GOVERNMENTOF ORISSA WORKS DEPARTMENT ORISSASTATE ROAD PROJEG~ + ,"r FEASIBILITY STUDY AND DETAILED PRO PREPARATION FOR PHASE-I ROAD 1584 v8 AND ACTlOW PLAN PREVENTIONAND CONTROL HIVI AIDS TRANSMISSION July 2007 - IIhGINllEltS (;1t0UlB 1:I'l). T Table of Contents Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmissior Table of Contents 4.3.3 Behavior Change Communication(BCC) 4.4.2 Orissa State RoadwaysProject Needs 4-6 4.4.3 Objectiveof CondomPromotion 4-7 4.4.4 The Free Condom Strategy: 4-7 Consultancy Service for Feasibility Study and Detailed 1 Project Preparation for Proposed Orissa State Road F'roject Consulting EngineersGroup Ltd.,Jaipur Strategy and Action Plan for Preventionof HIVIAIDS Transmissior Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project EXECUTIVE SUMMARY Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Preventionof HIVIAIDS Transmission EXECUTIVE SUMMARY 1 Introduction Works Department Government of Orissa has planned to improve its core network of about 906 km of state highways under Onssa State Road Project(0SRP) with the loan assistance from World Bank in phase-I. OSRP Phase-I has three major component namely Road Improvement Component including resettlement and rehabilitation, Institutional Development& Policy Component and CommunityDevelopment Initiative component It is well established that because of improvements of road, mobility of CSW'S and truckers also increases and hence chances of transmission of HIVIAIDS. Until the present Road Project (OSRP), Other State road projects2 were not equipped with special targeted intervention strategy for skirmishing HIVIAIDS transmission. It was integrated with resettlement and rehabilitation in other state road projects. As a result HIVIAIDS issues were remained neglected or weakly emphasized during project implementation. In other words HIVIAIDS prevention programme have not given due attention towards fulfilling social responsibility of the project. 2 Project Locations for Targeted Intervention Prevention and control of HIVIAIDS transmission is one of the important social responsibility World Bank has recognized in recent past. Hence prevention and control of transmission of HIVIAIDS have become important component of social safeguard instruments prepared during project preparation of present road improvement. For this purpose a settlement level analysis was undertaken to understand socio-economic characteristics of community. From the empirical studies it is established that knowledge level about prevalence rate, epidemiologtcal behavior of HIV is low in the State. Thus there is need to generate awareness about HIVIAIDS epidemiology to general population and at Targeted Locations.(Table 0.1) Table 1: Project Location for Targeted Intervention Constr No. of Constru uction Of Truck Road Section Chainage Commu ction Parka Brothel Parks nities camp ge* Chandbali - Bhadrak (SH-09) 00-45 28 1 1 1 1 Bhadrak -Anandpur (SH-53) 00-51 28 4 1 1 2 Berhampur -Taptapani (SH-17) 00-41 19 5 1 1 3 Khariar - Bhawanipatna (SH-16) 02-70 27 1 1 1 4 Taptapani - Raipanka (SH-17) 41-109 14 1 1 1 Raipanka-Bangi Jn (SH-17) 109-151 11 1 5 Bangi Jn -JK Pur (SH-04) 161-119 10 - 1 Jagatpur-Kendrapara-Chandbali 00-99 55 3 1 2 6 (SH-9A) Chandbali-Bhadrak(SH-09) 45-53 04 3 - - Bhadrak-Anandpur (SH-53) 51-57 03 1 - 7 Anandpur -Karanjia (SH-53) 00-65 22 1 1 Karanjia-Jashipur (SH-49) 45-60 06 ICommercial Sex Workers OSRP is the first state road project which included prevention of HIVIAIDS transmission as integral part of SSIs and also part of concept document(P1D) as a part of project planning. Consultancy Service for Feasibility Study and Detailed 1 ProjectPreparation for Proposed Orissa State Road Project ConsultingEngineersGroup Ltd.,Jaipur Strategy and Action Plan for Prevention of HIVIAIDSTransmission Management of risk of HIVIAIDS emerging out from road improvement is important components of present project concept document (PID~).Spatial proliferation of HIVIAIDS is the most dreaded and hidden bye-product of road improvement. This bye-product's externalities are generally experienced after few years of construction of roads in operation phase. In the context of HIV; Planners perceive the aftermath of road improvement much earlier in project preparation phase itself and develop strategies to combat the negative impact. 3 Strategy for Prevention of HIVIAIDS Realizing the impact of increasing mobility of high risk behavior during construction and operation phase, epidemiological behavior of HIVIAIDS in the context of traditional culture of Onssa State; intervention strategies have been formulated to minimize the risk of road users, constructionworkers and road side communities. People of Orissa possess a very rich, traditional culture and their norms; value system is rooted in past history. Generally; innovation strateges and new approach towards change in social behavior and cultural ethos is resisted by the society Therefore intervention strategy requirespointed approach to addressHIVIAIDSissues. There are.a number of issues that emerge out in the context of road improvements and the transmission of HIV I AIDS. These issues requires followingprevention strategy. Table 2: Prevention Strategy for HIVIAIDS Prevention Strategy1Care and Support HIVIAIDS Issues to HIV infected People -- Target GKU~ To increase the level of awareness about Mobility, Migration and High-Risk (Sexual) prevention and control of HIVIAIDS Behavior among the different communities' Truckersas Frequent Road Users particularly tribal communities in Sex Workers close to the Project Comdor scheduledareas abuttingproject road. Induced HIV AIDS issue To promote safe sex behavior through Displacement due to Projects - Resettlement promotion of condom use Issues and High-fisk Behavior Developing referral awareness for medical care and treatment. LOSSof Livelihood or business leading to ~ O S S Availability of ART and other facilities to of income and ultimately forced into flesh trade. Social and Psychological support to AIDS I infected I HIV prevention aim to change individual behavior, but community interventions often need to be developed to change norms and behaviors at the group level. While HIV risk may grow 'Project Information Document August,2005, WBlOSRPlorg Consultancy Service for FeasibilityStudy and Detailed 2 Project Preparation for ProposedOrissaStateRoad Project Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission quickly in a community, attitudes are a major barrier to popularizing safer behaviors. BCC even bring changes in laggard of the society, a wide array of communication approaches rangng from mass media (radio, television, and newspapers) to person-to-person counseling and conversation used to promote healthy behaviors. Following table discusses BCC strategy in the project corridor. Fig 1: Framework for BCC Stagesin BehaviourChange Enabling factors continuum I n Providing effective Unaware Aware Concerned Community Knowledgeable Environment- networks I Motivated to policies, &traditional change communityvalues, media Trailof new human rights \ behaviour 71 Adoptionof new Providing user- 1 n t e r p e o ~/~ 1 u behaviour friendly, I accessible services 4 Action Plan Based on strategy as discussed above an action plan is prepared for the prevention and control of HIVIAIDS transmission. The Action Plan identifies important role of institutional stakeholders. They will be stimulating stakeholders in the formulation of prevention strategy and grounding action plan. Consultation with stakeholders such as OSACS~and other Targeted Intervention (TI) partners reveals an inbuilt mechanism for the implementation of action plan. The plan envisages following important component. Partnership Developmentand Capacity Building NGO Partnership Development Partnering Other Institutions HIV 1AIDS Capacity Building Training Display and Distribution of I-E-C Materials Action Plan for Care and Support 5 ImplementationArrangement Organization for planning and implementation of Action Plan for prevention of HIVIAIDS transmission is utmost important because Works Department is mainly an engineering organization. Timely establishment and involvement of appropriate institutions would Orissa StateAIDS Control Society Consultancy Service for Feasibility Study and Detailed 3 Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd.,Jaipur Smtegy and Action Plan for Preventionof HIVIAIDS Transmission significantly facilitate achievement of objectives of the HrV action plan. Present plan has envisaged an in-built institutionalframework for the implementation of HIV action Plan. The main institutionswhich are likely to wok would include: Works Department at different level; Social Impact Management and Safeguard Unit(S1MSU) NGO (Non GovernmentalOrganization); OSACS and other PartneringInstitution Local CBOs and Panchayati Raj Institutions 6 Budget A consolidatedoverview of the budget is provided and the cost estimates gven below shall be viewed accordingly. The cost estimatesfor training and capacity buildinghas been provided by OSACS. The budget is indicativeof outlays for the different expenditurecategories and is calculatedat the 2005-2006 price indexes. The plan outlays for three years is gven. Budget for year 2 and Year 3 would have additional provision of inflation. This budget would be entirely financed from the communitydevelopment initiative component. 7 Summaryof the Cost The cost of H N action plan is divided in capacity Building and Training, Development and Distribution of I-E-CBCC materials and partnership development with NGOs. Details of breakup given in below. Table 3: Summaryof the Cost Consultancy Service for Feasibility Study and Detailed Project Preparation for ProposedOrissa State Road Project Chapter-I INTRODUCTION Consulting EngineersGroup Ltd., Jaipur Swtegy and Action Plan for Preventionof HIV/AIDS Transmission CHAPTER 1 INTRODUCTION 1.1 General Works Department Government of Orissa has planned to improve its core network of about 906 krn of state hghways under Onssa State Road Project (OSRP) with the loan assistance from World Bank in phase-I. This has been learnt that road improvement with enhance mobility increase transmission of HIVIAIDS. Prevention and control of HIVIAIDS transmission is one of the important social responsibilities World Bank has recognized in recent past. Hence prevention and control of transmission of HIVIAIDS have become important component of social management plans prepared during project preparation of present road improvement. 1.2 Prologue Need for Strategy and HIVIAIDSAction Plan It is well established that because of improvements of road, mobility of CSWs and truckers also increases and hence chances of transmission of HIVIAIDS. Until the present Road Project (OSRP), Other State road projects' were not emphasized with special targeted intervention strateges (as in present case of OSRP) for skirmishing HIVIAIDS transmission. It was integrated with resettlement and rehabilitation in other state road projects. As a result HIVIAIDS issues were remained neglected or weakly emphasized during project implementation. In other words HIVIAIDS prevention program have not given due attention towards fulfilling social responsibility of the road projects. Orissa is a low prevalence rate state and awareness about AIDS in general population is moderate. Consultations with high-risk group revealed low to very low commitment to prevent the pandemic. Therefore efforts are required to cover general population for mass awareness about HIVIAIDS and based on first hand information, goal oriented specific intervention program needs to be carried out for targeted population (CSWs, Tuckers, IDU etc). Targeted population can be classified into 1. Core Groups CSWs IDUs(They are now increasing in Orissa now) MSM 2. None core Groups (which regularly interacts with the core groups) Truckers Construction workers (Construction camps) Migrant laborers Handiallocal country liquor sellers (more vulnerable in tribal areas) Children and adolescent (high vulnerable group) ' OSRP is the first state road project which included prevention of HIV/AIDS transmission as integral part of SMPss and also part of concept document(P1D) as a part of project planning. Consultancy Service for Feasibility Study and Detailed 1-1 Project Preparation for Proposed Orissa State Road Project ConsultingEngineers Group Ltd., Jaipur Strategyand Action Plan for Prevention of HIVIAIDS Transmission People at the margin of society are poor people, especially women at high risk because of potentialities of transforming themselves as CSWs and HIVIAIDS orphan. Therefore a targeted intervention is required to focus on these target groups for the present preventive program. Moreover the State is a buffer zone of high prevalence state of West Bengal and Andhra Pradesh. Onssa is well connected with these two high states by means of road transports. Road improvement and mobility of high-risk groups are positively correlated. Thereforethere will be increase mobility of high-risk groups in the state in general and along the project roads in particular. Thus, the state is almost at the fringe of potentially high prevalence of the HIVIAIDS epidemics and there is need to location specific intervention strategies for the prevention of HIVIAIDS transmission. HIVIAIDS transmission is generally caused by mobility of the people such as migration (out&in), sexual activeness (specific age group and socio-cultural behavior of the people), poverty, low literacy and lack of knowledge of epidemiologcal behavior etc. These causative factors are common to all parts of the state. At present the State is in the category of highly vulnerable status (low H N prevalence).Based on prevalence rate, spatial distributionof high risk groups and hot pots, potentiality of spread of epidemic; it is evident that there is urgent need to initiate a collectiveeffort to combat such a threat to mankind. Public consultation, FGDs, NGOs partnership development and joining hands with other institution such as SACS, DFID, USAIDS provides clear cut intervention strateges for the prevention of the HIVIAIDS pandemic. Thls is also important to understand sexual networking in the project areas and nature of infiltrations of CSWs from distant location as most cases of HIVIAIDS are sexually transmitted. Above mentioned discussions indicate a strong linkages is required among different stakeholders for an effective preventive program. Effectiveness of these programmes require strong linkages with the community and other stakeholders. These linkages can be established with very effective communication strategy like Information, education and communication (I-E-C) and Behavior change communication (BCC). Thus target oriented and focused campaign delivery method and partnership development with stakeholders are requiredfor effectiveimplementation of the preventive program. From the above mentioned internal debate number of issues have emergeout in the context of road improvement and the spread of HIV I AIDS diseases in the state. Based on these emergent issues following objectivehave been delineated for the present studies. 1.3 Objectives 1. To understand epidemiology of HIVIAIDS in the context of Orissa StateRoad project (OSRP) 2. To identify role of intervention strategy for the prevention campaign of HIVIAIDS transmission relevant for OSRP 3. To prepare a target specificaction plan as applicable to OSRP 1.4 Methodology Present study has been based on primary information collected during baseline socio- economic and census survey, consultation and secondary database support. During the survey information were collected about HIVIAIDS epidemiology, behavior change communication, level of awareness about AIDS and other highway related diseases. Focused Group Discussion (FGDs) preparation of village diary has substantiated information base about ConsultancyServicefor Feasibility Studyand Detailed 1-2 Project Reparation for Roposed Orissa State Road Project ConsultingEngineers Group Ltd., Jaipur Strategy and Action Plan for Preventionof HIVIAIDS Transmission HIVIAID and causes of its spread. Identification of hot spots and location of Targeted Intervention(TI) has been establishedbased on informationfrom above mentioned sources. Consultationwith community,behavior of communitywith HIV positive people, consultation with other institutional stakeholders such as SACS, OXFAME, NGOs (working in HIVIAIDSproject in close coordination with SACS),have gven basis for the management of implementation framework. 1.5 Structure of Report This report is an attempt to develop strateges, and framework for implementation. Chapter wise content is mentioned below in the table. Chapter Name of Chapter Description Number Outlines Project background, objective and 1 Introduction methodology adopted. This chapter illustrates status of HIVIAIDS, Assessment of HIVIAIDS 2 intervention strategies of OSACS and othe TI Scenario partners and highlight of NACP III(2007-2011). Describes causes of HIVIAIDS and road Project Locations for improvement and transmission of HIVIAIDS Targeted Intervention project roads and socio-economic characteristics of the project area. Discusses Strategy for the preparation of action 4 Strategy for Awareness Plan Action Plan for the Details of action plan such as BCCII-E-C plan, 5 Prevention of HIVIAIDS capacity building. condom distribution and Transmission Partnership development. This chapter describes role and responsibilities of 6 InstitutionalArrangement stakeholders in implementation of HIVIAIDS Iaction plan 1 1 1This chapter outlines implementation schedule and 7 ImplementationSchedule as Der constructionschedule. Details out activity wise cost provision of each 8 Budget activities. 1.6 Acknowledgement The consultant is very much thankful to support and assistance provided by OWD local officials during fieldwork and PIU(Wor1d Bank) officials for the assistance provided in developing framework of the report. The consultant takes this opportunity to thank Chief Engineer, PIU (World Bank) for his contributiontowards arranging information from SACS. Finally special thanks is accorded to M. Hasan for his valuable suggestion and consistent guidelines for the preparation of the Report during Mission Visit (Jan 2006, March 2006, June 2006, July 2006, and November 2006) ,in the World Bank office 24IhJan2006 and 25" August 2006) and constantlyprovidingnecessary guidelinesthrough e-mail. Consultancy Servicefor Feasibility Study and Detailed Project Preparationfor Proposed Orissa StateRoad Project Chapter-2 ASSESSMENT OF HIV/AIDS SCENARIO IN THESTATE Consulting EngineersGroup Ltd.,Jaipur Strategyand Action Plan for Preventionof HIVIAIDS Transmission CHAPTER 2 ASSESSMENTOF HIVIAIDS SCENARIOIN THE STATE 2.1 Project Background The Orissa Works Department (OWD) of the Government of Orissa (GOO)has planned to improve the core network of roads in the state with funding from the World Bank. Based on the road network analysisand feasibilitystudies, the project proposes to widen and strengthen of about 906 km of the core network, mainly State Highways.(Table 2.1). Table 2.1: List of the project Road - S1. Name of Road SH/MDR Project Districts No. 1 [ ~ a ~ a t ~Kendrapada - ChandbaliBhadrak - u r I 1 [a)Jagatpur - Kendrapada - Chadbali ( SH-9A 1 99 1 Cuttack,Kendrapara I b)Chandbali - Bhadrak I SH-9 ( 53 1 Bhadrak - Bhadrak Anandapur Karanjia- Jashipur - - a) Bhadrak - Anandapur SH-53 46 Bhadrak, Keonjhar 2 b) Anandapur - Karanjia SH-53 79 Keonjhar, Mayurbhanja c) Karanjia - Jashipur SH-49 17 Mayurbhanja Berhampur - Raygada 3 a) Berhampur - Bang Jn. Ganjam, Gajapati, SH-17 150 Rayagada b) Bang Jn. - JK Pur SH4 51 Rayagada khariar Bhawani~atna- Muni~uda- Kerada - I I Nuapada, Bolangir, a) Khariar - Bhawanipatna SH-16 70 Kalahandi 4 b) Bhawanipatna - Muniguda SH-6 68 Kalahandi,Rayagada c) Muniguda - J.K.Pur SH-5 50 Rayagada d) J.K. Pur-Raygada SH-4 10 Rayagada e) Ravgada - Kerada MDR-48B 25 Rava~ada I I~anar~al-Daspalla - Bhanjanagar - Aska - Digapahandi MDR- Angul, Dhenkanal, a) Banarpal - Daspalla 89 5 18,19 Nayagarh B) Daspalla-Bhanjanagar SH-37 61 Nayagarh, Ganjam 1 Ib) Bhaniana~ar- Aska I SH-7 1 38 1 Ganiam I TOTAL 1 906 1 Source: Orissa State Road Project, Works department Previous chapter has indicated that HIVIAIDS is generally caused by mobility and migration of HRG. Proposed road improvement wll enhance mobility of these HRG. The corridors (mentioned in table 2.1) connect important state highways of the State (SH-9,SH- 49,SH17,SH-64 and SH-16) with important high density National highwaysw) of the countryw-5,NH-201,NH 224,NH-6). Amongst the above mentioned road comdors (as mentioned in table 2.1) few of roads pass through virgin ethnic group in Schedule areas and road improvement need careful analysis and risk support system to protect these scheduled areas so far HIVIAIDS infection are concerned. Following sections deal about HIVIAIDS status, intervention strateges and need for convergence with OSACS in planning and implementationof action plan. Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission 2.2 HIV AIDS Status in the State In Orissa, numbers of reported cases are low in comparison to other state of the country. Reported low prevalence rate is because of traditional culture of the state, lower surveillance data, lack of knowledge about HIVIAIDS in tribal and rural areas especially in primitive ethnic groups. Traditional culture of Orissa and swathe social structure has hidden actual prevalence of HIVIAIDS scenario in the state. The HIVIAIDS, looks like an iceberg(on1y 1110~part is visible) in the state, thus it is very difficult to establish identification of hot spots, nature, extent & mode of transmission of HIVIAIDS among general population, concentration of commercial sex workers (CSWs), location of road intersection(point) as a diffusion point of HIVIAIDS in the State. However HIV prevalence status may indicate nature and cause of pandemic in the State. 2.2.1 HIVIAIDS Scenario As per Sentinel Surveillancedata 2005, the HIV prevalence rate in Orissa is 0.6%. Since this is less than 1% of prevalence rate, the status of Orissa on HIVIAIDS is considered LOW. Because of border to the high prevalence adjoining states(AP and West Bengal) and due to large scale of out-migration to other state (Gujarat, Maharastra,Andhra Pradesh, Tamil Nadu, West Bengal)the HIV prevalence seems to be increasing in Orissa. Table 2.2: Status of HIV +Ve 1AIDS Cases (as on August 31,2006) Consultancy Service for Feasibility Study and Detailed Project Reparation for Proposed Orissa State Road Project 2-2 Consulting Engineers Group Ltd.,Jaipur Strategy and Action Plan for Preventionof HIVIAIDS Transmission Souce :OSACS 2007 2.2.2 Districts vulnerable to HIVIAIDS: As per ORGMARC SituationMapping report 2005, HIGHLY VULNERABLE DISTRICTS = Khurda, Pun, Keonjhar, Nawarangpur, Ganjam, Bolangir, Bhadrak, Kalahandi, Nuapada, Deogarh (10 districts). MEDIUM VULNERABLE DISTRICTS = Koraput, Rayagada, Nayagarh, Balasore, Mayurbhanj, Sonepur, Cuttack, Sundergarh, Malkangiri, Jagatsingpur, Sambalpur (11districts). LOW VLTLNERABLE DISTRICTS = Angul, Bargarh, Boudh, Dhenkanal, Gajapati, Jajpur, Jharsuguda, Kandhamal,Kendrapara (9 districts). 2.2.3 Ongoing Programmes on HIVIAIDS in Orissa OSACS (Ministry of Health and Family Welfare, GOO)has been the nodal agency for the prevention and control program of HIVIAIDS transmission for different partners such as NACO, DFID, Oxfame, UNAIDS, HLFPPT etc. in Orissa. Ongoing program by OSACS is mentioned in Table 2.3. Table 2.3: Ongoing HIVIAIDS Programme in Orissa Year Year S1.No. Item Purpose 2005-2006 2006-2007 TI to FSWs,MSM,Migrant 1 TI Projects 3 33 labourers,IDU General population and HRG for 2 VCCTC 35 -- counseling P Integrated 3 Counseling - 26 Centre Medical check-up and free 4 STD Clinics 34 34 medicines to all Prevent parent to child 5 PPTCT 30 32 transmission Condom 6 Vending 3 3 HRG for control of HIVIAIDS Mechines Community 4 4 PLWHA Care Centre Drop in 8 1 1 PLWHA Centres 9 ART Centres 1 1 From the information mentioned in the above table it is inferred that I-E-C and BCC is weekly emphasizedby OSACS, therefore OSRP should emphasizemore on I-E-C and BCC. -- -- ConsultancyService for Feasibility Study and Detailed Project Preparation for Proposed Orissa StateRoad Project Consulting Engineers Group Ltd.,Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission Condom Vending machines should also be provided, as number of machines is very less. These are NGOs working as TI partners with OSACS. List of NGOs worlung is appended. 2.2.4 National and InternationalSupport for the prevention and Control of HIVIAIDS in Orissa Under MAINSTREAMING on HIVIAIDS, Onssa State AIDS Control Society(0SACS) has collaboratedwith the following organizations + UNDP for establishing ICT kiosks in Ganjam, Nayagarh and Kendrapara districts (Orissa) and Surat, Alang (Gujarat) for promoting SafeMigration. + Catholic Relief Services (CRS) and Lepra India for providing Care & Support for 86 HIV +ve persons in Ganjam district. + Hindustan Latex Family Planning Promotion Trust (HLFPPT), Population S e ~ c e s International (PSI) and Parivar Seva Sanstha (PSS) for promoting social marketing of condoms in the State. + Hindustan Latex Limited (HLL) for installing Condom Vending Machine (CVM) in Orissa. + OXFAM for providing drugs for opportunistic infections; training of Private and Government Medical Practitioners; training of State level trainers on Counselling; Meha advocacyand PRI sensitization. + Indian Oil Corporation Limited (IOCL) for information and services dissemination among the truckers through their retail outlets. + Hotel & Restaurant Association of Orissa (HRAO) for information and services disseminationthrough their district level associations. + Department of School & Mass Education for imparting School Adolescence Education Programme in the Government Secondary schools and +2 Colleges of the State. This will be a continuing activity every year. The cumculum on HIVIAIDS have been decided to be finalised for Class -IX to Class -XI1 for incorporationin the syllabus during this academic year for which action has already been initiated by Orissa Secondary Board of Education and +2 Council. + UNICEF for providing training for PPTCT programme in the State and technical support to the School AdolescenceEducation Programme. 2.3 NACO Initiativesin NACP I11 NACP Phase-I11 will start from April 2007 to March 201lwith followingobjectives Preventionof new infections in high-risk groups and vulnerablepopulations. Increasing the proportion of persons living with HIVIAIDS receiving care and treatment. Strengthening the infrastructure, systems and human resources in prevention and treatment programs at the district, state and national levels. Establishingnation wide strategc planning, programme management, monitoring and evaluation system. Major Activities of NACP-I11 in Orissa 150new TIs will be taken up in order to saturatethe core and bridge groups. Consultancy Service for Feasibility Study and Detailed 2-4 Project Preparation for Proposed Orissa State Road Project Consulting EngineersGroup Ltd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission 408 STD clinics will be opened in Medical institutionsof Orissa. 65 licensedBlood Banks will receive support from OSACS 15Blood Component SeparationUnits will be set up in the State. 408 VCCTCs up to the PHC level will be set up. 408 PPTCTs up to the PHC level will be set up. 29 Community Care Centres up to the district level will be set up in the State. 6 ART centres will be set up in the State. 29 drop in centres will be set up to the District level in the State. ART treatment will be provided to the PLWI-IAs in the State. 2.4 Need of Convergence with SACS Programme Orissa State Road projects(0SRP) is mainly a road improvement and maintenance of road project has considered HIVIAIDS is modem threat especially after improvements of the proposed roads. These proposed comdors are covered under ongoing HIVIAIDS prevention programme of OSACS. To avoid overlapping herein convergence of HIVIAIDS prevention and control program is sought. Fig. 2.2 provides ongoing TI programs in Orissa. - Field investigation revealed that the proposed comdor under road improvement does not have enough evidenceof detailed I-E-C and BCC interventionmeasures of OSACS. Recomaissance survey and first hand information collected along the roads suggest that there is a need to emphasize I-E-C and BCC along the project road. Jagatpur-Bhadrak-Chandbali- Anandpur-Karanjia section has not evidenced I-E-C campaign materials. However Consultancy Service for FeasibilityStudy and Detailed Project Preparation for Proposed Orissa State Road Project Consulting EngineersGroup Ltd., Jaipur Strategyand Action Plan for Preventionof HIVIAIDS Transmission Berhampur-,Raygada Section has evidence of I-E-C materials. To avoid repetition of TI intervention program, convergence with OSACS (along with its TI partners mainly NGOs) will provide detailed intervention strateges to cover these areas. OSRP TI(imp1ementing NGO) partner will be joining hands to OSACS TI partners in the proposed project Districts and ongoing program. Consultancy Service for FeasibilityStudy and Detailed Project Preparation for Proposed Orissa StateRoad Project '2-6 Chapter-3 PROJECT LOCATION FOR TARGETEDINTER VENTION Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Preventionof HIVIAIDS Transmission CHAPTER 3 PROJECT LOCATION FOR TARGETED INTERVENTION 3.1 Background From the cross-cultural examples and statistical evidences;it is believed with significant level of confidence that most cases of HIV are transmitted through un rotected sex and important P vectors are truckers, CSWs and construction workers (HRG ). Brothel, Dhabas, major crossings are centres of the transmission (Hot spots2). The interaction of truckers and CSWs mobility (high risk groups) are reinforced because of improvement of road transport. The epidemic also follows laws of diffusion and distance decay principles. It means diffusion will be faster near high prevalence region and it will decrease fiom the high prevalence regon to low prevalence regon. Region and State of low prevalence rate3(hgh vulnerable status) like Orissa is more susceptible to the impact of road improvement and mobility of these high risk groups. Thus to understand issues associated with road improvements and epidemiology of HIVIAIDS an extensive fieldwork, consultation ,FGDs at the local level, community level, at major brothel and Dhabas is done. These exercises have not only helped to understand cause, nature and extent (epidemiology) of HIVIAIDS in the State and along the project road but also assisted in the formulation of Strategy and Action Plan for the Prevention of HIVIAIDS. Following section outlines epidemiology, important potential hot spots of road improvement. 3.2 Epidemiologyof HIVIAIDS Human Immunodeficiency Virus (HIV) is virulent to immune system of body. People infected with the virus may not have symptoms in early stages of infection. AIDS (Acquired Immunodeficiency Syndrome) is later stage of HIV virulent infection. A person with HIV infection has AIDS when She has immune system count below a standard level (200 CD4 count). A person of any age sex, race etc can get HIV, which is evident fiom epidemiological study and research that HIV is generally caused by unprotected sex using unsafe needles, blood transfusion (Table 3.1). This is also evidenced fiom epidemiological study that HIV can only be transmitted if infected blood, semen, vaginal fluids or breast milk gets into the body. Having understood the causative factors, following sections examines location of TargetedIntervention (TI) along the project route. Table 3.1:Epidemiologyof HIVIAIDS S1.No. Causes of HIV Vectors CSWs.Peo~leofhigh sexual Unprotected sex with a person having 1 activeness, Truckers, laborers in HIV construction camp, migrants.MSM 2 Sharing of Needles, Synnges to inject drugs Intervenesdrug users(1DUs) Babies can be infected from mother during 3 Infectedmother(AIDSOrphan) pregnancy, breast feeding Health care and maintenance worker may 4 Heath officer exposed to blood ' High Risk Group * Also known as Targeted location for Intervention State with low prevalence rate is more prone to virulent infection because epidemiological behavior of disease is not understood appropriately by the society hence prevalence rate is also underestimated. Thus there is need to generate awareness about the pandemic in the State. Consultancy Service for FeasibilityStudy and Detailed 3-1 Project Preparation for Proposed Orissa State Road Project Consulting EngineersGroup Ltd.,Jaipur Strategy and Action Plan for Prevention of HIV/AIDSTransmission 3 3 Communities along the Project Corridor A settlement level analysis was undertaken to understand socio-economic characteristics of community. From the empirical studies it is established that knowledge level about prevalence rate, epidemiolog~calbehavior of HIV is low in the State. Thus there is need to generate awareness about HIVIAIDS epidemiology. Communities along the project corridor are divided in two parts. Communities living in non-scheduled areas are practicing agncultural in rural areas and business and other activities in urban areas. They are more exposedto HIV infection at present. Communities living in scheduled areas are still not much aware about the disease but due to road improvement they would be interacted more frequently to the people of complex societies and exposure to HIV will be high. Therefore intervention approach should emphasize strategies to control HIVIAIDS in non-schedule areas and prevention strategiesin scheduled areas. Table: 3.2: Communities along the road (Targeted Location) SH-53 (Bhadrak-Anandpur) (00-51Km) Communities Chainage Communities Chainage Communities Chainage Bonth Chhak 00-01 Tillo Badasahi 17-18 Chorgadia 33-34 Bhadrak 01-02 Tillo 18-19 Bancho 34-35 Bagurai 02-03 Bonth 19-20 Dadhibanpur 35-36-37 Randia 03-04 Chainpur 22-23 Fakirpur 40-4 1-42 42-43-44- Mundimara 06-07 Orali Chhak 24-25 Anandpur 45-46 Barapada 07-08-09 Basantia 25-26-27 Padmapur 47-48 Ganijanga 11-12 Biranchipur 27-28 Sarangi 48-49-50 Hasin~ur 12-13 Jalakalanea 29-30 Bankhidi 50-51 I Palasa 1 13-14 1 Hatadihi 1 30-31 1 I I I Ambagadia ( 15-16 1 Chhenapadi 1 31-32 1 Communities Chainage Communities Chainage Communities Chainage First Gate 00-01 Dengapadar 11-12 Nua Maulabhanja 28-29 Puruna Dakhinnpur 03-04 Narayanpur 3-1 29-30 Maulabhanja Lanjia 04-05 Gania Nala 15-16 Dengausta 32-34 Balkrishnapur 05-06 Pitamabarpur 17-18 Kansarnari 34-35 Padarbali 07-08 Gokarnpur 18-20 Pudamari 36-38 Consultancy Service for FeasibilityStudy and Detailed Project Preparation for Proposed Orissa State Road Roject Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Preventionof HIVIAIDS Transmission Patitapabanpur 08-09 Anangapur 20-21 Balipada 09-11 Digapahandi 22-25 SH-17(Taptapani-Raipanka)(41-109Km) Communities Chainage Communities Chainage Communities Chainage T. Gobindapur 45-46 Mohona g 67-69 Belaguda 50-51 Chapetapanka 71-72 Birikot 89-91 Kamalapur 53-54 Bramunidei 73-74 Mundimeara I01-102 Luhagudi 54-55 Adava 80-81 Raipanka 108-109 Liliguda 63-64 Podagaon 81-83 Jagatpur 02-01 Katarpada 31-30 Jajhanga 56-55 Trilochanpur 58-57 Padmapur 06-05 Katikata 36-35 Patharkani 62-61 Padmapur 07-06 Kusunpur 37-36 Gangapada 63-62 Padmapur 08-07 Sapanpur 18-17 Gogua 65-64 Badamulabasant Mohajanpur 09-08 Machhuati 19-18 66-65 a Paga Chhaka 10-09 Katakia 38-37 Pahala 67-66 Bahugrama 11-10 Chandol 39-38 Kasananta 73-72 ConsultancyService for FeasibilityStudy and Detailed Project Preparationfor ProposedOrissa State Road Project Consulting EngineersGroup Ltd., Jaipur Strategyand Action Plan for Preventionof HIVIAIDS Transmission ' Nondolgara 14-13 Chandol 40-39 Kasananta 74-73 Nondolgara 15-14 Anuapada 42-41 Gopalpur 75-74 Naliamohan 16-15 Khamol 43-42 Bilikana 76-75 Sishua 17-16 Chandibazar 44-43 Bharatpur 77-76 Salepur 21-20 Balia 45-44 Singiri 78-77 Kulia 1 22-21 1 Jantilo 46-45 Singiri 1 79-78 1 I Kulia 1 23-22 1 Balabhadra~ur 1 46-47 1 Mala~atana 1 80-79 1 Karanjia 60-59 Kumlia 56-55 Tato 53-51 Gidhibash Sarubali 59-58 Kanakada 55-54 50-4Y Chhak -- MDR-48B (Rayagada-Kereda) (00-24 Km) , Communities Chainage Communities Chainage Communities Chainage Pitamahal 03-05 Jarnadevi Pentha 15-16 Kereda 24-25 Jarnidipeta 09-10 Kunchka Valsa 18-19 Gudam 14-15 Seskhal 19-20 Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project ConsultingEngineersGroup Ltd.,Jaipur Strategy and Action Plan for Preventionof HIVIAIDSTransmission MDR-IS& 19, SH-65 (Daspalla-Banaral) I Sidhamula 1 00-01 1 Kishoraprasad [ 03-04 / 1 - -- ~p Gopalapur 20-21 1 Jogi Bandha 1 01-02 1 Erapada 04-05 r *Villages of scheduled areas are mentioned in Italics Source: Consultant study 3.4 Way Side Amenities (Bus Bay and Truck Parks) It is expected that traffic would increase after development of proposed transport corridors. Consequently, There will be change in economy, transport, tourism, land use along the corridor, which in turn, will bring change in occupational pattern. There will be more dhabas, truck parks, rest areas along the project road. These facilities would be attracted by small business house such as dhabas, motor mechanic shops and other related economic activities. These places would also attract CSWs, MSM (hot spots), truckers and other road users. Thus these places would be targeted locations for prevention of HIV/AIDS program. (TI locations). Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd., Jaipur Stmtegy and Action Plan for Prevention of HIVIAIDS Transmission Table:3.3 Way SideAmenitiesalong the project road in the Proposed Corridor StateHighways Name of Location Remarks From To Communities SH-9 11500 11600 Bhadrak Finalized SH-53 41700 41800 Karanta Finalized I SH-17 1 421400 1 421500 1 Khemandikholo I Finalized I SH-16 211900 221224 Belapada Finalized SH-9A 881900 891000 Kalpohada Notfinalized Jassipur More SH-49 11/00 121200 Notfinalized Randia SH-64 13/00 131100 Tulmull Notfinalized SH-5 43/00 431100 Gawlakana Notfinalized SH-6 121300 121400 Deypur Notfinalized SH-4 38/00 381100 Hatikhamba Notfinalized *Location (in italics) of truck parks would be fmalized after approval of alignments by OWD. Source :consultant Study 3.5 Brothel and Other Hotspots As mentioned earlier, illegal sexual activities are like an iceberg in Onssa. There are not many recognized brothels (Female Sex Workers for fixed location). But informal flesh trades do exist along the project stretch especially near junction of National Highways (NH) and truck parks. Few tribal have been located doing such illegal activities along the road during night along the National Highways of high traffic density. It is expected that after improvement of proposed corridors under OSRP there may be migration of these HRG from the NH to OSRP roads. These locations will be hot spots for targeted intervention. Information about brothels and other hot spots is presented in Table 3.4. Table: 3.4 Brothel and Other Hot Spots along the Project Corridor (Within 1 km Radius) Project Corridor Location Chainage Major hot spots Dhabas, Truck Jagatpur O0-O2 camps(Informal0 Kendrapara Jagatpur- (Lalbagh Brothel),Tinimohani 51-50 Truck Camps, Brothel Chandbali- Chak(Informal), Bhadrak(SH-9) Ashuresar Village Brothel(informa1) Moahu(1km of Aul) 86-85 Brothel(informa1) Chandbali Bus stand 49-52 Migratory CSWs ---- Tihadi 17-18 Brothel(Informa1) Bonthchak(T0wards old Bus Bhadrak- 00-01 Brothel(Informa1) Stand, Bhadrak) I Anandpur- Randia(Near Facor) 03-04 Brothel(Informa1) Jasipur(SH- Senapadi Chhak(Truck Halt) 31-32 Brothel(Informa1) 53&SH-49) Anandpur 42-45 Brothel(Informa1) Berhampur Bus stand, Migratory CSWs and 0°-01 Berhampur 1 Gate informal hidden CSWs Berhampur- Migratory CSWs and Jkpur(SH- Digapahandi 22-25 informal hidden CSWs 17&SH-4) Mohna 67-69 CSWs(Informa1) J.K.Pur 119-120 CSWs(Informa1) Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission 8 Kareda-Raygada Bishamkatak 34-38 CSWs(Informa1) Bhawanipatna- Muniguda 65-66 CSWs(Infonna1) Khariar(SH-5,SH- Bhawanipatna 00-01 CSWs(Informa1) I I Aska-Bhanjnagar- Aska I 1 46-49 1 CSWs(Informa1) 1Daspalla- Bonharpal (SH- Bonharpal 17,SH-37,SH-64) 1 I Source: Consultant study Conclusion Orissa is a culturally rich State. It is difficult to identify exact number and location of brothel and other hot spots. However with the improvement of road and increased mobility of high- risk groups; intervention strategies require specific targeted module such as I-E-C and BCC. These strategies will be grounded by suitable implementation and management framework. Consultancy Service for Feasibility Study and Detailed Project Preparation for ProposedOrissa State Road Project 3-7 Chapter-4 STRATEGY FOR THEPREVENTION OF HIV/AIDS TRANSMISSION Consulting EngineersGroup Ltd., Jaipur Strategyand Action Plan for Prevention of HIVIAIDS Transmission CHAPTER 4 STRATEGY FOR THE PREVENTION OF Hn7IAIDS TRANSMISSION 4.1 Introduction Management of risk of HIVIAIDS emerging out fiom road improvement is important components of present project concept document (PID). Spatial proliferation of HIVIAIDS is the most dreaded and hidden bye-product of road improvement. %s bye-product's externalities are generally experienced after few years of construction of roads in operation phase. In the context of HIV Planners perceive the aftermath of road improvement much earlier in project preparation phase itself and develop strategies to combat the negative impact. 4.2 Prologue Realizing the impact of increasing mobility of KRG during construction and operation phase, epidemiological behavior of HIVIAIDS in the context of traditional culture of Orissa State and location of important hot spots; intervention strateges have been formulated to minimize the risk of road users, constructionworkers and road side communities. People of Orissa possess a very rich, traditional culture and their norms; value system is rooted in past history. Generally, innovationlstrategies and new approach towards change in social behavior is resisted by the society Therefore intervention strategy requires pointed approach to address HIVIADS issues. From the consultation, group discussion and other empirical studies, key technical elements for HIV are grouped into three main categories: prevention of HIVIAIDS for those at risk for HIV, Control of transmission in potentially affected areas by targeted intervention & care and support for those infected or affected by HIVIAIDS within a defined comdor which influences road side business and econometrics. The intervention measure also outlined sustainabilityof strateges adopted. 4.3 Prevention Strategy There are a number of issues that emerge out in the context of road improvements and the transmission of HIV I AIDS. These issues require followingprevention strategy Table 4.1 Prevention Strategies for HIVIAIDS Prevention Prevention Strategy1Care and Support to HIVIAIDS Issues HIV infected People Target Group To increase the level of awareness about Mobility, Migration and High-ksk prevention and control of HIVIAIDS among 1 1 (Sexual)Behavior ( the different communities' particularly tribal 1 Truckers as Frequent Road Users communities in scheduled areas abutting Sex Workers close to the Project Comdor , project road. Induced HIV AIDS issue I To promote safe sex behavior through Displacement due to Projects - promotionofcondomuse Resettlement Issues and High-Risk Developing referral awareness for medical care Behavior and treatment. Availability of ART and other facilities to Loss of Livelihood or business leading to patient Consultancy Service for Feasibility Study and Detailed 4-1 Project Preparationfor Proposed Orissa State Road Project Consulting Engineers Group Ltd., Jaipur Sbategy and Action Plan for Prevention of HIVlAIDS Transmission Prevention Strategy1Care and Support to HIVIAIDS Issues HIV infected People loss of income and ultimately forced into Social and Psychological support to AIDS flesh trade. infected 43.1 Approaches for the Prevention of HIVIAIDS Transmission From the above-mentioned paragraphs I-E-C is one of the most important prevention strategy This will emphasize all targeted location and potential road users. Prevention strategy for HIVIAIDS in the present context will based on nature of road users, HRG and distributionof HRG along the project road. Ubiquitous presence of HRG will warrant for more intensive preventive strategies. table 4.2 illustratesIEC campaign strategies. Table 4.2: IEC Campaign Strategies SI. Targeted I-E-C Strategy Institutional Actors No. Location Display and Distribution of I-E-C Implementing materials,Mahila sammelan,Panchayat NGOs,SMU(OWD) Road side sammelan,Street Theatre,Film show,Best 1 Communities Vilage award, Gadhua tuth(Bathing Ghat discourse) of female, Sobha Yatra,wall writing, Street theatre, songs, Display and distribution Implementing NGOs Haat (weekly of I-E-C materials ,Wall writing, CommunicatingI-E-C with animal benchmark Goru hat in animal market Implementing I-E-C materials, film screening, Peer group 3 Truck Parks NGOs,SMU(OWD), education peer educator Construction I-E-C materials, film screening, Peer group Implementing A Lt camps education NGOs,SMU(OWD) Display and Distribution of I-E-C materials, Implementing 5 Brothel CSWs sammelan,Best pimps, Street Theatre, NGOs,SMU(OWD) Film show.. Implementing 6 Other hotspots Display and Distributionof I-E-C materials NGOs,SMU(OWD) Leaders aarn Display and Distribution of I-E-C materials, Implementing 7 Sabha wall writing NGOs,SMU(OWD) Implementing 8 Exihibition Display and Distributionof I-E-C materials, NGOs,SMU(OWD) and Implementing Peer Group education,Teahers sammelan, 9 Other NGOs,SMU(OWD) Quiz contest among students,schooltheatre. Institution 4.3.2 Activities Related to I-E-C Road Yatra by SMU and local Engineer A Road procession of OWD officers, implementing NGOs and officers from District administration will be flag off the HIVIAIDS campaign from important locations. These locations will be important communities as motioned in chapter 3. Consultancy Service for Feasibility Study and Detailed 4-2 Project Preparation for Proposed Orissa State Road Project ConsultingEngineersGroup Ltd., Jaipur Strategyand Action Plan for Prevention of HlVlAlDS Transmission There are numerous weekly haat along the project areas. There will be mass contact program at these places to attract the attention of common people through exhibition. People will be encouraged to participate in mass contactprogram. Path Prant Yatra (Natak or street theatre) A skit will be prepared with references to the local area, culture, art, architecture and important current happening to ensure the maximum attentionof the target audience.The slut will be in the local dialect to make it easily communicable. This play will be first and foremost entertainingand there will be no direct reference to the HIVI AIDS. It will, in a very subtle and humorous manner, highlighting the problems and know-how of the HIVI AIDS. Lok Sangeet (Local Songs) The songs will be prepared highlighting the different aspects of HIVI AIDS in the folk tradition of the project area. Mahila Sabha It has been observed that if change has to be brought in; then women folk, both of younger and older generation will have avery important role to play. With the help of women panchyat member, a meeting of women will be called where the problem related to the HIVIAIDS can be discussed. A small film or a skit can be performed to in these meeting to make the gathering more lively and interactive. "hkhari Sammelan" of women in Onssa can be important location for this purpose. Sobha Yatra A procession of important people of the area will be taken out emphasizing the theme of HIVI AIDS. This procession will have people performing different lund of activities like magcian, folk singers of that area etc. Kishor Sena It is believed that children are a great opinion maker in their home and locality. To ensure the participation of the students first a team will visit school. After performing a skit hghlighting the danger of HIVI AIDS and interactive session with them a posterlquiz competition will be organized in the school. The first three posters from every school will be part of a mobile exhibition, which will be exhibited at several places. At every place people will be encouraged to pick three best posters. And after taking into account the people's opinion three best posters will be identified and awarded. A procession of the children will be organized in the award winning villages first followed by in other villages. Gram Panchyat Sammelan In every panchyat, a meting will be called of all the members and there cooperation will be solicitedto make this program successful and its importance in their areas. Separately another meeting of women panchyat member will be called to impressed upon them that how important there role in turning this program in to a success story and how important it is for the wellbeing of the society. 1 5working day(Gnevance day) is the date of meeting of gram ~ panchayat in Orissa and will be suitablytied -up with this meeting. Meeting of Teachers To ensure that the educational institutions should help this campaign a meeting of the teachers will be called at block level. This meeting will ensure their participation in the ConsultancyService for FeasibilityStudy and Detailed Project Preparationfor Proposed Orissa State Road Project Consulting EngineersGroup Ltd.,Jaipur Strategy and Action Plan for Preventionof HIVIAIDS Transmission campaign. It is very important because these teachers can help not only ensuring the participation of the students but also in creating a positive feeling towards this campaign among masses. The Best Village The village showing the biggest change in the HIVI AIDS awareness scenario during the campaign will be given a prize at the District level. Film Screening Films made by agencies such as NACO, UNAIDS, DFID on HIVI AIDS can be screened at public places. It will help to create a favorableclimate for preventingHIVI AIDS. Wall Writing Wall painting will be done in every villages abutting project road to disseminate information. To ensure longer durabilitypainting quality will be maintained. Weekly market is the characteristicsof present project stretch especially in scheduled areas. Goruhaat is also a common to all areas. Any information if communicated through these places will be propagated in hinterland quickly. SadharanSabha Orissa is known for local level participation in State affairs and vis-vis. Sadharan sabha(other than electoral sabha) of important leaders of the State in the project District. This could be a better location for songs,natak and distribution of I-E-C related to HIVIAIDS. Other Important I-E-C could be mass media campaign, bimonthly Handout, Leaflet distribution along the project corridor. 4.3.3 Behavior Change Communication(BCC) Prevention programs of HIV also aim to change individual behavior. Community interventions are often required to develop change norms and behaviors at the group level. While HIV risk may grow quickly in a community, attitudes are a major barrier to popularizing safer behaviors. BCC even bring changes in laggard of the society, a wide array of communication approaches rangng from mass media (radio, television, and newspapers) to person-to-person counseling and conversation used to promote healthy behaviors. Followingtable discussesBCC strategy in the project corridor. -- Consultancy Service for Feasibility Studyand Detailed Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Preventionof HIVIAIDS Transmission mI Fig 4.1 Framework for BCC design Stagesin Behaviour Change Enabling factors Channels Unaware Aware Concerned Knowledgeable Motivated to policies, change communityvalues, Trail of new human rights behaviour Adoptionof new behaviour friendly, accessible Behaviour Change Communicationgoals: Increase perception of risk or change attitudestoward use of condoms. Increase demand for services. Createdemand for information on HIV and AIDS. Createdemand for appropriate ST1services. Interest policymakers in investingin youth-friendly VCT services. Promote acceptance among communities of youth sexuality and the value of reproductive health servicesfor youth. Increased safer sexual practices (more frequent condom use, fewer partners). Increased incidence of healthcare-seeking behavior for STIs, TB and VCT (for example, calls or visits to facilities). Increased use of universal precautions to improve blood safety. Increased blood donations (where appropriate). Improved compliance with drug treatment regimens. Adherence by medical practitioners to treatment guidelines. Increased use of new or disinfectedsynnges and needles by IDUs. Decline in stigma associated with HIVJAIDS. Reduced incidence of discriminatory activity directed at PLHA and other identified high- risk groups. Improved attitudes and behavior among healthcare, social service and other service delivery workers who interact with PLHA, SWs, IDUs and other margnalized groups. Increased involvement of opinion leaders and policymakers, private sector managers and community members. Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project Consulting EngineersGroup Ltd., Jaipur Strategy and Action Plan for Preventionof HIVIAIDS Transmission Table 4.3: Issues and Strategy of BCC Key Issues BCC Strategy Will stimulate community discussion on factors that contribute to Community HIVIAIDS, such as risk behaviors and the environment that creates dialogue :hem and demand for information and for prevention (and care and support services, wherever applicable) Provision of ill provide individuals with basic facts in language and information visuallmedia formats that are simple and easy to understand and and rnotivate positive behavior change education Promotion of kill communicatepromotional information on HIVIAIDS programs services and and services which could include treatment, Drugs, institutional products support groups including PLWHA (People Living With HIVIAIDS) petworks and social and economic support,wherever applicable Promotion of ill communicate promotional information on HIVIAIDS programs services and and services products Will convey the issue of stigma to attempt to influence the social in all communications as it relates to prevention. Stigma behavior on the part of those individuals others, and manifests itself in a range of ways, from needs of a person or group to psychologcally or the stigmatized. BCC programs that address from motivated persons or groups, such as LWHAs, CSWs and MSM, who can work effectively for change as bolicy advocatesand serve as caregvers and peer educators. 4.4 Strategy to control HIVIAIDS Transmission 4.4.1 Condom Promotion strategy Condom promotion encompasses a set of interventions to promote the adoption of policies and strateges aiming at increasingthe acceptability,availabilityand use of condoms.Condom Promotion is basically done by targeting the user group. Condom promotion is a key HIVIAIDS strategybecause: The consistent and correct use of condoms significantly reduces the risk of HIV and other STIs; Condoms offer simultaneousprotection against unwanted pregnancy and the possible transmission of STIsIHIV. 4.4.2 Orissa State Roadproject Needs Sensitizepeople for using condomsas the best preventive step against HIV and STD. Convince the clients and the commercial sex workers, about the importance of use of condomsas a means for preventingthe HIV transmission. Make available low cost and good quality condoms to the people all over the country easily at the time and place when they need it. To inculcate better understanding, overall strategy is presented through the following vicious cycle: Consultancy Service for Feasibility Study and Detailed Roject Preparation for Proposed Orissa State Road Project ConsultingEngineers Group Ltd., Jaipur Strategyand Action Plan for Prevention of HIVIAIDS Transmission Figure 4.2 Condom Distributions& Procurement bm Utilisation Promotion (High Risk \ w Population) (Emphasison Effective Channel) 4.4.3 Objective of Condom Promotion The objective of the condom promotion is to ensure easy access to good quality, affordable and acceptable condoms to promote the safe sex encounters. Condom promotion will be strengthenedby : (i)Condoms are available and affordable to high-risk, including rural population. Train NGO personnel in interpersonal communication and distribution slulls, product knowledge,and HIVIAIDS knowledge. Establish condom distribution network to cover high-risk areas and rural areas in all 14districtsof OSRP coverage. Develop partnership with non-partner NGOs to expand condom social marketing base in rural areas. (ii) Sustainablesystem for supply of condomsfunctioning. Establish and maintain cost-effective social marketing operations, including premises, staff, systems for procurement, sales and distribution, promotion, finance and administration. Engage commercial condom marketers, social marketing organisations and NGOs in discussionsto coordinate condom promotion and distribution. (iii) Condom acceptability increased. Identify the key determinants of condom use and acceptability among target populationthrough research. Develop key BCC messages based on the identified key determinants. Develop and implement a mix of communication activities to promote the key messages. Monitor the impact of communication activitiesand fine-tune accordingly. 4.4.4 The Free Condom Strategy: The Govt Health Deptt and all the local Health Service Centres provide the Free Condom to the Community. ConsultancyService for FeasibilityStudy and Detailed Project Preparation for Proposed Orissa State Road Project Consulting Engineers GroupLtd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission These Condoms are specific brand (NIRODH) and fiee of cost and easily available to the user on requisition. Some of the NGOs and CBOs provide the Free Brand (Nirodh) during Awareness Camps / As per NACO guidelines, the condoms are to be made freely available to the Core Group like Female Sex Workers (FSW), Injecting Drug Users (IDU) and Men having Sex with Men (MSM). 4.5 Linking Prevention and Control of HIVIAIDS Program with Other Social Management Activities As part of resettlement strategy; places of high traffic density, location of ensured community participation and adrmnistrative support will be selected for development of truck parks as a resettlement site for relocation of project displaced business communities. The site will be equipped with all kind of facilities like motor mechanic shops, chemist shop, general store condom vending machines etc.. The site will act as centre of information dissemination. I-E- C and BCC strategy. Every HIVIAIDS campaign will take-off fiom this centre. The site will also be centre of awareness of the project by package level NGOs. There will be a HIVIAIDS kiosk for information regarding HIVIAIDS, ensured periodic availability of doctor and medicine 4.6 Care and Support Strategy When a person gets exposed to HIV, society does not accept the infected persons in normal circumstances. AIDS orphan' are the most sufferer. People who are infected with HIV require social and psychological support fiom the society and fiom their family members. The date on which this HIVIAIDS awareness campaign will start and the date it will finish it is expected that all HIV infected2people will get treatment and ignorance and negligence will no more be as stringent as at it is now. Therefore the strategy will aim at to achieve care and support services to cent-percentHIV infected people and especiallyto AIDS orphan Making ART drugs available to all infected people is itself a challenge. It requires a well planned realistic strategy that will effectively implement and sustain programs to access to ART all those who are eligible involving several partners like SACS, DFID, -- ' In Kendarpara parents infected with HIVIAIDS died recently and their 3 years child also HIV infected is denounced by their near relative is now under care and support of local NGO. In Berhampur,an AIDS infected mother aIlowed to admit her child only after interventionof NGO working for HIVIAIDS in the city. 2 WHO 3m of 5m HIVIAIDS treatment and ART to all by 2010. Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission UNAIDS.OSACS will provide ART to implementing NGOs. There is need to develop communig care home for AIDS orphan. + Secure commitment from SACS for ensuring availabilityof ART + Strengthenand internalize implementingNGOs capacity for partnership development. + Ensure uninterrupted supply of ART through internal financing + Ensure treatment adherencethrough partnership development including (PLWHA) for de-stigmatizingpeople. + Care and support to AIDS orphan + Adequate financial support 4.7 Strategy for Sustainability of Program Implementation framework of OSRP phase-I envisages a time bound road improvement program in which prevention of HIVIAIDS transmission is a social responsibility of the project. After the completion of construction activities HIVIAIDS program should continue as it was during constructionperiod. Activities for proposed program to continue in future: + Secure commitment from SACS for ensuring sustainabilityof program. + Strengthen, internalize and train out reach worker (ORWsIother resident workers) (para medical officer) as peer educatorsto continuethe program. + Toll plaza should be given responsibility of partnership development with ORWs (paramedicalofficers,Out reach worker) and road safety awarenessraisers. + Road safety awareness raisers and paramedical officers should have close coordinationand linkages. + Emergency van of highways should also be act as information centre and equipped with semi-medical facilities and act as luosks + Kiosks and some support should be gven to paramedical officers, outreach workers(0RWs) within the communities + Socially active people (representativesPR1) of society, Nehru Yuva Kendra, Bajrang Dal and other volunteer organization etc should be given education, training, and incentives for sustainability of programs time to time to time to time. This budget should be indicated in toll collection and road safety management. + OSRP Phase I1 & I11 should link road safety and prevention of HIVIAIDS program together to have target specific social goals of the project. + Recommendation of M&E consultant4should be grounded at the earliest. + Linlung the program with mission shakti to get government patronage + Linlung program with Families and child welfare Department + Identification of Village people who can be directly interact with package manager in operation stage and can act as peer educator in operation stage. 'Community care home will be part of IPDP, for that detail discussion with OSACS, community and local institutional partners is in progress One of the objective of M&E consultant is to suggest corrective measures of ongoing HIVIAIDS programme and ways and means of sustainable management of the prevention and control of HIVIAIDS programme. Consultancy Service for Feasibility Study and Detailed 4-9 Project Preparation for Proposed Orissa State Road Project Chapter - 5 ACTION PLAN FOR THEPREVENTION OFHIV/AIDS Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission CHAPTER 5 ACTION PLAN FOR THE PREVENTION OF HIVIAIDS 5.1 Introduction Based on strategy discussed in previous chapter an Action Plan is formulated in the following section. The Action Plan discusses framework of partnership development, training to awareness raisers, distribution of I-E-C materials and approaches towards BCC. Partnership development and capacity building exercise will be done at Headquarter (PIU) level and awarenesscampaign at package level. 5.2 Partnership Developments and Capacity Building One of the basic requirements of this plan to be successful is to assess capacity of the Works Department,and enhance institutionalcapacityby strengtheningit through skilled manpower, resources such as, fund flow, I-E-C materials, training and networking. Partnership development could be the most important tool to strengthenOWD implementationcapability. In this regard following activitiesis required. 5.3 NGO Partnership Development Project Coordinating Unit PCU, ( O W ) being an engineers institution, lacks enough manpower,skilled persons/resourcepersons for effective communicationand implementation of HIV Action Plan. This HIV Action Plan implementation is time bound and goal oriented activities. Therefore, NGOs partnership development is required for the prevention and control of HIVIAIDS transmission. Since other social management and safeguardinstruments are also being prepared and will be implemented simultaneously NGOs partnership will be collectiveto enable OWD implement critical activities ,buffer activities of parallel SSIs such as information dissemination, awareness etc to ensure community participation. This will reduce cost on the implementation. However, having understood quantum of the work involved and length and breadth of coverage of the project, two tier implementation strategies is formulated. NGOs services will be hired at State level and at package level. State level NGOs (nodal) will be providing consultingservicesto PIU at headquarter level. Pnme task of the nodal NGO will be institutional strengthening, training to awareness risers and coordination with SACS, DFID, UNAIDS etc. Package level NGOs will be hired for each package to ground Action Plan in realities. Roles and responsibilities of NGOs have been outlined in annexure. 5.4 Partnering with Other Institutions Prevention and control of HIVIAIDS transmission has become one of the most important agenda of Government through NACO, SACS. Thls is also prime concern of several international agencies such as WHO, UNAIDS, DFID etc. Few international hnding agencies, NGO etc have also realized threats associated with the AIDS pandemic. These agencies easily come forward to join hands with local partners to combat the threat to the society. In this regard OWD has been in constant touch with SACS and seek help in implementation arrangement. Interdepartmental Memorandum of Understanding (MoU) will be signed in this regard. Social Development Advisor along with nodal NGO will work for partnership development with these multilateral organizations. This organization will assist Social Management Unit (SMU), PCU in formulating Campaign Delivery Method, Campaign Implementationplan, Training to awareness raiser, availability of I-E-C materials and transformationbrought in epidemiology,symptoms and treatment methodology etc. Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission 5.5 HIV I AIDS Capacity Building Training Capacity Building i.n the context of HIVIAIDS prevention in road improvement comprises following set of activities. To have an active cadre of health educators consisting of motivated volunteers from the trucking community, migrant laborers and Sex workers or the persons linked to the occupation of target populations. They will effectively reach these target populations with correct and complete information and provide counseling on HIVIAIDS and other sexual and reproductive health issues to ensure responsible sexual behavior. They may be peer educators also. Following objective is assigned for capacity building. Peer educators: School Teachers, PHC nurses, Truckers, Pimps, CSW, Dhaba Workers(Truckersfavorite boys, Old Dhaba Owners). Key Capacity Building: Technical Capacity Building, Counseling and Communication Technique, Way of teaching about correct use of condoms etc Providers: SACS, DFID,UNAIDS SIMSU(PCU, Works Department),Local Social Organization Activities planned for capacity building and providing enabling environment are as follow. Various modules of training for capacity building of the institutional actors at various levels have been proposed. Trainings will be impartedby SACS Table 5.1:Capacity Building and Enabling Environment S1.No. Capacity Building Enabling Environment(Advocacy) 1 Needs Assessment workshop Advocacy workshop with the Police 2 Proposal writing workshop Advocacy workshop with the Media 3 Induction Training for project Advocacy with the Civil Societies & Opinion staff nos Leaders 4 Induction Training for Peer Advocacy with Religous leaders/ Groups Educators 5 Training on Syndromic Mgmt. Advocacy with Hoteliers / Dhaba Owners To TI doctors + Nurses 6 Refresher training for Project Advocacy with Labour contractors at Staff construction camps 7 Refreshertraining for ORWs Advocacy with Beauty / Massage parlours 8 Refresher training for Peer Advocacy with PLWHA networks Educators 9 Advocacy with district administration 10 Advocacy with Works Department officials 11 Advocacy with SupervisionConsultant 12 Advocacy with Deptt. of Health & FW 13 Advocacy with Petrol Pump owners associations 14 Advocacy with the PRI members 15 Advocacy with Tourism & Transport Deptt. Consultancy Sewice for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project Consultinn Enmneers Group Ltd., Jai~ur Stratem and Action Plan for Revention of HIVIAIDS Transmission 5.6 Quantity of I-E-C Materials for Display and Distribution Awareness creation by distributing I-E-C materials will be adopted for Targeted Intervention (TI) locations. These locations are communities along the road,hospitals schools along the project areas. major junctions, truck parks, toll plaza, construction workers camps etc. The content could be massage about prevention strategy, threat of HIV/AIDS, correct use of condoms. Targeted ~ntervention'(TI) location will be road side communities, truck parks, brothel, and construction camps. Specific intervention plan will target Truck Park, constructioncamps and brothel along the project comdor. Following tables outline number of TI location along the project comdor. Table 5.2: Number of TI Location Road Section * Construction package Ito 5 is in year one road Above mentioned locations will be TI locations for I-E-C, BCC and condom promotion. Following activities will be done at the above-mentionedlocation. Details have been mentioned in chapter 3. Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project 5-3 Consulting Engineers Grouv Ltd.,Jaivur Strategy and Action Plan for Prevention of HIVIAIDS Transmission *As mentioned in chapter 3 there are 329 communities,l2 truck parks,l2 construction camps and 25 identified formal as well as informal brothel.Theseare TI Consultancy Service for Feasibility Study and Detailed ProjectPreparationfor Proposed Orissa State Road Project Consulting Engineers Group Ltd., Jaipur Strategyand Action Plan for Prevention of HIVIAIDS Transmission Framework of HIVIAction Plan Implementation (A Methodology for Campaign Delivery) The Methodologies of Action plan is shown in Table 5.4. The table addresses task wise and sub task wise activitiesto be performed and the beneficiaries of the project. This is prepared as per the requirement of TORand addresses all aspects. Detailed activity has been given in annexure 5.1. Table 5.4: CampaignDelivery Method Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project 5-5 Consulting EngineersGroup Ltd., Jaipur Strategy and Action Plan for Preventionof HIVIAIDS Transmission The above mentionedactivities are indicative in nature. Detailed campaign implementation will be finalizedwhen the partneringNGO operationallizethis plan. Fig below provides a flow chart showing steps to be followed during implementation. -- - 'Note: Approximately 100 persons assumedto be benefited at a single time. Consultancy Service for FeasibilityStudy and Detailed Project Preparationfor ProposedOrissa State Road Project Consulting Engineers Group Ltd., Jaipur Sbategy and Action Plan for Revention of HIVIAIDSTransmission ~~~~~~~~~~~~ I PREPARA~ONOF DETAILED FRAMEWORK.QF HlVlAlDS ACTION PLAN ";; .. Stakeholders Implementation Plan (CIP) DELIVERTRAININGTO AWARENESS RAISERS 3 Training Awareness Trainees Raisers Traineesto betrained DELIVERINGHNIAIDS AWARENESS CAMPAIGN -, Control Testing Consultation1 Measures Centers Campaign Materials I CAMPAIGN MONITORING, EVALUATIONAND COORDlNATION I I El Creating Suggestions M&E System Evaluation Figure 5.1: Concept and Tasks for Preparation of Awareness Campaign 5.7 Action Plan for Care and Support This initiative will ensure access to ART for all people who are at risk of exclusion due to social and economic barrier. Following action will be initiated by package level NGOs ConsultancyService for FeasibilityStudy and Detailed ProjectPreparationfor Proposed Orissa State Road Project Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission Identify people who are infected with HIVIAIDS within a Corridor of 1 km along the project route Identify AIDS orphan along the project route To find out status of HIV infection Ensure Availability of ART. Coordinatewith OSACS for further medical facilitiesin the vicinity of the area EnsureAIDS orphanhas received social care and psychologicalsupport Based on stages of HIVIAIDS infection suggestedtreatment could be as follow. Highly Active Anti Retroviral ~reatment~(HART) Preventivetreatment to avoid opportunisticinfection Treatment for HIV related illness Healthy living practices. However in present project, care and prevention strategy depends on initiatives of OSACS and other institutional partners. These institutional partners make HAART and other drugs available directly to HIVIAIDS patients. The care and support strategy also include construction of community care centers. These centers will be finalized in consultation with OSACS. For this purpose partnership with OSACS, Department of Family and Health, and Chief Minister Office could be initiated by PW. 5.8 Fund Availabilityand Location of Community Care Home This has been learnt during consultationthat OSRP is a dream project for Orissa. During the consultation with OSACS it is inferred that assistance fiom Chief Minister Fund could be possible for community care home. OSACS could also contribute in this planning. OWD with the help of partnering NGO will take up initiative for construction of community care home at least one and OSACS will be partnering in management of community care home. Berhampur will be the location for the community care home. (Requirement and management of care home is appended). Detail activities will be finalized after formal agreement between OSACS and OSRP. HAART is combination NRTI, NNRTI, protease inhibitors, entry inhibitors of dugs and suitability depends nature of infection vis-vis combination of drugs. Consultancy Service for Feasibility Study and Detailed 5-8 Project Preparation for Proposed Orissa State Road Project Chapter- 6 INSTITUTIONAL ARRANGEMENT Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDSTransmission CHAPTER 6 INSTITUTIONAL ARRANGEMENT 6.1 Institutional Framework Organization for planning and implementation of Action Plan for prevention of HNIAIDS transmission is utmost important because Works Department is mainly an engnnering organization and lack expertise in social issues especially HIVIAIDS. Timely establishment and involvement of appropriate institutions will significantly facilitate achievement of objectives of the HIV action plan. Present document in hand has envisaged an in-built institutional framework for the implementation of HIV action Plan. The main institutions, which are likely to wok, will include: . Works Department at differentlevel; . Social Management Unit (SMU) .. NGO (Non Governmental Organization); OSACS and other partnering Institution . Local CBOs and Panchayati Raj Institutions; . District Administration and other partnering institutions. Detailed implementation framework has already been mentioned in Resettlement Action Plan. Followingsection identifies role of partnering institutionsin implementation. 6.2 PartneringInstitutions OSACS with its Project Support Unit (PSU) would be the Nodal agency for monitoring and providing technical assistance. OSACS would identify and liaison with other important institutional stakeholdersto participate in the OSRP implementation plan. For this purpose, Works Department and OSACS would be worlung closely. Social Management Specialist (SMU) would be the coordinating officer and would lisaon with OSACS. Responsibilities of OSACS and other partnering institutionswill be : . Framework for advocacy and training module t.. Need Assessment Workshop Assist in preparationand development of I-E-C . Trainingto Stakeholders. Documentation of and Development of BCC strategyand Capacitybuilding Research . Production of Annual Report . . Strengtheningof NGO partnershipforum Ensure sustainability of program by linking OSRP HIVIAIDS program with ongoing OSACS program. (Fig6.1). Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission Fig 6.1 Institutional Arrangement Display I Development Distribution of 1.E.C Material + Capacity Building SACS, DFID, Oxfame, UNAIDS v- BCC TI Location, Brothel, Truck Park, Roadside Training to Awareness raiserspackage level - I-E-C Community1 NGOs.ORWs Implementing Treatment Care and Support NGOs of State Referral Medical Treatment Availability of HAART Drugs Orphan Preventive Treatment to avoid opportunistic infection Evaluation/Sustainable programme - Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project Chapter- 7 IMPLEMENTATIONSCHEDULE Consulting Engineers Group Ltd., Jaipur Shategy and Action Plan for Revention of HIVIAIDS Transmission CHAPTER 7 IMPLEMENTATION SCHEDULE 7.1 Implementation Schedule The implementation framework envisages two tier implementation arrangements. Implementation of HIV action plan emphasizes training and capacity building as important component, which will be done mostly at Headquarter level. Advocacy and enabling environment is another important component and will be done at District Headquarter level. However implementation of awareness campaign would be done in TI locations along the project road. For this purpose parhering NGOs has to play important role. Details implementationscheduleis mentioned Fig 7.1. 7.2 Implementation Mechanism Social Management Unit (SMU), PIU will be responsible for successful and timely completion of each activities as mentioned in fig 7.1. Completion of many activities such as advocacy with construction workers, supervision consultant or OWD local staffs would depend upon construction schedule. Time frame work of implementation suggests three years period for project implementation in each contract package. The campaign can be extended at least up to the completion of construction works or start of OSRP phase I1whichever is earlier to ensure sustainabilityof awarenessprogram. 7.3 Schedules for Project Implementation The period for awareness campaign is of 36 months. However, monitoring and evaluation will continuebeyond the period of implementationwith the help from OSACS. Consultancy Service for FeasibilityStudy and Detailed Roject Reparation for Roposed Orissa State Road Roject 7-1 Chapter - 8 COSTAND BUDGET Consulting Engineers Group Ltd., Jaipur Sbategy and Action Plan for Prevention of HIVIAIDS Transmission CHAPTER 8 COST AND BUDGET 8.1 Introduction A consolidated overview of the budget is provided and the cost estimates given below shall be viewed accordingly. The cost has been prepared in close coordination with OSACS, Orissa. The budget is indicative of outlays for the different expenditurecategoriesand is calculated at the 2005-2006 price indexes. The plan outlays for three years are given. Budget for year 2 and Year 3 would have additional provision of inflation. This budget would be entirely financedfiom the Road Improvement Component. 8.2 Summaryof the Cost The cost of HIV action plan is divided in capacity Building and Training, Development and Distribution of I-E-CTSCC materials. Implementation of HIVIAIDS action Plan would be in concurrencewith other social management plans. Details of breakup are given below. Table 8.1 Summary of the Cost Consultancy Service for Feasibility Study and Detailed 8-1 Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission Table 8.2 Budget for Development of Training Materials Amount Type of Training material Content of the material Type' Rate Quantity No. Design tkcs.) 1.0 Development of Modules Training Material for Project Staff Self learning Capacity building tool for the PM, 1 70 500 35000 in 0riya Counsellor, Accountant Training Material for Field staff in Self learning Capacity building & practical tool for the 1 70 500 35000 0riya PEs 1.3 OSRP newsletter Field level programme documentation initiative 12 10 900 108000 1.4 Strategy document on BCC Self learning Intervention tool on BCC related to TIs 1 60 450 27000 Strategy document on Condom Self learning intervention tool on condom promotion 1 60 450 27000 promotion related to TIs Strategy document on Advocacy & Self learning intervention tool on Advocacy related to 1 60 450 27000 Networking Tls Hiring of Consultant for 5000 '7 1 24 1200000 development of materials 0 NGO Intervention Operational " Programmatic & Financial guidelines 1 50 100 5000 guidelines MIS partner recording & reporting 3000 1.9 1 12 360000 system 0 Sub Total - 1824000 Consultancy Service for Feas~bilityStudy and Detailed Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission Table 8.3: Year wise Budget for Capacity Building 1Training Nos. of Level at Nos. of days Nos. of which Type of Training YEAR- I YEAR I1- YEAR 111 - participants per Training training to be training imparted CAPACITY BUILDING FOR Nos Budget Nos Budget Nos Budget Nos Budget State Region TI PARTNERS Needs Assessment 27 2 3 1 50000 1 50000 1 50000 3 150000 3 workshop1(9 TIs) Proposal writing 27 2 3 1 50000 1 50000 1 50000 3 150000 3 workshop (9 Tls) Induction Training for project staff (4 36 2 3 1 50000 1 50000 1 50000 3 150000 3 staff per NGO per 100 kms) 9 nos. - Induction Training 72 3 6 2 100000 2 100000 2 100000 6 300000 3 for ORWs Induction Training 72 3 6 2 100000 2 100000 2 100000 6 300000 3 for Peer Educators Training on Syndromic Mgmt. To TI doctors + OSACS shall provide training 0 0 Nurses Refresher training for Project Staff (4 36 2 3 1 50000 1 50000 1 50000 3 150000 3 staff per NGO per 100 kms) 9 nos. - ' There will be 9 NGOs in 900 km. Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd.,Jaipur Strategy and Action Plan for Prevention of HIVlAIDS Transmission 8 ORWs would be selected by NGOs for training in 100 km stretch. They would be trained to continue the programme in post implementation period. 'Non-partners are other OWD staffs not involved in implementation such as staffs of rural road, NH division. They may get posting in OSRP in later part of implementation. There are 14 Districts in proposed project road. Advocacy would be done in each Districts Training module for 30 person have been considered as per OSACS training modules norms.. Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd., Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission Advocacy workshop with the 420 1 14 14 420000 14 420000 14 420000 42 1260000 1 41 Media Advocacy with the Civil Societies & 420 1 14 14 420000 14 420000 14 420000 42 1260000 1 41 Opinion Leaders Advocacy with Auto Rickshaw & 420 1 14 14 420000 14 420000 14 420000 42 1260000 1 41 Tyre repairing shops Advocacy with Hoteliers I Dhaba 840 1 28 28 840000 28 840000 28 840000 84 2520000 1 41 Owners Advocacy with Trucker 840 1 28 28 840000 28 840000 28 840000 84 2520000 1 41 ~ssociations~ Advocacy with Labour contractors 840 1 28 28 840000 28 840000 28 840000 84 2520000 1 41 at construction camps Advocacy with Beauty I Massage 420 1 14 14 420000 14 420000 14 420000 42 1260000 1 41 parlours Advocacy with district 420 1 14 14 420000 14 420000 14 420000 42 1260000 1 41 administration Advocacy with Works Department 420 1 14 14 420000 14 420000 14 420000 42 1260000 1 41 officials Advocacy with directly associated groups such as trucker, Dhaba owners has been intensified. Consultancy Service for Feasibility Study and Detailed Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd.,Jaipur Strategy and Action Plan for Prevention of HIVIAIDS Transmission Table 8.4 Budget for Development of BCC Materials Sl. Type of IEC I BCC Content of the YEAR- YEAR- Rate Quantity YEAR-I TOTAL No. material material Design II 111 1 2 3 4 5 6 7 9 10 11 Development of IEC/BCC materials Flip bookFlash Generic 3 100 500 each 150000 150000 300000 1.1 Card/Flex for Field Thematic 3 100 500 each 150000 300000 staff (FSWIIDUIMSM) 150000 Kit bag for Peer For carrying BCCIIEC 1 50 800 40000 40000 Educators & Field staff materials 1.3 Booklet of FAQ For PEs & ORWs 1 50 500 25000 25000 50000 Mobile Exhibition kits '4 For Group sessions 1 2000 500 1000000 1000000 @ Rs. 20001- BCC Strategy & State level strategy for 1.5 Capacity Building 1 300000 1 300000 300000 Core & non-core groups Research for OSRP Webpage maintenance Periodic updating & 1.6 1 50000 1 50000 50000 50000 150000 maintenance Condom Vending Multipurpose vending 1 16000 100 1600000 1600000 Machines machines Documentation of Case Field report of TI " 4 100 100 40000 40000 40000 120000 StudieslBest practices partners HIVIAIDS Kiosks For sustainability of the 1.9 1500 450 675000 675000 675000 2025000 programme Production of Annual Programmatic & Report financial outlay & 1.10 1 1000 50 50000 50000 50000 150000 achievements for one year - Consultancy Service for Feasibility Study and Detailed 8-7 Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd., Jaipur Strategyand Action Plan for Prevention of HIVIAIDS Transmission BCC & IEC materials designing through reputed advertising Sub - Total 5665000 2320000 2595000 10580000 Pre-testing of the Design development & 2 materials at the field pre-test of the prototype 25000 25000 129750 179750 level material Hiring of an Consultant for design & 60000 12 720000 720000 720000 2160000 development of the above materials GRAND TOTAL 6410000 3065000 3444750 12919750 The above-mentioned activities and budget are in concurrence with the overall OSACS activities. - Consultancy Service for Feasibility Study and DetaiIed Project Preparation for Proposed Orissa State Road Project Consulting Engineers Group Ltd.. 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