Welcome to e-mentor site Prevention Program
Trucker Intervention Program Implemented in TN
A central strategy of India’s National AIDS Control Programme III (NACP III) is to reduce sexual transmission of HIV within high-risk sexual networks, and from these high-risk networks into the general population. Accordingly, NACP III prioritizes HIV prevention among truckers as a key programme component. Reaching truckers with effective HIV prevention programmes and services is important for a number of reasons:
1. Evidence in India and elsewhere shows that the community of truckers is vulnerable to HIV due to a higher prevalence of risky sexual behaviour, which results from a variety of social and economic factors as well as their work patterns.
2. Reportedly, close to 36%1 of truckers are clients of sex workers and 15-20%2 of clients appear to be truckers. Therefore, truckers represent a key “sub-segment” of the total male client population.
3. Because long-distance truckers move throughout the country, those who are at higher risk of HIV can form transmission “bridges” from areas of higher prevalence to those of lower prevalence.
Intervention locations for truckers will be more selective than under NACP II. Under NACP III, in order to achieve efficiency and effectiveness of coverage, there will be significantly fewer interventions than before.
This is because two key factors will be considered in placing interventions for truckers:
Efficiency of coverage: In order to optimize the utilisation of resources, it is necessary to access truckers at major catchment areas where they congregate in large numbers.
Quality of engagement: From an intervention perspective, it is also important that the point of access provides an environment where the trucker has the time and inclination to engage in depth with the programme. Truckers spend on average 55%-75% of their time on the road, so interventions and service delivery can only happen at places where they congregate.
A detailed mapping study must be commissioned by the national consortium in conjunction with the assessment study mentioned in Section 2.1 above prior to finalising the halt points for implementation of the NNTIT.
This study should be restricted to the major kinds of halt points listed in Section 2.2.1 above. However, it should cover all major national routes and focus on identifying high traffic volume routes along the National Highways.
At each location, the mapping exercise should provide the following information:
Volume of trucks moving through the location
Major destinations of trucks being dispatched from the location
Major source locations of trucks coming into the location
The existence of sex networks (both male and female sex workers) and the support structures for These networks at the halt point
Available facilities at the halt point which can be utilised by the project for effective implementation (e.g. clinics, HPCL, IOCL, rest houses, etc.)
In order to ensure a comprehensive network, the final list of halt points for the NNTIT must satisfy the following criteria:
A total of 200 halt points, spread across the country
All major national routes are covered
Interventions are set up either at source or destination trans-shipment locations of all major national routes
At least 80% of the long-distance trucking population is covered
Themes for Capacity Building
Basic information on HIV and STIs
Community development and strategies for personal development and empowerment of communities
Stigma and discrimination
Human rights and violence
Community participation and empowerment
HIV testing and counselling
BCC and development of IEC materials
Peer education and community outreach
STI management
Condom programming
Safer sex negotiation
Sex and sexuality
Advocacy
Dealing with myths and misconceptions
National AIDS Control Programme III & Targeted Intervention Programme
Reporting systems (SIMS)
Project management
Resource mobilisation
Counselling
Syndromic management of STI
Fixed working hours and lengths of trips for truckers
Collectivising truckers on the State/National levels
Establishment of improved and safe stay facilities
Building pressure groups
Ensuring induction education for new truckers
Ensuring adoption of halt points
An effective intervention for truck drivers, conductors and cleaners will comprise:
Information services and Behaviour Change Communication (BCC) to increase their knowledge and Motivate them change present unsafe behavioural practices and reduce their vulnerability
Care facilities for STI infections, condoms and counselling
Efforts to build an enabling environment and advocacy among the important influencers in their lives (Secondary and tertiary stakeholders) to support the initiative
Under NACP III, the strategy for trucker’s intervention will operate at three levels:
National Networked Targeted Trucker Intervention (NNTIT)
Structural interventions at the national and State level
Local interventions for high-risk truckers
These guidelines focus on the objectives, criteria for selection, required infrastructure, equipment, Supplies, and human resources
Dialogue-based peer-led Interpersonal Communication (IPC)
Creative, synchronized and thematic mid-media
Selective mass media
Peer-led dialogue-based IPC
Active peers: Truck drivers and helpers who are currently driving. Such peers are effective in Mobilising trust and establishing credibility with in the key population.
Anchored peers: These are ex-drivers and helpers who are currently employed within the transhipment location. Anchored peers also include service providers to the trucking community such as mechanics, tea shop owners, etc.
Be representative and true peers of key population (i.e. truck drivers and helpers)
Must know the site well and be credible individuals at the halt point
Must retain their existing profession and only contribute a portion of their time to project outreach (tobe built into their contract)
Be motivated to work with their peers on HIV/STI risk reduction
Be available to participate in the entire IPC process (training, fieldwork, feedback/project design workshop)
Within the trans-shipment location peers can be identified in the following ways:
Contacting brokers, transporters and their assistants who have been truck drivers and helpers
Directly approaching drivers interested in and committed to working with other truck drivers and helpers
Contacting drivers who have settled in nearby villages or trans-shipment locations without any current assignment and who are looking for jobs
Exploring the static population in and around the trans-shipment location (ex-drivers and helpers working as brokers’ assistants, mechanics, petty shop owners, dhaba owners, barbers, etc.) who interact with and are will known within the community
Street Plays: Street plays focused on dispelling common myths and enhancing health-seeking behaviour are very effective in creating awareness about and demand for programme services. Multiple themes need to be enacted on a cyclic basis, changing every quarter. An intervention location may expose an audience of 50 to 100 per street play at least 12 times during a month to a minimum of three themes enacted four times each. The timing and location may be synchronised with the operation of satellite clinics in the intervention location. It is best to recruit local troupes accredited by the local SACS to present street plays, with time-bound contracts.
Health Games/IEC Booths: Co-located with the satellite clinic, IEC booths manned by two outreach staff are effective in attracting large numbers (about 50-100 truckers). Such games test individual skills and disseminate health messages. Low-cost gifts can be distributed to winners as prizes. Condom demonstration and dissemination of information through leaflets is also done. The programme can meaningfully expose 2,000 truckers in a month to its messaging and create demand for nearby clinical services and IPC sessions.
Film Shows: To utilise the leisure time of truckers effectively, a weekly film show can be organised at the transporter/broker’s premises or in a public area at the location. This serves to draw the crowd and post film IPC sessions may be scheduled to engage the community in dialogue.
Health Drives: Thematic health drives can be held on a fixed date every month at each intervention location to promote the programme’s medical services. The location must be a static clinic. Specialists in eye/skin/ortho/gastric ailments may be invited from the local public health institutions around the theme for the month.
The health drive may be publicized at the IEC booths/IPC sessions so as to generate interest and traffic. Health drives are an important advocacy tool in positioning the programme clinics as meaningful health providers for an array of services for the local community.
Infotainment Events: Large-format infotainment events may be conducted on a quarterly basis at the intervention location to promote awareness and visibility for the programme and services offered. These events serve to attract large crowds and generate interest in programme services. The entertainment at the event can be “educative”, e.g. street plays incorporating HIV and condom themes, musical performances interspersed with messages on programme services, etc.
Local stakeholders such as transporters/brokers should be involved with the implementing NGO to organise these activities, thereby fostering ownership and solidarity. If such events are synchronised across all intervention locations on the same day, a powerful impact is created and large corporates associated with the transport sector can be involved in the activity by way of creative promotions for the services they offer.
Infotainment events can be a powerful advocacy tool with large stake holding organisations relevant to the trucking community. An infotainment event with proper pre-event publicity via IEC booths/IPC sessions/leaflets/invitations should aim to attract an attendance of 1,000 truckers or more. This forum may also be used to generate solidarity by appropriately thanking key stakeholders in the trucking community for their contributions to the programme.
Mass media provides a means of expanding programme messages and creating demand beyond the boundaries of the intervention. It has the added advantage of reaching the population outside a formal intervention environment, at a time when truckers may be more receptive to behaviour change messaging.
Radio and Cassettes: Truckers listen to radio and cassettes frequently on their long journeys on the highway. This is the most effective method of meaningfully engaging them when outside the halt point. Appropriate and popular content for the cassettes can be developed with the help of the creative agency and distributed to the truckers. Cassettes may contain a mix of popular content and important health related messages. Innovative serial-based radio programmes may also be designed.
Signage: Since large volumes of trucks pass through major check posts, visible outdoor signage there can significantly enhance programme awareness and recall.
Static clinic
Satellite clinic
The projects will be monitored regularly by the NNTIT consortium and NACO. The robustness of data collection and the intervention level as well as at the national level (decentralised and centralised levels) will aim to inform national intervention quality and design.
Treated Across Clinics.
The officers/team visiting the projects will have a clear agenda for the visit which will be shared with the implementing organisation well in advance
All evaluation visits will be documented and the suggestions/recommendations shared in writing with the implementing organisation, the support committee, NACO and structural intervention team
Quarterly third-party audits should be undertaken to ensure line item variances are within 5% tolerance.
Suggestions/recommendations made by the monitoring officer/team will be implemented by the organisation
All documents, reports and plans maintained by the project will be open for scrutiny during these monitoring visits
Staff reviews will be part of the monitoring process The CMIS/MIS data must be used to correlate the progress made by the project
Quarterly reviews are to be used to evaluate trends and improvements.
The project will be evaluated annually by the eleventh month by an external agency/evaluator appointed by NACO, and on the basis of the evaluation report proposals for the project will be made
NNTIT will also be subject to reviews and evaluations at intervals determined by NACO
>>>>>>for more details refer the guidelines and contact your PO