SWAASTHYA CASE STUDY

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SWAASTHYA CASE STUDY
Reducing Vulnerability to HIV/AIDS
by
DR. GEETA SODHI
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Swaasthya

• Non Government Organization working at the
  grassroots
• Vision Bridging the gap between Macro and Micro
• Uses participatory approaches in developing,
  implementing,
• and monitoring its programs

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Adolescent Sexual Health Intervention
Program in Tigri Resettlement Colony
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Based on the findings from Sexual Behavior
Research adolescent intervention program
designed that address Individual (Adolescent
girl) Immediate environment (women, girls, boys
and men) through Interpersonal and Videographic
communication package Skills building
program Social support
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Study Location

• Tigri resettlement colony, New Delhi, India
• Migrated from the states of Uttar Pradesh,
  Rajasthan Bihar
• 15,000 population majority Hindu
• Monthly household income Rs 2,000 Rs 8,000
  per month
• Most are daily wage earners / contractors
• Inhabited by mix of joint and nuclear families

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Unmarried Adolescent girls Program Conceptual
Framework
Supportive immediate environment
Researcher
Information
Perspective Building
Empowered Adolescent Girl

Men fathers, brothers
Women mothers, sisters-in-law
Perspective
Information
Skills
Education
Advocates
Redefining social norms
Girls peer group

• Key Strategies
• Enabling empowerment of individuals
• Facilitating an enabling supportive
  environment (gate keepers)
• Ensuring participation and involvement of
  adolescents at all levels
• Creating interfaces between adolescents and
  gate keepers

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Communication Package

• Interpersonal Communication
• One to one outreach and small group discussions
  in streets, corners
• Educators and Communicators from the Community
• Use of peer groups for target population
• Use of testimonials of change
• Videography for Narrow casting
• Young people from community trained (scripting,
  camera, editing)
• A video magazine format program called Tigri
  Dharkan prepared
• Each episode 3 parts local news, social
  issues, IEC on issues
• 7 episodes so far narrow casted through local
  cable network and
• prime time

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Skills Building Program

• Concept of self and self-esteem
• Decision making and problem solving
• Communication, assertiveness and negotiation
• Emotional understanding and effective management
• Relationships and boundaries
• Sexuality and prevention of sexual abuse

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Social Support

• Girls groups were formed
• Women's groups were formed (mothers,
  grandmothers,
• bhabis, peers)
• FGDs were conducted
• Dialogue in proxy for sensitization and changing
  perspective
• Resulted in conducive, sensitive, supporting and
  enabling
• environment for adolescents

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An important factor in success
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Elements of Swaasthyas Community based RSH
program
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Key Findings
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Comparison Between Survey1 and Survey2 on
Intervention, Intermediate and Outcome variables
Variables
Percentage
S 1
S 2
Interaction with Swaasthya Didi 0, No Contact 1,
contact (1 thru 7)
39.9 60.1
59.6 40.4
Member of Swaasthya Social Support groups 0, Not
member 1, Member
83.3 16.7
85.3 14.7
Supportive gatekeepers Low (Lowest thru 1)
High (2 thru 4)
87.8 12.2
32.2 67.8
Knowledge of RSH issues Low (Lowest thru 5) High
(6 thru 16)
52.4 47.6
55.6 44.4
Knowledge of legal issues Low (Lowest thru
3) High (4 thru 5)
42.4 57.6
79.1 20.9
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Variables
Percentage
S 1
S 2
Positive Perspective Score Low (Lowest thru
4) High (5 thru 8)
54.1 45.9
68.1 31.9
Perceived Self Determination Low (Lowest thru
2) High (3)
64.1 35.9
52.9 47.1
Note Comparison of the other outcome variable
hygienic menstrual management is not given over
a time interval, as this variable was not
observed at the first survey
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Multivariate Logistic Regression analysis with
perceived Autonomy as the outcome variable
95 Confidence Interval for Exp (B)
Signifi cance
Exp (B)
Variables
Lower Bound
Upper Bound
Respondents Age 0 (12 thru 15) 1 (16 thru 22)
0.017
1.771
1.006
2.622
Respondents Education 0, Upto Middle school
complete 1, High school and above
1.343
3.427
0.000
2.262
Interaction with Swaasthya Didi 0, No Contact 1,
Contact (1 thru 7)
0.016
1.112
2.767
1.754
Skills Building Program (SBM) 0, Not Attended 1,
Attended
6.920
1.911
25.064
0.003
Social Support groups 0, Non members 1, Members
0.360
0.169
0.765
0.008
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Multivariate Logistic Regression analysis with
Hygienic menstrual management as the outcome
variable
95 Confidence Interval for Exp (B)
Signifi cance
Exp (B)
Variables
Lower Bound
Upper Bound
Respondents Age 0 (12 thru 15) 1 (16 thru 22)
0.007
4.059
2.402
6.859
Respondents Education 0, Upto Middle school
complete 1, High school and above
1.823
5.667
0.000
3.214
Interaction with Swaasthya Didi 0, No Contact 1,
Contact (1 thru 7)
0.001
1.498
4.504
2.600
Skills Building Program (SBM) 0, Not Attended 1,
Attended
3.560
1.689
18.361
0.130
Social Support groups 0, Non members 1, Members
0.552
0.238
1.146
0.105
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