Sankalp :
Sankalp was launched in December 2003 to 2013 as the first scaled up targeted intervention project for sex workers, MSM and Transgender populations in Karnataka. The project is funded by Bill and Melinda Gates Foundation and aims to reduce STI, transmission of HIV and increase condom use among sex workers and MSM T. The project is being implemented in partnership with NGOs and CBOs in 20 districts of Karnataka and Maharashtra. The first phase of Sankalp (2003-2009) included scaling up interventions in the state. The second phase (2009-2013) prepares local communities and the government to assume management of these initiatives in 2014.
The project also addresses critical social issues that exacerbate the vulnerability of high-risk groups, particularly, stigma and discrimination, violence and harassment, and exclusion from social entitlements. To bolster solidarity within and enhance the agency of affected groups, Sankalp facilitates the formation of community groups of sex workers, MSM and transgenders at the district level.
Strategies, interventions, outputs
The main strategy for achieving the goal is to implement high quality, evidence-based programs for the prevention of HIV and STIs in 13 priority districts, covering about half of the state. Three critical interventions are being implemented in an integrated fashion in each of the priority districts: focused HIV and STI prevention programs among FSWs; behaviour change programs for HIV and STI risk reduction in selected high-risk male populations; and improved quality and accessibility of STI management services. The main outputs of these interventions are: increased condom use by female sex workers with clients and other sexual partners; reduced incidence of curable sexually transmitted infections among female sex workers; increased prevalence of condom use by high risk men with non-regular sexual partners; and reduced incidence of curable sexually transmitted infections among high risk men. This project is set in the context of a program of support for HIV/AIDS prevention and control in India, the India AIDS Initiative, supported by the Bill & and Melinda Gates Foundation.
Outcomes
Significant accomplishments during the first three years of implementation included: 1) Establishment of a strong technical team, where a talented and committed core team with strengths in program development and implementation, program management, STI services, monitoring and evaluation, and finance and administration was formed. The core team also brought extensive experience in HIV program implementation, that quickened the pace of start-up. The core team was supplemented by a strong group of experienced consultants from both within India and from outside India. 2) Strong implementing partners were selected. We had partnered with NGOs which had strong community development experiences in the districts and strong management systems. Each NGO partner covered at least one full district (population average over 2 million). In terms of rapidly scaling up programs, this strategy has enabled the project to establish outreach programs in 75 key urban areas in all districts. 3) Mapping and initiation of programs and services. We had mapped more than 180 urban towns/cities and 53 zones in Bangalore. The mapping methodology provided lists and profiles of locations where there was a high concentration of high-risk sexual networks and other high risk activity (e.g. injection drug use). 4) Rapid scaling up of outreach. Starting from a very low baseline of existing programs and NGOs in this field, the project had succeeded in initiating outreach programs and services in over 120 urban centres. By the end of March 2012, the project covered 1,65,808 FSWs and 72,655 MSM-T at least once via outreach in Karnataka.
