Wednesday, June 25, 2008
a few bumps in the road
The interviews should be finished by the end of Wednesday, July 2nd. I've gotten about 50 back so far, but the answers for about 30 of the interviews still need to be translated into English. One of the most important questions on the interview, "if you knew that an HIV+ woman wanted to have a child, what would you say to them and why" was mis-translated, so some of the SureStart team members didn't ask their clients this question since it implied that the client had to know an HIV+ woman in order to answer this question. So the SureStart field workers are going back into the field today to ask that question again. There's another more pressing issue at hand...and that is I'm having trouble finding and downloading (internet connection is not so great here) that can analyze my free response answers (i.e. text-based). Obviously, qualitative data is hard to quantify, but at least I can maybe code the answers and that way the software program can output statistical results. Because of my time table, it looks like i'll be bringing back all of the translated interviews back with me (so I will need to make space in my suitcase), analyze them with a software program in order to determine what needs to be addressed in the awareness program!
Thursday, June 19, 2008
Lost in translation....and some other stuff
Just to give you an update, all of the interviews have been translated, edited and copied and the interviews started today!!!!! It turns out we have about 5 facilitators from the DISHA team (conducting the HIV+ interviews) and 5 from the SureStart team (conducting the HIV-/unknown status interviews); therefore, it will take about 10 days. I plan to get 10 interviews back each day and translate the Marathi answers into English. Unfortunately, all of this means that all of the interviews will not be finished until Wednesday, July 2nd and I leave on July 7th. Today I had 2 separate meetings w/ the DISHA and SureStart community health workers to address all of their questions, problems, concerns etc. There was only one mis-translation/ miscommunication problem about one of the questions with the DISHA team. There were a few complaints with the SureStart team about how long the interviews took (about 2 hours) because the women who were responding to the questions have a lot of work in the morning and can’t give up that much time. So, they’ve decided to start interviewing in the afternoon. A lot of the SureStart members were worried about what they should write down if the respondent doesn’t know what HIV/AIDS is, and they were worried about some of the responses concerning myths about HIV transmission etc. But I told them that’s exactly what I wanted to hear. I want to know what the respondents already know, what they think they know, what they don’t know and what they want to know, because that’s the only way an effective awareness program can be created. Sure, it's frustrtating to create these interviews, know them inside and out, and then worry that they aren't being conducted correctly to get the information we want to collect. But, I don't have a choice...and that's something that I'll just have to learn to deal with.
As mentioned before in the objectives for this project, we plan to create an awareness program, so I have a bit of a dilemma (i.e. 2 options). One option is to carry out the project at home in America, while the other option is to pass it on to another volunteer. I would love to carry out this project from home, but the truth is that I’m not really qualified to…I have no experience; I don’t know the first thing about developing an awareness program. However, I feel that this is my project, kind of like my baby, not an obligation. I want to at least be involved in creating the program.
Once I have the answers to the interviews, I will understand what the women in the slums know about HIV/AIDS specifically in relation to MTCT and how they feel about HIV+ women reproducing. I feel that in order to reduce the stigma and discrimination surrounding this issue, we need to focus on teaching them basic facts about HIV/AIDS, and then we can proceed to teaching HIV+ women how to prevent MTCT through ways that that they can afford. Obviously, ARVs aren’t a viable option for slum dwellers, but milk substitutes may be. Also, with a program like SureStart and their hospital referral system, the families could save up money for a C-section instead of a normal vaginal birth.
Some side notes:
I’ve been doing some side projects and there have been some updates on other projects going on. In some of my past blogs I talked about the IDU site called the Pune City Action Plan that was located in Pimpri and that I’ve made ID cards, logos and letterheads for, well, they just opened up their new center closer to the city at 2pm.
Not last weekend, but the weekend before that, I attended a performance by Saheli kids. Saheli is another NGO that is a sex workers collective in Pune that takes care of kids of sex workers. Some of these kids have been pulled from the red light district, while others were put into the program. So, some of the volunteers at Deep Griha want to take them out to the park and hang out with them a few days during the week. Also, for the first week of July, a few us, especially including Bhavana, a Sahara volunteer (another NGO that takes care of HIV+ patients) who has had a lot of experience with working with sex workers and understanding their relationship with the society including the law, would like to try and get other sex worker collective NGOs together and do something for their international awareness week. So although I only have a little over 2 weeks left, I’m going to try and help out with these last two projects.
As mentioned before in the objectives for this project, we plan to create an awareness program, so I have a bit of a dilemma (i.e. 2 options). One option is to carry out the project at home in America, while the other option is to pass it on to another volunteer. I would love to carry out this project from home, but the truth is that I’m not really qualified to…I have no experience; I don’t know the first thing about developing an awareness program. However, I feel that this is my project, kind of like my baby, not an obligation. I want to at least be involved in creating the program.
Once I have the answers to the interviews, I will understand what the women in the slums know about HIV/AIDS specifically in relation to MTCT and how they feel about HIV+ women reproducing. I feel that in order to reduce the stigma and discrimination surrounding this issue, we need to focus on teaching them basic facts about HIV/AIDS, and then we can proceed to teaching HIV+ women how to prevent MTCT through ways that that they can afford. Obviously, ARVs aren’t a viable option for slum dwellers, but milk substitutes may be. Also, with a program like SureStart and their hospital referral system, the families could save up money for a C-section instead of a normal vaginal birth.
Some side notes:
I’ve been doing some side projects and there have been some updates on other projects going on. In some of my past blogs I talked about the IDU site called the Pune City Action Plan that was located in Pimpri and that I’ve made ID cards, logos and letterheads for, well, they just opened up their new center closer to the city at 2pm.
Not last weekend, but the weekend before that, I attended a performance by Saheli kids. Saheli is another NGO that is a sex workers collective in Pune that takes care of kids of sex workers. Some of these kids have been pulled from the red light district, while others were put into the program. So, some of the volunteers at Deep Griha want to take them out to the park and hang out with them a few days during the week. Also, for the first week of July, a few us, especially including Bhavana, a Sahara volunteer (another NGO that takes care of HIV+ patients) who has had a lot of experience with working with sex workers and understanding their relationship with the society including the law, would like to try and get other sex worker collective NGOs together and do something for their international awareness week. So although I only have a little over 2 weeks left, I’m going to try and help out with these last two projects.
Tuesday, June 10, 2008
Details Details Details
So it’s been about a week, and I’ve done a lot of work since then. Here are some more details on the study:
In order to decrease the prevalence and the further spread of HIV/AIDS in Pune, it is important to educate people on how it is transmitted and therefore awareness about HIV/AIDS is a major prevention strategy to contracting this virus and disease that cannot be cured. Hence, it is essential to evaluate the current level of awareness about HIV/AIDS and its preventive measures among those of high risk groups, such as Pune slum dwellers, so that we can create an effective awareness program. Although awareness programs can be effective in reducing the spread of HIV, it can also be effective in reducing the associated stigma and discrimination since education about HIV reduces the fear surrounding HIV/AIDS.
One of the major ways that HIV is transmitted is mother to child transmission during pregnancy, labor, delivery and breastfeeding. Without any care, HIV+ women have a 15% to 30% chance of passing the virus to their infants during pregnancy, labor, or delivery. Breastfeeding (not exclusive during the first 6 months) will transmit HIV to another 10% to 20% of infants. In other words, 3 to 6 babies out of 20 births by HIV+ women, would be born infected, and another 2 to 4 would be infected if breastfed (Johns Hopkins Bloomberg School Of Public Health, 2007)
Women planning to be pregnant as well as new mothers must be informed about this type of transmission especially since ARV medications, cesarean-section delivery, and avoidance of breastfeeding can reduce MTCT risk. Again, it is important to find out how many of these women in the slums and to what extent they know about mother to child transmission in order to assess the stigma and discrimination concerning HIV+ pregnant women in the slums so that an effective awareness program can be developed.
Introduction to the DISHA/SureStart (DSS)
Background Information and goals of the project:
Awareness about HIV/AIDS transmission and prevention strategies decreases the fear surrounding HIV/AIDS and therefore decreases the associated stigma and discrimination
Many women believe that babies born to HIV+ women will be infected, or that HIV+ women are too sick to have healthy pregnancies and give birth to healthy children.
It’s been shown that HIV can be transmitted from mother to child during pregnancy, labor, delivery and breastfeeding. Without any care, HIV+ women have a 15% to 30% chance of passing the virus to their infants during pregnancy, labor, or delivery. Breastfeeding (not exclusive during the first 6 months) will transmit HIV to another 10% to 20% of infants. (Johns Hopkins Bloomberg School Of Public Health, 2007)
However, if we can educate them about mother to child transmission and ways to prevent it by having the mother and/or the child take ARV medications, getting a cesarean section delivery, and avoiding breastfeeding, the baby can be HIV- and healthy
The goal of this project is to create an effective awareness program for the women in the slums in relation to mother to child transmission (MTCT), but we first need to find out what they already know about HIV/AIDS and how they feel about issues concerning HIV+ women having children
· Objectives
o To conduct a knowledge assessment about HIV/AIDS, the preventive measures, and its related stigma and discrimination among women living in the Tadiwala Rd. slum
o To examine the level of misconceptions about modes of transmission of HIV/AIDS and its related stigma and discrimination specifically in relation to mother to child transmission among those with known and unknown HIV status
o The results of this study will be used to develop an awareness program.
Methods:
The target population
100 women from the Tadiwala Rd. slum
Preference to women who plan to become pregnant, who are currently pregnant and mothers were recently pregnant (i.e. have young children)
DISHA and SureStart community health workers will interview one woman a day for about 10 days using interview questions that have already been prepared
The interview
This interview is more of a discussion with the respondent, not a survey or a questionnaire, so the client should feel comfortable conversing with the interviewer
Every interview will begin with the “Pre-Interview” packet and will then proceed to another interview packet, either the “HIV-/unknown status” or the “HIV+” packet
Using DISHA resources, we will know the HIV status of some of the clients
If the HIV status is known, then the corresponding packet will be used
If the HIV status of the client is unknown, then the “HIV-/unknown status” interview packet is used
We had a training session yesterday, where I introduced the project, and went over the interviews with the 20 DISHA/SureStart community health workers so that they could practice. They were split into teams of 2 and conducted mock interviews. Currently, the interviews are being translated from English to Marathi and hopefully we can start this Friday or next week. I’ll try and attach the interview documents when I can.
In order to decrease the prevalence and the further spread of HIV/AIDS in Pune, it is important to educate people on how it is transmitted and therefore awareness about HIV/AIDS is a major prevention strategy to contracting this virus and disease that cannot be cured. Hence, it is essential to evaluate the current level of awareness about HIV/AIDS and its preventive measures among those of high risk groups, such as Pune slum dwellers, so that we can create an effective awareness program. Although awareness programs can be effective in reducing the spread of HIV, it can also be effective in reducing the associated stigma and discrimination since education about HIV reduces the fear surrounding HIV/AIDS.
One of the major ways that HIV is transmitted is mother to child transmission during pregnancy, labor, delivery and breastfeeding. Without any care, HIV+ women have a 15% to 30% chance of passing the virus to their infants during pregnancy, labor, or delivery. Breastfeeding (not exclusive during the first 6 months) will transmit HIV to another 10% to 20% of infants. In other words, 3 to 6 babies out of 20 births by HIV+ women, would be born infected, and another 2 to 4 would be infected if breastfed (Johns Hopkins Bloomberg School Of Public Health, 2007)
Women planning to be pregnant as well as new mothers must be informed about this type of transmission especially since ARV medications, cesarean-section delivery, and avoidance of breastfeeding can reduce MTCT risk. Again, it is important to find out how many of these women in the slums and to what extent they know about mother to child transmission in order to assess the stigma and discrimination concerning HIV+ pregnant women in the slums so that an effective awareness program can be developed.
Introduction to the DISHA/SureStart (DSS)
Background Information and goals of the project:
Awareness about HIV/AIDS transmission and prevention strategies decreases the fear surrounding HIV/AIDS and therefore decreases the associated stigma and discrimination
Many women believe that babies born to HIV+ women will be infected, or that HIV+ women are too sick to have healthy pregnancies and give birth to healthy children.
It’s been shown that HIV can be transmitted from mother to child during pregnancy, labor, delivery and breastfeeding. Without any care, HIV+ women have a 15% to 30% chance of passing the virus to their infants during pregnancy, labor, or delivery. Breastfeeding (not exclusive during the first 6 months) will transmit HIV to another 10% to 20% of infants. (Johns Hopkins Bloomberg School Of Public Health, 2007)
However, if we can educate them about mother to child transmission and ways to prevent it by having the mother and/or the child take ARV medications, getting a cesarean section delivery, and avoiding breastfeeding, the baby can be HIV- and healthy
The goal of this project is to create an effective awareness program for the women in the slums in relation to mother to child transmission (MTCT), but we first need to find out what they already know about HIV/AIDS and how they feel about issues concerning HIV+ women having children
· Objectives
o To conduct a knowledge assessment about HIV/AIDS, the preventive measures, and its related stigma and discrimination among women living in the Tadiwala Rd. slum
o To examine the level of misconceptions about modes of transmission of HIV/AIDS and its related stigma and discrimination specifically in relation to mother to child transmission among those with known and unknown HIV status
o The results of this study will be used to develop an awareness program.
Methods:
The target population
100 women from the Tadiwala Rd. slum
Preference to women who plan to become pregnant, who are currently pregnant and mothers were recently pregnant (i.e. have young children)
DISHA and SureStart community health workers will interview one woman a day for about 10 days using interview questions that have already been prepared
The interview
This interview is more of a discussion with the respondent, not a survey or a questionnaire, so the client should feel comfortable conversing with the interviewer
Every interview will begin with the “Pre-Interview” packet and will then proceed to another interview packet, either the “HIV-/unknown status” or the “HIV+” packet
Using DISHA resources, we will know the HIV status of some of the clients
If the HIV status is known, then the corresponding packet will be used
If the HIV status of the client is unknown, then the “HIV-/unknown status” interview packet is used
We had a training session yesterday, where I introduced the project, and went over the interviews with the 20 DISHA/SureStart community health workers so that they could practice. They were split into teams of 2 and conducted mock interviews. Currently, the interviews are being translated from English to Marathi and hopefully we can start this Friday or next week. I’ll try and attach the interview documents when I can.
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