HIV Prevention and Care Program for Rural and Tribal Youth in Orissa and Rajasthan

As a part of the roll-out of this project, Centre for Advocacy & Research (CFAR), New Delhi was asked to develop an advocacy framework in consultation with various stakeholders, including youth and adolescents. SARDI and CFAR consulted with Oxfam partners, mostly community-based organisations (CBOs) and non-governmental organisations (NGOs), to get an idea of their experience of working on the ground, to learn to what extent they had succeeded in creating awareness and brought about behavioural change, and to explore what kind of mechanisms they used to strengthen community participation as part of an earlier project they had carried out related to infant mortality rate (IMR) and maternal mortality rate (MMR).

A key emphasis was on creating an advocacy strategy for the present project that was contextual, i.e., specific to the culture in the areas where organisers focused their work. To refine this strategy, SARDI organised a 4-day advocacy capacity building workshop in November 2005. Goals included revisiting and consolidating the advocacy concepts learned in state-level orientation meetings, building the capacity of the partners on actual skills in advocacy for health rights and issues of rural and tribal youth, developing an implementation plan for local-level advocacy efforts, and documenting the training methodology for inclusion in an advocacy toolkit.

Researchers indicated that they faced an uphill task in talking to youth and adolescents in those tribal pockets of undivided Koraput in Orissa. While consulting different stakeholders, researchers learned from a few local people that a young man named known as "Tendka Muduli", which means "common iguana" in the Desia language, might be a good starting point. Tendka was described as being "very much present" and connected with the community itself, as well as having a presence in more than 4 adjoining districts. Researchers learned that he often went out and organised public performances to entertain people. In 2003, he had created an audio cassette featuring 8 songs in the Desia language that "was huge a success in the area. Since then he has been referred to as Tendka Muduli, liked by one and all. In that particular year, he told, he sold more than 50,000 cassettes!! His popularity is so high that sometime the district collector takes his help in organizing community mobilization programs..."

Researchers indicated that Tendka was crucial in their efforts to host focus group discussions (FGDs) and participatory rural appraisal (PRA). They explain that, "[w]hen we took him with us and apprised him of the purpose, he facilitated with his magic touch. Through his usual entertaining, he created a conducive environment and we discussed even critical health and risky behaviors with young and adolescent tribal girls." Researchers stress the importance of the role that such pivotal local people can play in health interventions for youth that draw on the strategies of mobilisation, advocacy, and behaviour change communication (BCC).

The research process detailed above led to the development of an advocacy framework for each district, which organisers submitted to Oxfam. Planned advocacy activities were to draw on a variety of communication tools and approaches, such as the following: sensitisation meetings with service providers and the media (involving people living with HIV/AIDS, or PLHA); a rally amongst youth and their families; written letters to health officials detailing the health status of PLHA; the development of information, education, and communication (IEC) materials; the creation of alliances with NGOs working on HIV/AIDS issues; documentation; meetings with community stakeholders; publication of case studies and demands in local and regional newspapers and in electronic media; training youth; and involving youth clubs in demanding that IEC materials be made available at the village level.

HIV/AIDS, Youth.

Organisers have identified some of the issues related to HIV/AIDS in Orissa as: high migration levels, high incidence of sexually transmitted infections (STIs)/reproductive tract infections (RTIs), low awareness on HIV/AIDS and STIs, low knowledge about (and cultural issues related to) condom use, high levels of misconceptions and stigma, unavailability of voluntary counselling and testing centres (VCTCs), unwelcoming attitudes of service providers, refusal to provide condom programming, unavailability of antiretrovirals (ARVs) and opportunistic infection (OI) drugs, lack of provision of prevention of parent to child transmission (PPTCT) and CD4 count facilities, and lack of political will.