons learnt Way forward. agenda.

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Avahan principles and experience on community involvement

Avahan PRINCIPLES AND EXPERIENCE ON COMMUNITY INVOLVEMENT

July 23, 2014

Sameer Kumta

Senior Programme Officer


Agenda
agenda

  • Avahan overview

  • Why community mobilization?

  • How community mobilization is critical for HIV prevention? Data from programs

  • Lessons learnt

  • Way forward


Agenda1
agenda

  • Avahan overview

  • Why community mobilization?

  • How community mobilization is critical for HIV prevention? Data from programs

  • Lessons learnt

  • Way forward


Avahan goals
Avahan Goals

Avahan Phase I

Avahan Phase II

Avahan Phase III

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

2015

2016

2017

  • Build and operate key population program at scale

  • Demonstrate program at scale with coverage, quality

  • Declining HIV infection trends in core, bridge, general population

Transfer the program to government

Sustain funding / management

Foster and disseminate lessons learnt within India and worldwide

Risk and Vulnerability reduction for sustained HIV impact


Scale and focus
SCALE AND FOCUS

  • 6 states, 82 districts, 600+ towns

  • Combined State Population ~ 300 million

  • High risk groups covered – over 320,000

  • FSW – 221,800

  • High risk MSM and Transgenders 81,600

  • IDU – 18,000

  • Bridge population covered Men at risk – ~5 million

Avahan Design Choices

Focus on MARPs

…and geographies most affected

Proven package of interventions

Integrated approach

Simultaneous and rapid scale up

Source: Avahan routine monitoring data, all six states


Agenda2
agenda

  • Avahan overview

  • Why community mobilization?

  • How community mobilization is critical for HIV prevention? Data from programs

  • Lessons learnt

  • Way forward


Community mobilization strengthens risk reduction
Community Mobilization Strengthens Risk Reduction

Consistent Condom Use

Targeted Interventions

Reported STIs Reduced


Sustainability is driven through an investment in community
Sustainability is driven through an investment in community

Targeted Interventions

Sustainable

Consistent Condom Use

Structural Interventions

Reported STIs Reduced

Organizational Development


Agenda3
agenda

  • Avahan overview

  • Why community mobilization?

  • How community mobilization is critical for HIV prevention? Data from programs

  • Lessons learnt

  • Way forward


Violence is associated with less access to services
Violence is Associated With Less Access To Services

Percentage

Percentage

Percentage

Percentage

Percentage

Source: IBBA Karnataka State, Karnataka Health Promotion Trust (KHPT), 2006-7 also see Beatty et al., BMC Pub Health, 2010


Collective identity and agency are associated with condom use
COLLECTIVE IDENTITY AND AGENCY ARE ASSOCIATED WITH CONDOM USE

RED = significant at the .05 level or better

Source: Blankenship K; Power, community mobilization, and condom use practices among female sex workers in Andhra Pradesh, India: AIDS 2008


Agenda4
agenda

  • Avahan overview

  • Why community mobilization?

  • How community mobilization is critical for HIV prevention? Data from programs

  • Lessons learnt

  • Way forward


Lessons learnt
LESSONS LEARNT

  • Community organizational development helps to sustain the HIV response

    • Organizational development: leadership, governance etc.

    • Incorporation of democratic processes at the CO’s

  • Enabling environment critical to build community collectives and ownership

    • Provide an opportunity for informal sharing and discussion (DIC – safe spaces)

    • Identifying local champions, build a sense of self worth

    • Facilitate exchanges and exposures- sharing of best practices

    • Invest and groom community leaders to take the ownership

    • Critical Role of promoters as facilitators and mentors

    • Building effective governance and management systems

    • Building and sustaining community organizations is a long term process


Lessons learnt1
LESSONS LEARNT

  • Community mobilization requires dedicated effort/ capacity development

    • Cadre of community leaders, community workers required

    • On site mentoring support in addition to classroom based training

    • Community to community learning through exposure visits can be a powerful tool

  • Organized communities build greater accountability to ensure access

    • Thematic committees - condom, outreach, clinic services and advocacy

      • Represent the issues with appropriate authority

      • Assess the demand and ensure the supply

    • Report card to monitor the supply and flagging the stock outs

    • Connect with police and legal services (para legal volunteers)

    • Linkages with Government schemes and entitlements


Agenda5
agenda

  • Avahan overview

  • Why community mobilization?

  • How community mobilization is critical for HIV prevention? Data from programs

  • Lessons learnt

  • Way forward


Way forward transfer ownership to communities

Avahan III

Way forward: transfer ownership to communities

Risks/ barriers

Service delivery

Biomedical risks

Structural barriers

Vulnerabilities

Social & Economic

Commodities, access to treatment etc.

Crises & Violence

Process/System to address risks

Government funded system (TIs)

Community Level Processes

1

2

3

4

5

Organizational development

Advocacy for service delivery

Crisis response system

Social protection

Financial security

Objective

Sustained epidemic impact

“Capacitated Communities”


Acknowledgements
ACKNOWLEDGEMENTS

  • Our partnership with the Department of AIDS Control (DAC) and Government of India

  • All our Grantees

  • Implementing NGOs and Community Based Organizations (CBOs)

  • Our Communities


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