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 l.jpg

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

Anja Teltschik, UNICEF Consultant

3 September 2009


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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


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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


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I. Political buy-in: advocacy for MARA


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  • 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



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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



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Methodological issues

  • Sampling

  • Recruitment

  • Language and understanding of questionnaires

    Ethical issues

  • Documenting the process: tracking referrals and cases of abuse



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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…


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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



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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



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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


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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


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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


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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)


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environmentSpecial 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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THANK YOU! environment