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Summary of the practice

 SCD modest experience in working with communities particularly with youth on HIV and AIDS awareness raising and advocacy for a proposal was submitted to Balochistan AIDS Network under the Tameer Project for which in June 2006 the project details were finalized and Prevention of HIV and AIDS among Out of School Youth project was formally initiated in Barech colony area of Quetta. SCD project on Prevention of HIV and AIDS among Out of School Youth basically encompasses provision of Voluntary counseling and referral services, primary health care services, advocacy among the most vulnerable youth targeted under the project.

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Level of intervention

The level of intervention primarily focused on the behaviour change needs of the target group and further to the community,   secondly through trained field staff & peer educators to ensure practices of basic communication skills for BCC/outreach with primary audiences and stakeholder, developing appropriate vocabulary for outreach work with the youth.

Information dissemination on safer sex methods (availability of condom and information on its usage) and some approaches to negotiation were also part of the implementation strategy. Moreover, information about HIV/AIDS and its modes of transmission; symptoms/lack of symptoms, signs/symptoms of STIs, its long term effects, treatment and the results/effects of untreated STIs, were shared with the target group through the VCR centre. Furthermore, orientation session’s and one to one meetings were conducted with the target groups by the peer educators, as well as from the field officer, outreach worker and other staff of the project.

The implementation strategy encompassed voluntarily

testing referral cases and provided support to the National &

Provincial AIDS Control Program by providing the statistics gathered through the project implementation

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Prospective users of the practice

The out of School youth have been targeted for bringing change in their attitudes and behaviour particularly focusing their safer sex practicing and increased information regarding HIV and AIDS .

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Problem addressed

Out of School youth have no access to STI treatment and reproductive health services and information

 Out of School youth have no access to gain information on HIV and AIDS

Out of School youth have most probably involved in many sexually transmitted infections while having sex

Involvement of youth in high risk behaviours due to not going to school

The tendency in this age to attain any sort of ethical and moral evil is relatively high

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Purpose of intervention

As many of the children and youth are out school and they are more or less at high risk to be infected with HIV and AIDS, therefore, the purpose of the intervention is to focus this targeted group to aware them on the menace of HIV and AIDS.

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Context

Quetta is the capital of Blochistan in which the migrated families from rural areas are increasingly inhabited due to which numbers of the problems have arisen. In Quetta there are almost 2500000 populations in which most of them are from middle class families and having access to the small businesses.

Barech Colony is situated in satellite town Quetta, it total population count for 5000 approximately in which 90% of the population are speaking Pashto and 10% speak other languages . Religiously they are more having extreme As per the observational survey , most of the youth are out of school and are more vulnerable in term of HIV and AIDS, IDUs and other social evils. Therefore, there is dire need of intervention as because there is either intervention is minimum or no intervention.

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History and activities

Establishment of centre

Hiring of Staff and orientation to the staff

One to one meeting with target group

Peer educators training

Availability of condoms through VCR centre

Distribution and dissemination of IC materials

Establishment of Voluntary Counselling and referral centre.

Building Collaboration for STIs services   

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Steps in implementation

For the VCR centre capable professional staff was to be engaged through the recruitment policy adopted at SCD. The positions were advertised in the newspapers and a rigorous process of recruitment and interviews was carried out. In Balochistan there is a scarcity of good qualified professionals and saturation in the employment market. Therefore this process became a tiresome, and after a rigorous process a capable and professional team of professionals was engaged for the project that included the following:

Programme Manager

Project Coordinator

Field Officer

Doctor/Psychiatrist

Admin & Finance Officer

Outreach workers (1)

Peer Educators (2)

Dispenser (1)

Office Attendant

Watchman

Sweeper

1. Establishing the Voluntary Counselling and Referral Centre

After visiting different areas and based on previous learning a conclusion was drawn that the center should be established in heart of the project area where most of the targeted group can access. Again when the process of search for a suitable place was initiated the question of high building rents and unavailability of such a building which could offer a larger space for activities to be conducted. In order to solve this issue a stake holder meeting of the community was arranged where the concerns were shared and after brainstorming. One of the stake holders agreed to provide the space for VCR in his Organization and the VCR was established with the cooperation and support of community and a step towards public private partnership.

2. Demarcation of the Target Area

VCR centre cover the entire respective city areas and majority of the target population i.e. out of school youth are concentrated in low income population segments concentrated in the Barech colony. The youth focused under the project are very mobile and move to their work areas or usual hangouts. All such areas were visited and demarcation was made accordingly. Catchments areas for the VCR centre were drawn out.

During the project demarcation SCD teams established contacts and rapport with the out of school youth and other stakeholders.

3. Social Mapping of the Project Area

A map of project area was made which included those areas such as those aforementioned. Through the social mapping exercise the reality behind the whole concept of HIV and AIDS epidemic was deeply looked into and enabled to identify the types of out of school youth focused under the project.

4. Rapid Situation Assessment

The Rapid Situation Assessment (RSA) study was carried out through subletting it to a renowned consultant. It was done to collect baseline data on existing situation in the target area. To estimate knowledge, attitude, behaviour and practices on HIV/AIDS issues among out of school Youth.

5. Capacity Building

Capacity Building was the main crux of the project in which focus was both on the beneficiaries and that of the project staff. Throughout the project period regular efforts were made by the management to enhance the capacity of the project staff and that of the peer educators to understand the concept involved so that they could easily transfer the message to the community. While another level was the capacity building of the beneficiaries. This was based on the idea on building upon the existing knowledge base and taking into account the local context where maximum care has to be taken in discussing sex related issues it being a social taboo. Apart from staff capacity building explained above the following two capacities building initiatives were undertaken:

5.1. Peer educator training

Peer Education is a technique which was used in the project for information dissemination as it is known that a person is more easily influenced by his/her peer, acknowledge his/her views, suggestion and can also relate to each other being from one and the same context and background which gives space for intimate sharing. In simple words it would mean “friend to friend education”. In this project peer education was used for HIV and AIDS prevention awareness activities and three days training on Peer Education were conducted during the project period. The objective was train the out of school youth as peer educators for HIV and AIDS prevention awareness. Total of 80 out of school youth were focused for the Peer Education training.

6. Advocacy

Apart from capacity building and awareness raising advocacy plays an important part in the achievement of the goal of the project. In this regard advocacy was also an important component of the project. Two major advocacy activities included the following during the course of the project period.

6.1. Seminar

One-day advocacy seminar on “Importance of HIV and AIDS prevention among out of school youth “ was organized on 15^th November 2006 at Quetta Serena Hotel in collaboration of DANESH/CDO where around 122 participants from different civil society organizations and community participated. The objective of the seminar was sensitizing key stakeholders, policy makers and representatives of print and electronic media. Following papers were presented at the seminar:

Current situation and new challenges against HIV and AIDS

Peer Education and role of peer educators as change agents

Awareness of STIs and its importance

6.2. Theatres

For the purpose of mass level awareness for the prevention of HIV and AIDS among out of school youth informative theatres were organized in the project area. Kiran International Theatre of Pakistan conducted these. This theatre on HIV and AIDS youth awareness was so designed to raise awareness in the communities about HIV and AIDS, to challenge participants to take action against the spread of HIV and AIDS and encourage a positive, caring response towards those living positively with HIV and AIDS.

7. Voluntary Counseling and Referral Services

SCD/CYO clinic within the VCR center was established where a part time doctor was engaged to provide VCR services for HIV testing in the targeted area. Through the mobilization of the outreach worker and peer educators the target group population was motivated to avail services at the clinic after which the doctor would refer them to hospitals for HIV testing if required after thorough counselling and the STI cases.

 8. Primary Health Care Services

SCD/CYO clinic also provided primary health care and STIs management services to the target group. On average 60 to 80 patients received the above services and facilities per month. Besides the doctor also provided that voluntary counselling for HIV and AIDS and STIs. As a matter of fact the doctor, medical attendant and the doctor detected several cases of STIs through this process.

Also in primary health care component condom distribution was also a part. The main purpose of condom distribution was to promote safe sex behaviors in the community. It was tough task to motivate them for use of condom but strong mobilization made it possible. Initially the people were a little apprehensive but later they understood and became confident in acquiring condoms from the clinic. The availability of the condom was assured in three places that is in the Project office, in VCR and with the volunteer peer educators

9. Distribution of IEC material

SCD/CYO developed and collected from other sources relevant IEC and promotional material so as to improve the understanding and take forward the agenda of the project among the targeted community. During the course of the project period in order to generate awareness among the community the SCD/CYO staff distributed different type of IEC and promotional material to enhance knowledge base regarding HIV and AIDS. The IEC Material included the following:

Leaflets

Pamphlets

Brochures

Posters

Badges

Pens

This enabled to support the project activities and put a positive impact on the community.

10. Public-Private Partnership:

Sharing of monthly progress report was done with the Govt. line department so as to cater support for the Project. Moreover, the statistics provided proved to be helpful to the Govt. for updating their database.

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Duration

1^st June 2005 to 15^th November 2006

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Resources required

Program Manager

Project Coordinator

Field Supervisor

Doctor

Out reach worker

Peer Educator

Dispenser

Rs 18,83,750.00

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Indicators for monitoring

The project activity would be monitored and evaluated against the set objectives of the project. These objectives would be further dissolve into number of activities which have been carried out during the reporting period of the project.

The out of school going youth must be aware of all contents of the project activity specifically the awareness raising program. Number of the youth would be facilitated with free counselling sessions and as a result must be well aware of the threatening issue HIV and AIDS.

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Impact

The staff were very well trained on subject

Safe sex education provided to youth for prevention of HIV and AIDS / STI’s now they are aware of the concern evidenced by their demonstration in behaviour

One of the tools was to train the peer educators for the persuasion of the process; in that perspective 100 out of school youth were trained.

As impact based change required the number of the condoms to ensure safe sex behaviour.

VCR centre established.

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Challenges and pitfalls

Due to strict taboos, cultural norms, traditional values in the start of the project lot of problems arose, but with the passage of time and getting access in activities after few months our trained staff took those youth in confidence.   

The following Challenges we faced

1. Discussion of STIs/HIV/AIDS, 2. Discussion on Sex, Discussion on condom

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Critical issues and lessons learnt

Basically the subject is quiet referring to stigma in our society; therefore, it was a challengeable task to talk about HIV and AIDS.

From advocacy it was noticed that as long as the project goes on, it would result a impact based changes in the behaviour of the target group and other stakeholders.

In initial stages of any project. There is a dire need of development of confidence building as to look foresight for a purposeful objective result.

The issue very much hidden in the target group because lake of awareness therefore need to be on priority bases having long term initiatives .

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Source of practice and dialogue

Society for Community Development ( SCD Balochistan)

D-33 Kabir Building MA Jinnah Road Quetta.

Telephone: 0812841052

Fax: 0812837001

Email: submer2010@yahoo.com

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Editor’s note for learning

The initiatives taken by the project funded by PNAC through BAN was ice breaking and changing notion experience in the target area. The intervention made in the focused area and group resulted some positive impacts in term of disseminating the information containing HIV and AIDS contents. Still much more need to be done working in same issue particularly in Quetta and generally in all Balochistan more preferably to work on sustainability of the project. Yet to intervene the focused area with so many staking objectives so that our set targets may be achieved.