Where I come from it is very difficult to collect effective data for gender minorities because most of them are afraid to go public for fear of stigmatization. Actually rather than be stigmatized, most of them find it easier to keep their affairs secret and therefore makes it very difficult to help them. The way I see it, there is an urgent need to educate our people on the subject of gender minorities. It is important for them to know that being a gender minority is not a crime but rather a way for life for some people which must be respected. It is important for our people to know that every human being has a right to live their lives as they wish and that we must learn to respect that right even if we find their way of life strange or different from the way we percive to be right way of life. In my view if this can be done successfully, then we can begin to collect data for effective monotoring and evaluation. But as things stand now most gender monorities in my country continues to suffer silently for fear of stigmatization. mariasururu Nairobi, Kenya

Recently (more than a year now), NTP in The Gambia has updated and revised their routine data collection tools for the TB Control Program to capture the age and gender issues and after a year of regular data collection and analysis of the data, it has been found that more males are diagnosed and treated for TB than females,more males default treatment than females. However a desk review also showed that the mortality rate in female TB patients is higher than male TB patients and also the HIV positivity rate (HIV 1 or 2 or both) is higher in the female TB patients than male TB patients. These are findings similar to what is found in some studies in other African countries.

Please find below the contribution from Jane from Nigeria.

Thank you for your contribution!

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Primary Sources: Usually taken from on-the-spot observation, interaction etc., hence authentic and reliable.

Find below the contribution from Kelefhile from Botswana.

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Alastair
e-Forum Facilitator

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How many women or girls (can be percentages) are accessing the services in HIV and AIDS and malaria:

 

- according to rural and urban, what type of services are offered (care & support, TB treatment and services for malaria, prevention from mother to child),

- are there NGO's helping to deliver the services

- a tool to test knowledge of HIV & AIDS malaria & TB from the interventions

- are people or the government addressing issues of sexual minorities, are these issues freely discussed

- what is the govenment doing in the schools to address girl issues (intervention programmes in schools)

Data: how many people accessing the services in HIV and AIDS and malaria, how many people understand these issues, how many people are empowered, how many peolpe are taking TB treatment and HIV and AIDS, how many people understand malaria.

Find below the contribution from LKM from India

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The surveillance of women, girls and sexual minorities by the NGOs with all stakeholders as a pre-requisite for desiging Programmes in relation to HIV/AIDS, tuberculosis and malaria in respect of above categories. The programme on the basis of this shall be sustainable.

Here sending my answers for your kind acknowledgement.

What kind of data could and should be provided to the Global Fund to substantiate that a program is:

· designed to address the needs of women, girls and sexual minorities in relation to HIV/AIDS, tuberculosis and malaria?

   Normally when talking about Gender in HIV/AIDS Women living with HIV/AIDS adolescent children (Girls) and Transgender women living with HIV/AIDS have more stigma from the society. Due to that they are facing discrimination and their life is in deep trouble. In this context we need to address their practical problem crucial to focus their needs.

  Young women living with HIV/AIDS most of them living in rural setup are Widows living with HIV/AIDS. They are seeking help from their parents not from their in-laws. Their parents are aged... After 4 or 5 years who will be the guardian for those women living HIV/AIDS? Their survival is in question mark? Need to promote women property rights; It is an urgent areas of policy and program integration which need to be promoted by Governments and policy makers and donors.

   Because securing women property rights can help positive women live with dignity and it will contributes to gender equalities also. Extending the legal support process is much better for women and children living with HIV/AIDS.

   Secondly Children living with HIV/AIDS have problem in their education. Mostly they are orphan or semi orphan. Their survival, education, right to play & recreation are affected because of their HIV status.

   Third Marginalized care especially for Transgender Living with HIV/AIDS is facing double discrimination due to their gender and HIV status. They face lack of social acceptance and lack of job opportunities. Community people ill-treat and miss-behave them in public at their gender. They will have self stigma too which leads them a bad healthcare.

   Need to address their need in care and support either home care, hospital care or their sustainable life style. The process of collecting data is important. For women and Transgender and Girls need to segregate the section of groups living with HIV/AIDS , According to their age group , in case of Widows show how many of them living with parents custody or living in hostels , How many of them living with In –laws custody, Their earning source, education literacy level, income generating skills,etc.

   When we talk about children living with HIV/AIDS age group present custody, infected or affected, those who are in ART whether they are in severe OI everything we need to collect the data. Good MIS to be used to collect the data with facts and figures.

· sound in approach, feasible, and has the potential for sustainability and impact?

Thanks,

David Daisy.

Please find below the contribution from Md.Moniruzzaman from Bangladesh.

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Barisal divisional town on of the oldest residential area of Bangladesh. Business and education activity stated here from historic period. There was a cultural ethnic interchange has occurs back from Colonial era by various philanthropic and missionaries organization. As a result, expansion of multiple business and   activities established through outside people. Consequently movements of temporary resident population have increase tremendously. Communication network through roads and high way has been expanding decades together. This temporary residing population comprising truck driver, rickshaw puller a many of odd job laborer as     such indiscriminate sexual activates are increasing day by day which is a potential for transmitting emerging HIV / AIDS and other STI.

From our national sources it is documented 363 AIDS patents of which 9 dide. It is estimated that about 30,000 of HIV positive cases exist at present nationally. Experts also agreed that Bangladesh still in early stages HIV epidemic and the entire critical factor are in place for its expansion. This is frequent travel across borders like India and Myanmar where HIV / AIDS is acknowledged as being a major public health problem. There is a thriving commercial sex industry with in Bangladesh and a large number of street and hotel based sex workers involved in sex business. The national transportation system is largely involving a great number of truck drivers and rickshaw pullers who have multiple sexual partner and travel back and forth across the country.

Awareness of the problem of HIV / AIDS has not yet been translated and how it can be prevented. As a result young adult people like elsewhere, are a sexually active and among them are engaged in premarital and extra marital sex. In addition to extra marital sex most of the young who   are enjoying sex with multiple partner drug uses is a potential for HIV / AIDS infection. The first national sentinel surveillance for HIV /STI conducted in 1998 by the ICDDRB for the government of Bangladesh among the high risk behavior practicing group showed that drug abusers and sex workers had the highest HIV prevalence of 2.5% and 0.6% respectively. The prevalence of syphilis was found 30% among the drug users and 48.5% among the brother based workers and 57% among the street sex workers. Sentinel surveillance conducted in 2005 HIV prevalence among inject able drug users was 40%. It is observed in the forth national surveillance that 72% rickshaw puller 76% truckers 28% MSM and 56% IDUS go to the female sex workers. So it is clear this finding that HIV can easily be sprit to the innocent people from the high reach group.

With Best Regards,

--
Md.Moniruzzaman
Executive Director
Aid Organization
Amirkutir,Alekanda,
Barisal-8200
BANGLADESH

What kind of data could and should be provided to the Global Fund to substantiate that a program is.

·designed to address the needs of w om en, girls and sexual minorities in relation to HIV/AIDS, tuberculosis and malaria?

 Global fund should seek reports to evidence based programs,  attendance lists, photos and communities' opinions.

·sound in approach, feasible, and has the potential for sustainability and impact?

Global fund should know their Need assessment strategy, project implementation style and monitoring and evaluation plan.

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Regarding robust addressing data for the needs of women, girls,& sexual minorties understanding of social,cultural,traditional& economical interventions are essential.

Robust data can include human ecology,bio-behaviour,& reciprocity of social,economic,physical,biological environmental factors.

For reduction of HIV/AIDS vulnerability to women,girls& sexual minorties robust data should be based on multiple factors i.e. social& structure factors including demographic,religion,& educational(literacy level of female),raising awareness about HIV/AIDS before marriage ,partners,use of preventive methods, economical factors including micro-insurance,income,family & social support ,housing & employment.

Data related to population &individual's opportunity for access of general health protection,understanding of pathogens, conducive education policy for universal primary education with health education model based on human ecology,bio-behaviour change process and its integration with physical& social environmental factors rather than primary sexual education can give sound approach & potential impact on reduction of vulnerability of HIV/AIDS & reduction in high risk of sexual behaviour.

Understanding of child norms/spacing ,nutrition,immunization, hygiene ,family health could enable women/female to bring about significant impact in their own and their partners/family health.

Basic health information system and its integration  with pre-disposing factors& response could give effective data with monitoring & evaluation framework. 

Thankyou
                                ASHISH SRIVASTAVA
                            EX-International marketing
                              & c.c.m (SEAR-INDIA)
                                  81237

FOR  THE PROGRAMME TO BE RELEVANT TO WOMEN, THE PROGRAMME SHOULD HAVE ADEQUATE FEMALE REPRESENTATION AT EVERY STAGE OF ITS IMPLIMENTATION.THERE SHOULD THEREFORE BE DATA INDICATING THE PERCENTAGE OF FEMALE INVOLVEMENT IN THE PROGRAMME,THE CAPACIY OF THOSE WOMEN, THIER LEVEL OF INVOLVEMENT AND PARTICIPATION . THE OWNERSHIP STRUCTURE OF THE ORGINIZAYION SHOULD ALSO BE INDICATED.

I have found these suggestions very interesting. I particularly support the point that data for M and E must not add additional major burdens to already overstretched systems. It is counterproductive to produce dream lists of indicators when HMIS systems may be in complete disarray. there is also the important issue of data use - data tend if anything to be underused, so adding more in to the system risks simply more underuse. we need more practical examples of approaches that have been able to strike the right balance - effective indicators,few of them, able to be generated or collected within existing constraints (e.g. through sentinel sites, selective upgrading of quality of facilities data), don't disable other parts of the HMIS or take away existing staff, and have a clear link to use.

The epidemic that has engulfed majority of population in developing and developed countries is about to perish the human race if the remedies of it are not properly designed and implemented. The developing and under developing nations are of course under the severe threat of these epidemics. The main issue that has always been focused on is the to implement the remedies in its true soul and spirit. Unfortunately, some of the organizations that are working in the name of development and facilitation of marginalized and deprived individuals use these funds as a source of improving their individual financial position which of course is a very sad fact.I thing that for proper monitoring and evaluation and for collection of data, the Organizations with far better reputation and genuine cause should be given the task for the original analysis and the authentic data to be provided to the fund for the proper implementation of the program.The ugly giants who are the disgusting source of defamation of the NGOs should be eradicated from the scenes in order to tackle the killing epidemics in a far better way. Thanks Hussain Shah Human Development Foundation Pakistan

The question of data is clearly a central one. Recently, there have been increasing calls to "know your epidemic" as a cornerstone of any country's national AIDS response. And, as many comments have noted, "knowing your epidemic" requires data that is fully disaggregated. And to "know your epidemic in gender terms" means that data must be disaggregated by sex and age, at the very least. It also means that this data must be disaggregated across the board. For example, rather than assuming that all sex workers are female, we need data that tells us how many are female, how many are male and how many are transgender. Similarly with injecting drug users, where the assumption is that IDUs are male. Guidance to help "know your epidemic in gender terms" exists in a variety of forms and is now being more fully developed - with attention to women and girls, men and boys, and sexual minorities. The methodologies and tools for integrating issues of gender and sexual minorities into national AIDS responses still needs to be more fully developed so that it becomes a guide for use by a wide variety of actors -- AND it will help to develop more finely articulated information about the local context of HIV. Some key steps might include -- building stronger and more sustainable linkages between HIV and gender Ministries, identifying national experts in gender and HIV, including those with expertise in sexual minority and HIV issues, and developing more robust tools for understanding the impact of HIV interventions on gender equality issues and the impact of gender equality interventions on HIV. - Susana T. Fried, Gender Advisor, UNDP/HIV Group