FHI - Aastha Project, Maharashtra (2004

JUNE 2007 —Why was FHI's Aastha Project cited as a model by Bill & Melinda Gates Foundation at the 2006 International AIDS Conference in Toronto? The foundation recognized the project's innovative approaches to the challenge of reducing the incidence of HIV and other sexually transmitted infections for sex workers in the Mumbai and Thane districts of Maharashtra.

Enlisting the participation of the project's beneficiaries helps accomplish this goal. The feedback of the sex workers informed the niche marketing and high-quality communication strategies to increase the demand for condoms and STI services and make both more accessible. What's more, all project activities and interventions contain built-in and ongoing reviews, permitting the flexibility to overcome challenges and ensuring that accountability and decision-making occur at levels closest to the key population.

The name of the project—Aastha, which translates as "to care about" in English—and its logo were chosen by the sex workers. The ensuing branding increased the visibility of services offered and the sense of ownership of beneficiaries. Their feedback also influenced the design of a reddish-pink condom named "Aastha," whose packaging resembles a mouth-freshener or shampoo sachet.

To support the project's objectives and increase uptake for clinical services, the project offers other services: facilitation of school admissions and government ration cards, literacy classes, and training courses in tailoring and other vocations. Self-help groups of sex workers contribute significantly to such efforts, in addition to providing psychosocial support for their peers and organizing health camps and condom distribution.

To increase accessibility of services and help rapidly scale up service uptake, the project delivers quality STI services in mobile health camps as well as stationary clinics, thus providing services for sex workers who cannot or do not go to clinics.

The Aastha Project divides Mumbai and Thane into zones, each with one site manager and 50 sex workers. The site managers are peer educators who are trained in dialogue-based communication, leadership skills, and group facilitation techniques. Most can now use and analyze elementary plans, lead and facilitate groups, plan and budget health camps, make presentations, and complete service records. In consultation with project staff, these site managers ensure that the minimum package of health, communication, and HIV prevention services reach all sex workers in their zones.

The Bill & Melinda Gates Foundation awarded FHI a five-year grant for the Aastha Project in March 2004, through the foundation's $258-million Avahan India AIDS Initiatives. Avahan (or "call for action") was launched in 2003 to fund community-driven, HIV-prevention services in six high-prevalence states and major national highways.

In India, FHI has three other grants from Bill & Melinda Gates Foundation: as a capacity building partner for high-quality STI services; a monitoring and evaluation partner conducting the Integrated Behavioral and Biological Assessment and developing the Computerized Management Information System; and as an advocacy partner working with the Indian Network of People Living with HIV/AIDS.

PHOTO: Unveiling of the Aastha Project logo in Mumbai, India, in 2005.

Related Resources:

Aastha Parivaar Empowers Sex Workers to Prevent HIV/AIDS and STIs (2009)

Aastha Strategic Behavioral Communication Manual (2009)

Peer Educator Intermediate Training Manual (2009)

FHI/India Supportive Supervision Training Manual Now Online (2009)

Indian NGOs Commemorate World AIDS Day (2006)

Aastha Project, Maharashtra (2004–09)