In India, it is reported that HIV is concentrated among the poor and marginalized sections of society. These include female sex workers, injecting drug users, men who have sex with men and migrant laborers. Some survey reports have pointed out that this profile is changing and the epidemic is now spreading from high-risk populations to the general population and from urban to rural areas. This trend is certainly pointing towards a danger signal and the solution has to be seen beyond the subject of Public Health.
But, what is the response to this issue at the national level? Consultants are called and they dole out all kinds of strategies to tackle the problem. NGOs are roped in to carry out the task at the field level. Targeting high risk group is given priority and what emerges subsequently is the Targeted Intervention strategy. Today Targeted Intervention (TI) is one of the major components of the National AIDS Control Programme implemented through the NGOs. The idea is to reduce the rate of transmission, through direct intervention involving multi-pronged strategies, ‘beginning from behaviour change communication, counselling, providing health care support, treatment for STD, and creating an enabling environment that will facilitate behaviour change’.
NGOs across the country are struggling to do what has been contracted to them through the state AIDS control societies. While the activities and strategies are within the domain of the NGOS, the number of formats, reports, and registrars mandated to be filled under what is called the Management Information system (MIS), is so huge and burdensome that the NGO staff is more preoccupied and concerned in completing the paper work. A MIS should be a mean to know the process, projections, positions, possibilities, performance and progress and assist in policy making, planning strategies and in programme design and interventions, but in TI project implemented by NGOs, the time consuming and bothersome MIS has become an end in itself. a
With so much of paperwork to do, the project staff has hardly any time to take care of their field work. They are more worried about filling the formats, registers and write reports and minutes of the meetings, that the actual task at the ground level has lost its essence. The MIS work load is huge and under these circumstances NGOs hardly have any room to innovate. On top of this, the monitoring done by officials, agencies and consultants, all of whom act more like a school teacher checking MIS homework and in their field visits, the behaviour is more like a drill sergeant, checking the roll call, inspecting if the barracks are in order, finding faults, wanting better performance, and grading the NGOs drill, field craft, map reading, fire fighting, etc. In such a situation the NGO heads are constantly on the line of fire. Many are continuing with the project just for the sake of it, without their mind and heart in the programme. The ever cribbing project staffs are always comparing their pay and perks with the officers and staffs of the funding agencies and their consultants. In the meantime NGO project staffs are only enhancing their Bio-data and waiting for better opportunities.