Implementing Comprehensive HIV/STI Programmes with Sex Workers Implementing Comprehensive HIV/STI Programmes with | Page 38

1 Community Empowerment

sustained support. The marginalization of sex workers within the broader economic and social
discourse makes sustainability of sex worker-led organizations and networks more challenging. It is
essential that, at this point in the community empowerment process, power has been transferred to
the community and that community advocates are respected partners in policy-making, irrespective
of the legal status of sex work.
A strong, healthy and vibrant civil society working in genuine partnership has been the backbone of
the HIV response for 30 years. As we move forward, sex worker organizations and networks should
be core members of that partnership.

1.3 Monitoring progress
It is important that communities monitor progress to improve the services they provide and shape
the services they receive. HIV programmes based on human rights and community empowerment
require that sex worker-led organizations set the parameters for monitoring and evaluation of
programmes across all stages of development, including the monitoring and evaluation of the sex
worker movement itself.
Short- and long-term objectives and goals need to be established that specifically address the
community empowerment process. As an example, monitoring community empowerment in relation
to HIV prevention, treatment, care and support and health services would measure sex worker
involvement in each of the following: how services are run, quality assurance, funding allocations,
training of health personnel to address stigma, and advocacy to address discrimination; rather than
simply whether a target percentage of sex workers has accessed a particular service.
In a community empowerment-based programme, monitoring and evaluation should not only
include services provided and health outcomes achieved, but should also attempt to monitor and
evaluate whether and to what extent the community empowerment process is occurring. Frequently,
programme indicators measure quantitative outputs, such as sex workers contacted and condoms
distributed, rather than documenting sex worker-led organizational progress and social inclusion.
Box 1.9 and Table 1.2 describe approaches to monitoring community empowerment.

Box 1.9

Case example: Monitoring community empowerment of sex worker
organizations in India
Monitoring empowerment is challenging because numbers alone do not convey the complex interaction
of factors that define empowerment. In the Avahan India AIDS Initiative, where NGOs worked with
community leaders to establish formally registered CBOs, it was found that simply reporting the number
of community groups or meetings held was inadequate, because these data did not capture the quality of
the capacity-building and the functioning and autonomy of the groups. To address this, special surveys
were developed to capture the various aspects of community empowerment, using an index with multiple
groups of indicators. The surveys were administered over a period of several days by trained facilitators
with leaders and members of each CBO as well as staff of the NGO implementing the programme, using a
small-group discussion format. Initial survey results were immediately reported to the CBO and NGO and
discussed with them, with a detailed analysis following later. It was found that a combination of qualitative
and quantitative indicators and approaches to monitoring and evaluation was needed to document the
complex process of community group formation and the development and sustainability of each collective.

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