Samarth: From community involvement to community ownership!
India HIV/AIDS Alliance initiated the program, Samarth (meaning, empowered), in June 2016, based on the principle of establishing ‘test-treat-adhere-prevent’ cascade for men who have sex with men (MSM) and transgender (TG) population in India. Samarth community clinics offers friendly services for HIV screening tests to MSM, transgenders and hijras. The purpose is to develop a positive health seeking behaviour, knowing ones status and enabling the individuals to act irrespective of the result.
In August this year, a five day clinical management training was organized at the National AIDS Research Institute (NARI), Pune, where community staff from Samarth clinics shared their learnings on the HIV test and treatment cascade. Their in-depth knowledge and articulation, was well received and appreciated by the scientists from NARI. In September, HIV screening tests were initiated across the six Samarth clinics in Noida-Uttar Pradesh, Jalandhar-Punjab, Vododara-Gujarat, Pune-Maharashtra, Hyderabad-Telengana and Hooghly-West Bengal; and by October, the program had provided HIV testing to 749 MSM and 129 TG people, who had never been tested before. Thus the programme is achieving in a very limited time what it set out ot do – provide choices to the communities to understand and know their status whenever required in comfortable, sensitive and convenient surroundings. In earlier programs, the involvement of community members’ in outreach and in programme management was considered important to improve HIV awareness in their own communities. However, involvement alone is not sufficient for increasing the uptake of HIV services that are exclusively available in mainstream Government facilities that often lack sensitivity towards MSM and TG and other marginalized communities. Addressing this need, Samarth, is designed to bring greater community involvement, particularly, at the level of clinical service delivery and make these services more accessible. Across the six Samarth community clinics, 95% of the staff, including, doctors and nurses, are from MSM and TG communities. Thus, ensuring an enabling clinical environment for MSM and TG individuals to access services in a friendly set-up.
The program also empowers non-clinical staff on quality management and basics of healthcare that further translate among the clients as standard of healthy practices. It is rewarding when a Samarth staff advices not to touch used testing kits without gloves, or, when a client teaches a friend about the correct techniques of hand-washing, indicating how community centric programming, can transform individuals from being recipients to becoming change-makers. Especially, since many of them did not even have basic understanding, such as, the difference between HIV and AIDS when the program began in June.
The subtle changes in those involved with the program, indicates, how improving the understanding around health and well-being is a gradual process but ultimately effective in increasing voluntary and regular HIV testing among MSM and TG individuals. Therefore, Samarth demonstrates how community based and community led initiatives, bring about empowerment in individuals and exponentially empowers entire communities.
This blog is written by Alliance India’s, Rohit Sarkar. Rohit is a Senior Programme Officer: Gender Sexuality Rights and Project Lead for Samarth. He has over a decade of experience in HIV/AIDS working with affected communities, including, MSM, transgender and PLHIV.