PRIDEDIVERSITY YEAR 1
PEHCHAN
UNITY
EQUALITY
Pehchān is funded by the Global Fund under Round 9 and is their largest single-country grant to date, focused on the HIV response for vulnerable and underserved sexual minorities. Pehchān means ‘identity’, ‘recognition’ or ‘acknowledgement’ in Hindi, and by 2015, the programme will strengthen and build the capacity of 200 community-based organisations (CBOs) to provide HIV prevention programming for more than 450,000 men who have sex with men (MSM), transgenders and hijras in 17 Indian states.
Building on a History of Collaboration
Pehchān’s origins date back to March 2008 when a group of eight MSM, transgender and hijra (MTH) activists met to discuss the opportunity for a large-scale programme by and for MTH communities in India to complement the government’s response. Through a process of consultation and negotiation, a consortium of partners developed the programme model and built the necessary support from community leaders, government, the Global Fund, and other stakeholders. The bid was eventually submitted in Round 9, and what once seemed an unattainable aspiration has become real.
Partnering for Success
The Pehchān consortium includes the India HIV/AIDS Alliance, Humsafar Trust, Maan AIDS Foundation, SAATHII, Sangama, and SIAAP. The partners work in selected states and provide organisational development, technical and capacity building support to new and existing CBOs working with MTH communities. Using a rights-based approach, the programme strengthens CBOs to serve as implementing partners with India’s National AIDS Control Programme, works to ensure community-friendly services in the health system, and engages in advocacy to improve the lives and health of MTH populations in India.
Completing Year One
Drafting Pehchan’s Blueprint
The programme formally began in October 2010 and is actively collaborating with the National AIDS Control Organisation (NACO) and 17 State AIDS Control Societies (SACS). Pehchān has successfully completed its first year of implementation and is already developing a range of best practices for MTH interventions, community programme governance, and stakeholder collaboration that can serve as resources to improve the AIDS response for sexual minorities around the world.
The model for MTH community systems strengthening that is at the heart of Pehchān was first proposed in India for Global Fund’s Round 8. Further evidence of Pehchān’s feasibility was requested, and the model was piloted from 2009 to 2011 in a programme funded by UNDP India. called “Sashakt.”
Building Responsive Systems
A three-tier governance system involving the community, state, and national stakeholders has been established under Pehchān to ensure the transparent and responsive governance. Community Advisory Boards (CABs): Developed at regional level, CABs serve as
the voice of the community in Pehchān and enable linkages and synergy between implementing partners and the communities with whom they work, facilitating dialogue and addressing conflicts if they arise. State Oversight Committee (SOCs): Formed in each of the 17 programme states, SOCs are the interface between Pehchān and the SACS, providing oversight and technical guidance. Membership includes representatives from SACS, development partners, and Pehchān CBOs. Programme Advisory Body (PAB): Functioning at the national level, the PAB is a national body chaired by NACO with membership from World Bank, UNDP, DFID, UNAIDS, and the Pehchān consortium.It ensures smooth implementation and coordination with the national programme.
Assessing CBO Partner Capacity
At the heart of Pehchān are 200 CBOs chosen through a robust process of document verification, directed self-assessment and site visits. Assessments were conducted using a tool adapted from one used by NACO and developed in consultation with MTH community representatives. The assessment approach has helped establish supportive relationships with CBOs asan essential first step toward effective capacity building.
Strengthening the Existing Response India’s national response to HIV had prioritised prevention for high-risk groups using the Targeted Intervention (TI) model. To date, 18 existing TIs are collaborating with Pehchān to develop additional and complementary services to increase health-seeking behaviour of MTH beneficiaries. Pehchān will also continue to collaborate with NACO and SACS to develop the capacity of CBO partners to implement TIs.
Reaching the Unreached
Pehchān is filling gaps in the national response. In collaboration with NACO and SACS in Punjab, Rajasthan, Jharkhand and Madhya Pradesh, 22 new pre-TI interventions have been started so far to develop CBO capacity to support TIs and reach previously unreached MTH populations.
Leveraging Community Involvement SOCs are mechanisms that facilitate formal collaboration— often for the first time— between government and MTH communities to ensure effective implementation of Pehchān at state level.To date, 66 SOC meetings have taken place across India, supporting activities such as the finalisation of the programme’s 200 CBO partners.
Building a National MTH Training Network
Crowning Miss Transgender Beauty Queen, 2011, Manipur
National and regional training units for Pehchân have been set up under the guidance of the programme’s consortium partners. Through a series of technical consultations,five training modules consisting of 18 thematic components have been developed to support an ambitious training agenda in Pehchān’s first phase, 2010-12. Capacity building topics range from issues in HIV prevention, life skills and mental health to institutional development in areas of governance, financial management, and advocacy.
An estimated 2,000 people attended an evening solidarity event in Imphal, Manipur, that featured a transgender beauty pageant. Thirty-one contestants made it to the finals, and the appreciative crowd included MTH community members, Pehchān stakeholders, and the general population, including police and military personnel.
Establishing a Baseline
A baseline survey has been completed of MTH communities in 10 programme states to provide data to support effective implementation and management of Pehchān. Survey tools were designed in consultation with MTH communities. To address challenges in identifying and building trust with survey subjects, community representatives were engaged to facilitate and support data collection. An analysis report on the baseline data will be released in early 2012.
Expanding Advocacy
Pehchān is developing advocacy capacity at the regional, state and community level through training and outreach events. In each state, solidarity events have been supported to increase MTH visibility, provide a platform for community mobilisation, and increase understanding of the programme. Events were organised in all 17 states by Pehchān CBO in collaboration with consortium partners, and SACS provided support of various degrees from attendance to partial funding.
Progress Against Global Fund Indicators (Quarter ending 30 September 2011) Indicator
Target
Result
Achievement
Partner staff trained on programme management & thematic areas Number of MSM, transgenders and hijras reached through community mobilisation meetings Number of groups (proto-CBOs) formed by MTH Number of CBOs providing at least two new services to members of MTH communities. Number of beneficiaries among MTH communities reached by CBOs with at least two new services Number of registered MSM, transgenders and hijras referred to HIV testing & counselling and who know their results Number of MSM, transgenders and hijras in the project living with HIV referred to and registered at ART centres Number of MSM, transgenders and hijras on ART receiving adherence support Number of female partners of MSM, transgenders and hijras seeking sexual and reproductive health services
378
412
109%
500
715
143%
25
33
132%
40
40
100%
2,340
2,509
107%
1,498
1,715
114%
139
57
41%
22
29
132%
No target
9
N/A
From Programme Update & Disbursement Request, submitted to Global Fund on 15 November 2011
Looking to the Future
The first year of Pehchān focused on setting up operational systems and establishing collaborative partnerships between stakeholders at every level. Year Two will build on this foundation, scaling up support to more than 160 CBOs on ground and ensuring that quality interventions reach a growing number of MTH community members. Operational research: While NACO has supported research on MTH communities, knowledge gaps remain. Pehchān has dedicated funding for seven operations research projects to enrich programme implementation, support advocacy, and contribute to national and global dialogues. In the second year of Pehchān, two studies are planned: one on sexual reassignment surgery (SRS) practices in India and the other on MSM, transgenders and hijras with female partners. Computerized Management Information System (CMIS): The launch of the Pehchān CMIS at the end of 2011 will provide the programme with a cutting-edge data collection tool allowing information to be entered both online and off. The system supports data compilation and analysis to monitor the programme’s progress and contribute to more management decision-making. Strengthening enabling environment through advocacy: CBOs and the MTH communities they serve continue to face difficulties, ranging from lack of access to services and social discrimination to verbal and physical violence. Pehchān will expand support for advocacy efforts, increasing the capacity of communities to organise and address local issues themselves. Sensitising the media, judiciary and police: MTH community members continue to face challenges of depiction and perception in the media and often encounter discrimination in government services, including during interactions with the police and judiciary. Pehchān will address these challenges through sensitisation training for officials and representatives of the police, judiciary and media. Disseminating the Pehchān experience: In a world that continues to under invest in HIV programming for MSM and transgender people, Pehchān remains the largest intervention of its kind anywhere. In Year Two, efforts will be scaled up to share programme experiences to implementers and governments around the world looking to expand programming and systems strengthening for MTH communities.
Pehchan Consortium Partners India HIV/AIDS Alliance (www.allianceindia.org) Pehchān Focus: National coordination and grant oversight The India HIV/AIDS Alliance (Alliance India) is a diverse partnership that brings together committed organisations and communities to support sustained responses to HIV in India. Complementing the Indian national programme, we work through capacity building, knowledge sharing, technical support and advocacy. Through our network of partners, Alliance India supports the delivery of effective, innovative, community-based HIV programmes to key populations affected by the epidemic. The Humsafar Trust (www.humsafar.org) Pehchān Focus: Maharashtra, Madhya Pradesh, Goa, Gujarat and Rajasthan For nearly two decades, Humsafar Trust has worked with MSM and transgender communities in Mumbai, Maharashtra. It has successfully linked community advocacy and support activities to the development of effective HIV prevention and health services. It is one of the pioneers among MSM and transgender organisations in India and serves as the national secretariat of the Indian Network for Sexual Minorities (INFOSEM). Maan AIDS Foundation (www.maanfoundation.org) Pehchān Focus: Punjab, Delhi, Uttar Pradesh and Bihar Maan AIDS Foundation works towards improving the sexual health, welfare and human rights for MSM, hijras and their partners. It provides technical assistance, capacity building and institutional support to local self–help sexual networks, groups and organisations for the development of community-based and beneficiary-led HIV and sexual health services. Solidarity and Action Against The HIV Infection in India (SAATHII) (www.saathii.org) Pehchān Focus: West Bengal, Manipur, Orissa and Jharkhand With offices in seven states and over 10 years of experience, SAATHII’s focus is on sexual and reproductive health, advocacy on gender and sexuality issues, and HIV-related capacity building, particularly for MSM, transgender and hijra organizations. SAATHII works closely with SACS and Technical Support Units and is the SACS-designated State Training and Resource Centre in Odisha and Rajasthan. South India AIDS Action Programme (SIAAP) (www.siaapindia.org) Pehchān Focus: Tamil Nadu SIAAP brings more than 22 years of experience with community-driven and community development focussed programmes, counselling, advocacy for progressive policies, and training to address HIV and wider vulnerability issues for MSM, transgender and hijra community. Sangama (www.sangama.org) Pehchān Focus: Karnataka and Kerala For more than 20 years, Sangama has been assisting MSM, transgender and hijra communities to live their lives with self-acceptance, self-respect and dignity. Sangama lobbies for changes in existing laws that discriminate against sexual minorities and for changing public opinion in their favour. Alliance India Andhra Pradesh (www.allianceindia.org) Pehchān Focus: Andhra Pradesh Alliance India supports a regional office in Hyderabad, Andhra Pradesh, that serves as a State Lead Partner of the Bill & Melinda Gates Foundation’s Avahan India AIDS Initiative and leads implementation of Pehchān in Andhra Pradesh.
Preventing HIV, protecting rights & ensuring health in MSM, transgender & hijra communities in India
Pehchān would like to express gratitude to the many stakeholders and partners who have helped the programme succeed. Special thanks to our government partners—especially NACO and the State AIDS Control Societies—for their untiring collaboration and to the Global Fund for providing the financial support to make our work possible.
© India HIV/AIDS Alliance Published: November 2011 Images © Prashant Panjiar for India HIV/AIDS Alliance Unless otherwise stated, the appearance of individuals in this document gives no indication of their HIV status. India HIV/AIDS Alliance Kushal House, Third Floor 39 Nehru Place New Delhi - 110019 T: +91-11-4163-3081 www.allianceindia.org