Professional Documents
Culture Documents
2014 - 2015
INDEX
INTRODUCTION OF SNBS
Page No. 2 to 2
AGAR URBAN HEALTH PROGRAMME (AUHP)
Page No. 3 to 6
NATIONAL CHILD LABOUR PROGRAMME
Page No.7 to 9
TARGETTED INTERVENTION
Page No.10 to 27
POINT OF USE (POU) SERVRY
Page No.28 to 28
- 4830
Slum Data :
S.No.
Link
Workers
Name
Suman
lata
Slums
Name
2.
Pushpa
Deavi
3.
4.
1.
Total
population
covered
4242
House
Holds
No.
549
Total
families
covered
740
Total
pregnant
women
60
Total 0-1 yr
children
Ram
Nagar
4079
572
767
85
93
Bharti
Nagla
Ber
2893
393
460
34
48
Manju
Nagla
Ber
1937
349
369
51
86
Total
13151
1863
2336
230
298
Ram
Nagar
71
Discussion during review meeting by Mr. Ravi Kashyap,President,SNBS and Mrs. Khushbu Gupta ,PM, SNBS
Community Meetings
We have organized 10 community meetings in the intervention area during the quarter. We discussed
MCHN and WATSAN issues with the community women. We discussed about new born care and
Care during pregnancy and ANC, PNC and INC. MCHN and WATSAN issues with the community
women.
We discussed about new born care and Care during pregnancy and ANC, PNC and INC.
Extra meal during pregnancy.
Problem related to water and sanitation was discussed in the meetings.
Vaccination
We have organized Vaccination sessions in every month with supported from Deptt. of Health and
Family welfare, Agra. The details of the vaccination is as below:
Name of
the slum
Name of
LW
TT
TT
II
ANC
I
ANC
II
BCG
DPT-I
DPT-II
DPT-III
Hpt
Hpt
Hpt
Measles
Ramnagar
Suman lata
49
41
56
45
52
36
23
12
Ramnagar
Pushpa Devi
49
22
20
14
44
20
Nagla Ber
Bharti
18
12
20
13
13
10
Nagla Ber
Manju
30
24
22
15
57
53
40
31
18
Total
146
99
107
79
173
122
85
62
39
GOAL
Reduction In prevalence of HIV/AIDS infection in destination migrants in Kanpur.
OBJECTIVES
Reduction in HIV/AIDS prevalence in 10000 destination migrants in Kanpur.
HIV/AIDS
Human immunodeficiency virus infection
&
Acquired immune deficiency
(HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus
(HIV). Following initial infection, a person may experience a brief period of influenza-like illness.
This is typically followed by a prolonged period without symptoms. As the infection progresses, it
interferes more and more with the immune system, making the person much more susceptible to
common infections like tuberculosis, as well as opportunistic infections and tumors that do not usually
affect people who have working immune systems. The late symptoms of the infection are referred to
as AIDS. This stage is often complicated by an infection of the lung known as pneumocystis
pneumonia, severe weight loss, a type of cancer known as Kaposi's sarcoma, or other AIDS-defining
conditions.
10
HIV is transmitted primarily via unprotected sexual intercourse (including anal and oral sex),
contaminated blood transfusions, hypodermic needles, and from mother to child during pregnancy,
delivery, or breastfeeding. Some bodily fluids, such as saliva and tears, do not transmit HIV. Common
methods of prevention HIV/AIDS include encouraging safe sex, needle-exchange programs,
and treating those who are infected.There is no cure or vaccine; however, antiretroviral can slow the
course of the disease and may lead to a near-normal life expectancy. While antiretroviral treatment
reduces the risk of death and complications from the disease, these medications are expensive and
have side effects. Without treatment, the average survival time after infection with HIV is estimated to
be 9 to 11 years, depending on the HIV subtype. Since its discovery, AIDS has caused an estimated
36 million deaths worldwide (as of 2012). In 2013 it resulted in about 1.34 million deaths.
As of 2012, approximately 35.3 million people are living with HIV globally. HIV/AIDS is considered
a pandemica disease outbreak which is present over a large area and is actively spreading. Genetic
research indicates that HIV originated in west-central Africa during the late nineteenth or early
twentieth century. AIDS was first recognized by the United States Centers (CDC) in 1981 and its
causeHIV infectionwas identified in the early part of the decade.
HIV/AIDS has had a great impact on society, both as an illness and as a source of discrimination. The
disease also has significant economic impacts. There are many misconceptions about HIV/AIDS such
as the belief that it can be transmitted by casual non-sexual contact. The disease has become subject to
many controversies involving religion. It has attracted international medical and political attention as
well as large-scale funding since it was identified in the 1980s.
Social strategies
Social strategies do not require any drug or object to be effective, but rather require persons to change
their behavior in order to gain protection from HIV. Some social strategies which people consider
include the following.
Sex education
Needle-exchange Programs
Safe sex
Sexual abstinence
Immigration regulation
11
12
13
Other STDs or STIs you may get. Already having STDs and STIs puts you at a higher risk for
getting HIV. The infections weaken your immune system and make you more susceptible to
contracting HIV when you are exposed. This is why you should treat these problems, as well as
normal health problems like yeast infections, immediately if you suspect you may have them. You can
also get vaccinated against certain STD/Is like Help A and B, if you are at high risk.
Ever share needles or syringes. Needles and syringes can easily carry HIV from one person to
another. Never use recreational drugs which use needles and never use any needles not given to you by
your doctor. If you have problems with addiction to these drugs, get help for addiction and find out if
your area has a needle exchange program to help keep you and others safe.
Be circumcised. If you're male and having sex with women, circumcision can greatly lower your risk
of contracting HIV. Having sex with a circumcised male does not protect you if you are a woman,
however, and circumcision seems to offer no significant benefit in male-male sex. If you are not
already circumcised, you can get circumcised as an adult if you choose to.
React quickly if you believe you've become exposed. If you do expose yourself to HIV, seek medical
attention immediately. If treated within 72 hours (and the sooner the better), you may be able to
prevent the HIV infection from permanently settling down in your body through Post-Exposure
Prophylaxis (or PEP) treatment. PEP is not a 100% guarantee, with studies showing
the highest risk of failure with those treated 55 hours or more after exposure and males who received
penetrative anal sex.
Avoid contact with other people's blood and certain other bodily fluids. You never know who has
HIV, since there is no stereotype, and someone may not even know if he or she is infected, so the best
policy is to always be careful. Avoid touching other people's blood if at all possible and also avoid
contact with the other bodily fluids that can spread HIV. These fluids include.
Vaginal fluids
Breast milk
Amniotic fluid, cerebrospinal fluid, and synovial fluid (usually only exposed if you work
in
a medical field)
Get medical treatment if you become pregnant. If you become pregnant and you're worried that you
may have HIV, get tested and seek medical help immediately. It is possible to prevent the spread of
the infection to your child, but you'll need a doctor's help to do it.
14
Talk to your doctor. As always, if you have a medical problem or questions, you should ask a doctor!
If you don't have adoctor or medical insurance, most areas have free or low-cost clinic and many
government programs exist to help you find help. Research what's available in your area.
Working with Your PartnerGet tested often and together. Frequent testing can help both you and your sexual partner stay safe.
Protecting each other if you're at risk or in a new relationship is something that good sexual partners
do! Since some partners may lie about getting tested or what the results were, the safest bet is to get
tested together.
Always, always, always use protection. Only engage in unprotected sex if you are in a mutually
monogamous relationship in which both you and your partner are uninfected by HIV or any other
STD. This is the most important part of preventing HIV. Protected sex will go the furthest to protect
you and your partner if one of you is at risk or has contracted an HIV infection.
Of course, it's easy to say "just this one time" to skipping protection but all it takes is one time: be on
the safe side and insist on protection! Your options include:
Male condoms
Female condoms
Dental dams (can be used for female-female, male-female, and male-male sex!)
Use lube. Lube may not seem like it can prevent HIV but it can actually help a lot! When you're using
condoms, you put yourself at serious risk if the condom breaks. The best way to prevent condom
breakage is by reducing the stress on the condom...with lube! Always use water based lube, as other
lubes can degrade the latex of the condom and put you at risk.
Lube is especially important with anal sex, since it not only protects your body from tears but also
protects the condom, as anal sex is more stressful on condoms that vaginal sex.
15
WHY MIGRANTS?
Introduction:
Migration is the spatial mobility of people from one geographical area (place of origin / source) to
another (place of destination), with the intention of settling temporarily or permanently or semipermanently. There are a variety of reasons for migration - economic (livelihood, economic
imbalance, job opportunities etc.), environmental factors (drought), demographic reasons (family
migration, movement of young and retired persons) or political reasons (refugee movements etc.).
Some of these are factors related to origin (push factors) and others opportunities in the place of
destination (pull factors). Migration over long distances also involves temporary stops, also called
Transit points.
Migration is a highly complex human behavior, as old as human existence itself. There are many
typologies (and combinations of typologies), some of which are described below:
Rural vs Urban - Rural to Urban, Urban to Urban, Rural to Rural
Persons Single male, single female, Couples, Couples with children (sometimes some), whole
family
Location Inter-state, intra-state, inter- district, intra-district, international
Distance Long distance, Short distance
Length of stay Temporary (up to 3 months), semi-permanent (up to 6 months in a year, returning to
villages during rainy season) and permanent (only returning for key holidays)
In and out From the point of view of a geographical location, In-migration or Out migration or both
Others Step migration (transit itself become a place for short migration), relay migration (one
family member living in the destination and others taking turns to relieve, reverse migration (UrbanRural)
Mobility and Migration are two distinct concepts. Mobility is when a person moves from the place of
origin, travels / works and returns back to origin the same day or week (for example people who live
in Pune and work in Mumbai). On the other hand migration involves movement of those people who
establish residence at the destination place for a significant period of time.
In the 2001 census, using the change in residence concept, 30.1% of the population is considered to
have migrated (that is, 314 million of the total 1028 million persons), which shows a considerable
increase from 27.4% in 1991. In the case of males it increased from 14.7% in 1991 to 17.5% in 2001.
In the case of females, it increased from 41.6% in 1991 to 44.6% in 2001 (Population Council, 2008;
Population Council, 2009). The migration during 1991-2001 has increased rapidly.
The primary destinations for migrants (22% to Maharashtra, 7.8% to Andhra Pradesh, 7% to Gujarat
and 5% to Karnataka) are also the states with higher HIV prevalence (Varma and Saggurti et.al. 2007).
The migrant workers seeking employment in these destination locales are often from tribal and rural
communities with low technical knowledge and high rates of illiteracy, offering a cheap labour force
for urban settings (Patel, 2002). Male migrant workers including unskilled labourers, construction and
industrial workers, leaving behind their families and spouses at their native places dominate the
traditional rural to urban migration in India (Base et.al., 1987). Migration in India is predominantly
short distance, with around 60% of migrants changing their residence within the district of
enumeration and over 20% within the state of enumeration while the rest move across the state
boundaries (Srivastava and Sasikumar, 2003).
SNBS AGRA Progress Report, 2014 2015 (www.snbsindia.org)
16
Previous research on migration in India has shown that the migration is highly selective by age, sex
and education. Rapid urbanization coupled with poor housing facilities in city areas leads to migrant
labourers staying away from families.
Most migration literature makes a distinction between pull and push factors, which, however do not
operate in isolation of one another. Migration occurs when workers in source areas lack suitable
options for employment/livelihood, and there some expectation of improvement in circumstances
through migration (Srivastava and Sasikumar, 2003). The proportion migrating for economic reasons
is greater among long-distance migrants; most male migrants moving between states did so for
economic reasons.
Migrants vs. Informal workers:
Migration could include formal and informal workers, rural to urban, etc the typification are many.
Informal workers are unskilled labourers who work largely in unorganised sector, many times are
migrants from rural to urban/semi-urban areas in search of work. Thus informal workers include a
large section of migrant workers1.
Informal workers, many of whom are migrants, are hired on a daily or seasonal basis for short
stretches of time, working in low skill activities, not within the mainstream of the sectors, but in the
small and unorganised part of the sector. When they do work in formal settings, it is to address
fluctuations in production or in low skill activities which support the formal entities within the sector
(like allied activities, supply chains up or down stream) or in small and medium enterprises. Some of
the informal workers (like construction) work in cities which are growing due to industries but not
directly working in those industries.
17
A cross border study between Bangladesh and India has indicated a link between migration, mobility
and HIV vulnerability due to the presence of mobile and hidden sex trade along border area, reported
STDs and HIV positive cases among mobile people and the infection is significantly associated with
practicing sexual risk behaviour in the border region, trafficking and violence against migrant women
(Tajer et.al., 2004). An awareness study among patients attending STD clinics indicate a low levels
of knowledge about HIV and poor early treatment of STDs among the migrants (Changedia and
Gilada, 2000).
A number of studies in India further indicate that migration propels the HIV epidemic by creating
living conditions that heighten engagement in risky behaviours (e.g., husbands residing without wives
go to FSWs) and by providing a vehicle through which infection can move from high to low epidemic
regions (Singh, 2001; UNAIDS, 2006; Rego et.al., 2002; Decosas et.al., 1995). Studies document that
men living without wives, not being married or migration away from wives, are engaging in
transactional sex (Singh, 2003; Mishra, 2004; Gangakhedkaret.al., 2007). Additional research further
documents that certain migrant jobs, such as heavy load labour (mathadilabour) in port cities, which
provide higher wages are providing these men who do often reside without wives greater disposable
income with which to indulge in risky alcohol use and transactional sex (Kutikuppala, 1998; Saggurti
et al., 2008). While residence without wives and access to higher wages facilitates involvement with
risky alcohol use and sex for migrant workers, these risks are exacerbated by high density of alcohol
and transactional sex venues and locales within migrant male communities (Chakraborty, 2004).
Further, migrant men report that peer pressure and monotonous working and living conditions support
their involvement in these risky activities as a social norm within the migrant male workgroup
(Chakraborty, 2004). Simultaneously, HIV knowledge and risk perceptions are low in this population
(Chakraboty, 2004); illiteracy and lack of access to HIV and alcohol education in either their places of
origin, or destination, leave these men engaging in these behaviors
without recognition of their risks (Carlier, 1999; Mishra, 2002). These social, contextual and cognitive
factors come together to create high HIV/STI rates in this population and to support behaviours among
them that bridge these infections to new regions (Gupta et.al. 2002; Thappa et.al. 2002; Singh KK
et.al. 2004). These findings parallel that research from Population Council with male migrant workers,
showcasing the need for migrant male HIV interventions that addresses the groups and the individuals.
There are studies that have shown that informal workers are significantly at higher risk than general
population their knowledge levels are lower, two7 to four times more number of informal workers
have non-regular partners or visit sex workers, only 25-29 percent use condoms in these encounters
compared to 42 percent by others. 5 percent and 13 percent (M/F) report STI symptoms nearly
double the national average. In another study, 2/3rd of the locations where informal workers operate,
sex workers were also found to operate. Studies have also shown evidence that informal workers, are
at a higher risk than the general population, to acquire STIs or HIV. The countrys National Family
Health Survey (NFHS), which covered over 15,576 households, reiterates the vulnerabilities.
In another study in Mumbai8, operation of sex workers is reported in around 2/3rd of the construction
sites and women informal workers reported to work as part-time9 sex workers. A study carried out by
the (United Nations Development Fund for Women) UNIFEM among Railway workers states that
about 44 percent of the respondents had more than one sex partner in the preceding 12 months,
71percent of those who visited sex workers did not use condoms10. The Annual Sentinel Surveillance
reports spouses of truckers, unskilled workers and factory workers are amongst the top categories of
ANCs tested positive for HIV11
A study by Population Council12 examined the patterns of migration/mobility among male workers
and their links with HIV risk in four states that have a high HIV prevalence and found that contracted
male labourers are largely young (70 percent between 18 to 29 years) and over half were married, and
a third resided away from their wives because of work. 31 percent reported sex with either a sex
worker or non-spousal unpaid female partner in their places of origin over the past 2 years.
An interesting example is Ganjam (in Orissa state) which is a district where out-migration is
substantial to Surat (in Gujarat) which is a migration hub due to its textile and diamond polishing
industries. A local member of the Gujarat chapter of the Indian Network of People Living with HIV
(INP+), reports that as many as 70 new HIV-infected cases emerge every month in Surat. As was
SNBS AGRA Progress Report, 2014 2015 (www.snbsindia.org)
18
mentioned earlier, a large percentage of the migrants visit sex workers and have unprotected sex. The
returning migrants have been fuelling the epidemic in their home district of Ganjam, which has seen a
rapid increase in prevalence levels in the last few years, particularly amongst migrants.
The story of Ganjam is not unique there are several such districts where informal workers migrate
for survival and livelihood. Some within their district (rural-urban), some outside their district and
sometime outside their state (or even country).
Some of the other links which are emerging are:
Movement of sex workers between administrative borders Sexual behaviour pattern of Male
migrants, particularly Men who have sex with men and Injecting Drug Users Sexual exploitation of
migrant women at transit and destination and those left behind in source
Vulnerability of women:
Apart from the biological fact that women are more vulnerable to HIV, for women who are informal
workers, their vulnerabilities are related to their work situation (where sexual exploitation is reported).
Occasionally, some of the female informal workers also involved as part or full time sex work, many
times not using condoms. For women who are spouses of informal workers, they are vulnerable to
infections from their husbands (1/4th visit sex workers, 1/4th use condoms13). Sometimes they are
not travelling with their husbands and are in rural areas and are likely to acquire the infection from
their husband on their return. If they have other sexual relations, they are also likely to pass the
infection to others (as is evident in some of the rural high prevalence districts like Bagalkot).
The male migrants from the poorer parts of the country going in search of work to the more developed
parts are now well recognised to be carrying back the infection to their places of residence and
contributing to the emergence of hotspots in the low prevalent area. While under the national
programme, technical support is available to companies to scale-up interventions for formal workers,
it is now increasingly realized that reaching out to informal workers in the high priority areas that
requires much more focused effort and outreach, which goes beyond the formal settings.
An analysis of flow of migrants based on 2001 census data shows that, Uttar Pradesh, which
constitutes 41 percent of all out migrants, migration to Maharashtra accounts for 32 percent. Likewise,
out migrants from Orissa preferred Gujarat and Maharashtra as the destination even when these states
are not border states. Out-migration to these states made up to 34 percent of total out-migrants from
Orissa. From the flow matrix, Maharashtra, Gujarat and Haryana attract over 80 percent of all
interstate migrants during the intercensal period 1991-2001.
DISTRICT PROFILE (KANPUR)
Kanpur has urban population of 3015645 of total population 4581268.Out of the total Kanpur Nagar
population for 2011 census, 65.83 percent lives in urban regions of district. In total 3,015,645 people
lives in urban areas of which males are 1,622,546 and females are 1,393,099. Sex Ratio in urban
region of Kanpur Nagar district is 859 as per 2011 census data.Similarly child sex ratio in Kanpur
Nagar district was 865 in 2011 census. Child population (0-6) in urban region was 295,847 of which
males and females were 158,664 and 137,183. This child population figure of Kanpur Nagar district is
9.78 % of total urban population. Average literacy rate in Kanpur Nagar district as per census 2011 is
82.10 % of which males and females are 84.35 % and 79.47 % literates respectively. In actual number
SNBS AGRA Progress Report, 2014 2015 (www.snbsindia.org)
19
2,232,870 people are literate in urban region of which males and females are 1,234,812 and 998,058
respectively.
SNBS provides many services to migrants
We provides many services to migrants labour related to HIV/AIDS, DOTS, STI/RTI.
Clinic Services- In this year SNBS also provides clinic services to migrants. We provides clinic
services to 2177 migrants people during this year.
HIV Tested-In this year SNBS also done so many HIV Tested of migrants.
We done HIV Test of 1235 migrant in this year.
Where we also found FOUR positive results of HIV/AIDS.
HIV POSITIVE
Unnao
1
Jaipur
Kanpur
Dehaat
Health camp in slums- SNBS organize 10 Health Camp in different different areas in Kanpur. We
organize camp in industrial area and brick field.
In the Health Camp we provide free health facilities to each and every member of slum. In the Health
Camp we also get so much support of our Respected Doctor.
By the Health Camp we fulfilled our motive and also get a fruitful feedback.
20
NukkadNatak- SNBS organize different nukkadnatak in many slums areas So, that people will
understand that what is HIV/AIDS and how we can fight with HIV/AIDS. We organize 22
nukkadnatakin Kanpur.
Our main motive for nukkadnatak is Awareness for HIV/AIDS. And by this we achieve our motive
and we also achieve the happiness of people who lives in slums and not able to do some enjoyment
coz of lack of money and so many problems.
We also inspire people that the checkup of HIV/AIDS is also a very important task in our life. andwe
give free medical checkup facilities to our migrants.
The main motive of SNBS is to provide a pleasant life to migrants.
21
JAN
FEB
MAR
Nukkad
Natak
Health
Camp
NIL
Meeting with factorial managers-SNBS organize many types of meetings and discussed the topic of
HIV/AIDS. With the help of Peer and ORW we organize meeting with Factorial Manager and we give
our views and get views of other people. By this meeting we get to know that how we can stop
HIV/AIDS.
22
Celebrate World AIDA DAYWorld AIDA DAY is held on 1December each year and is an opportunity for people worldwide to
unite in the fight against HIV, show their support for people living with HIV and to commemorate
people who have died. World AIDS Day was the first ever global health day and the first one was held
in 1988.
SNBS organize a NUKKAD NATAK program in Galglahshetra where we also get the help from
Kanpur Mirja Group. We give awareness to migrants with the help of NUKKAD NATAK.
By our NUKKAD NATAK we also give happiness to the people who lives in slums as well as
awareness of HIV/AIDS.
We organize our programs in many areas and We covered many sites in Kanpur as well as we
covered many MigrantsCount of migrantsWe covered 12535 migrants population in industrial areas and brick field.
SitesFajalGanj- In this slum there are many Workshop where people make the parts of truck. In this slum
mainly people are belongs to Bihar, Bihrich , Gondar , Sultanpur slum.
Panki Industrial area- We found good population in this slum.
Dada Nagar- We found good population in this slum.
Transport Nagar/ Jhakarkati- We found good population in this slum.
Mandhna/ Chaubepur- We found good population in this slum.
Billhour- We found good population in this slum.
Tikra- We found good population in this slum.
Brick Field- We found many good people in this slum.
23
24
We started organize the review meetings in so many slums. By the review meetings we get to
know about the actual situation of HIV/AIDS.
We planned so many Field Visit & Brick Field. By the field visit we get to know about the
mental status of migrants.
The ORW(Out Reach Workers) of our staff is very hard working. By the help of our ORW we
get so many easy solutions in our work.
We also done the Mapping System. By Mapping System we identify the migrants sites and put
the hot spot.
For a good working in all fields we make 15 Peer and also we took help from the stakeholders.
SNBS AGRA Progress Report, 2014 2015 (www.snbsindia.org)
25
With the help of stakeholder and ORW we organize the Health Camp. So , that we can give
help to migrants. And migrants must aware from the HIV/AIDS points.
We also took help from Counselor. With the help of counselor we did a good job in every field.
We also took help from our Respected Doctor. He gives his support in every field.
Every week we also done the meeting for our strategy with Peer that how we can give a speed
to this program.
NAME
POSITION
1
2
3
4
5
6
7
8
9
VineetaGautam
Dr. Surendra Kumar
Mohit Kumar
Saran Biharee Sharma
Saurabh Kumar
Shyam Singh
Vimal Prakash
Inderjeet Singh
Santosh Kumar
Project Manager
Doctor
Counselor
M&E
ORW
ORW
ORW
ORW
ORW
26
TARGET
10000
2000
2000
2000
24
10
ACHIEVEMENT
12535
2177
1235
2303
22
10
27
28