FY 2012 COP IOM Portfolio Review

1. FY 2012 COP IOM Portfolio Review 23 August 2011 International Organization for Migration

2. Portfolio Review Overall aim of your work 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 addressing the public health challenges of host/sending communities Programmatic Areas (Refer to notes for key approaches and activities) Service Delivery and Capacity Building To facilitate, provide and promote access to health services that are sensitive to the needs of migrants and communities affected by migration To increase capacity to deliver health services that are sensitive to the needs of migrants and communities affected by migration Advocacy for Policy Development To advocate for national and sectoral policies/strategies that address migration health concerns To facilitate and strengthen national coordination on migration health concerns Research To increase understanding of migration health issues through research in South Africa To promote migration health as a research Agenda (govt., academia, research institutions) * partners working in many areas should provide us with a chart

3. Structural Factors Environmental Factors Individual Drivers OUR APPROACH • 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

5. Where do we work? • Spaces of vulnerability • Targeting populations – sedentary and mobile – affected by the migration process • Commercial farming communities – high levels of seasonal and migrant labour • But could include mining, border and other migration affected communities • Currently working (2011) in : • Limpopo- Vhembe, Mopani and Waterberg • Mpumalanga- Enhlazeni district in Nkomazi • Gauteng- City of Johannesburg • KZN- eThekwini

6. WHO do you work with to achieve the 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

7. Achievements so far • Good practices on implementing effective interventions for migration affected communities; • Health Promotion and service delivery model implemented in the comm. Agric (Ripfumelo) and associated tools; • Bottom-up approaches • Combination HIV prevention strategies • Advocacy- migration on the agenda • Involvement in the NSP process; • Ongoing dialogue through different fora (MHF); • Supported implementation of the WHA Resolution 61.17 • National Farm worker Summit • Strategic alliances and Partnerships • Research • IBBS – 39% HIV prevalence amongst farm workers (49% in Malelane, Mpumalanga) • Country assessment

8. How do we know we are achieving our objectives • Baseline (formative assessment) • Measurable indicators for processes, outputs and outcomes • Regular monitoring (achievements against targets) • Include both quantitative and qualitative; • Mid-term reviews • Summative assessment- outcome evaluation • Documentation of lessons learnt and emerging field practices

9. Challenges • Sustainability (funding, government ownership, Competing development challenges • Migration still perceived negatively, even by policy makers and this prohibits effective responses • Few on the ground intervention to address the needs of migrants; • Strategic information (limited data on migration trends, migration dynamics in the context of HIV);

10. Programmatic Direction - two year horizon • Influences: • NSDA- particularly looking at social determinants of health and how migration needs to be broadly mainstreamed in policies; and • NSP on HIV/AIDS/STI and TB • UNDAF • Priorities: • Service delivery and capacity building • Advocacy for policy development • Research • Coordination

11. Alignment with the PF & PEPFAR 5-yr Strategy • Efforts to increase efficiencies- diversification of funding; partnerships with other UN agencies – WHO, UNAIDS, UNFPA etc. • Strengthen health and social systems- working through the national, provincial and district structures; capacity building on migration health • Engagement with broader health and development programs (social determinants of health, Spaces of Vulnerability) • Expand coverage of combination prevention – multilevel approaches drawing on biomedical, behavioral and social approaches • Community strengthening- working in partnership with local partners; involvement of key populations • Strategic information- generate data on migration and HIV, documenting what works (learning sites) • HIV/TB integration (population mobility plays a critical role in the spread and management of these conditions)

12. Scale down: • Ripfumelo project • Funding • Need to integrate migration health within the District Health Plans, national and provincial strategic plans • Sustainability • Build local ownership (working through and with local organizations); • Strategic Partnerships; • Capacity building for civil society and government; • Mainstreaming migration into health policies and strategies (NSP, NSDA); • Documenting and sharing best practices (including lessons learnt); • Mobilizing local and external resources (financial as well as material and technical)

13. FY 2012 Recommended Programmatic Budget Shifts • Increase support on the contextual/ structural barriers to change (not just the biomedical); • Build evidence through actual implementation on the ground (identify learning sites, and documents emerging practices); • Systems strengthening- support and strengthen coordination mechanisms such as the AIDS Councils and other relevant structures (MHF); • (Targeted) Focus interventions, looking at key populations