Madhumita Das

ICRW Releases Blueprint for Reducing HIV-related Stigma in India

Indian government officials and others gather to discuss strategy to address HIV-related stigma
Fri, 01/18/2013

ICRW helped develop a strategy for the Indian government to reduce HIV-related stigma and discrimination nationwide. On Jan. 18, researchers share their findings with government officials, UN organizations and others during an event in New Delhi. 

The International Center for Research on Women (ICRW) on Jan. 18 debuts a much-anticipated blueprint for how to effectively address HIV-related stigma and discrimination in numerous settings – from hospitals to college campuses – in India.

The country’s National AIDS Control Organization (NACO) tapped ICRW and other select organizations three years ago to devise a strategy for reducing HIV-related stigma and discrimination nationwide.

To that end, ICRW researchers used a global blueprint for reducing stigma that they had previously developed and adapted it to be culturally relevant for India. ICRW then tested the framework in five settings throughout India and assessed whether it would be feasible to integrate the framework into NACO’s – and other organizations’ – HIV programs.

India is the first country to pilot ICRW’s universal framework and evaluate whether it could appropriately guide national efforts to reduce stigma.

ICRW will host an event Jan. 18 in New Delhi to present the results of its study and discuss how the Indian government can move forward with the findings. Officials from NACO, the United Nations Development Programme (UNDP), World Health Organization (WHO), UNAIDS and other organizations will participate in the gathering. ICRW President Sarah Degnan Kambou and Ravi Verma, director of ICRW’s Asia Regional Office, as well as Madhumita Das, a senior technical specialist in that office and Anne Stangl, a senior behavioral scientist and HIV stigma expert in ICRW’s Washington office, will lead presentations.

“Our study, with evidence from multiple sectors, is timely and strategic,” Verma said. “With the right kind of advocacy and support from other international agencies like UNDP, UNAIDS and WHO, the framework we have developed can be at the forefront of the Indian government’s efforts to curb HIV.”

Despite a nearly 60 percent drop in HIV prevalence over the past decade, the epidemic persists among India’s most vulnerable populations, such as sex workers and intravenous drug users. ICRW experts say this suggests that more is needed to reduce barriers – like stigma and discrimination – that certain groups face in accessing HIV treatment, care and prevention.

Indeed, tackling stigma is a key component in NACO’s latest phase of programming in response to the epidemic.

For ICRW’s study, researchers worked in partnership with five organizations in three states to carry out a variety of activities aimed at decreasing stigma and discrimination. Specifically, the project took place among university faculty, female sex workers living with HIV, local government members, hospital workers and leadership teams in workplaces. 

ICRW ultimately determined that the global framework for reducing HIV-related stigma could indeed be adapted for India. ICRW found that to do so would require:

  • Addressing a fear of HIV infection and social judgment that is prevalent among many different populations
  • Working with several key groups in the same setting to influence the different factors that drive stigma, such a fear of infection through casual contact
  • Focusing on how HIV-related stigma may also intersect with other types of stigma and discrimination – such as that related to one’s caste or occupation
  • Working with family and peers of populations affected by HIV
  • Using a range of activities to engage a variety of groups – from families to institutions – to help foster an environment that can support lasting change
  • Creating opportunities to meet members of groups who experience stigma – such as transgender people – to help break down discriminatory attitudes

“Our findings will set the stage for a right move forward by the national government as it carries out efforts to address the HIV epidemic,” Verma said. “Our experience in India also demonstrates that the global framework ICRW designed can be adapted by other countries eager to address the underlying factors, like stigma and discrimination, that fuel HIV transmission and impede people’s access to services.”

Watch a video of participant attitudes toward HIV-related stigma here

Read the full summary report, “A Global HIV Stigma Reduction Framework Adapted and Implemented in Five Settings in India."

Innovative ICRW Sports Program to Expand

Parivartan program slated to expand geographically and include girls
Tue, 12/18/2012

Parivartan is a signature ICRW program that uses the medium of sports to engage youth in discussions about gender equality and preventing violence against women in India. Now, in two separate efforts, ICRW is gearing up to expand the reach of this innovative program, its participants and its curriculum.

As the year draws to a close, the International Center for Research on Women's (ICRW) Asia Regional Office in New Delhi, India, is preparing to expand a groundbreaking program that uses sports as a vehicle for social change.

In this case the sport is cricket, omnipresent in India, from high-end neighborhoods to slum communities. The ICRW program is called Parivartan, an innovative effort that from 2008 to 2012 drew in young men and boys through cricket to challenge them to question traditional notions of manhood in their society and teach them about respecting women and girls and preventing violence against them. Targeting boys 10 to 16 years old, the program took place in formal cricket sessions at Mumbai schools as well as informal settings in two Mumbai slum communities called Shivaji Nagar and ChittahCamp. With funding from The Nike Foundation, Parivartan was modeled after the "Coaching Boys Into Men" program by Futures Without Violence (formerly Family Violence Prevention Fund).

Now, ICRW will launch another version of Parivartan in 2013 with a new group of youth in two underserved areas. In a separate effort, experts in the New Delhi office also are proposing to scale up the original Parivartan model in two states that hold the highest incidences of violence against women nationally.

In each of these new endeavors, youth may play cricket or a different sport that is popular in their particular community.

ICRW's move comes at a time when the role of sports in international development and social change is gaining traction globally. The growing effort includes programs such as Fight for Peace in Brazil, which uses boxing and martial arts to help youth from violent communities realize their potential; Grassroot Soccer in South Africa, where with soccer games come lessons about HIV prevention; and Women Win, which uses sports as a strategy to advance the rights of girls and women around the world. Meanwhile, the United Nations General Assembly last month reaffirmed in a resolution the power of sports in empowering women and girls, strengthening education, facilitating conflict and more.

Indeed, Parivartan's program proved to have an impact on shifting participants' ideas about manhood and women's roles in society - their views became less patriarchal and more gender equitable after the program. Results from ICRW's evaluation of Parivartan demonstrated that sensitizing boys to gender issues can potentially change stereotypes they hold as well as their attitudes about violence against women.

For the next phase of the program, ICRW will develop "Parivartan Plus" as part of the British Department for International Development's STRIVE effort, which aims to address structural drivers - such as poverty and HIV-related stigma - that continue to fuel the AIDS epidemic. Parivartan Plus will take place in rural Karnataka in southern India and again in Shivaji Nagar, the Mumbai slum community of about 600,000 residents by using the local sport as a medium of engaging with adolescents.

The original Parivartan program model will be at the core of Parivartan Plus. However, ICRW and its partners will build upon the model by designing a curriculum to include components of HIV prevention, sexual and reproductive health as well as substance and alcohol use. And, for the first time, girl athletes will be included in the program.

"Part of what we want to evaluate is the feasibility of incorporating this Parivartan Plus model into the overall STRIVE strategy," said ICRW's Madhumita Das, a senior technical specialist who directs the Parivartan program. "We also want to better understand the links between gender norms, violence, substance use, HIV and sexual and reproductive health among youth."

The Parivartan Plus curriculum will be implemented by Kartnataka Health Promotion Trust (KHPT) with girls and boys in 40 to 60 schools and their catchment areas including thousands of villages in two districts in North Karnataka.

Girls also would be included for the first time in the other proposed Parivartan effort, which would involve a major expansion of the program. ICRW is proposing to replicate the original Parivartan model - this time with girls, too - in the states of Bihar and Rajasthan, which respectively have the highest and second-highest incidence of violence against women.

ICRW would partner with Magic Bus, an organization that uses sports-based curriculum to improve children's lives to reach an estimated 7,500 participants with almost 360 mentor coaches by engaging boys and girls of similar age from 90 villages across two districts of Bihar and Rajasthan. The original Parivartan program reached about 1,200 athletes.

Das said that the original Parivartan curriculum for the proposed expanded program should easily be transferrable to an audience of girls. "It's the way that you take up the discussion, not the content," she said. "And for girls especially, being involved in sports can be transformative in terms of boosting girls' confidence and self-efficacy."

"If you really want to achieve gender equality and reduce gender-based violence and see a larger impact on the lives of women and girls, you need to engage with boys and girls," Das added. "It's an investment in both."

Additional Resources: Parivartan: Transformation Through Sports

Using Cricket to Talk About Gender Equality

Thu, 08/02/2012
The Huffington Post

ICRW's Madhumita Das writes about the Parivartan program in a blog for The Huffington Post. The blog is part of a series organized by Huffington Post and InterAction during the London Olympics, and includes blogs centered the connection between sports and gender, disabilities, peace building and other topics.

Boys’ Attitudes Shift about Manhood, Violence Against Women

Views about gender roles improve among young Indian athletes in ICRW program
Wed, 07/18/2012

Parivartan, a three-year ICRW program in Mumbai, India, used a sports setting to challenge boys’ notions about manhood and women’s roles in society. A final evaluation shows that many of the athletes’ attitudes, perceptions and behaviors about gender equity changed for the better.

New International Center for Research on Women (ICRW) findings show that Indian boys’ views about manhood and women’s roles in society became less patriarchal and more equitable after participating in an ICRW program that aimed to shift norms about gender equity. 

The program, called Parivartan, drew in boys from Mumbai through the popular sport of cricket and challenged them to question traditional notions of manhood present in many societies, including their own. Results from ICRW’s evaluation provided proof that sensitizing boys to gender issues can potentially change stereotypes they hold and their attitudes about violence against women. 

Unfolding over three years among boys ages 10 to 16, Parivartan capitalized on cricket coaches’ role in the young athletes’ lives to impart the program’s key messages. It required the coaches, too, to shift their own ideas about expectations of men and women in society. 

“Parivartan demonstrated that role models for youth – in this case, sports coaches – hold great potential as conduits for helping to address and change seemingly indomitable societal norms,” said Madhumita Das, an ICRW senior technical specialist who directed Parivartan. “What we don’t know yet is if the changes that took place among program participants will remain with them into adulthood.” 

Parivartan’s athletes hailed from opposite ends of the socioeconomic spectrum: middle- and upper-class youth from Mumbai schools who had paid coaches and practiced their game in their cricketer’s white on a manicured field near a country club in downtown Mumbai; and boys from Mumbai’s slum community of Shivaji Nagar, who were coached by mentors close in age and practiced on dirt or asphalt, where they used recycled equipment and sometimes ran in sandals or barefoot. 

Modeled after the Coaching Boys into Men program by Futures Without Violence (formerly Family Violence Prevention Fund), ICRW sought to test whether the influence of coaches and the sports setting could serve as a venue – like home and school – to learn about gender roles and relationships. Experts aimed to document how attitudes, perceptions and behaviors did or did not change among athletes – as well as their coaches. 

“Coaches are more than just instructors of sports techniques. They’re also role models,” Das said. “So we wanted to value this unique relationship of coaches’ with their athletes, to have them channel positive messages to young men about manhood and respect for women.” 

The study sample consisted of 168 athletes in 26 Mumbai schools who were exposed to the Parivartan curriculum, and 141 athletes from 19 schools where the program was introduced later. This design provided a means of comparison, to gauge the effectiveness of the program. Similarly, 168 athletes from Shivaji Nagar took part in the program, while 133 athletes from another community served as the comparison group. 

Researchers sought to answer three questions: (1) What changes occurred in gender and violence-related attitudes, perceptions and behaviors among the Parivartan athletes? (2) What effects did participation in the training and the overall program have on the coaches? and (3) What changes did the wives, mothers or daughters of the coaches perceive as a result of the men’s participation in the program? 

In general, ICRW found that attitudes about gender equity and violence against women shifted for the better among the young cricketers. The coaches’ mindset and behavior also evolved positively. 

ICRW determined the changes by asking the athletes to respond to a series of statements centered on stereotypes around manhood and roles for girls and women. This included questions such as, “A wife should always obey her husband” and “Only men should work outside the home.” The participants were asked at the beginning and end of the Parivartan program to indicate on a 5-point scale whether or not they agreed. ICRW compared responses among athletes from the school setting, the slum community and the groups who did not receive the Parivartan curriculum.

Among ICRW’s findings was that most young cricketers supported a more traditional view of manhood when the program started – a view where boys are not expected to be faithful to girlfriends, where they must always act tough and where they believe they’ll lose respect if they talk about their problems. “This suggested that despite their young age, many boys had already been exposed to and internalized the idea that real men are tough, unfaithful and unemotional,” Das said. 

Those perceptions had changed for most by the end of the program. However, many participants said they still believed that only men can work outside of the home – one of the more deeply-engrained cultural expectations. 

When ICRW looked at changes across the three areas researchers studied – boys’ controlling behavior, manhood and masculinity and girls’ and women’s roles – it found that Parivartan participants’ attitudes about gender roles had changed significantly, compared to those who did not participate in the program. 

An important transformation took place in the Shivaji Nagar athletes’ opinions physical abuse of girls: they became less supportive of it. Such violence is not uncommon; many girls in India, particularly those from poor neighborhoods, are not valued much by their families or others in their community. Many don’t have the chance to attend school or have much say over the course of their lives. To that end, some men and boys see girls as disposable and to be controlled – sometimes, by using violence. In the Parivartan study, most young athletes agreed that a girl does not deserve to be hit if she doesn’t finish her homework, obey her elders or argues with her siblings. However, there was still somewhat strong agreement – specifically among the community athletes – that a girl deserves to be slapped or beaten when she doesn’t help with household chores. 

“Particularly in poor communities, girls are often seen as a big support to handle household chores and look after their younger siblings,” Das said. “More importance is placed on that role in the home, regardless of how young they are, than in getting an education.” 

It’s unclear whether the positive changes in attitudes and behavior that ICRW found will stick as the young men grow into adults. To guarantee such an outcome, ICRW recommends that Parivartan be institutionalized into the settings to which teenagers connect and learn, so that its messages are consistently reinforced. 

While the formal program in Mumbai is no longer, Parivartan is expanding its focus and working with a new group of youth in a rural area: Now, it will be Parivartan-Plus, and part of the U.K. Department for International Development’s STRIVE effort to address social inequities that continue to fuel the AIDS epidemic. The program will take place in rural Karnataka, in southern India, and along with addressing violence against women, it also will tackle sexuality and the links between alcohol and substance use and HIV. 

Gillian Gaynair is ICRW’s senior writer and editor.

Related Content:

Photo Slideshow: The Sport of Respect

Judge’s Incendiary Remarks On Women Highlights India’s Domestic Violence Crisis

Fri, 09/07/2012
International Business Times

ICRW's Madhumita Das is quoted in this article about violence against women in India.

Sports Effective Tool for Change in Gender Issues

Wed, 05/30/2012
News Track India

Sensitizing young cricket athletes and their coaches about gender issues can be an effective tool for prevention of violence against women, according to a study by ICRW. News Track India reports on findings.

Engaging Coaches and Athletes in Fostering Gender Equity

Engaging Coaches and Athletes in Fostering Gender Equity
Findings from the Parivartan Program in Mumbai, India

Madhumita Das, Sancheeta Ghosh, Elizabeth Miller, Brian O'Connor, Ravi Verma
2012

Parivartan, which means transformation, engaged cricket coaches and mentors in schools and the community to teach boys lessons about controlling aggression, preventing violence, and promoting respect. Based on the US-based program, Coaching Boys into Men developed by Futures Without Violence, the program engages coaches as positive role models and trains them to deliver messages to their male athletes about the importance of respecting women and understanding violence never equals strength. ICRW along with Futures Without Violence partnered with the Mumbai Schools Sports Association and the non-governmental organization Apnalaya to implement Parivartan in the formal school system and the slum community of Shivaji Nagar, respectively. This report describes the three-year program and summarizes key findings from the evaluation conducted by ICRW.

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We encourage the use and dissemination of our publications for non-commercial, educational purposes. Portions may be reproduced with acknowledgment to the International Center for Research on Women (ICRW). For questions, please contact publications@icrw.org; or (202) 797-0007.

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Universal Access for Women and Girls

Universal Access for Women and Girls
Accelerating Access to HIV Prevention, Treatment, Care and Support for Female Sex Workers and Wives of Migrant Men

Madhumita Das, Priya Nanda, Enisha Sarin, Alka Narang
2012

As part of the global initiative Universal Access for Women and Girls (UA Now!) to improve and achieve universal access to HIV prevention and treatment services for women, ICRW implemented a research study to expand the evidence base on access to services for two key populations in India: female sex workers and wives of migrant men in Pune, Maharashtra, and Ganjam, Orissa, respectively.

This report provides the results of a study undertaken by ICRW with support of the United Nations Development Programme (UNDP). The main objectives of the research study were to explore barriers to HIV services experienced by the study populations, and based on the findings, to identify entry points for improving HIV services among women in India more broadly.

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We encourage the use and dissemination of our publications for non-commercial, educational purposes. Portions may be reproduced with acknowledgment to the International Center for Research on Women (ICRW). For questions, please contact publications@icrw.org; or (202) 797-0007.

Terms and Conditions »

Protecting Human Rights

Protecting Human Rights (PHR) is a five year human rights activity project funded by USAID. ICRW is partnering with Plan and the Bangladesh National Woman Lawyers’ Association to reduce the high prevalence of domestic violence and other related human rights violations (including child marriage, anti-stalking, dowry, physical humiliation, torture, trafficking, rape and child abduction).

To achieve this goal, PHR is engaging in an array of activities to encourage policy reform and advocacy, enhance public awareness, and increase public dialogue between the government and civil society on issues of domestic violence and other associated human rights abuses. Interventions under PHR include: 1) advocating for the Government of Bangladesh to adopt and enforce comprehensive women‘s rights and domestic violence policies that includes legislation as the Domestic Violence Bill; 2) ensuring that survivors of domestic violence and other related human rights abuses have greater access to justice; 3) increasing the awareness and capacity of communities throughout Bangladesh to reduce domestic violence.

Duration: 
2011 - 2016
Location(s): 
Bangladesh

Strategic Framework and Implementation Guidelines for Reducing HIV-related Stigma in India

Globally, stigma and discrimination impede HIV prevention, testing and treatment efforts. Yet research by ICRW and others shows that stigma and discrimination can be reduced in different contexts, such as the community and health facilities, thus contributing to the success of HIV programs and services.

India’s National AIDS Control Organisation (NACO) recognizes HIV-related stigma as a key challenge to controlling the epidemic. With support from the United Nations Development Program (UNDP) and in collaboration with NACO, ICRW designed and tested a strategic framework and implementation guidelines for stigma reduction in multiple settings in India. The framework built on one previously developed by a global working group made up of stigma experts and led by ICRW. The framework for India identifies key entry points for stigma-focused programming and measurement.  

ICRW also provided technical support to select organizations in applying the framework and guidelines for stigma reduction.  ICRW then collected data on the organizations’ experiences in applying the tools and used the information to finalize the strategic framework and implementation guidelines. The final tools as well as study outcome was widely disseminated to guide policymakers and practitioners in addressing HIV-related stigma and discrimination at the local and national levels.

Overall, ICRW found that the global framework was relevant to the Indian context and feasible for use by organizations and institutions in guiding stigma-reduction program development, implementation and measurement. Learning from the pilot interventions offers guidelines for broader implementation.

Duration: 
November 2011 to March 2013
Location(s): 
India
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