Talking About Reproductive and Sexual Health Issues

The TARSHI Helpline Experience Reflections on Outreach and New Technologies Prabha Nagaraja

We Believe All people have the right to sexual well-being, and a self-affirming and enjoyable sexuality

Our Mission We work towards expanding sexual and reproductive choices in people’s lives in an effort to enable them to enjoy lives of dignity, freedom from fear, infection, and reproductive and sexual health problems

What we do... o TARSHI Helpline /IVRS Infoline o The South and Southeast Asia Resource Centre on Sexuality o Trainings & Institutes o Publications o Advocacy Initiatives / Public education o Website

TARSHI Helpline o Free, Confidential, Anonymous and Non-judgmental service from 1996 to 2009 o Information, Counselling and Referrals on sexuality, reproductive health and related issues o Especially for women and young people o IVRS from June 2010 o Monday – Friday, 9:30 am to 5:30 pm o Average of 300 calls a month

TARSHI Helpline o Over 60,000 calls received from 1996 to 2009 o Callers: women, men and transgender people o Age of callers: 12 to 70+ years o Diverse socio-economic backgrounds o General sex information, contraception, homosexuality, sexual abuse, relationship issues, HIV and AIDS etc

Outreach/Publicity o Only for women vs. Especially for women o Newspapers, magazines*, stickers, fliers – limited success o Cable TV – timings chosen for women/homemakers* o FM most successful* (in early days of FM in India) o Internet – increasingly popular even in smaller towns Publicity consistently aimed at women but more men reached!

Some Helpline Publications o Guidelines for Good Helpline Practice, 2003 o Talking About Sexuality: A Report, 2007 o A Review of the TARSHI Helpline for WHO by KIT, 2008 o Sustainability of Helplines, Models That Work,

Transition From a Helpline providing Information, Counselling and Referrals To A pre-recorded Information Based Service in

IVRS/Infoline o Pre-recorded information in English and Hindi o On seven topics: o Female Anatomy o Male Anatomy o Sexual Expression o Conception, Contraception and Abortion o Sexual and Gender Identities o HIV and STIs o Violence and Abuse

Setting Up an IVRS o Identify software provider o Budget o Past experience in similar work o Service record o Develop content o Structure of the system o Prioritising information

Setting Up an IVRS o Recording the content o Identify a studio if the software people do not provide this facility o Identify voices for recording – female/male, young/mature, accent etc. o Testing the service o Check the call flow o Check content and revise if required

Advantages o Callers can access basic, accurate, standardised information as many times as they want and in their own time. o In the absence of reliable sources of information or a CSE programme, this helps fill the information gaps to an extent. o Cost effective – initial cost of software, computer and telephone lines and then minimal running costs as opposed to having to pay for training counsellors, salaries, professional development etc.

Disadvantages o The amount of information you can fit into seconds is limited. o Technical glitches, disruptions in electricity supply etc. can interrupt the service. o The recordings are not a substitute for speaking to a well-trained human being and can put people off.

Ideally... An IVRS service for basic information linked to a live counselling service would be a good combination. This would provide basic pre-recorded information at all times of the day and specialised counselling at specified times of the week. Saves operating costs as well as maximises reach of the service in addition to providing both information and counselling services.

Other ‘New’ Technologies Mobile-based services Text message services On call 24 x 7 Internet-based services Websites, blogs, FAQs etc. -based counselling Chat-based counselling Calling through Skype/other services Elearning course

Pros and Cons AdvantagesDisadvantages Cost effective and wider reach including 24 x 7 access (websites, FAQs etc.) Reach limited to those with internet access and language skills. Standardised information available to all. Sometimes, technical terms and information difficult to understand without discussing with counsellor. Using web-based services like Skype calls, webinars etc. can reach farther at lower costs and can circumvent the risk of putting things in writing though other risks exist (not knowing who else is in the room for example). Legal and/or social implications of putting information in writing/on tape. For e.g. Giving information on Miso-Mife through chat/text in a country where it is illegal can put client and service provider both at risk.

In conclusion The potential of new technologies to reach wider audiences is immense and growing. While potential risks exist given the nature of our work, they can be circumvented through well-thought-out and well-planned interventions as we have heard during this meeting.

THANK YOU