Evaluating Behavior Change Among SW in Nigeria By: Oladosun Muyiwa, PhD Charles Ayo Toriola Femi Oladosu [MiraMonitor Consulting, Ltd (MMC)] VENUE: NMEMS, Abuja DATE: September 26, 2011.

Mission of MMC To provide quality consultancy services on human development projects to clients in a timely and speedy fashion. To serve as information powerhouse on best practices in social and human development issues using top-of-the-line approach.

Design and implement evidence-based monitoring and evaluation framework and systems. Provide products and services to companies and organizations in a timely and effective fashion. Design and implement evidence-based monitoring and evaluation framework and systems. Provide products and services to companies and organizations in a timely and effective fashion. Objectives of MMC (1)

Provide conceptually sound advice on effective project implementation and management. Conduct independent cutting edge studies and investigation on gray areas of human development towards improving quality of life. Provide conceptually sound advice on effective project implementation and management. Conduct independent cutting edge studies and investigation on gray areas of human development towards improving quality of life. Objectives of MMC (2)

Social & Health Research (Quantitative & Qualitative) Project Monitoring & Evaluation Quality Assessment & Control Capacity Building Management & Logistics Support Social & Health Research (Quantitative & Qualitative) Project Monitoring & Evaluation Quality Assessment & Control Capacity Building Management & Logistics Support MMC Core Areas

Four year project (October 2006 to October 2010) Implemented in 15 states Areas of Intervention: Brothel-Based FSWs, FSW Clients, OSY, OVC, Caregivers, BCS recipients Four year project (October 2006 to October 2010) Implemented in 15 states Areas of Intervention: Brothel-Based FSWs, FSW Clients, OSY, OVC, Caregivers, BCS recipients The AIDS Impact Mitigation (AIM) Project

Evaluation Methodology (1) Participatory Approach: Consultation with key stakeholders (WIA staff, IPs staff, and other stakeholders Ex-post comparison design: (both qualitative & quantitative approaches) Review of documents

Evaluation Methodology (2) Quantitative: Sample Size, 547 Qualitative: Six FGDs

Findings (1) Project Objective 1: Prevent HIV Transmission by Reducing Vulnerability Amongst FSW Exposure to HIV messagesFSW Ever heard of HIV/AIDS95% Involved in peer education and monitoring program79% Participated in peer education and mentoring training79% Total (N)547

Findings (2) Objective 2: Strengthened Capacity of Stakeholders (including FSW) Business Skills IndicatorsFSW (%) % trained on how to access business opportunities 19% % trained on business management skills23% % trained on financial accounting13% % trained in self esteem/self worth19% % trained in safe sexual practices21% Total (N)547 % of FSW according to types of business skills trainings received on IGA

Findings (3) Excerpts from FSW beneficiary Yola: “We were trained on business skills and we were given IGA. I was given rice, and I have started cooking for sale, so I am very busy now and most times too tired for anything else…now I don’t depend on any mans money, I have started saving money.” Quantitative Findings

Findings (4) Impact of HIV Prevention Activities (1) FSW Behavior Change (1): Most (88%) were still on sex trade Majority (83%) reported that PE & mentoring training received change their behavior. FSW Behavior Change (1): Most (88%) were still on sex trade Majority (83%) reported that PE & mentoring training received change their behavior.

Findings (5) Impact of HIV Prevention Activities (2) FSW Behavior Change (2): 19% reduction in number of sexual partners. 85% reported using condoms always 27% reported increased risk of HIV awareness FSW Behavior Change (2): 19% reduction in number of sexual partners. 85% reported using condoms always 27% reported increased risk of HIV awareness

Findings (6) FSW Involvement in IGA Activities: Over half (53%) were involved in IGA. 18% reported stopping sex work as result of IGA activities. Majority (93%) expressed desire to leave the trade. Over half (53%) were involved in IGA. 18% reported stopping sex work as result of IGA activities. Majority (93%) expressed desire to leave the trade.

Findings (7) FSW Ratings of Services (1): RatingsFSW Peer education and mentoring (%) IGA Received (%) Not satisfactory/don’t know15%64% Fairly Satisfactory5%4% Satisfactory43%14% Very satisfactory37%18% Total (N)547 Percentage distribution according to FSW ratings on peer education and mentoring, and IGA services received

Findings (8) FSW Ratings of Services (2): The majority of FSW reported that PE & mentoring program was satisfactory (43%) or very satisfactory (37%). Only 14% rated IGA as satisfactory or 18% as very satisfactory. The majority of FSW reported that PE & mentoring program was satisfactory (43%) or very satisfactory (37%). Only 14% rated IGA as satisfactory or 18% as very satisfactory.

Lessons Learnt Impact of program felt more in urban than rural areas Exposure to information on risky sexual behavior can result in positive change among FSW

Conclusions (1) Urban vs. rural difference in access and impact of services. FSW had challenges in transitioning to other trade mainly due to lack of facilities (getting a shop, paying for the shop, materials) Transition had to be done quick when desire was still high

Conclusions (2) Self efficacy to transition to other trade was weak because it involves making hard sacrifices There is the need to continue working with FSW to and scale-up to include others