Who decides for me – HLFPPT Dr Anasua Bagchi HLFPPT

Durban
Global FemaleCondom Conference
1st December, 2015
Dr Anasua Bagchi
Head, Technical Services Divn
HLFPPT, India
At 16 … “Fullora” the
mountain flower….. crossed
hills, valleys .. borders..
searching for food…till she
was sold off to a brothel at
Kolkata, India
Dulari, 28yrs
& mother of
4.. Struggles
with her and
two toddler’s
HIV positive
status..
While her
husband
abandones
her for a new
young bride..
Natasha, 23 yrs old Nurse , had a great
carrier ahead, till she was married off and
gifted with pregnancy in the same
week…’
Zade lotus, 25
Shabnam, 17 yrs .. a new
bride….. was all set to start her
little peaceful life…till death
struck her while bringing out a
new life out of her unprepared
body
yrs.. left her
village
sneaking in
Thailland..
Working in
fish market to
have rice on
the family
plate.. only
way to Keep
her daily
wage going is
giving her
body to the
series of
contractors...
As and when
they wish..
Vulnerability of Women Across Asia are no different..
Main ( Condom) lagane ko boli toh
woh (husband) mujhe Jharoo se
mara, bola Sali Nakhre karti hai” -
“
•Non-consensual sex
•Fear of violence
•Economic dependence
•Inability to negotiate condom use
•Restricted prevention options for
women
•Lop sided preference for Male child in
family
•Restricted Access to services,
Commodities
“Hum Pet ke liye karte hain”- we do it ( sex
without condom) for survival”- A Peer Educator
from Dhaka, Bangladesh
When I ask him to use protection he
beats me and abuse me saying no…
Arti, a Mother of two from Kolkata
“ Ghar me chic-chic nahin chahiye,
bina condom ke karte hain, malum hai
wo kuta to kahin bhi jata hai” –
I do not want any kind of uneasiness
at home, thus do it without condom.
But I know that unworthy fellow goes
to othersa House wife respondent of FC study
from Orissa..
In India ..
The Voices were largely heard … with overwhelming threat of a increasing HIV -AIDS
Epidemic…….National AIDS Control Organization (NACO) introduced Female Condom
in 2003..
Positioning FC as :
An empowerment tool
for women
An additional,
alternate option to
male condom
A Tool for protection
and safety against STIs,
HIV infection
Special Focus was on Addressing inconsistent Male Condon
usage and Reinforce Risk perception with Intimate partners
How Far we could GO with FC ?
Creating - >0.3million FC
Users
Inclusion of FC Social
marketing as a National HIV
prevention program
strategy
Generating valuable
Evidence of acceptance of FC
as a Family Planning Choice
among sexually active
couples
“ Used it when he was drunk”- “ Yahan bin piye to
koi bhi nahin aata, isliye batane ki jarurat hi nahin
rahti”
“ unko nahin bataya, light off kar ke karte hai
hum”- “did not inform the him, we do it with light
off
“Unka bhi ka nuksan nahin, hamar bhi nuksan
nahin, isliye maza aaya - It’s a win win situation
for both of Us- so felt more relaxed
What worked??
• A very responsive and responsible HIV prevention
programing in the country
• Multiple developmental partner and Commodity provider
engagement to sustain Govt of India’s initiative … UNFPA,
HLL life Care, HLFPPT, more than 350 Not for Profit Organisations, more
than 13 State Govts.. and much more…
2012- 13
2011-12
2009-10
2003-2004
Social
Acceptabil
ity Studies
in 3 states
2006-2007
2005-2006
Operation
al Studies
in 3 states
Preprogra
ming
Assessme
nt in 3
states
FC Social
Marketing
Program (
FCSMP) in 4
states with
High HIV
prevalence
20010-11
FC SMP in 4
states and
Impact
Assessment
Study
FC SMP
scale up in
13 states
&
Acceptabil
ity study
of Latex
HLL FC
Productio
n of Laetx
FC &
Advocacy
with GoI
for
inclusion
of FC in FP
product
basket
2013-14
Inclusion of
FC
promotion
Across India
as NACP –IV
strategy
• Over a decade of continued generation of strategic evidences
of feasibility and acceptability of FC in
• Providing Technical Support to GOI in Condom programing
and product positioning
What worked??
Advocacy..…
More than a decade of
Continued , Multi level
Evidence Based Advocacy with
GOI
Involving Clinicians, Policy
makers, social advocates and
Implementers in Advocacy
Efforts
What worked??...
And…
Simultaneous efforts at grass root level to form
Community Voices of Women .. And Creating Community
Friendly platforms to make them audible
Making FC Brand Queens – celebrating and Felicitating
Users
What worked??
Continuous direct engagement with the Women and Building
capacity of community
Most Importantly….
“Careful positioning of the Product”
FC was placed with careful Branding and Messaging to different
segments taking into the socio cultural perspective
Free Supplies

Target Group –
Eligible Couple
 Positioning - An
additional option in 
the basket of
contraceptive
choice

Social Marketing
Target Group –High 
Risk Group and
Vulnerable Women
Positioning - Women 
Empowerment,
Protection against
STI/HIV
Commercial
Target Group
Independent free
spirited women
Positioning Enabling choices
for ease of life,
Urban Elite
Across Asia..
Women are bound by Social TABOO..
Male partner Buy in and
• To talk and discuss sexuality and Engagement is almost nil &
hard to establish
contraception
• To express Pleasure in Sex
No Communication
• Shop for
strategy, Investment,
contraception/Prevention
commitment …
• Inform or Guide husbands and
Partners.. With the overt cultural No Concept Marketing ….
male domination..
.. Positioning and Messaging ..
Must be Uniquely crafted with social, cultural
acceptability..
Investing in FC Promotion is Largely Policy Makers’
Perception driven !!
- Why we need one more? Isn’t Male Condom enough??
- Decades of Male condom promotion has not yielded result.
Why should FC?
- Sufficient supply of Condom Has been provisioned – why FC?
- Its very large!! Only Sex workers can use it.. Not our “Normal”
Women!
- Do male accept It ?????!!
- May be only for Urban high class- Not for rural simple
women!!!
- Why? We have all sorts of Contraceptive choices for women..
They need no more of new painful things!!!!!!
We Badly Need :
Joining Hands and Making voices Audible
&
Mutual reinforcement with all of You..