ToT on Adolescent Mental Health Support – Phase:2
As a follow up to Phase: 1, SIAAP continued to provide ongoing support to Counsellors working in the District Child Protection Units under Directorate of Social Defence. SIAAP trainers and supervisors devised a plan to visit DCPU in each District to monitor and record observations to improve counselling skills of counsellors. There were supervision visits to provide handholding support, before and after advanced counselling training. The supervisors conducted refresher training for counsellors and provided inputs on common barriers observed during supervision visits. By the end of the program, all the counsellors were given Training of Trainers programme in Counselling in order to sustain the training requirements in the District. They were assessed based on their skills and a cadre of counsellors were identified as master trainers and certified as counselling trainers by SIAAP.
Strengthen Sex worker-led interventions
Through this project, SIAAP and Vadamalar aims to Strengthen Sex worker-led interventions through formal or informal institutions of justice; Build cross movement alliances for secure livelihoods; Access affirmative action and justice. The project period is from 1st June 2017 to 31st May 2019. As part of this project, SIAAP and Vadamalar jointly have identified and collectivized 300 young women in sex work in seven Districts in Tamil Nadu. The women are given education of their rights and legal position. They are addressed about prevention of STIs by insisting clients/partners to use condoms and reinforced for immediate and complete treatment for STIs.
ToT on Adolescent Mental Health Support – Phase:1
SIAAP was identified as resource agency to strengthen the adolescent mental health program in Tamil Nadu by building the capacities of counsellors working in the District Child Protection Units. As part of Phase: 1, the counsellors were given orientation to the concept of counselling and training on basic counselling skills and practices. It was a short term project and Unicef requested to SIAAP to provide advanced counselling skills as part of Phase: 2.
Improving nutritional outcomes of HIV positive mothers and their children under 2
Improving the nutritional status of the mothers and children through addressing nutritional, infant and young child feeding and food safety and hygiene in Krishnagiri and Chennai district. SIAAP will support and mentor the ORWs and build their capacity to improve the service delivery. Also support the mother to translate the message received from ORWs into practice and ensure the uninterrupted supply of micronutrients, take home ration (nutritional powder) and vitamin tablets at Anganwadi Centers.
Assessment of adolescent friendly health, nutrition, HIV and Wash services in Salem district in Tamil Nadu
Adolescents represent a significant proportion of the population of India. The Census 2011 reports that they constitute about 22% of the population with state wise variations. Adolescents in India are not a homogenous group since they are embedded in their socio-cultural and economic diversities. These diversities at multiple levels starting from the individual to the familial to the social, cultural and governance systems are nested in each other, producing their unique risk and protective factors matrix. Adolescence as a stage, is technically, unique and special. Latest neurological research suggests that, the adolescent brain goes through a growth and differentiation spurt akin to the early childhood. Risk taking behaviours, a unique feature of adolescence are similar to the exploratory behaviours of very young toddlers. All these factors make policy, planning and implementation, which are friendly for adolescents a real challenge; nevertheless, a challenge worth tackling, for the rewards of such an initiative are multifold. With this in mind SIAAP along with UNICEF attempted to assess the current inter departmental linkages within health & HIV, nutrition and sanitation schemes / programmes and with other in school, child protection and out of school programmes for adolescent friendly services at state and district level, the adolescent and community participation and awareness in Salem district vis-a- vis key adolescent programmes in Health & HIV, Nutrition and Sanitation and finally to provide policy recommendations at state level and operational recommendations at district level on how to improve coverage and quality of services and inter-sectoral linkages.
Building Agency of Sex Workers in Tamil Nadu, Andhra Pradesh and Karnatka
Interventions between 1997 and 2010 supported women to form collectives and to register community based organizations. HIVOS and the Gates Foundation were key supporters in this aspect. Several organizations/ collectives of women in different parts of the country now exist and are help their members negotiate safer sex, address problems with police, and access social entitlements including quality health care. Missing in these interventions are efforts to secure the personal growth of individual women including elements such as self-confidence, assertiveness, ability to seek and use existing government or private sector based resources, communication and negotiation skills, ability to set and maintain boundaries, and to build supportive relationships within the family and community. The strategy draws upon Amartya Sen’s capability approach to development. Using this approach, Sarvojana (Coailition of like mined NGOs in Tamil Nadu, Andhra Pradesh, Karnatka and Maharastra) proposed to deepen the agency of the women by strengthening their capabilities to understand and respond to the environment
Alliance India is the Principal Recipient of a five-year programme funded through Global Fund Round 9. Named ‘Pehchān’ which in Hindi means ‘identity’, ‘recognition’ or ‘acknowledgement’, the initiative will strengthen and build the capacity of community-based organisations (CBOs) to provide HIV prevention programming for men who have sex with men (MSM), transgenders and hijras in 17 Indian states. This is the largest Global Fund grant thus far to strengthen HIV prevention among MTH communities. The programme was launched on 1 October 2010. SIAAP is one of the Sub-Recipients of this grant working in Tamilnadu. The programme will work closely with NACP-III, both to ensure maximum reach and also to improve mapping and tracking mechanisms for MTH in the country. The programme will strengthen CBOs with the goal to implement Targeted Interventions on behalf of the government over the course of the programme to ensure sustainability of services.
The negative portrayal of MSM and FSW in the context of their profession, sexuality, sexual preference and HIV/AIDS in the media has left indelible scars and continues to negatively impact current HIV/AIDS discourse. The reach of the media is far and wide and can be effectively utilized to bring about positive changes. This project attempted to change the attitude of the print media towards community and vice-versa representing approximately 83,414 of FSW and MSM in Tamil Nadu through a comprehensive, collaborative media sensitization campaign. This project aimed at creating a supportive environment impacting positively on community members’ self-esteem. It seeks to address root causes of the problem and not the symptoms alone.
Sashakt (meaning empowerment) is an UNDP India supported project to strengthen community systems for MSM/TG/Hijra communities in India. This is an 18 month pilot project to the approved Global Fund Round 9 initiated from September 2009 – February 2011. This project is implemented by India HIV/AIDS Alliance in collaboration with four civil societies – SAATHII, SIAAP, HST and Maan AIDS Foundation. The project aims at demonstrating two basic intervention themes – ability of the community to come together in form of groups and synergize with the national HIV/AIDS programme by taking on programmes specific to their communities and to demonstrate need and approaches that address specific issues and services for the MSM/TG/Hijra community. SIAAP entered into an agreement with India HIV/AIDS alliance as a state lead partner in October 2009 and chose to work with Social Welfare Association for Men (SWAM) as the implementing partner since we have had a long-term association with them and because they are one of the oldest and successful CBOs in the city running sexual health projects for MSM and TG in the city of Chennai.
Rural Youth Project in 13 districts of Tamil Nadu
The year 2009-2012 we proposed to work towards Improving HIV prevention and care among young women and men (15-29), FSW and MSM in rural Tamil Nadu. Reduce HIV prevalence through promoting gender equality, human rights and poverty reduction, and access to STI and HIV prevention and care resources. The programme will be implemented in 13 districts in Tamil Nadu with high prevalence of either STIs and/or HIV, with a strong presence of community organizations of Female Sex Workers and Men who have Sex with Men, developed and supported by these communities in partnership with SIAAP. The districts include Kanyakumari, Madurai, Nagapattinam, Pudukottai, Salem, Thanjavur, Theni, Tirunelveli, Tiruvannamalai, Tuticorin, Vellore, Erode and Krishnagiri.
Evaluation of PMTCT in Kyrgystan
SIAAP was invited by UNICEF between October and December of 2007 to evaluate their PMTCT programme in Kyrgyzstan, Central Asia. Interviews were held with key informants, select sites were visited and a seminar was conducted with the Ministry of Health, Kyrgyzstan. A report was submitted to UNICEF with key recommendations.
Setting up of Coalition of NGOs and CVCTCs
A strategic arrangement during 2006 was the formation of a national level coalition - Sarvojana - with like-minded NGOs and CBOs to set up community managed VCTCs in their respective geographical areas. In keeping with NACP III plans, the coalition runs seven Community Voluntary Counseling & Testing Centers (CVCTC) to directly address stigma and discrimination of communities affected by HIV& AIDS; encourage early diagnosis;, and bridge needs with available services in the public and the private sector. The project was designed with an overall objective to reduce poverty and improve quality of life of poor and traditionally marginalized communities disproportionately affected by or vulnerable to HIV & AIDS; and empower civil society organizations to check the spread of HIV and reduce the impact of AIDS in the highest prevalence states of Maharashtra, Tamil Nadu, Andhra Pradesh, and Karnataka and the contiguous state of Kerala.
Assessment of NESA supported HIV interventions in Tamil Nadu, Andhra Pradesh and Karnataka
SIAAP was contracted to evaluate New Entity for Social Action (NESA) in Bangalore, working in the area of Human rights with special focus on Dalits. NESA’s HIV programmes located in the states of Tamil Nadu, Andhra Pradesh, Kerala and Karnataka. Assessment of the organisations involved, their outreach performance, impact among the community members and the integration of the HIV/AIDS activities as a part of their regular programme. Over 13 sites in Tamil Nadu and Karnataka covered by 10 organisations were evaluated during this process. The report was presented by SIAAP, during the NESA’s Annual convention at Hosur.
Evaluation of APAC-VHS supported VCTCs
APAC-VHS & USAID
SIAAP evaluated APAC-supported VCTCs in 2006 based on pre-determined criteria such as involvement of the Project Holder, quality of counselling, testing and documentation including data, involvement of the Medical Officer, infrastructure and other relevant parameters. All VCTCs were graded on a five-point scale and a report with recommendations was submitted to APAC.
Research Study on Burn Out among PPTCT and VCTC counselors
SIAAP also conducted a research study among counsellors in Tamil Nadu titled “Burnout amongst HIV/AIDS Counsellors in TN” using tools developed by UNAIDS (tool 3) and the Macrulnet Burnout Inventory-Human Services Survey. The study was conducted in four districts of Tamil Nadu, India in March 2005. One-hundred and sixty five HIV/AIDS counsellors from Voluntary Counselling and Testing Centres, Prevention of Parent to Child Transmission (PPTCT) centres, Blood Banks, STD clinics and those working in NGOs among chemical dependents were the subjects of this study. SIAAP was selected to present this paper at the National Annual Conference of Indian Association of Clinical Psychologists held at Jaipur in 2006.
Capacity Building, Guiding, Monitoring, Evaluation and Report NGO based VCTCs in Tamil Nadu
SIAAP was selected by APAC in 2005 to build capacity, guide, monitor, evaluate and report about the NGO-based VCTCs and those in select private hospitals in Tamil Nadu and Pondicherry. The VCTCs were monitored on a monthly basis on the following parameters, compilation of data, coverage of clients, especially vulnerable groups such as FSW, MSM, TG, IDU, truckers, migrants, quality of counseling, adherence to national guidelines with regard to HIV counselling and testing, documentation of counselling sessions, extent of networking with other agencies such as NGOs, Positive Networks, Private Hospitals/Laboratories, Government Hospitals.
Research studies on PPTCT
SIAAP conducted a “Client Satisfaction Survey” among PPTCT clinic attendees in 2004 along with TANSACS covering 300 respondents across the state. A study on “Reasons for Low HIV Test Result Pick-up Rate by antenatal women” was also conducted among 78 counsellors from 65 PPTCT centers in Tamil Nadu during the same period.
Monitoring PPTCT in Tamil Nadu
SIAAP was invited by TANSACS to monitor the PPTCT centres in the state of Tamil Nadu between 2003 and 2004. The SIAAP team visited sites on a regular basis: assessed the quality of counselling and testing, adequacy of supplies/consumables, client flow management, support for PLHA and for urgent issues functioned as a bridge between the site and TANSACS for speedy redressal. SIAAP assisted with monthly reviews of the counsellors along with the Project Director-TANSACS, UNICEF and provided technical inputs based on their needs.
Establishment of Community Voluntary Counselling Center
A model Community Health Voluntary Counselling Center was established at Alandur, Chennai suburb, in 2003 with high levels of untreated sexually transmitted infections (STIs). Based on this model, SIAAP facilitated 21 CBOc (Sangams) of FSW and MSM to set up Community Voluntary Counselling Centers.
Setting up of Model VCTC in India
TNSACS & WHO
First model Voluntary Counselling and Testing Center was established.
Conceptualizing and Operationalizing the PPTCT in Tamil Nadu
TNSACS & UNICEF
SIAAP partnered with TANSACS and UNICEF in conceptualizing and operationalizing the PPTCT Programme (Prevention of Parent to Child Transmission) in Tamil Nadu, between 2002 and 2004.
Formation of Community Organisation for PLHIV to advocate for rights
SIAAP promoted Anbu Karangal Pengal Paadukappu Urimai Sangam in Namakkal district in 2002 to enable positive women, many of who were widows and single parents to advocate for their rights.
Formation of Thrift Co-operatives
In 2001, first Thrift and Credit Societies for the economic empowerment of the communities we work with.
Formation of Community Organisations
SIAAP helped register its first community organization, ‘sangam’, to empower women in sex work and gay/bisexual men, strengthen their fight against the impact of HIV/AIDS, and establish a linkage to health, development, livelihood and other issues. SIAAP now supports around 20 sangams throughout the state of Tamil Nadu.
Selvi Memorial Illam Society – Short Stay Facility
It is a model project, is a community organization started in 1999, of people affected by and living with HIV. SIAAP enabled SMIS to set up a comfortable and viable short-stay facility for HIV patients and/or family members accessing services at Government Hospital of Thoracic Medicine, Tambaram.
Counselling services at hospitals and supervising counsellors
Since 1996, SIAAP has helped train, place, and supervise counsellors in over 150 counselling centres and government hospitals in India. Over 150 counsellors were recruited from mainstream as well as marginalized communities including women in sex work, gay and bisexual men, visually challenged and PLHAs. This network was in partnership with nodal agencies such as Belgaum Integrated Rural Development Society (BIRDS) in Karnataka, AIRTDS in Andhra Pradesh. Counselling curriculum was designed and developed by a team of trainers both from within SIAAP and abroad. In order to integrate the component of supervision into all our training programmes, our staff was trained in the certificate course on ‘Supervisory Skills and Theory’ through affiliation with the Central School for Counselling Training, London. This helped SIAAP set up a system of supervising counsellors in Tamil Nadu.
Documentations of concerns of women selling sex in India
National Commission for Women
In 1996 we collaborated with the National Commission for Women (NCW) to make recommendations addressing the concerns of women selling sex in India.
Counselling for HIV – Pilot Porject
AIDS Action Foundation of the Blind
SIAAP tested a pilot-counselling project in Government Royapettah Hospital, Chennai between 1993 and 1996, by placing one trained counsellor in the STD clinic, to offer counselling services during outpatient hours. The conviction that counselling can be a principal strategy to bridge rights of people with their health, resulted in SIAAP initiating counselling services in Tamil Nadu, Karnataka and Andhra Pradesh by recruiting and training counsellors. Selection was based on significant life experience; comfort discussing issues around sex and sexuality; and openness to learning.
Sexual Health Intervention for Visually Challenged People
AIDS Action Foundation of the Blind
In 1993, we started the only sexual health intervention among blind people in Asia, through the AIDS Action Foundation of the Blind (AAFOB).
Intervention with Truckers and Sex Workers
In 1992, SIAAP began working with women selling sex and truckers in and around Chennai, combining outreach with advocacy against violence. To increase access of vulnerable communities to quality STI services in the public sector, SIAAP sought to marry the strengths of the public with the private sector by introducing innovative approaches.
Capacity Building of NGOs
SIAAP built the capacities of 200 NGOs to take up HIV/ AIDS work in the states of Tamil Nadu, Andhra Pradesh and Karnataka when denial and silence was at full swing.
Public Interest Litigation
Public Interest Litigation, by Shyamala Natraj, SIAAP Founder Trustee in the year 01.09.1989 challenged the illegal detention of women testing positive for HIV in Tamil Nadu. In a landmark judgment in 1990, the Madras High Court ordered the release of over 600 women detained around the state and further ruled that no individual could be held on grounds of being HIV infected. The judgment became a benchmark for issues around HIV policy in India and is valid till date. (Annexure : Enclosed Judgment Copy)