FY 2012 COP FY 2012 COP IOM Portfolio ReviewIOM Portfolio Review

23 August 201123 August 2011

International Organization International Organization for Migrationfor Migration

Portfolio ReviewPortfolio Review

Overall aim of your work Overall aim of your work To improve the physical, mental and social well being of migrants and affected communities To improve the physical, mental and social well being of migrants and affected communities by responding to their health needs throughout all phases of the migration process, and by responding to their health needs throughout all phases of the migration process, and addressing the public health challenges of host/sending communities addressing the public health challenges of host/sending communities

Programmatic Areas (Programmatic Areas (Refer to notes for key approaches and activities)Refer to notes for key approaches and activities)Service Delivery and Capacity BuildingService Delivery and Capacity Building To facilitate, provide and promote access to health services that are sensitive to To facilitate, provide and promote access to health services that are sensitive to

the needs of migrants and communities affected by migrationthe needs of migrants and communities affected by migration To increase capacity to deliver health services that are sensitive to the needs of To increase capacity to deliver health services that are sensitive to the needs of

migrants and communities affected by migrationmigrants and communities affected by migration Advocacy for Policy DevelopmentAdvocacy for Policy Development TTo advocate for national and sectoral policies/strategies that address migration o advocate for national and sectoral policies/strategies that address migration

health concerns health concerns To facilitate and strengthen national coordination on migration health concerns To facilitate and strengthen national coordination on migration health concerns ResearchResearch To increase understanding of migration health issues through research in South To increase understanding of migration health issues through research in South

AfricaAfrica To promote migration health as a research Agenda (govt., academia, research To promote migration health as a research Agenda (govt., academia, research

institutions)institutions)* partners working in many areas should

provide us with a chart 2

OUR APPROACHOUR APPROACH

Environmental Factors

Structural Factors

Individual Drivers

• Include migration in development instruments- IDPs, PGDS• Labour migration and workplace responses- (TB in mines, Sectoral Policy guidelines •Address gender dynamics•Engage in Policy dialogue addressing HIV and other health issues- NSP process; MHF, policy briefs (key populations) to advocate for migrant-sensitive policies and services•Building social cohesion and social capital

• Facilitate access to services

• Address occupational health risks•inclusive workplace wellness policies/programmes for seasonal/temp workers• Contextual factors

• Boredom – lack of recreation

• Low literacy / low skilled • Other life skills

•Focused and appropriate health promotion information- using SBCC approaches (community dialogues)•Addressing other social determinants of health in a particular spaces

• Promote health seeking behaviour (i.e. know your HIV status), health not a priority

• Access to prevention tools• Partner reduction strategies

• Peer-led education and communication

Where do we work?Where do we work?

Spaces of vulnerabilitySpaces of vulnerability Targeting populations – sedentary and mobile – Targeting populations – sedentary and mobile –

affected by the migration processaffected by the migration process Commercial farming communities – high levels of Commercial farming communities – high levels of

seasonal and migrant labourseasonal and migrant labour• But could include mining, border and other migration But could include mining, border and other migration

affected communitiesaffected communities Currently working (2011) in :Currently working (2011) in :

Limpopo- Vhembe, Mopani and WaterbergLimpopo- Vhembe, Mopani and Waterberg Mpumalanga- Enhlazeni district in NkomaziMpumalanga- Enhlazeni district in Nkomazi Gauteng- City of JohannesburgGauteng- City of Johannesburg KZN- eThekwiniKZN- eThekwini

WHO do you work with to achieve WHO do you work with to achieve the objectivesthe objectives

Our target populations:

• Policy makers• Implementers/ service providers• Migrants • Migration affected communities (border districts, farming communities, mining,

Our SAG counterparts • National Department of Health• National Department of Social Development (Population Unit)• Other National Depts: DHA, DPSA, DAFF, DoT• Provincial and Local Government (Office of the Premier, DHSD, etc)

Other partners • Other UN Agencies (WHO,UNAIDS, UNFPA, UNHCR, UNDP)• SABCOHA• Unions• INGO• Local organizations

Achievements so farAchievements so far Good practices on implementing effective interventions for Good practices on implementing effective interventions for

migration affected communities;migration affected communities;• Health Promotion and service delivery model implemented in the Health Promotion and service delivery model implemented in the

comm. Agric (Ripfumelo) and associated tools;comm. Agric (Ripfumelo) and associated tools;• Bottom-up approachesBottom-up approaches• Combination HIV prevention strategiesCombination HIV prevention strategies

Advocacy- migration on the agendaAdvocacy- migration on the agenda• Involvement in the NSP process;Involvement in the NSP process;• Ongoing dialogue through different fora (MHF);Ongoing dialogue through different fora (MHF);• Supported implementation of the WHA Resolution 61.17Supported implementation of the WHA Resolution 61.17• National Farm worker SummitNational Farm worker Summit• Strategic alliances and Partnerships Strategic alliances and Partnerships

ResearchResearch• IBBS – 39% HIV prevalence amongst farm workers (49% in Malelane, IBBS – 39% HIV prevalence amongst farm workers (49% in Malelane,

Mpumalanga)Mpumalanga)• Country assessmentCountry assessment

How do we know we are achieving How do we know we are achieving our objectivesour objectives

Baseline (formative assessment)Baseline (formative assessment) Measurable indicators for processes, outputs and Measurable indicators for processes, outputs and

outcomesoutcomes Regular monitoring (achievements against targets)Regular monitoring (achievements against targets) Include both quantitative and qualitative;Include both quantitative and qualitative; Mid-term reviewsMid-term reviews Summative assessment- outcome evaluationSummative assessment- outcome evaluation Documentation of lessons learnt and emerging field Documentation of lessons learnt and emerging field

practicespractices

ChallengesChallenges

Sustainability (funding, government ownership, Sustainability (funding, government ownership, Competing development challengesCompeting development challenges

Migration still perceived negatively, even by policy Migration still perceived negatively, even by policy makers and this prohibits effective responsesmakers and this prohibits effective responses

Few on the ground intervention to address the needs Few on the ground intervention to address the needs of migrants;of migrants;

Strategic information (limited data on migration Strategic information (limited data on migration trends, migration dynamics in the context of HIV);trends, migration dynamics in the context of HIV);

Programmatic Direction - two year Programmatic Direction - two year horizonhorizon Influences:Influences:

• NSDA- particularly looking at social determinants of health and how NSDA- particularly looking at social determinants of health and how migration needs to be broadly mainstreamed in policies; and migration needs to be broadly mainstreamed in policies; and

• NSP on HIV/AIDS/STI and TBNSP on HIV/AIDS/STI and TB• UNDAFUNDAF

Priorities: Priorities: • Service delivery and capacity buildingService delivery and capacity building• Advocacy for policy developmentAdvocacy for policy development• ResearchResearch• CoordinationCoordination

Alignment with the PF & PEPFAR 5-yr StrategyAlignment with the PF & PEPFAR 5-yr Strategy• Efforts to increase efficiencies-Efforts to increase efficiencies- diversification of funding; partnerships diversification of funding; partnerships

with other UN agencies – WHO, UNAIDS, UNFPA etc.with other UN agencies – WHO, UNAIDS, UNFPA etc.• Strengthen health and social systems-Strengthen health and social systems- working through the national, working through the national,

provincial and district structures; capacity building on migration provincial and district structures; capacity building on migration healthhealth

• Engagement with broader health and development programs (social Engagement with broader health and development programs (social determinants of health, Spaces of Vulnerability)determinants of health, Spaces of Vulnerability)

• Expand coverage of combination prevention – multilevel approaches Expand coverage of combination prevention – multilevel approaches drawing on biomedical, behavioral and social approachesdrawing on biomedical, behavioral and social approaches

• Community strengthening- working in partnership with local partners; Community strengthening- working in partnership with local partners; involvement of key populationsinvolvement of key populations

• Strategic information- generate data on migration and HIV, Strategic information- generate data on migration and HIV, documenting what works (documenting what works (learning siteslearning sites))

• HIV/TB integration (population mobility plays a critical role in the HIV/TB integration (population mobility plays a critical role in the spread and management of these conditions)spread and management of these conditions)

Scale down:Scale down:• Ripfumelo projectRipfumelo project

FundingFunding Need to integrate migration health within the District Health Plans, Need to integrate migration health within the District Health Plans,

national and provincial strategic plansnational and provincial strategic plans SustainabilitySustainability

• Build local ownership (working through and with local organizations);Build local ownership (working through and with local organizations);• Strategic Partnerships;Strategic Partnerships;• Capacity building for civil society and government;Capacity building for civil society and government;• Mainstreaming migration into health policies and strategies (NSP, Mainstreaming migration into health policies and strategies (NSP,

NSDA);NSDA);• Documenting and sharing best practices (including lessons learnt);Documenting and sharing best practices (including lessons learnt);• Mobilizing local and external resources (financial as well as material Mobilizing local and external resources (financial as well as material

and technical)and technical)

FY 2012 Recommended Programmatic Budget ShiftsFY 2012 Recommended Programmatic Budget Shifts

Increase support on the contextual/ structural Increase support on the contextual/ structural barriers to change (not just the biomedical);barriers to change (not just the biomedical);

Build evidence through actual implementation on Build evidence through actual implementation on the ground (identify learning sites, and the ground (identify learning sites, and documents emerging practices);documents emerging practices);

Systems strengthening- support and strengthen Systems strengthening- support and strengthen coordination mechanisms such as the AIDS coordination mechanisms such as the AIDS Councils and other relevant structures (MHF);Councils and other relevant structures (MHF);

(Targeted) Focus interventions, looking at key (Targeted) Focus interventions, looking at key populations populations