1

Summary of the practice

The project “HIV/AIDS Prevention among out of school youth at Double Road garage Area Zarghoon Road Quetta” was launched To create awareness about HIV&AIDS among out of school Youths age (14 to 25 years) through trainings, seminars, Peer Education, Quiz Contest, sports events and provision of Voluntary counselling and referral services for target group through DANESH/CDO Tameer Clinic with the provision of PHC and STI management services.

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Level of intervention

§   Awareness creation.

§   Capacity building for preventive measures.

§   Counselling and Referral services for HIV/AIDS and STIs under the cover of Primary Health care.

§   Information sharing through Peer Education technique.

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Prospective users of the practice

Non Govt organization, garage association who realize the situation and want to work youth issues.

Out of School Youths working in the area.

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Problem Addressed

Among the young population, Out of School youths is a big group who is at risk due to their poverty and illiteracy. They are often difficult to reach for intervention purposes because they are not organized and scattered in the different localities. This group is at high risk because they have least opportunities to aware about the HIV/AIDS/STIs and their economic conditions do not allow them to access any source which provides them Primary health, STIs and HIV infection awareness and services.

The youths in Balochistan, like young the world over, are also vulnerable to HIV/AIDS infection. The young people in adolescence time may be interested about sex and drugs. They are forming their habits, values and are heavily influenced by their peers. Further high unemployment levels, the relatively easy availability of drugs, and economic frustration can all influence them to engage in unsafe behaviours which may put them at increased risk of HIV infection.

Therefore HIV/AIDS preventive education is only the mean to aware the out school youths about effective preventions and care with HIV/AIDS/STIs. If this education will not be delivered among them, they will cause to increase the rapid spread in transmission of HIV/AIDs. 

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Purpose of intervention

§         To educate & prevent out of school youth about HIV /AIDS/STIs.

§         To train over 130 out of school youths as peer educator,

§         To establish Voluntary Counselling and Referral Centre,

§         To promote safe sex behaviour and distribution of condom,   etc.

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Context

Double Road Garage area is approximately 3-5 kilometre radius and full of garages, hotels, mini cinemas, spare parts shops, dentor shops etc. At least 2000- 2500 out of school youths aged 14-25 are working in the garages, hotels& spare parts shops. The literacy ratio is very low and majority of these out of schools are illiterate. There is no proper Doctor is available in this area and further the financial conditions of the out of school youths also hinder them to access any medical facility in case of ailment and accidents. However they face many health problems and injuries due the nature of their work. RSA report indicates that at this area FSWs and MSM are present here and youths are also victim of sexual exploitations by their masters. Obviously they facing forced sex. People are reluctant to use condom. The social and cultural constraints hide all these activities and out of school youths feel unsecured to identify these victims.

So the illiteracy, poverty, Social and cultural constraints and non availability of any avenue for getting knowledge about the basic health and healthy practices, the out of school youths working in this area are at high risk and all the situation increasing their vulnerability to HIV/AIDS and STIs.

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History and activities

 DANESH was formed in 1996 under the social welfare act 1961 as a non-profit & non-government Organization, with a mission to combat the problems of drug addiction and its associated hazardous effects on affected population and struggle to minimize the sufferings of Vulnerables.

Since 1996 DANESH is working with the vulnerable communities to reduce their vulnerabilities and risks.

Following projects has successfully implemented by DANESH till now.

ü  Empowering the Rural Women through Skills Development and Health Education Intervention in Union Council Dasht District Mastung (From January, 2006 to December, 2006).Funded by British High Commission Islamabad. The objective of this project was to increase and diversify the livelihood opportunities and small enterprise Development of Rural women”.

ü  Support Afghan Refugees in Pakistan (November 2004 to January 2006)     Funded by MCP/E.C

ü  Pre & Post Natal care of mothers. (May 2003 to Dec 2003).funded by Unicef       

ü  Support to Disadvantaged women for their Rights and Income Generation Activities.    (From 1999 to 2001). Funded by Oxfam GB.

ü  Balochistan Integrated Heroin Addiction Control Program. Funded by EU and OXFAM-GB from Nov1995 to Nov 1998.

Balochistan is known to be the backward and ignorant province of Pakistan and looking to the threats of HIV/AIDS has become very alarming issue. Tameer project has contributed its professional efforts to mitigate the consequences of the epidemic targeting the out of school Youth through implementation of various activities. The target area chosen is the Garage area of double Road Quetta where the large numbers of out school Youths are engaged in economic activities. At the beginning of Tameer DANESH/CDO project “HIV/AIDs prevention among Out of School Youths” (from June 2005 to June 2006 and extension up to June 2007.)” the aim to provide awareness in large Community of Garages individuals were considered a challenge for the project team and with the passage of time with the effective community mobilization the activities successfully implemented and community own the project and feel the seriousness of the HIV/AIDS issue. The following activities were carried out during the project initial phase and during the extension period.

§            7 Advocacy Meetings in the targeted areas.

§            4 Peer Education Trainings.

§            5 One Day Trainings Workshop for Target Group.

§            Establishment of Voluntary counselling and referral services.

§         Provision of General Primary Health Care, Counselling and STI Services through VCR Centre.

§            Distribution of Condom.

§            Mutual support Group of out of School youth and their Association Formation.

§            Advocacy Seminars.

§            Quiz contest.

§            Sports event.

§            Focus Group discussions.

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Steps in implementation

The following steps taken for implementation of the project.

Ø      Experience Staff Hiring was carried out at the initial stage of project.

Ø      Staff Orientation about Project was conducted.

Ø      Advocacy Meetings in the targeted areas arranged for mobilization of the community.

Ø      Rapid Situation Analysis to identify the basic information of project area and target groups regarding Health issues, risky behaviours and vulnerability to STIs and HIV/AIDs.

Ø      Then Registration of 420 out of school Youth as target group was completed and formed Mutual support Group of out of School youths and then their Association was formed.

Ø      After that 4 Peer Education Trainings, 5 One day Trainings Workshop on HIV/AIDs and STIs prevention for target group, 2 Advocacy Seminars, Quiz contest, Sports event and Focus Group discussions for Target Group were conducted successfully.

Ø      One Voluntary counselling and referral services centre was established in the target area. Through VCR Primary Health Care, Counselling/Referrals and STI Services are still providing to the target group.

Ø      Through effective community mobilization the shyness of the community to use condoms was decreased and through out the project period condoms were distributed through VCR Centre and out Reach worker field visits.

Ø      IEC material developed and Distributed among target group regular intervals.

Ø      Close coordination between target Group and Management of the organization to fill the gaps, improve the quality of work and to ensure the community participation and know the current situation at community level.

Ø      Regular Monitoring and supervision of the project Activities.

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Resources required

Human, Financial & technical resources.

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Indicators for monitoring

ü      Registration Data

ü      Progress reports.

ü      Technical Reports.

ü      Work Plan.

ü      OPD Register.(Patients Record)

ü      Training Reports.

ü      Attendance Sheets.

ü      Field Visits.

ü      Meeting with Beneficiaries.

ü      Photographs.

ü      Interviews.

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Impact

The target group is now well aware about the danger of HIV/AIDS and have the knowledge about preventive measures, showing safe sex behaviour. The Advocacy meetings improved the knowledge, change the community attitude and Behaviors ad ensure the community participation in project.

130 peer educators are present in the area and spreading the information through peer education technique. The impact of the information sharing could be seen in the area and checked by the interviews. The peer educators have made 720 more peers and share the information about HIV/AIDs Prevention.  Community is cooperative and for DANESH/CDO Tameer Clinic (VCR centre) provide rent free place. Tameer Clinic fully functional with the support of community & still working in the area and appreciated by the community. The people who were shy to use condoms, now using condoms and taking from DANESH/CDO Tameer Clinic (VCR Centre). Community is actively participating in the project and pressurize the Organization to expend and extend this project with other out of school youth in the area and other areas of the city.

Through recreational activities and quiz contest the knowledge of general target group about HIV/AIDs prevention increased and target group enjoy and learn through these events.

The IEC material which was developed and distributed by Organization also motivate the target group and provide information as most of them are illiterate but through Pictorial messages they get information and most of the target group disseminate at their work place for the dissemination of information for others.

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Challenges and pitfalls

Following three issues were faced during the project period and were needed to solve because for successful implementation of the project it was necessary to mange the issues positively.

ü      Acceptance of the Community.

ü      Condom Distribution.

ü      Shyness about STIs.

DANESH/CDO management and staff handle these issues positively and technically. Strong and effective social mobilization and counselling support to solve these issues in a proper way and give amazing results as community fully motivated and actively participated in the project activities. The proof of strong community mobilization is the rent free place given by the community for Tameer clinic is the great achievement of DANESH/CDO. The qualified and Experienced Doctor in the Tameer Clinic also motivated the STI patients. His strong counselling resulted that now the community has a trust upon him, listen him and his careful attitude make it possible that STIs Patients come and easily discuss with doctor about STI disease. Special sessions were arranged for community on STIS prevention as they were insisting to Know about its causes, symptoms, treatment and prevention. The availability of Condoms in Tamer clinic is now an easy access for target groups and they collect them without any shyness and hesitation.

The community is willing for voluntary testing of HIV/AIDs and Hepatitis as they now realize the Importance of HIV/AIDs prevention. They have the high risks of incidents due to their nature of work and need blood transfusion in emergency.

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Critical issues and lessons learnt

The critical Issue was the social and cultural constraints and habits of the community. They were very seriously acted against the information collection against the FSWs and MSM activities. However these activities were observed there but they refuse about it. Similarly they react for STIs identification.

The lesson learnt that the community mobilization and advocacy is the principal and important tool for getting the community support. Proper and effective counselling through trained and expert Counsellor Play the vital role in behaviour change. DANESH get all the successes through trained and expert professional staff and Close coordination with target group and key persons of the targeted area and monitoring visits of the management made possible to achieve the targets and objective of the project.

It was also learnt that Peer education is very effective technique to create awareness among out of school youth. The indicators shows that through this technique the message of HIV/AID prevention pass a lot of people in less resource and in short time.

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Source of practice and dialogue

DANESH office H.# D-1-15 railway housing Society Quetta.

PH:# 0812444093.

E-Mail: danesh_qta@yahoo.com

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Editor’s note for learning

DANEH take a bold step and focus this target group which is working in Workshops, Hotels and shops located at Double road Garage area  in Quetta city and started the project “Project HIV/AIDs prevention among out of school youths” with the support of Interact worldwide through Pakistan National AIDs Consortium. In this project DANESH focused the out of school youths aged 14-25 years, working in different garages, Hotels & shops. The awareness about HIV/AIDS prevention was enhanced through Advocacy meetings, Peer Education trainings advocacy Workshops Advocacy Seminars, Quiz contest, sport events and FGDs. The response of the community is observed very supportive. The Garage Association provide rent free place for DANESH Tameer Clinic which is basically Volunteer counselling and referral centre (VCR) which is fully functional in the area and experienced Doctor is providing Primary health care and STI services and facilitating the out of school youths for counselling on HIV/AIDS preventions and safe sex behaviours.