Presentation made by Dr. Anasua on Global Female Condom day on 12th september, 2012 at HLFPPT Noida office

1. "Experience and Lessons of
Introducing Female Condoms in India
Global Female Condom Day
12th September 2012
Presented by HLFPPT
Dr Anasua Bagchi
Head - Technical Services Divn

2. Some stories..
To set the context..

3. Munni ….. Nepal se Pune Tak..
16 Years she was … a blossoming
mountain flower….. when she
crossed the hills and valleys and
reached border – searching for food.
She lies in one of
the 12 bedded room
in a Pune shack ……
green printed curtain
swaying between her
and 11 other
mountain
flowers……. as 20-22
men enters her inner
most soul and body
per day……
Munni finally has ensured food on her plate

4. Champa…. Bengal ke us par se is par..
At 17, She was a new and
naïve bride…..
she crossed rivers and
meadows and border….
her dark eyes searching her
love and future…..
She stands in one of holding the chit of paper that
the most pious her pati had given her to
places on Earth…… meet…
the temple premises She was all set to start her
of KALIGHAT – little peaceful life…
Kolkata wearing dark
kajals in her dark
eyes……. as 18-20
men buys her inner
most beauty and
body per day…… Champa finally has value for her love.

5. Sold by father to
Born in to the
oldest profession
earn bread… she
smiles with
more stories to telll ..
in earth, she enchanting fullness
wants to be like Widow with
her mother.. three
daughters… Drug
Madhu
HIV Sumi, 28, yrs never says no addict
positive 19 yrs to life and still
While Her Seema,
and still 18 yrs going
smile clears Madhu,
full of life Anchal, with life
the truck 24 ys
drivers worries 40
higways.., her Mariamma, Pinky, learnt to stand up
one year old 30yrs 22 yrs again and again
yearns for her Venda,
Ann, 32 34 yrs Anna, when beaten up by
milk in the years Police and rowdies
lonely shack.. 28 yrs
Rasi, 33 yrs Husband had …
Have been Abandoned cut her both
hauled across by husband arms… he was Devdashi ..
32 cities… still and angry!! She is proud
dreans of her family…takes She still of her origin
small hilly care of the embraces two and destiny..
village children and toddlers with
life with stride the stumps

6. more stories to come …..
Arti, Binnu, Titli, Marie, Sarita, Zara, Kashmira, Ammu, Mitu,
Roshni , Anju , Vasi, Punyya……. Coming SOON…..

7. What made provision of
Female Condom (FC) In
India…
•Increased realization of „empowering
women to take control of their lives’
•Global research highlighting need for
female controlled prevention methods

8. Vulnerability –
“Main ( Condom) lagane ko boli toh woh (husband)
mujhe Jharoo se mara, bola Sali Nakhre karti hai”
When I ask him to use protection he beats me and
abuse me saying no… Arti from Kolkata
•Non-consensual sex
•Fear of violence “ Ghar me chic-chic nahin
•Economic dependence chahiye, is liye bina condom ke
karte hain, malum hai wo kuta
•Inability to negotiate condom use to kahin bhi jata hai” –
•Restricted prevention options for women
do not want any kind of
““humey kahan accha lagta hai jub ganda muh uneasiness at home, thus do it
hamare samne ata hai”- we do not like when without condom, we know that
someone drunk come to us”. – Laxmi from Tamil unworthy fellow goes to others-
Nadu
a respondent of FC study from
“Hum Pet ke liye karte hain”- we do it for survival”- Orissa..
A Peer Educator from Bilaspur

9. National AIDS Control Organization (NACO)
introduced Female Condom as..
• An empowerment tool for women
• An additional, alternate option to
male condom
• A Tool for protection and safety
against STIs, HIV infection
Address inconsistent Male Condon
usage and Reinforce Risk
perception with regular partner

10. Female Condom program Journey in India so far..
2011-12 Scale Up in 13 states
2010-11 Scale Up phase II , 4
states-
2009-10 Impact Assessment Study -WB,
MA, TN
2008-09 Scale Up Program in – WB, Maharashtra,
AP & TN
2006-07
Pre Programming Assessment Study-
WB, Ma, , AP & TN
2005-06
Operational Study in WB, Gujarat and MA
2003-2004
Social Acceptability Study in AP, Kerala and MA
HLFPPT had been an active advocate of Female Condom
program in India from program initiation days ……..

11. Reaching out to –
•> 3LAKH FSWs
•Approx 300 TIs
•13 States
Program Strategies
• Capacity Building
• BCC & Demand
Generation
• Social Marketing
• Monitoring & Evaluation
With training and Communication Material in 10 Languages

12. Capacity Building
7000
5886
6000
5000
4000 3349
3000 2357
2000
1000 295 Series1
0
No NGOs team PE Trained Counselors NGO staffs
Trained trained
FC SMP CB Fact Sheet – 2009 -12
Learning -
The thrust of entire capacity building process need to
be on increasing ownership of TI partners and
stakeholders in sustaining- increased use of FC by
target group

13. Behavior Change Communication (BCC) Strategy and Demand
Generation
Advocacy workshops at
State/district/community
level for creating
• Peer Educators
enabling environment • ORWs
IPC with • Counselors -TI
FSW • ANM/MO of TI clinic
• Counselors- STI
Clinic, ICTC
Direct
Communi • SWAYAM events
cation • DIC meetings
with • TI community events
FSWs -
• Branded Kiosk
Mid- • Banners
• Branded Boards for
Media TIs & STI clinics

14. Impact of
Nov – Aug 614906
Swayam 98% of
Primary sales programme Swayam
July 2010 – Aug Achievement
2011
in terms of
primary 376500
Community events
Sale .
292300
195730
176558
114250
73650
43850 46050
6000 7000 13000 5000 12000
189782
Impact of SWAYAM ON
Learning Secondary Sales 163650
151862 154195
July 2010 –Aug 2011
125487 125957
Successful model for
96923
Demand Generation 84940
and Direct 62362
51832
44696
Communication 36786 35630
29462
IPC with > 85,000
FSWs
1280 Hot spots and Male inclusion events conducted in 8
states

15. Social Marketing
Focus is on demand generation and
acceptance of the product •Procures condoms from the
NACO manufacturer
Step 1 – Enhancing knowledge about
FC among communities and TI •Procures condoms from
NGOs SMO NACO @Re. 1.00/ piece
Step – 2 – Placing the product to the
•Procures condoms from SMO
target population. @ Rs. 2.00/ piece
NGO/CBO
Step – 3 - communication strategies
to continue demand generation •Procures condoms from
PE NGO/CBO @ Rs. 2.50/ piece
No of Coverage of Off take of Female
states FSWs Condom from SMO to
NGOs ( 2009-12) •Procures condoms from PE @
13 3, 25,44 Rs. 3.50/ piece
Approx 4 FSW
million

16. M&E Reporting flow at TI NGO
FSW 1 FSW 2 FSW 3 • Peer Educator fill the form on
weekly basis capturing
• 1.- IPC : actual number of KP's
reached
Peer • 2. Female condom sales to
Educator Form B each FSW
Guidance by • Form B compiled on weekly
ORW FE basis ORWs
M&E/
Accountant TSU PO
• Form- C - compilation of form -
FC TEAM Form C B capturing the information on
SACS Monthly basis by ORW
TSG NACO • M & E officer share report of
IPC and sales to SACS and PO
Compilation TSU Monthly Basis
Close Monitoring Program M&E
, Mentorship , and monitoring, Technic
process facilitation al
by TSG guidance, support
by NACO -
•Integrated M&E (Simplified reporting system ) in CMIS
•Regular feedback mechanism.
•Systematic tracking of sales data from field.

17. Key Learning's
• Continued Interaction between user and service “I cannot trust my
provider is critical for acceptance partner, he may be
– Interpersonal communication backed up with sleeping with other
regular demonstration and counseling women also…..with
Female Condom I can be
• Communication strategy need to be tailor made rest assured about my
as per the socio – demographic and Professional safety.”-
profile of the women
25 yrs, FSW from
Baluguda, Damanjodi
• FC has established itself has a empowerment
tool to women “I hear about so many new
diseases and infections
today and a poor women
• FC is perceived as a tool for protection and
like me who have limited
maintenance of health to partners
means of income and
resources depend on
• > 80% of users re purchase the product Female condom for my
establishing the fact that FC demand has been protection. It empowers
degenered me.”
FSW, 40 yrs from Silchar

18. Global Positioning of FC….
Condoms in spotlight after 19 years of FC are a cost-effective
neglect….. and lifesaving tools, yet
Juan
NINETEEN years after female condoms they represent only 1% of
were approved by the US FDA in all condoms distributed
1993, they are not yet available as worldwide
widely as one would have wished.
Aurora
What could have delayed their optimal utilisation to meet the unmet
prevention needs:-
was it because female condoms were not rolled out under a
robust enough and well-resourced comprehensive programme
and strategy, Zawadi
or
Potential users didn’t prefer using them?
Universal Access to Female
Condoms (UAFC) -) Paper Sookjay
Dolls Campaign

19. How we can built on the learning?
• Investing time and efforts on FSWs preparedness of FC
• Work on enhancing use among regular partners
• Strong advocacy at all levels to develop conducive environment
• Reinforce ownership among the NGOs/CBOs
• Mainstream FC in existing health services (Counseling and
testing centers /STIs clinics), Monitoring system, Training structure
and IECs

20. There are large arenas untouched by FC – which are
waiting for it with open hands and hope….
Lets make FC reachable to them..