Saturday, 13 August 2011

IMPLICATIONS TO MARPs-RELATED PROGRAMMING OF A LARGE YOUNG POPULATION BELOW 35 YEARS OF AGE IN UGANDA (MOST AT RISK POPULATIONS’ SOCIETY IN UGANDA PUBLICATION_2011)

MARPS IN UGANDA just ended a full year’s exploratory exercise into MARPs issues and a report is on the way. As an organisation contributing to HIV response we wanted to share this insight with MARPs-related organisations. The 12th of August is International Youth Day. It means many things to youths. For instance to Nelson: “It means that a day has been set aside for youth issues.”  And to Zulaika a lesbian: “well all this is still skewed to reflect a straight girl because I cannot go out there and start telling my story. Yet, this day is to enable youths to tell stories. All governments and NGOs want to hear are the palatable stories of a good child going to school and earning good marks, then getting back home to be subservient to donning parents.” This day brings to the fore what youth need to participate in planning for their future. This was the idea that led to the formation of “World Programme for action of Youth”- WPAY.  They need to have opportunity to voice their issues right from homes, schools, health facilities, faiths, culture and districts and at national level. This enables government to have prioritised specific planning. It also enables youths to engage in activities for self determination. Youth friendly counselling, HIV/STIs prevention and health education need to be holistic to be able to promote informed decision-making based on youth specific needs. These needs should be expressed in a non-discriminatory/stigmatising environment. Patriarchy has denied certain expressions, especially if they are intended to be male-specific or female specific.  This need to conform begins all the antagonism. Imagine a Nelson and Zulaika near you. Imagine they have gone to seek sexual health counselling and their counsellor is not youth friendly compliant. Three quarters of the information given to them may not immediately help them. So far, we have only looked at the soft/attitude skills. Let us also look at the hard/technical skills and the environment that brings this about. Numerical strength of the youths and the roles they play in the social economic transformation of their countries is enormous. In order for this to occur there is need for technical skills. Business Technical Vocational Education and Training (BTVET) enables a critical skilled labour force prevail among the youths. Nelson and Zulaika are youths and important adoptions of programming have helped to highlight certain priorities under the WPAY. Human Rights-based approaches and litigation in some cases then make the WPAY priorities friendlier to all youths. The youths should also be aware of the BTVET setting that assumes participation and voluntary enrolment. Otherwise if they do not enrol they will miss out on the benefits such as:
1.       Investing in productivity/skills raises incomes, there-by reducing poverty.
2.       Youths need to train in order to improve on critical skills sets that may change with times.
3.       Skilled workers are adaptable and embrace newer technologies, processes and knowledge.
4.       A skilled labour force critical in the social change processes of a country. It contributes to value addition, enhances productivity and quality of goods and services.
5.       A skilled labour force that enhances innovation and creativity.
This day is reserved to highlight all issues youth face. In participating in national celebrations one gets to meet many people, fellow youths and an opportunity to learn more about the day. All youths and organisations that promote youth self determination should look out and position themselves along these WPAY priority areas: Employment, education, hunger, poverty, health, environment, drug-Use, juvenile delinquency, leisure time activities, girls and Young Women, participation, globalisation, information and Communication Technologies , HIV-AIDS, youth, Conflicts and  Intergenerational relations.           

Thursday, 11 August 2011

Thank you so much

It helps to understand what we have to before we engage in translating it into action.

Wednesday, 10 August 2011

PROGRAMMING TARGETING MARPs, KEY AFFECTED PERSONS AND MARGINALISED PERSONS

Can we improve on planning for MARPs? Seminar discussion tools.

THE GAY, MSM/TG

·         Social-Political Contextual issues addressing discrimination
·         Providing safe friendly spaces
·         Immunisation
·         Community building skills
·         Sports, creativity  and Games
·         Advocacy and communication-based projects
·         Rectal-microbicide advocacy
·         Prevention Advocacy and Gay Men's Health
·         Care and support projects for MSM/TG living with HIV
·          Capacity building and or leadership development projects for MSM/TG
·         Capacity building for health workers serving MSM/TG
·          Drug/alcohol use and abuse focused projects for MSM/TG
·         HIV/STI counselling and testing projects for MSM/TG
·         HIV/STI prevention projects for MSM/TG
·         Projects utilizing new technologies and/or online social networking
·         Research on MSM/TG health issues
·         Community mobilisation
·         Other MSM under incarceration
·         Other MSM with erectile dysfunction
·         pre-exposure prophylaxis (PrEP) – among MSM/TG
·         post-exposure prophylaxis (PEP) – among MSM/TG
·         Prevention with positives
·         Partner in prevention
·         Topical Microbicides for preventing HIV.
·         Counselling for Community integration for reformed/rehabilitated former in-mates 
·         Structural interventions that address factors such as poverty, educational attainment, human rights, access to health care, etc.
·         Access to Services and knowledge regarding HIV services
·         Care and Treatment
·         Condom Use
·         Lubricant distribution
·         Epidemiology
·         Government AIDS Programmes
·         HIV-AIDS
·         Prevention Intervention (ARV-Based)
·         Prevention Interventions (Behavioural)
·         Prevention Interventions (General)
·         Resilience
·         Risk Factors
·         Testing
·         Access to credit
·         Welfare services for those who have undergone sex-reassignment surgery


THE LESBIAN, and BISEXUALS (MOST SIMILAR WITH THOSE AMONG MSM/TG)

·         Advocacy and communication-based projects
·         Partner Counselling
·         SRH/Family planning Services
·         Cancer examination
·         Immunisation
·         Care and support projects for those living with HIV
·          Capacity building and or leadership development projects
·          Drug/alcohol use and abuse focused projects
·         HIV/STI counselling and testing projects
·         HIV/STI prevention projects
·         Projects utilizing new technologies and/or online social networking
·         Research in health issues
·         Structural interventions that address factors such as poverty, educational attainment, human rights, access to health care, etc.
·         Access to credit
·         Welfare services for those who have undergone sex-reassignment surgery
·         Affirming commodities

INTERSEX

·         Advocacy and communication-based projects
·         Care and support projects for those living with HIV
·          Capacity building and or leadership development projects
·          Drug/alcohol use and abuse focused projects
·         HIV/STI counselling and testing projects
·         HIV/STI prevention projects
·         Projects utilizing new technologies and/or online social networking
·         Research in health issues
·         Structural interventions that address factors such as poverty, educational attainment, human rights, access to health care, etc.
·         Access to Credit
·         Welfare services for those who have undergone sex-reassignment surgery

THE COMMERCIAL SEX-WORKERS

·         Advocacy and communication-based projects
·         Care and support projects for those living with HIV
·          Capacity building and or leadership development projects
·          Drug/alcohol use and abuse focused projects
·         HIV/STI counselling and testing projects
·         HIV/STI prevention projects
·         Projects utilizing new technologies and/or online social networking
·         Research in health issues
·         Structural interventions that address factors such as poverty, educational attainment, human rights, access to health care, etc.
·         Access to Credit
·         Welfare services

THE FISHER FOLK

·         Advocacy and communication-based projects
·         Care and support projects for those living with HIV
·          Capacity building and or leadership development projects
·          Drug/alcohol use and abuse focused projects
·         HIV/STI counselling and testing projects
·         HIV/STI prevention projects
·         Projects utilizing new technologies
·         Research in health issues
·         Structural interventions that address factors such as poverty, educational attainment, human rights, access to health care, etc.
·         Literacy and functional numeracy
·         Access to banking and credit
·         Access to alternatives to fishing
·         Environment sustainability projects

 

THE MOBILE MEN WITH MONEY/THOSE SUBJECT TO CAMPS AND FREQUENT DEPLOYMENTS/ TRUCK DRIVERS/CONSTRUCTION WORKERS

·         Work Place based HIV services
·         Advocacy and communication-based projects
·         Care and support projects targeting those living with HIV
·          Capacity building and or leadership development projects
·          Drug/alcohol use and abuse focused projects
·         HIV/STI counselling and testing projects
·         HIV/STI prevention projects
·         Projects utilizing new technologies and/or online social networking
·         Research in health issues
·         Structural interventions that address factors such as poverty, educational attainment, human rights, access to health care, etc.
·         Literacy and functional numeracy
·         Access to banking and credit
·         Access to alternatives to mobile markets
·         Environment sustainability projects

THE MOBILE WOMEN

·         Advocacy and communication-based projects
·         Care and support projects for those living with HIV
·          Capacity building and or leadership development
·          Drug/alcohol use and abuse focused projects
·         HIV/STI counselling and testing projects
·         HIV/STI prevention projects
·         Projects utilizing new technologies and/or online social networking
·         Research in health issues
·         Structural interventions that address factors such as poverty, educational attainment, human rights, access to health care, etc.
·         Literacy and functional numeracy
·         Access to banking and credit
·         Access to alternatives to mobile markets
·         Environment sustainability projects

 

THE IN-MATES

·         Advocacy and communication-based projects
·         Care and support projects for  those living with HIV
·         TB/Malaria/HIV Care
·          Capacity building and or leadership development
·          Drug/alcohol use and abuse focused projects
·         HIV/STI counselling and testing projects
·         HIV/STI prevention projects
·         Projects utilizing new technologies and/or online social networking
·         Research in health issues in rehabilitation settings
·         Structural interventions that address factors such as poverty, educational attainment, human rights, access to health care, etc.
·         Literacy and functional numeracy
·         Access to banking and credit
·         Environment sustainability projects

THE SUBSTANCE USERS

·         Support groups
·         Harm Reduction approaches
·         Advocacy and communication-based projects
·         Care and support projects for those living with HIV
·          Capacity building and or leadership development
·          Drug/alcohol use and abuse focused projects
·         HIV/STI counselling and testing projects
·         HIV/STI prevention projects
·         Projects utilizing new technologies and/or online social networking
·         Research into impact of drug use on health
·         Structural interventions that address factors such as poverty, educational attainment, human rights, access to health care, etc.
·         Literacy and functional numeracy
·         Access to banking and credit
·         Access to alternative income generating activities
·         Environment sustainability projects

THE DISPLACED PERSONS

·         Resettlement/Settlement
·         Access to self esteem building  counselling services
·         Advocacy and communication-based projects
·         Care and support projects for those living with HIV
·          Capacity building and or leadership development projects
·          Drug/alcohol use and abuse focused projects
·         HIV/STI counselling and testing projects
·         HIV/STI prevention projects
·         Projects utilizing new technologies and/or online social networking
·         Researching in health issues
·         Structural interventions that address factors such as poverty, educational attainment, human rights, access to health care, etc.
·         Literacy and functional numeracy
·         Access to livelihood improvement
·         Access to skills development  education
·         Environment sustainability projects

THE OVCs

·         Bereavement support for those under 18 year-olds.
·         Sexuality, growth and development
·         Advocacy and communication-based projects
·         Care and support projects for OVCs living with HIV
·          Capacity building and or leadership development
·          Drug/alcohol use and abuse focused projects
·         HIV/STI counselling and testing projects
·         HIV/STI prevention projects
·         Projects utilizing new technologies and/or online social networking
·         Research in health issues
·         Structural interventions that address factors such as poverty, educational attainment, human rights, access to health care, etc.
·         Access to alternatives to education
·         Environment sustainability projects

THE ELDERLY

·         Advocacy and communication-based projects
·         Care and support projects
·          Drug/alcohol use and abuse focused projects for the elderly
·         HIV/STI counselling and testing projects
·         Home visits/Nursing care
·         HIV/STI prevention projects
·         Projects utilizing new technologies
·         Research in geriatric health issues
·         Structural interventions that address factors such as welfare, pension and care for elderly persons.

The Psycho-social behavioural determinants and "At Risk" Contexts in Uganda


MARPS IN UGANDA has concluded an appraisal exercise of MARPs issues in 10 regions covering Uganda from July 2010-August 2011. The objective was: to gauge topography, characteristics and contexts within which MARPs and Key affected populations are defined in Uganda as well as showing need for clarity and specificity of programmes targeting overall MARPs and key affected populations.
Methodology: 13,250 key leaders were interviewed around vulnerability, environment, economic and socio-politico status that affect MARPs; 270 men only board game groups, 150 pool kiosks and 25 University-based groups were used to generate information on substance use; 52 MSM/TG safe spaces were used to generate information on repercussions of Criminalisation; MARPs were sub-divided further into key affected populations ( MSM, TG, Sex-workers and  Substance Users); 2500 men were probed for health, development and social issues in communities; 120 lower level government key persons were asked about MARPs and a possibility of existence for programming targeting MARPs; Reviews and actual visits to 12,200 CSOs/FBOs/NGOs/Development Partners to check concrete plans targeting MARPs were done.  25 religious/cultural-based leaders were interviewed on their role in eradicating violence, abuse, discrimination and stigma.
Findings: Vulnerability is due to environment, economic and socio-politico status; Criminalisation; Men and the environment have a big role in promoting critical health, development and social issues in communities; local governments are a potential for programming targeting MARPs if they have flexible planning side by side with indicative planning; CSOs/FBOs/NGOs/Development Partners have concrete plans targeting MARPs but religious/cultural influence seems to fuel violence, abuse, discrimination and stigma; Key affected populations’ needs are Psycho-socio-behavioural and few organisations have solid plans to address them; Community structures are a potential to address both MARPs and key affected populations’ issues; Comprehensive knowledge on HIV/STIs prevention still low; Knowledge, attitude and Practices geared towards preserving quality life are influenced by many factors; Factors include: Condition, geographical location, age, education, family status, settlements (urban/rural), occupation and gender/sexuality/orientation.
 Conclusion: MARPs such as: Fisher folk, Long distance Truckers, Uniformed services and in-mates have effective programming. Programmes targeting key affected populations should involve their input, should follow characteristics and typology informed by them and should address broader issues of violence, abuse, discrimination and stigma including decriminalisation. Key affected populations’ issues such as: Drug users should be addressed using harm reduction mechanisms; sex-workers’ issues should be addressed to promote reduction in risks exposure; MSM/TG issues should be addressed in such a way as to promote dignity and self esteem.