Equalizing Gender Relationships in the context of HIV/AIDS A joint project of the Indian Railways and UNIFEM South Asia Regional Office August 16,2005

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Equalizing Gender Relationships in the
context of HIV/AIDSA joint project of the
Indian Railways and UNIFEM South Asia Regional
Office August 16,2005
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Context

• A unique opportunity for UNIFEM to partner a
  public sector undertaking and for the Railways to
  engender their initiatives
• The challenge of making gender equality and human
  rights perspectives central to the work on
  HIV/AIDS and facilitate interventions that are
  multi-sector and convergent in nature
• To demonstrate that focused, integrated community
  approaches to gender equality based on enabling
  legislation and policies, can contribute to
  lowering HIV/AIDS prevalence rates, to reducing
  stigma and discrimination and mitigating the
  epidemics social and economic impact

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Background

• MoU between UNIFEM and the Indian Railways signed
  in December 2002 for a period of three years
• Active support from South Central Railways and
  their institutions
• MoU with The Norwegian Agency for Development
  Cooperation, New Delhi and UNIFEM in 2002
• Financial support from other partners The UN
  Trust Fund for Human Security, UNDP, and UNFPA
• The Railways Womens Empowerment and AIDS
  Prevention Society (REAPS) registered in January
  2003 as the implementing arm of the project
• Strategic Partnership with the South Central
  Railways Vijayawada Division Womens Welfare
  Organization

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VIJAYAWADA DIVISION -1327 kms. -30,000
employees -1.5 million population -15 Health
Units -Divisional HQ. Hospital -261 living with
HIV 36 couples - Deaths since 1994 - 300
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Development Objective To prevent the spread
of HIV/AIDS epidemic in India Project
Objectives

• Strengthen the capacity of Indian Railways in
  gender sensitive counseling services
• Enhance understanding about the fundamental link
  between gender and HIV/AIDS

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Strategy

• 1. Building a cadre of peer counselors through
  diverse entry points
• Schools and junior colleges
• Mahila Samiti
• Health Units
• Running rooms engine drivers rest rooms wagon
  depots
• Technical Institutes
• Trade Unions
• Community and households.
• 2. Catalyzing the Railway Institutions and
  creating an enabling environment for
  gender-responsive mechanisms/policies and
  relations

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Outputs

• Outcome of counseling process
• Reduced stigma and isolation
• Increased ability to access information
• Development of an enabling environment for people
  to discuss hidden issues
• Opening new space for community interaction and
  interventions
• Increased responsiveness from community
• Enhanced capacities of peer educators and other
  key representatives resulting in reduced risk
  behavior
• More positive and rights based attitudes towards
  PLWHAs in the railway community
• Increased support for women in households
  affected by HIV/AIDS
• Enabling policy and program advocacy to promote
  gender equality in the railway community

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Evidence Based Processes

• Counselling Needs Assessment - 250 individuals
  from five different circles of the railway
  community (2002)
• Credit Needs Assessment - 47 PLWHAs and their
  families 5 sample districts to assess the
  economic impact of HIV and debt burden on
  individuals and their families
• KABP study - 2970 individuals to gauge knowledge
  levels on gender and HIV indicators ( 2003-04)
• KABP study with 5 Railways schools - 777
  students from class IX and X (2003)
• Communications Needs Assessment Qualitative
  study, projective techniques and indicative
  guides on gender sensitive issues and notions of
  masculinity (2004)

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Indian Railways and UNIFEM
Research Committee
Advisory Committee
Technical experts
SCR Zone
Partners
DRM and team
Governing body
Mahila Samiti
REAPS Project Director Team
President SCRWWO
Resource Agencies
Peer Counselors
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49 Peer Counsellors Backbone of the Project

• Trained by Dr Jacob John and his dedicated team
  from CMC Vellore
• Personalized individual and group counseling to
  members (women, men and children) at workplace,
  schools, homes, public spaces, community sites
• Make referrals to the hospital and to the SC
  Railway Welfare Organisation for credit funds,
  hospitals, VCTC
• Provide technical inputs into all research,
• IEC and materials being developed
• for the community
• REAPS team has now trained the new batch of
• counsellors with support from CMC
• POPULATION OF 1,83,251 COVERED

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Multi-faceted roles

• Counselling related to HIV testing
• Working with the family members
• Cases of suicide and attempted suicide
  alcoholism grief and bereavement
• Home-based care dealing with denial anxiety
  depression anti retroviral therapy struggles
  between women and men
• Working with the children in a family education
  of girl child early marriage
• Homosexual relationships
• Empowering women to negotiate safer sex
  practices sex and sexuality wanting to get
  married
• How to handle stigma and discrimination
• Coming to terms with being HIV positive
  relationships, secrecy, health and work
• They have to build their skills on
• Time management, creative and critical thinking,
• Advocacy, planning, settings goals for each
  session, opening and closing sessions
• Working with individuals and groups, health
  education and counselling
• Building a referral base, networking with others
  in their area,
• How to avoid burnout
• By institutionalising certain practices the
  counsellors have motivated themselves and each
  other

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REAPS supervisory roles resource
centre telephone helpline advocacy and
networking support to the Division
community Undertaking studies, campaigns M/E
Facilitating technical expertise

Gender sensitive life skills training
Activities
Schools/Junior Colleges Life skills
education Sensitization of parents Teachers Int
egration into curriculum
Gender and Rights Training
Knowledge Products Newsletters, Fliers,
directories of NGOs
Resource Center in the Railway Hospital
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Health Units/Hospitals High risk groups
screened Patient friendly checklist Provision of
maternity services to positive women Wider
outreach for improved access to
treatment Increasing nos. of women accessing
VCTC Study visits Personalized messages for
positive and affected
Community - sensitization and linkages/referrals
Directing Persons to VCTC Railway hospital
EXHIBITIONS, CAMPAIGNS, RALLIES
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COMMUNICATIONS Strategy on Gender sensitive tools
and processes POSTERS, HOARDINGS, 60 SEC. SPOT
for CC T.V.
I know the importance of protection (same for
both) But does he/she? We need to talk. Safe
sexual relationship is the foundation for a happy
life. Talk to your peer counselor for answers to
your queries. Peer counselors advice leads you
towards a happy and healthy life. Complete
information keeps AIDS at bay.
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Support group of Positive people
Trade Unions Mazdoor Union SC/ST
Association Stigma and discrimination Compassionat
e appointment
REVOLVING FUND
SCRWWO Revolving fund Sanctioning Committee 46
loans around 5 lacs Social empowerment
Training in income generation Linkages for
marketing and upgrading entrepreneurial Skills
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Training for other agencies fund raising
Revolving fund Sanctioning Committee 46 loans
Networking and Alliance Building
Enabling environment
Compassionate appointments Providing one stop
facility for ART Inclusion of HIV issues at all
policy meetings Openness to discuss gender issues
and responsible male behaviors
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Key Results

• A significant baseline developed at several entry
  points
• A trained cadre of more than 65 peer counselors -
  Outreach to approx. 1,83,251
• During week long campaigns alone outreach is
  45,954 - Pushkaran mela July 2004
• In the last 6 months 11,260 women and 15,685 men
  and 3,002 covered in counseling sessions
• 1604 individuals have benefited from VCTC and
  increased nos. of women for testing noted 814
  women accessed VCT services in 2003-05 period
  compared to 790 males
• Jan April 2005 No. of persons visited 211
  male-98 and female -113 No. of positive cases
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• Currently 71 people are on ART 12 are women and
  linkages strengthened with positive people
• 2100 students trained in life skills education

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Contd

• Loans from revolving funds 46 women amounting
  to close to
• Rs. 5 lacs another 15 applications under
  consideration
• Process documentation and communications campaign
  and products successfully launched and evaluated
  Phase I
• Rich documentation - Case records, verbatims
• Enabling environment created - High level
  commitment at Policy levels and proactive
  leadership
• Select up-scaling sensitization in Guntur
  lessons being shared
• Second generation training peer counselors and
  supervisors are resource persons
• Showcasing project work at several for a
  national and international
• Dr Heyzers high level visit to the project area
  in May 2005

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• Thank you