Pathfinder International Mukta Project

Pathfinder International:

Pathfinder International is a non-profit international and non-governmental organization established in 1957. Pathfinder seeks to improve information and access to quality reproductive health services in 26 countries throughout Asia, Africa and Latin America. Pathfinder is headquartered in Boston, USA and has locally staffed field offices in all the regions where they have programmes. Pathfinder works among groups that are vulnerable, marginalized, hard to reach and has brought out qualitative and sustainable behaviour change amongst them. Pathfinder International is one of the pioneers to successfully integrate HIV/AIDS programs into existing reproductive health and family planning programmes, as well as a pioneer in community home based care and adolescent sexual and reproductive health around the world.

The India Programme:

Pathfinder’s current projects are located in the urban slums and rural areas of 5 Indian states. Project interventions include adolescent reproductive and sexual health, family planning, safe abortion and prevention of STI / HIV / AIDS. Pathfinder supports over 40 partner NGOs to carry out these interventions at the community level. Pathfinder also supports over 14 NGOs/ medical institutions that are engaged in training field level workers and practitioners at the primary health care level.

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Mukta:

Pathfinder is implementing a targeted intervention for groups at risk project, known locally as Mukta, in 11 high prevalence districts of Maharashtra. The districts are: Ahmednagar, Beed, Jalgaon, Kolhapur, Latur, Nandurbar, Nashik, Parbhani, Pune, Raigarh and Yavatmal.

• The goal of the Mukta project is:
  
  To reduce STI prevalence among sex workers and MSM, and thereby control the spread of HIV amongst sex workers, MSM, their clients, and partners.
  
  
• The Objectives of the project are to:
  
  
  • Build an enabling environment through empowering communities at risk so that their vulnerability is reduced.
  • Increase access to condoms at intervention sites
  • Increase condom use with non-paying/regular partners and increase/maintain the current levels of high condom use with paying partners.
  • Improve access to STI services for sex workers and MSM.
  • Increase the utilization of STI/HIV/AIDS related services by sex workers, MSM and their partners in project intervention sites.
  
  
• The project seeks to achieve the following outcomes:
  
  
  • Decreased ulcerative and non-ulcerative STI prevalence rates among sex workers and other vulnerable groups
  • including regular STI screening, among all typologies of sex workers and other vulnerable groups, e.g. MSM.
  • Increased consistent condom use among sex workers and MSM with both paying and non-paying partners.
  • Improved enabling environments for risk reduction, behaviour change and the protection of human rights for vulnerable groups, especially sex workers and MSM.
  
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• The Vision of the Mukta project:
  
  Pathfinder International seeks to empower sex workers and MSMs to make informed choices and adopt behaviors that will reduce their vulnerability to STI/HIV/AIDS thus enabling them to improve and gain greater control over their lives.”

Mukta will achieve these objectives through a combination of clinic and community-based STI diagnosis and treatment, HIV education and prevention and behaviour change programs.

A network of static and satellite clinics will be established or upgraded in brothel and non-brothel based areas in Maharashtra and the project will train, supervise, and support facilities upgrades for existing preferred providers working with vulnerable groups in the 10 districts. Clinic based activities are complemented by community-based outreach activities with sex workers, clients of sex workers, MSMs, police, and madams.

Outreach activities include interpersonal communication through peer educators, group activities, and mobilization through outreach workers identified and trained by implementing NGOs using Community Led Structural Initiatives (CLSI).

The project also seeks to create enabling environments for behaviour change to occur, as well as creating and building the capacity of associations of sex workers and MSMs to advocate for their rights and demand quality health and social services.

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Current Status:

Currently the project is implemented through 14 NGO partners from various districts. They are:

• Ahmednagar – Snehalaya
• Beed – Gramin Vikas Mandal
• Jalgaon – Godavari Foundation
• Kolhapur – Muslim Samaj Prabodhan Va Shikshan Sanstha
• Latur – Sahayog Nirmitee
• Nandurbar – Shriram Ahirrao Memorial Trust
• Nashik –Pravara Medical Trust
• Parbhani –Socio-economic Development Trust
• Pune – John Paul Slum Development Project
• Pune – Vanchit Vikas
• Pune – Samabhavana Society
• Pune - Udaan
• Pune - Kayakalp
• Yavatmal – Gramin Samasya Mukti Trust

The focus of the Mukta Project is on interventions with Female Sex workers (Brothel based, Street Based, Lodge based, Slum based, Privately Operating), Tamasha Girls, Eunuchs and MSM.

The project is also implementing information and activities for auto drivers, industrial workers, military men, lodge boys, school children, college youth, slum dwellers etc.

Our partner NGOs provide a wide range of services through Mukta Clinics and Drop-In-Centers (DIC)

The package of services provided by the clinics include :

• A daily general out patient clinic where women and their children can report for all common ailments like URTI, fever, gastrointestinal diseases, skin infections and general debility
• Antenatal cases may be registered and managed and referred to the Government/nearby hospitals for delivery. Post-partum care and infant immunization will be provided
• Diagnosis and treatment of RTI/STI and urinary tract infections receive special emphasis. Counseling for STI, HIV, contraception, and for other issues related to sex workers is offered.
• Contraceptive services including clinical contraception such as IUD and DMPA will be offered to enable sex workers to avoid unwanted pregnancy. This is in addition to the promotion of condoms as a dual protection device
• Special stress is laid on diagnosis and management of HIV positive cases and treatment of opportunistic infections. The starting point is the non-judgmental, non-discriminatory attitude of clinic staff. Confidentiality is ensured. All drugs for any opportunistic infections are made available from locally purchased medicines.
• Every effort is made to provide holistic care. Nutritional advice is provided by clinic staff, including by the receptionist, social workers and doctors, so that HIV positive people can obtain the best possible diet within their limited resources. Information on hygiene and sanitation is also provided including education on proper disposal of waste such as condoms and sanitary pads.
• The clinic establishes referral linkages with Government and private hospitals, practitioners, and other agencies and refer patients for a variety of health as well as non-health issues including for the management of complicated STI cases, to support groups and networks of positive people, to centers offering anti-retroviral therapy (ARV therapy), for VCTC, and for services for their children, and for services for rehabilitation- should they be desired.

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Services offered at the DICs include:

• Space for the community to group, network and plan for development
• A venue for orienting the community, peer educators and sex workers about different health / developmental topics
• Venue for advisory / advocacy members/ project staff to meet at periodic intervals to review project activities.
• Venue for offering a range of discounted health and beauty products to attract women to the center
• A venue for special health camps
• A venue for in-house events organized by/for the community during special days