Suchergebnisse

Populism is a phenomenon of political communication that can be a political strategy for politicians who want to represent themselves. In the campaign period for the Election of West Java Governor Ridwan Kamil as a candidate for governor used a populist strategy to gain political support from the people of West Java. Populism strategy is very important in democracy, the characteristics of Ridwan Kamil's populism can be found in the form of Instagram posts, starting from May 27, 2018 - June 27, 2018 during the campaign period of the West Java Governor General Ridwan Kamil giving Instagram posts that match 9 characteristics of polulism. To find out the characteristics of Ridwan Kamil's populism on Instagram using data collection methods by taking interview data from Mr. Khalid Zabidi, a Golkar Party cadre, Ridwan Kamil's Instagram direct observation, literature study to support research and document studies.Populisme merupakan fenomena komunikasi politik yang dapat menjadi strategi politik bagi politikus yang ingin merepresentasikan dirinya. Dalam masa kampanye Pemilihan Gubernur Jawa Barat Ridwan Kamil sebagai calon gubernur menggunakan strategi populis untuk mendapatkan dukungan politik dari masyarakat Jawa Barat. Strategi populisme sangat penting dalam demokrasi, karakteristik populisme Ridwan Kamil bisa di temui dalam bentuk postingan Instagram,Terhitung dari 27 Mei 2018 – 27 Juni 2018 saat masa kampanye Pemilihan Gubenur Jawa Barat Ridwan Kamil memberikan postingan Instagram yang sesuai dengan 9 karakteristik polulisme. Untuk mengetahui karakteristik populisme Ridwan Kamil di Instagram menggunakan cara pengumpulan data dengan mengambil data wawancara Bapak Khalid Zabidi Kader Partai Golkar, observasi langsung Instagram Ridwan Kamil, studi pustaka untuk mendukung penelitian dan studi dokumen.

Background Child marriage (<18 years) and school drop-out disproportionately affect girls living in impoverished households in rural areas, with long-term economic and health consequences. Improving retention in education, and delaying age at marriage and first pregnancy have received substantial attention at the national and global level, in line with the Millennium Development Goals and the Sustainable Development Goals (SDGs) (2015-2030). Methods We examined changes over time in economic, education and child marriage indicators among adolescents from rural households in (i) Northern Karnataka (the most deprived region of Karnataka), (ii) Karnataka state, and (iii) all India, using individualized data from four pre-existing, nationally-representative datasets (District Level Household and Facility Surveys (DLHS 2-4) (2002/4–2012/3) and the National Family Health Survey (NFHS-4) (2015-16)). Results At the national and state level, we found large improvements in secondary educational attainment among girls and boys living in rural settings (proportion of adolescents completing age-appropriate secondary school education (all India): girls 12.4% 2002/3 vs. 31.6% 2015/6; boys 18.9% 2002/4 vs. 36.8% 2015/6). We also observed large reductions in child marriage and early child-bearing rates (proportion of married women aged 18-24 years married <18 years: 62.4% 2002/4 vs. 23.8% 2015/6; proportion of married girls aged <19 years who are pregnant or have children: 62.4% 2002/4 vs. 21.9% 2015/6). In addition, we found evidence of "clustered deprivations", whereby girls in rural areas from the poorest families and lowest castes continue to experience multiple forms of disadvantage, with child marriage significantly associated with scheduled caste / scheduled tribe (SC/ST) caste (odds ratio (OR)=1.25, 95% confidence interval (CI)=1.18-1.32), poorest quintile (OR=2.38, 95% CI=2.21-2.55) and illiteracy (OR=2.09, 95% CI=1.95-2.23); and not completing secondary education significantly associated with SC/ST caste (OR=1.52, 95% CI=1.45-1.59), poorest quintile (OR=4.17, 95% CI=3.90-4.46), and child marriage (OR=2.05, 95% CI=1.85-2.26). Conclusions The results show substantial improvements in economic, educational and child marriage indicators at the state and national level over the past 14 years. The government has implemented multiple programmes and policies to address child marriage and school drop-out, and these trends suggest such efforts may be having a positive impact. If India is to achieve the SDGs, designing targeted interventions to reach those who continue to be left furthest behind is going to be key.

BACKGROUND: Child marriage (<18 years) and school drop-out disproportionately affect girls living in impoverished households in rural areas, with long-term economic and health consequences. Improving retention in education, and delaying age at marriage and first pregnancy have received substantial attention at the national and global level, in line with the Millennium Development Goals and the Sustainable Development Goals (SDGs) (2015-2030). METHODS: We examined changes over time in economic, education and child marriage indicators among adolescents from rural households in (i) Northern Karnataka (the most deprived region of Karnataka), (ii) Karnataka state, and (iii) all India, using individualized data from four pre-existing, nationally-representative datasets (District Level Household and Facility Surveys (DLHS 2-4) (2002/4–2012/3) and the National Family Health Survey (NFHS-4) (2015-16)). RESULTS: At the national and state level, we found large improvements in secondary educational attainment among girls and boys living in rural settings (proportion of adolescents completing age-appropriate secondary school education (all India): girls 12.4% 2002/3 vs. 31.6% 2015/6; boys 18.9% 2002/4 vs. 36.8% 2015/6). We also observed large reductions in child marriage and early child-bearing rates (proportion of married women aged 18-24 years married <18 years: 62.4% 2002/4 vs. 23.8% 2015/6; proportion of married girls aged <19 years who are pregnant or have children: 62.4% 2002/4 vs. 21.9% 2015/6). In addition, we found evidence of "clustered deprivations", whereby girls in rural areas from the poorest families and lowest castes continue to experience multiple forms of disadvantage, with child marriage significantly associated with scheduled caste / scheduled tribe (SC/ST) caste (odds ratio (OR)=1.25, 95% confidence interval (CI)=1.18-1.32), poorest quintile (OR=2.38, 95% CI=2.21-2.55) and illiteracy (OR=2.09, 95% CI=1.95-2.23); and not completing secondary education significantly associated with SC/ST caste (OR=1.52, 95% CI=1.45-1.59), poorest quintile (OR=4.17, 95% CI=3.90-4.46), and child marriage (OR=2.05, 95% CI=1.85-2.26). CONCLUSIONS: The results show substantial improvements in economic, educational and child marriage indicators at the state and national level over the past 14 years. The government has implemented multiple programmes and policies to address child marriage and school drop-out, and these trends suggest such efforts may be having a positive impact. If India is to achieve the SDGs, designing targeted interventions to reach those who continue to be left furthest behind is going to be key.

BACKGROUND: Despite high HIV prevalence rates among most-at-risk groups, utilisation of HIV testing, treatment and care services was relatively low in Karnataka prior to 2008. The authors aimed to understand the barriers to and identify potential solutions for improving HIV service utilisation. METHODS: Focus group discussions were carried out among homogeneous groups of female sex workers, men who have sex with men and transgenders, and programme peer educators in six districts across Karnataka in March and April 2008. RESULTS: 26 focus group discussions were conducted, involving 302 participants. Participants had good knowledge about HIV and HIV voluntary counselling and testing (VCT) services, but awareness of other HIV services was low. The fear of the psychological impact of a positive HIV test result and the perceived repercussions of being seen accessing HIV services were key personal and interpersonal barriers to HIV service utilisation. Previous experiences of discrimination at government healthcare services, coupled with discriminatory attitudes and behaviours by VCT staff, were key structural barriers to VCT service uptake among those who had not been HIV tested. Among those who had used government-managed prevention of parent to child transmission and antiretroviral treatment services, poor physical facilities, long waiting times, lack of available treatment, the need to give bribes to receive care and discriminatory attitudes of healthcare staff presented additional structural barriers. CONCLUSIONS: Embedding some HIV care services within existing programmes for vulnerable populations, as well as improving service quality at government facilities, are suggested to help overcome the multiple barriers to service utilisation. Increasing the uptake of HIV testing, treatment and care services is key to improving the quality and longevity of the lives of HIV-infected individuals.

Abstract Background Emergency Neonatal Care (EmNC) is an important service for the health and survival of newborns. The objective of our study was to assess the availability of emergency neonatal care services in the north-eastern region of Karnataka state in India. Methods We undertook a cross-sectional epidemiologic study in the year 2010. We assessed the provision of eight life-saving 'signal functions' (Comprehensive EmNC) or at least five 'signal functions' (Basic EmNC) by self-reporting through a structured questionnaire, coupled with verification by direct observation for presence of drugs and equipment in the prior three months. The assessment was undertaken in 443 government and 422 private healthcare facilities of eight districts of Karnataka. Results There was an average of 3.6 EmNC facilities available per 500,000 population for the entire region. Only three out of eight districts and 10 of 42 sub-districts in the region had the recommended [greater than or equal to 5] EmNC facilities per 500,000. Further, over 95 % of CEmNC facilities and 88 % of BEmNC facilities were within the private sector. About 80 % of government hospitals at district and sub-district levels did not have EmNC capability. Conclusions This study demonstrates the feasibility of using a simple assessment tool to measure health facility availability of life-saving services for newborn care. EmNC availability was seen to be suboptimal at the regional, district and sub-district levels within the northern part of Karnataka state. There is a need to improve availability of emergency newborn care in health facilities, with special emphasis on equity at population level.

Abstract Background Emergency Neonatal Care (EmNC) is an important service for the health and survival of newborns. The objective of our study was to assess the availability of emergency neonatal care services in the north-eastern region of Karnataka state in India. Methods We undertook a cross-sectional epidemiologic study in the year 2010. We assessed the provision of eight life-saving 'signal functions' (Comprehensive EmNC) or at least five 'signal functions' (Basic EmNC) by self-reporting through a structured questionnaire, coupled with verification by direct observation for presence of drugs and equipment in the prior three months. The assessment was undertaken in 443 government and 422 private healthcare facilities of eight districts of Karnataka. Results There was an average of 3.6 EmNC facilities available per 500,000 population for the entire region. Only three out of eight districts and 10 of 42 sub-districts in the region had the recommended [greater than or equal to 5] EmNC facilities per 500,000. Further, over 95 % of CEmNC facilities and 88 % of BEmNC facilities were within the private sector. About 80 % of government hospitals at district and sub-district levels did not have EmNC capability. Conclusions This study demonstrates the feasibility of using a simple assessment tool to measure health facility availability of life-saving services for newborn care. EmNC availability was seen to be suboptimal at the regional, district and sub-district levels within the northern part of Karnataka state. There is a need to improve availability of emergency newborn care in health facilities, with special emphasis on equity at population level.

AbstractIntroductionHIV prevention cascades have emerged as a programme management and monitoring tool that outlines the sequential steps of an HIV prevention programme. We describe the application of an HIV combination prevention programme cascade framework to monitor and improve HIV prevention interventions for female sex workers (FSWs) in Kenya.MethodsTwo data sources were analysed: (1) annual programme outcome surveys conducted using a polling booth survey methodology in 2017 among 4393 FSWs, and (2) routine programme monitoring data collected by (a) 92 implementing partners between July 2017 and June 2018, and (b) Learning Site in Mombasa (2014 to 2015) and Nairobi (2013). We present national, sub‐national and implementing partner level cascades.ResultsAt the national level, the population size estimates for FSW were 133,675 while the programme coverage targets were 174,073. Programme targets as denominator, during the period 2017 to 2018, 156,220 (90%) FSWs received peer education and contact, 148,713 (85%) received condoms and 83,053 (48%) received condoms as per their estimated need. At the outcome level, 92% of FSWs used condoms at the last sex with their client but 73% reported consistent condom use. Although 96% of FSWs had ever tested for HIV, 85% had tested in the last three months. Seventy‐nine per cent of the HIV‐positive FSWs were enrolled in HIV care, 73% were currently enrolled on antiretroviral therapy (ART) and 52% had attended an ART clinic in the last month. In the last six months, 48% of the FSWs had experienced police violence but 24% received violence support. National and sub‐national level cascades showed proportions of FSWs lost at each step of programme implementation and variability in programme achievement. Hotspot and sub‐population level cascades, presented as examples, demonstrate development and use of these cascades at the implementation level.ConclusionsHIV prevention programme cascades, drawing on multiple data sources to provide an understanding of gaps in programme outputs and outcomes, can provide powerful information for monitoring and improving HIV prevention programmes for FSWs at all levels of implementation and decision‐making. Complexity of prevention programmes and the paucity of consistent data can pose a challenge to development of these cascades.

IntroductionFemale sex workers (FSWs) frequently experience violence, harassment and arrest by the police or their clients, but there is little evidence as to the impact that such factors may have on HIV risk or whether community interventions could mitigate this impact.MethodsAs part of the evaluation of the Avahan programme in Karnataka, serial integrated behavioural and biological assessment (IBBA) surveys (four districts) (2005 to 2011) and anonymous polling booth surveys (PBS) (16 districts) (2007 to 2011) were conducted with random samples of FSWs. Logistic regression analysis was used to assess 1) changes in reported violence and arrests over time and 2) associations between violence by non‐partners and police arrest and HIV/STI risk and prevalence. Mediation analysis was used to identify mediating factors.Results5,792 FSWs participated in the IBBAs and 15,813 participated in the PBS. Over time, there were significant reductions in the percentages of FSWs reporting being raped in the past year (PBS) (30.0% in 2007, 10.0% in 2011, p<0.001), being arrested in the past year [adjusted odds ratio (AOR) 0.57 (0.35, 0.93), p=0.025] and being beaten in the past six months by a non‐partner (clients, police, pimps, strangers, rowdies) [AOR 0.69 (0.49, 0.95), p=0.024)] (IBBA). The proportion drinking alcohol (during the past week) also fell significantly (32.5% in 2005, 24.9% in 2008, 16.8% in 2011; p<0.001). Violence by non‐partners (being raped in the past year and/or beaten in the past six months) and being arrested in the past year were both strongly associated with HIV infection [AOR 1.59 (1.18, 2.15), p=0.002; AOR 1.91 (1.17, 3.12), p=0.01, respectively]. They were also associated with drinking alcohol (during the past week) [AOR 1.98 (1.54, 2.53), p<0.001; AOR 2.79 (1.93, 4.04), p<0.001, respectively], reduced condom self‐efficacy with clients [AOR 0.36 (0.27, 0.47), p<0.001; AOR 0.62 (0.39, 0.98), p=0.039, respectively], symptomatic STI (during the past year) [AOR 2.62 (2.07, 3.30), p<0.001; AOR 2.17 (1.51, 3.13), p<0.001, respectively], gonorrhoea infection [AOR 2.79 (1.51, 5.15), p=0.001; AOR 2.69 (0.96, 7.56), p=0.060, respectively] and syphilis infection [AOR 1.86 (1.04, 3.31), p=0.036; AOR 3.35 (1.78, 6.28), p<0.001, respectively], but not with exposure to peer education, community mobilization or HIV testing uptake. Mediation analysis suggests that alcohol use and STIs may partially mediate the association between violence or arrests and HIV prevalence.DiscussionViolence by non‐partners and arrest are both strongly associated with HIV infection among FSWs. Large‐scale, comprehensive HIV prevention programming can reduce violence, arrests and HIV/STI infection among FSWs.

Abstract Background While community mobilization has been widely endorsed as an important component of HIV prevention among vulnerable populations such as female sex workers (FSWs), there is uncertainty as to the mechanism through which it impacts upon HIV risk. We explored the hypothesis that individual and collective empowerment of FSW is an outcome of community mobilization, and we examined the means through which HIV risk and vulnerability reduction as well as personal and social transformation are achieved. Methods This study was conducted in five districts in south India, where community mobilization programs are implemented as part of the Avahan program (India AIDS Initiative) of the Bill & Melinda Gates Foundation. We used a theoretically derived "integrated empowerment framework" to conduct a secondary analysis of a representative behavioural tracking survey conducted among 1,750 FSWs. We explored the associations between involvement with community mobilization programs, self-reported empowerment (defined as three domains including power within to represent self-esteem and confidence, power with as a measure of collective identity and solidarity, and power over as access to social entitlements, which were created using Principal Components analysis), and outcomes of HIV risk reduction and social transformation. Results In multivariate analysis, we found that engagement with HIV programs and community mobilization activities was associated with the domains of empowerment. Power within and power with were positively associated with more program contact (p < .01 and p < .001 respectively). These measures of empowerment were also associated with outcomes of "personal transformation" in terms of self-efficacy for condom and health service use (p < .001). Collective empowerment (power with others) was most strongly associated with "social transformation" variables including higher autonomy and reduced violence and coercion, particularly in districts with programs of longer duration (p < .05). Condom use with clients was associated with power with others (p < .001), while power within was associated with more condom use with regular partners (p < .01) and higher service utilization (p < .05). Conclusion These findings support the hypothesis that community mobilization has benefits for empowering FSWs both individually and collectively. HIV prevention is strengthened by improving their ability to address different psycho-social and community-level sources of their vulnerability. Future challenges include the need to develop social, political and legal contexts that support community mobilization of FSWs, and to prospectively measure the impact of combined community-level interventions on measures of empowerment as a means to HIV prevention. ; Peer Reviewed

Abstract Background Structural factors are known to affect individual risk and vulnerability to HIV. In the context of an HIV prevention programme for over 60,000 female sex workers (FSWs) in south India, we developed structural interventions involving policy makers, secondary stakeholders (police, government officials, lawyers, media) and primary stakeholders (FSWs themselves). The purpose of the interventions was to address context-specific factors (social inequity, violence and harassment, and stigma and discrimination) contributing to HIV vulnerability. We advocated with government authorities for HIV/AIDS as an economic, social and developmental issue, and solicited political leadership to embed HIV/AIDS issues throughout governmental programmes. We mobilised FSWs and appraised them of their legal rights, and worked with FSWs and people with HIV/AIDS to implement sensitization and awareness training for more than 175 government officials, 13,500 police and 950 journalists. Methods Standardised, routine programme monitoring indicators on service provision, service uptake, and community activities were collected monthly from 18 districts in Karnataka between 2007 and 2009. Daily tracking of news articles concerning HIV/AIDS and FSWs was undertaken manually in selected districts between 2005 and 2008. Results The HIV prevention programme is now operating at scale, with over 60,000 FSWs regularly contacted by peer educators, and over 17,000 FSWs accessing project services for sexually transmitted infections monthly. FSW membership in community-based organisations has increased from 8,000 to 37,000, and over 46,000 FSWs have now been referred for government-sponsored social entitlements. FSWs were supported to redress > 90% of the 4,600 reported incidents of violence and harassment reported between 2007-2009, and monitoring of news stories has shown a 50% increase in the number of positive media reports on HIV/AIDS and FSWs. Conclusions Stigma, discrimination, violence, harassment and social equity issues are critical concerns of FSWs. This report demonstrates that it is possible to address these broader structural factors as part of large-scale HIV prevention programming. Although assessing the impact of the various components of a structural intervention on reducing HIV vulnerability is difficult, addressing the broader structural factors contributing to FSW vulnerability is critical to enable these vulnerable women to become sufficiently empowered to adopt the safer sexual behaviours which are required to respond effectively to the HIV epidemic.

BACKGROUND: Structural factors are known to affect individual risk and vulnerability to HIV. In the context of an HIV prevention programme for over 60,000 female sex workers (FSWs) in south India, we developed structural interventions involving policy makers, secondary stakeholders (police, government officials, lawyers, media) and primary stakeholders (FSWs themselves). The purpose of the interventions was to address context-specific factors (social inequity, violence and harassment, and stigma and discrimination) contributing to HIV vulnerability. We advocated with government authorities for HIV/AIDS as an economic, social and developmental issue, and solicited political leadership to embed HIV/AIDS issues throughout governmental programmes. We mobilised FSWs and appraised them of their legal rights, and worked with FSWs and people with HIV/AIDS to implement sensitization and awareness training for more than 175 government officials, 13,500 police and 950 journalists. METHODS: Standardised, routine programme monitoring indicators on service provision, service uptake, and community activities were collected monthly from 18 districts in Karnataka between 2007 and 2009. Daily tracking of news articles concerning HIV/AIDS and FSWs was undertaken manually in selected districts between 2005 and 2008. RESULTS: The HIV prevention programme is now operating at scale, with over 60,000 FSWs regularly contacted by peer educators, and over 17,000 FSWs accessing project services for sexually transmitted infections monthly. FSW membership in community-based organisations has increased from 8,000 to 37,000, and over 46,000 FSWs have now been referred for government-sponsored social entitlements. FSWs were supported to redress > 90% of the 4,600 reported incidents of violence and harassment reported between 2007-2009, and monitoring of news stories has shown a 50% increase in the number of positive media reports on HIV/AIDS and FSWs. CONCLUSIONS: Stigma, discrimination, violence, harassment and social equity issues are critical concerns of FSWs. This report demonstrates that it is possible to address these broader structural factors as part of large-scale HIV prevention programming. Although assessing the impact of the various components of a structural intervention on reducing HIV vulnerability is difficult, addressing the broader structural factors contributing to FSW vulnerability is critical to enable these vulnerable women to become sufficiently empowered to adopt the safer sexual behaviours which are required to respond effectively to the HIV epidemic.

IntroductionFemale sex workers (FSWs) frequently experience violence in their work environments, violating their basic rights and increasing their vulnerability to HIV infection. Structural interventions addressing such violence are critical components of comprehensive HIV prevention programmes. We describe structural interventions developed to address violence against FSWs in the form of police arrest, in the context of the Bill and Melinda Gates Foundation's India AIDS Initiative (Avahan) in Karnataka, South India. We examine changes in FSW arrest between two consecutive time points during the intervention and identify characteristics that may increase FSW vulnerability to arrest in Karnataka.MethodsStructural interventions with police involved advocacy work with senior police officials, sensitization workshops, and integration of HIV and human rights topics in pre‐service curricula. Programmes for FSWs aimed to enhance collectivization, empowerment and awareness about human rights and to introduce crisis response mechanisms. Three rounds of integrated behavioural and biological assessment surveys were conducted among FSWs from 2004 to 2011. We conducted bivariate and multivariate analyses using data from the second (R2) and third (R3) survey rounds to examine changes in arrests among FSWs over time and to assess associations between police arrest, and the sociodemographic and sex work‐related characteristics of FSWs.ResultsAmong 4110 FSWs surveyed, rates of ever being arrested by the police significantly decreased over time, from 9.9% in R2 to 6.1% in R3 (adjusted odds ratio (AOR) [95% CI]=0.63 [0.48 to 0.83]). Arrests in the preceding year significantly decreased, from 5.5% in R2 to 2.8% in R3 (AOR [95% CI]=0.59 [0.41 to 0.86]). FSWs arrested as part of arbitrary police raids also decreased from 49.6 to 19.5% (AOR [95% CI]=0.21 [0.11 to 0.42]). Certain characteristics, including financial dependency on sex work, street‐ or brothel‐based solicitation and high client volumes, were found to significantly increase the odds of arrest for participants.ConclusionStructural interventions addressing police arrest of FSWs are feasible to implement. Based on our findings, the design of violence prevention and response interventions in Karnataka can be tailored to focus on FSWs, who are disproportionately vulnerable to arrest by police. Context‐specific structural interventions can reduce police arrests, create a safer work environment for FSWs and protect fundamental human rights.