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Empowerment of Adolescent Girls and Young Women to Escape from the Commercial Sex Industry in Hanoi Project Evaluation
Yvon Dandurand1 Dr. Amy Prevost2 Dr. Phan Thi Lan Huong3 Vivienne Chin4
International Centre for Criminal Law Reform and Criminal Justice Policy & University of the Fraser Valley
Plan International in Vietnam Hanoi, November 1, 2015
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Criminologist, Fellow and Senior Associate, International Centre for Criminal Law Reform and Criminal Justice Policy, and Associate Professor, School of Criminology, University of the Fraser Valley. Director, School of Criminology and Criminal Justice, University of the Fraser Valley, British Columbia, Canada. Deputy Head, International Cooperation Department, Hanoi Law University, and Head of Representative Office of Nagoya University in Vietnam. Senior Associate, International Centre for Criminal Law Reform and Criminal Justice Policy, Vancouver, Canada.
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Acronyms
CCCD:
Child-Centered Community Development Approach (Plan International)
CSAGA
Center for Studies and Applied Sciences in Gender, Family, Women and Adolescents
DOLISA
Department of Labor, Invalids and Social Affairs
DSVP
Department of Social Vices Prevention (previously DSEP)(at MOLISA)
FSW
Female Sex Worker
HNDSVP
Hanoi Department of Social Vices Prevention (at DOLISA)
LIGHT
New LIGHT
MOLISA
Ministry of Labor Invalids and Social Affairs
MTR
Mid-Term Review
NPAAP
National Plan of Action Against Prostitution
PC
Peer Counsellors
SSE
Sensitive Service Establishment (where sex workers work)
VBSP
Vietnam Bank for Social Policies
Acknowledgments: The project evaluation team wishes to thank leaders and representatives of the project implementation partner organizations, including the Department of Social Vices Prevention (previously DSEP)(MOLISA), the Hanoi Department of Social Vices Prevention and DOLISA, Plan international Vietnam, REACH, LIGHT, CSAGA and the Hanoi Police for their insights, help and support during the MTR. Special thanks are also extended the project beneficiaries and peer counsellors for their participation in and their generous contribution to the project evaluation. Our thanks also to, from Plan International in Vietnam, the project coordinator, Ms. Le Thi Mai Thao, the financial officer, Ms. Nguyen-Thi Thuy, the former project officer, Ms. Pham Thi Bich Ngoc and to Mrs. Le Quynh Lan, Manager,
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Hanoi Program Unit for their helpful and diligent assistance during the evaluation. Miss. Nguyen Quynh was our trusted interpreter.
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CONTENTS
Executive Summary
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1.
Introduction
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2.
Background and Context of the Project
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3.
Project Description
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4.
The Evaluation
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5.
Exiting Sex Work
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a)
The process and challenges of exiting sex work
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b)
The needs of FSWs
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c)
Best practices in delivering support to FSWs
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6.
Project Outputs and Outcomes: FSWs access to support
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a)
The sex workers reached by the project
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b)
Services and support offered to FSWs
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c)
Retention rate
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d)
Inter-agency collaboration
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e)
Impact of the interventions on the life of the FSWs
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7.
Project Outputs and Outcomes: Capacity building
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8.
Impact on Policy
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9.
Efficiency
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10.
Sustainability
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11.
Lessons Learned
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12.
Conclusions
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13.
Recommendations
Error! Bookmark not defined.
References
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Executive Summary In Vietnam, female sex workers (FSWs) who are considering leaving the sex industry find it very difficult to access the services and support they need in order to successfully transition to a new life. That transition is complex and challenging. Plan International in Vietnam implemented a project to empower adolescent girls and young women in Hanoi to escape from the commercial sex industry. The project involved both government agencies and NGO partners in the management and delivery of direct services to FSWs. The delivery of the multi-pronged intervention relied on the services provided by partner organizations and on the role of a network of peer counsellors. The services included: outreach contacts, health testing, life skills development, legal information, psychological counselling, vocational training and job placement, and business development assistance and a small loan. At the time of evaluation, four hundred and nine (409) women between the ages of 17 and 35 were reached by the project; eighty two (82) women participated in vocational training courses, seventy two (72) of them completed the programme and received job placement or business development support; and, thirty six (36) received a small grant and loan to implement a business plan. An evaluation of the project was conducted during the months of September and October 2015, based on a review of project documentation and project monitoring and financial data, as well as interviews and group discussions with project beneficiaries, peer counsellors, members of the project team, representatives of the partner organizations, and Hanoi police. The project achieved its goal to provide some sex workers access to community-based services. It significantly improved the capacity of participating partner organizations to understand the needs of FSWs and to support their social and economic reintegration. As a result, there is a greater understanding among the project partners of the importance of comprehensive interventions to support sex workers - whether they are immediately prepared to exit the sex trade or not. Given that the pathways to exiting the sex trade are very complex, the project allowed participating organizations to better map out these pathways and tailor their services to support sex workers.. This work must continue. The project was able to reach some of the targeted primary beneficiaries, in particular the older sex-workers with children who were considering leaving the sex industry. There is no doubt that the project had an immediate life-transforming effect on many of its beneficiaries. However, there remain outstanding questions about the outreach method used by the project and whether it could be improved or diversified in order to reach other segments of the FSWs population of Hanoi, including adolescents. The project took place at an opportune time, when the government was not only implementing its national action plan (NPAAP) but also when the City of Hanoi and MOLISA were in the process of proposing an action plan for the next planning period. The project team actively engaged in advocacy activities for policy change, but the impact of these activities is hard to assess at this point. The short duration of the project may have limited its future impact on government policy, but the project certainly demonstrated the relative effectiveness of an “economic empowerment model” when it was accompanied by other support services. The long term sustainability of the model developed for the project has not yet been firmly established. Project partners did not have sufficient time to develop a financially 6
sustainable approach to the delivery of comprehensive services to FSWs who are transitioning to a different life. Partner organizations are actively considering ways in which they may continue to offer some services to FSWs through existing programmes. However, this may not be sufficient to ensure the future of the project or to ensure that FSWs can continue to have access to the comprehensive assistance they need. Unless the project continues to develop the capacity of the various partner organizations, that capacity is at risk of dissipating.. The project’s intent was to demonstrate the effectiveness of a complex model of intervention that addresses the multiple needs and challenges of FSWs and can be delivered through effective collaboration between relevant government agencies and NGOs. Five partner organizations collaborated to deliver the necessary interventions. Once the model’s effectiveness was demonstrated, the next step was to form the basis of a policy guidance tool to direct and inspire the development of similar programmes in other parts of the country. The project’s apparent success has already had an impact on the plan of action that is being proposed by MOLISA for the coming years. There is also evidence that some of the changes in practice initiated by the project are slowly being institutionalized, but the process is just beginning. The potentially abrupt ending of the project is forcing participating organizations to reflect on what they can do and/or need to do after the end of the project. Some of the partner organizations expect to find ways to continue to offer some of the same services, but on a reduced scale. Some of the key lessons learned as a result of this project are as follows: The process of exiting the sex trade is more complex than might have been anticipated; It is importance to use multiple and varied methods for reaching out to FSWs; Long term assistance and support is needed to help the FSWs transform their lives; The role of peer counsellors was essential to the success of the project; that role evolved and must continue to be developed and researched; Sex workers need practical, and sometimes financial support, to help them integrate into the regular labour market or to take advantage of a business opportunity. Several recommendations were formulated as a result of the evaluation and were presented to representatives of participating organizations.
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1.
Introduction
In Vietnam, female sex workers (FSWs) who are considering leaving the sex industry find it difficult to access the services and support they need in order to successfully transition to a new life. That process of transition is very complex and challenging. Plan International in Vietnam implemented a project to empower adolescent girls and young women in Hanoi to escape from the commercial sex industry. The project involved both government agencies and NGO partners in the management and delivery of direct services to FSWs. The delivery of the multi-pronged intervention relied on the services provided by partner organizations and on the role of a network of peer counsellors. The services included: outreach contacts, health testing, life skills development, legal information, psychological counselling, vocational training and job placement, and business development assistance and a small loan. A project evaluation was conducted during the months of September and October 2015, based on a review of project documentation and the project’s monitoring and financial data, as well as interviews and group discussions with project beneficiaries, peer counsellors, members of the project team, representatives of the partner organizations, and Hanoi police. The findings and recommendations from this evaluation are presented here. The project adapted internationally recognized best practices to the national context and is the only one of its kind in Vietnam. The project was implemented during a time of transition from institution-based responses to sex work to a community-based approach that is still being defined and refined by government agencies and community-based stakeholders. Lessons learned during the project are directly relevant to the development of a national guidance document on the provision of reintegration support for sex workers.
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Background and Context of the Project
The situation of female sex workers (FSWs) in Vietnam is complicated and risky. It is difficult for FSWs to access social services and other supports, and, the opportunities for them to exit the sex trade and reintegrate into society are very limited. Exiting sex work is a process, rather than a single event, and, throughout that process, sex workers encounter financial, social, and psychological challenges that require support and assistance. The legal and policy framework regulating sex work in Vietnam is evolving. Sex work is illegal under the country’s administrative law. Article 4 of the Ordinance on Prostitution Prevention strictly bans selling and buying sex and related activities. Sex work is illegal and defined as a “social evil” under administrative law.5 In 2011, the Prime Minister approved the National Programme of Action Against Prostitution, 2011-20156 (NPAAP). The National Programme encourages women and children involved in sex work to access social services. Although sex work remains unlawful, the NPAAP includes harm reduction measures, such as HIV prevention and 5 6
Articles 4 and 23 of the Ordinance on Prostitution Prevention and Control, 2003. Decision No. 679/QD-TTg of 2011.
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health services, as well as treatment, care, support and social protection measures for sex workers. The NPAAP also promotes community-based efforts to help sex workers build alternative livelihoods. In 2012, the Government of Vietnam approved a new Law on Administrative Sanctions to end the administrative detention of sex workers.7 Decree 24/2012/QH13 stated that sex workers would no longer be re-educated at communes, wards or towns or sent to re-education camps; rather they would only be imposed other administrative sanctions such as a fine. Previously, under the Ordinance on Handling of Administrative Violations 20028, sex work and addiction to narcotics were administrative violations that could result in detention for up to two years in centres managed by the Ministry of Labor, Invalids and Social Affairs (MOLISA). These centres were referred to as “05 Centres” for sex workers and “06 Centres” for people suffering from drug addiction. Decree no 167/2013 ND-CP dated 12 November 2013 provides regulations on sanction of administrative violation in social security, order and safety, prevention and fighting of social evils, fire and domestic violence. Article 23 (Sale of sex) provides that: (1) a caution or a fine of between VND 100,000 and 300,000 shall be imposed for selling sex’; and, (2) a fine of between VND 300,000 and 500,000 shall be imposed for selling sex to many persons at the same time. The Penal Code 2000 provides that those who ‘harbour prostitutes’ shall be sentenced to between one and seven years of imprisonment.9 Where harbouring involves coercing others into sex work, the penalty is between five and fifteen years imprisonment. “Enticing and procuring prostitutes” is also a crime punishable by six months to five years of imprisonment, more (3 years) for repeated offences or offences when committed “against juveniles aged between full 16 years and under 18 years”.10 The Law on HIV/AIDS Prevention and Control 2006 states that sex workers (and other most-at-risk populations) are to be given priority access to information, education and communication on HIV prevention and control.11 Decree 108/2007 on Implementation of Articles of the Law on HIV/AIDS Prevention and Control provides that harm reduction interventions (including provision of free or subsidized condoms and guidance on condom use) are to be provided to sex workers. The Decree provides for identity cards to be issued to outreach workers including peer communicators and volunteers, and protects peer educators from prosecution if they have notified the People’s Committee and police prior to conducting outreach and are carrying their cards. The People’s Committee and police are responsible for creating favourable conditions for programmes and projects to operate and developof the network of condom distribution points in their localities.12 In April 2014, Decision 29/2014/QĐ-TTg, issued by the Prime Minister, created a credit programme for households and people living with HIV, individuals having completed a detoxification programme, individuals involved in a methadone treatment programme, 7
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Directive No. 24 issued by the National Assembly (came into force in July 2013). See also: Godwin, 2012, pp. 166-170. 44/2002/PL-UBTVQH10 of 2 July 2002. Vietnam Penal Code, Article 254. Vietnam Penal Code, Article 255. Law on HIV/AIDS Prevention and Control 2006, Article 11. Article 7 and 8 of the Decree 108/2007 on Implementation of Articles of the Law on HIV/AIDS Prevention and Control.
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and sex workers who exit prostitution. The programme is to be administered by the Vietnam Bank for Social Policies (VBSP).13 In September 2014, MOLISA issued a decision14 that approved a list of 15 provinces and National cities, including Hanoi) to pilot credit model for beneficiaries under the Decision 29/2014/QĐ-TTg”.
3.
Project Description
The Empowerment of Adolescent Girls and Young Women to Escape from the Commercial Sex Industry Hanoi / Vietnam is a three year pilot project implemented by Plan International Vietnam in partnership with government and local non-government organizations (NGOs). The project was implemented in cooperation with the Department of Social Vices Prevention (DSVP) - the Ministry of Labour, Invalids and Social Affairs (MOLISA), the Hanoi DSVP of the Hanoi Department of Labour, Invalids and Social Affairs (DOLISA), and three local NGOs, namely CSAGA, LIGHT and REACH. It also involved collaboration with the Hanoi Police. The total budget for the project was USD 603,544.00. The project’s specific objective is to “economically empower sex workers through the provision of market oriented vocational and entrepreneurship skills, job placement and loans for job creation support, as well as training a cadre of peer counselors to reach out to further sex workers, enabling them to leave the sex industry”.15 To that end, the project is piloting a community-based social and economic reintegration model for 400 adolescent girls and young women aged 17 to 35 involved in the sex industry. The project’s strategy rests on a package of linked services designed to create an enabling environment for sex workers and improve their access to state and non-state sexual health care, legal assistance, psycho-social support, vocational training, job placement services and self-employment support. The overall goal of the project is to inspire a national legal guidance document on reintegration support for sex workers. The overall strategy, in keeping with Plan’s Child-Centered Community Development Approach (CCCD), consisted of mobilizing key government agencies and local NGOs and engaging them in developing, implementing and perfecting an economic empowerment approach to supporting FSWs who might consider exiting the sex industry. The approach included measures to build local capacity and to advocate for more effective, rights-based, assistance for FSWs. The project was designed to play a key role in enhancing the ability of local stakeholders, including government agencies, non-governmental organizations, and local civil society organizations, to create sustainable changes in the manner in which girls and women are empowered to leave the sex industry. The project aimed to offer a replicable example of how close cooperation between government agencies and civil society actors can be fostered in an effort to improve protection of children and women. The project ran for 38 months from August 1, 2012 to October 31, 2015. It was designed to address the needs and challenges encountered by FSWs who were considering leaving the sex trade or had already decided to do so. It offered support, training and assistance to facilitate the social reintegration of sex workers. One of the main project objectives was to assist up to 400 sex workers between the ages of 17 13
See: Official document No. 337/NHCS-TDSV issued on 30/09/2014 by the Director General of VBSP on “Guidelines on lending operation in accordance with Decision 29/2014/QĐ-TTg”. 14 Decision 1150/QĐ-LĐTBXH issued on 09/09/2014 by MOLISA. 15 See: Final Project Document, 2012.
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and 25 without children, currently working in selected districts of Hanoi. The target group was later modified to include sex workers between the ages of 25 and 35 with children. Sex workers with current drug addiction issues were not eligible to participate in the vocational training and small business components of the intervention. The key implementing partners for the project were: the Department of Social Vices Prevention (DSVP) of the Ministry of Labor, Invalids and Social Affairs (MOLISA), with policy development, advocacy and coordination responsibilities; the Hanoi Department of Social Vices Prevention (HN DSVP) of the Department of Labor, Invalids and Social Affairs (DOLISA), with responsibilities for coordination and project management; LIGHT, an NGO with responsibilities for recruiting, training and supporting peer counsellors, for outreach activities and the recruitment of beneficiaries, as well as for offering life skills training and managing the livelihood and micro-lending aspects of the project; the Centre for Studies and Applied Services in Gender, Family, Women and Adolescents (CSAGA), responsible for delivering psychological counselling (individual and in group), legal information and some limited legal advice; and, REACH, which provided the vocational training and job placement components of the project. Although other similar projects exist in Vietnam, particularly as part of harm reduction initiatives, the current project was and remains the only one of its kind in the country. The effectiveness of the project’s emphasis on the economic empowerment of women – offering support, counselling, legal information and vocational training, facilitating access to employment, and support for starting a new business -- is what its proponents were hoping to demonstrate. The expected outcomes of the project were defined as follows: Outcome 1: Sex workers have access to the community-based social and economic reintegration services and make use of its services. Output 1.1: Sex workers are equipped with market oriented vocational training and entrepreneurship skills and have received job placement support and loans for job creation support. Output 1.2: Sex workers are equipped with psycho-social counseling and communication skills, including women’s labour and sexual health rights, for their task of peer counselor. Output 1.3: Sex workers receive psycho-social support and counseling services, legal assistance, and sexual health care treatment Outcome 2: Relevant government agencies, NGOs, and civil society promote and support the social and economic reintegration of sex workers. Output 2.1. Relevant government agencies, NGOs, and the community volunteer networks are strengthened in their skills to support the reintegration of sex workers. Output 2.2: Government agencies and civil society are sensitized on the link between gender based violence and sex work, and on the social and economic reintegration support needs of sex workers. Output 2.3: The social and economic reintegration model is used for lobbying to adapt/replicate in other districts or cities and for national policy adaptation.
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A Mid-term Review (MTR) of the project was conducted (Stephens, 2014) that led to fifteen recommendations, including a recommendation to extend the project’s timelines and to replicate it in at least one other city. Other recommendations included: increasing the stipends offered by the project to FSWs enrolled in the project; adjusting the counselling approach; developing an advocacy strategy for the remainder of the project; and, increasing the role of the police in the project. The MTR also referred to the issue of the large proportion of beneficiaries who had dropped out of the project, in particular the vocational training. Following the MTR, a management response was prepared, discussed among project partners and updated regularly during its implementation. On the issue of the project’s drop-out rate, the project team conducted a survey of current trainees enrolled in the vocational training programme and took specific measures to increase the initially low retention rate. Plan Vietnam proposed and obtained a three month no-cost extension to the project, to October 31, 2015, in order to complete some of its planned service delivery and advocacy activities and to ensure the proper documentation of the project’s methods and of lessons learned. The project was initially designed on the basis of the assumption that beneficiaries could be recruited from a re-education centre where sex workers were being detained for substantial periods of time. With the recent change in the law, the project had to develop an alternate outreach method, and it developed an outreach process based on informal contacts between peer counsellors and FSWs working in various venues (mostly indoor). The project was based on some simple assumptions about the needs and circumstances of sex workers and how to best assist them during a challenging transition to a new life. A baseline study (Do Viet Dung, 2013) and a needs assessment study (Ha Thi Thanh Thuy and Do Thi Ninh Xuan, 2013) was conducted to test these assumptions and to refine the project team’s understanding of the motivation, needs and circumstances of female sex workers in Hanoi. The baseline study revealed that only 38% of the sex workers interviewed were prepared to leave the sex trade. However, 18% were interested in reducing the frequency of sex work, while 44% percent indicated that they did not want to quit or had not thought of leaving (Dung, 2013). These results had important implications for the design of outreach activities, as well as identified important measurement considerations for evaluating the success of sex reintegration programmes. Some of the sex workers interviewed during the baseline study had considered an exit process. Specifically, these workers were interested in finding ways to earn an alternative income and had particular expectations about what this work might look like and the level of income they would need. They were well aware of the challenges involved in finding a job and generating a sufficient income (Dung, 2013: 31-32; see also: Ngo et al., 2007).
4.
The Evaluation
The project, as it is currently structured and funded, has come to an end. It was the only project of Plan International Vietnam that supported the social and economic empowerment of female sex workers, and it was one of the very few projects offering support to sex workers in Vietnam. As this pilot project was designed as an experiment from which lessons could be drawn for the development of a national approach or model for the provision of reintegration support for sex workers, it was always
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anticipated that the outcomes and impact of the project would be measured, and that the effectiveness, efficiency, and relevance of the model would be tested. The main objectives of the final evaluation were to:
evaluate the project achievements against its set objectives and expected outcomes;
assess the project’s relevance, effectiveness, efficiency, impact, and sustainability;
identify lessons learnt; and,
offer recommendations, based on its findings, to Plan International in Vietnam and its government and NGO partners on how to design and implement effective and efficient support and reintegration services for female sex workers in Vietnam.
Six evaluation criteria were used to structure the evaluation. They were: the project’s effectiveness or the extent to which the intended project goal, objectives and outcomes were achieved; the relevance of the intervention delivered through the project; the efficiency with which the project was delivered; the sustainability of the proposed intervention; the impact of the project, including its intended and unintended results; and, the knowledge generated by the project. The evaluation involved all project partners (DSVP; HNDSVP; LIGHT CSAGA; REACH), as well as the Hanoi Police. Many of the FSWs who benefited from the project, and some of the peer counsellors, were actively involved in the evaluation. They were not only provided information but they were also invited to participate in group discussions and to make recommendations concerning future interventions and services. After a desk review of project documents and other relevant literature, an inception report was prepared and discussed with representatives of partner organizations. Once the evaluation plan was completed and approved, data were collected on the following: project operations, including the implementation by the project team of the recommendations contained in the mid-term project review; project costs and utilization of resources (using summary data provided by the project team); perception of institutional stakeholders and partner organizations; the experience of project staff and of peer counsellors; the experience, perceptions and suggestions of project beneficiaries, and, the perceptions of representatives of the police obtained through a questionnaire. After the data had been analyzed, meetings were held with partner organizations during which the main findings of the evaluation and its draft recommendations were presented and discussed. The evaluation relied on semi-structured interviews and discussion groups with project managers and staff, group discussions with FSWs currently involved in the project, interviews with nine of the project’s remaining ten peer counsellors, and a questionnaire administered to representatives of Hanoi Police. In addition, project documents, financial reports and data, documents relating to the MTR and the management response, quarterly reports from partner organizations and project tracking data, were reviewed. Three focus group discussions with project beneficiaries were conducted in Vietnamese, in which a total of sixteen beneficiaries voluntarily consented to
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participate. An impromptu meeting with 5 beneficiaries involved in a vocational training programme also took place at the vocational training venue. One focus group discussion was also held with nine peer counsellors. Participation was entirely voluntary, thus creating what should be described as an opportunity sample. The evaluation parameters did not allow for systematic comparisons between the model adopted by the project and other available models. It was not possible to obtain the participation of beneficiaries who had completed or abandon the programme of interventions. With respect to the needs of the broader population of FSWs, the evaluation had to rely on the data collected by Plan at the beginning of the project in a baseline study and a needs assessment survey. Finally, although partner organizations had expressed interest in a more detailed cost-benefit analysis of the model and strategies used by the project, the evaluation could not produce more than a general comment in that regard. In future iteration of the project, there should be ongoing data collection about the involvement of all beneficiaries and about the outreach activities of the peer counsellors. However, the project will likely remain unable to track personal information on FSWs who have left the project and there would be ethical issues involved in attempting to collect and store information about the FSWs ongoing illegal activities.
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Exiting Sex Work a) The process and challenges of exiting sex work
The research literature on the situation of sex workers emphasizes the importance of understanding the population and their needs prior to forming policy responses or designing services to assist them. Some assumptions about the needs of FSWs can be misleading. For example, sex workers do not necessarily form a homogeneous group, and it is important to acknowledge diversity in commercial sex experiences (O’Doherty, 2015: 275). In order to provide effective support for women who wish to exit prostitution, it is necessary to understand how their life experiences differ from one another and how these experiences contribute to their ability to successfully leave the sex industry (Roe-Sepowitz, Hickle, and Simino 2012: 71; also Bindle et al, 2012). Exiting the sex industry is complicated by a number of factors, including fear of violence and coercion, lack of financial resources or social support, and lack of education. Meaningful programmes with adequate resources and sex worker participation are required to successfully assist in the transition to mainstream life (CPHA, 2014). It is important to provide exit strategies and programmes to support sex workers who wish to leave or for those women who were coerced into sex work. This is particularly important in Vietnam in view of the rapid growth of the sex industry over the last several years.16 The exit strategies facilitated by this project were based on an understanding of the circumstances and needs of sex workers. It is clear from existing research that, generally speaking, exiting prostitution is a process and not a single event in time. Researchers have identified the different 16
Theo báo cáo của Bộ Lao động - thương binh & Xã hội, ước tính năm 2013 cả nước có gần 33.000 gái mại dâm, nhưng số gái mại dâm có hồ sơ quản lý lại giảm mạnh, chỉ còn trên 9.000 người. (According to a MOLISA report, there were approximately 33,000, FSWs in Vietnam in 2013. However, the number of files was only 9000 cases) http://baodatviet.vn/chinh-tri-xa-hoi/tin-tuc-thoi-su/33000-gaimai-dam-va-khong-co-mai-dam-quat-lam-do-son-2364197/
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pathways and phases involved in the process of exiting (Baker, Dalla and Williamson, 2010; Saunders, 2007; Jackson, 2014 & 2015; Mayhew and Mossan, 2007; Hedin and Mansson, 2003; Oselin, 2010, 2014; Bindle et al, 2012). Some studies focussed primarily on the personal emotional and psychological process that accompanies a prostitute’s decision to leave sex work, while others identified environmental/structural factors associated with exiting. These factors include: (1) significant life events (e.g., violent incident, pregnancy, imprisonment, poor physical health); (2) accessing formal support services (drug treatment, counseling, access to safe housing); and (3) slow and natural progression toward exiting that results from an intrinsic desire for change or disillusionment with the prostitution lifestyle (Saunders, 2007). Saunders also described the yo-yo effect (Saunders, 2007: 87) to explain a transition process characterized by movement in and out of sex-work. This process is motivated by various factors such as financial or social pressure, the need for a “time out”, or a poorly planned exit. In addition to the pathways or phases, researchers have also noted several barriers to leaving the sex industry (Baker, Dalla, and Williamson, 2010; Bindle et al, 2012). A recent and comprehensive categorization of such barriers includes : individual factors (substance abuse and other self-destructive behaviour; physical health problems, mental health problems, effect of violence, trauma and adverse experiences; psychological stress, guilt, low self-esteem and lack of self-confidence and agency; poor coping skills); relational factors (isolation; coercion and pressure from exploiters; negative role models and influences; lack of support); structural factors (employment; limited job skills, lack of employment opportunities); and, societal factors (discrimination; stigmatization) (see: Baker, Dalla and Williamson, 2010). These barriers are particularly challenging when women are faced with discrimination, prejudice from families and the larger community, and the inaccessibility of relevant service providers (ISDS, 2015:10). Given these complexities, it is important to implement both informal and formal support mechanisms in the transition process. During every phase of the transition, sex workers face several challenges, especially as old life patterns clash with new expectations. As a result, the emphasis must be on building new relationships and social networks. The support of peer workers and professionals are vital to a successful exit from prostitution and to help facilitate the process of building a new life. Cusick and her colleagues (2011) recognized four exit patterns based on interviews with 40 sex workers with addiction issues who had successfully exited prostitution in the U.K. The patterns included: intervention assisted exits (following a drug treatment or other institutional intervention); opportunistic exits (an exit that occurs as a result of changes in their lives, new opportunities, and a re-evaluation of their involvement in the sex trade); gradual exits (a slow process, often related to age, that occurs over a period of time); and, strategic exits (an exit that results from a decision to resolve other issues, such as drug addiction, as part of a longer term plan) (Cusick et al., 2011). The opportunistic exiters, similar to the “yo-yo” exiters, are perceived as the most likely to return to sex-work, because their exit strategy often lacks a strong personal intent and they remain vulnerable to unexpected changes and continued financial demands (Cusick et al., 2011: 153). A recent study by Jackson (2014; 2015) also revealed the lengthy process involved in exiting the sex industry. These stages include readiness and engagement; treatment and support; transition and stabilization; reconstructing and rebuilding; and, acquiring or developing new roles and identities (Jackson, 2014; see also 2015). It should be
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noted that, for some women, leaving the sex trade is similar to breaking an “addiction,” where some aspects of sex work (i.e. the financial dependence) are particularly challenging to abandon. For some, sex work is associated with independence, autonomy and control over their life, while, for others, sex work can be part of an exciting lifestyle and is often the sex worker’s only social network. Some women have also reported enjoying the attention they receive from their male clients (Strega, Casey & Rutman, 2009)(Murphy and Venkatesh, 2004). In addition to the different phases, a number of women experience “turning points,” in which a particular event triggers their decision to exit the sex industry. Turning points are defined as an event that precipitates a different way of thinking about their personal experience. For example, a turning point may include a traumatic event, a pregnancy, an opportunity, or a new relationship (Hedin and Mansson, 2003; Mansson and Hedin, 1999). The turning point does not necessary lead to a sudden decision to leave, but yields a slow, gradual process. After an initial breakaway from sex work, a woman may often feel uncertain about her decision, and may find herself in a state of psychological turmoil and ambivalence while she tries to accommodate her new social role and develop new relationships. This can be particularly challenging for women with children, as rebuilding and maintaining a life outside of the sex trade requires tremendous support, motivation, and patience (see: Benoit and Millar, 2001). This is why peer support groups are essential to the success of the transition. For those assisting women during this transition, maintaining engagement and continuity of interventions can often become a challenge, as women weave in and out of programmes and, also, in and out of the sex trade. b) The needs of FSWs The baseline survey conducted for the project involved interviews with 400 sex workers in detention who were under the age of 25. Since it was not based on a random sample, it is difficult to generalize its findings to the FSWs population in Hanoi. However, it is worth noting that the mean age of the respondents was 22.6 and that most of them were under the age of 20. Ten percent (10%) of them had started sex work before they turned 18. A quick survey of sex workers conducted in August 2011 by Plan Hanoi at the Rehabilitation Center 2 in Ba Vi district, Hanoi, also indicated that 8% of the respondents were between the ages of 16 and 19, and 31% of them were under the age of 25. As will be seen, these demographics are different from those of the population of sex workers reached by the project. The needs assessment survey conducted as part of the project by the Department of Social Vice Prevention (DSVP) also highlighted the needs of FSWs as perceived by themselves and the difficulties they experienced or anticipated experiencing while attempting to exit the sex industry (Thuy and Xuan, 2013). Based on interviews with 408 sex workers between the ages of 18 and 45, the following characteristics were identified: the majority of them had 1 or 2 children and were their sole caregiver; health issues were a big concern; addiction issues were sometimes present but not necessarily; the primary motivation for entering sex work was financial (sometimes to help others as well, e.g. a family member); many of them, however, had other employment before they entered the sex trade. Many of the sex workers reported having been forced to engage in sex work and frequently faced violence and exploitation.
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The survey showed that FSWs were hoping for reintegration support, in particular services to help them prepare for and secure employment that can provide them with a sufficient income to support themselves (and, in many cases, their children), health and psychological support services and, in some instances, legal information and support (Thuy and Xuan, 2013). However, the needs assessment survey did not include sex workers under the age of 18 and the baseline study all but excluded girls involved in sex work. Neither study produced the kind of data that would have been useful in understanding the particular circumstances and needs of girls and adolescents involved in the sex trade. c) Best practices in delivering support to FSWs What one may learn from this research is that the pathways to exiting sex work consist of complex and contingent interactions between opportunities for change, pressures to continue the behaviour, and events and circumstances, all of which are perceived and processed through the individual’s sense of personal priorities, values, aspirations and relational concerns. Sex workers do not form a very homogeneous group and they all face their own individual challenges. With respect to an empowerment model of intervention, one must remember that not everyone responds to opportunities in the same manner. The change that is required is not simply a change of activity, but often a change in social relationships, personal identity, self-confidence and agency, hope, and possibly a change in values and beliefs. The diversity of pathways to exiting sex work is, in many ways, similar to what has been learned so far about the pathways to desistance from crime (Weaver, 2014) or the pathways to abandoning risky behaviours in general. Notwithstanding the diversity of pathways, efforts have been made to understand the various stages of exiting or desistance from sex work. The present project was inspired by the international best practices reviewed during its design phase. According to the best practices research, the most successful models of intervention to support women exiting sex work are those that offer dedicated and integrated long-term assistance, rooted in social justice and empowerment (Ouspenski, 2014; Mayhew and Mossam, 2007). As there are several reasons that contribute to a women’s decision to exit prostitution, interventions must be designed to address the complex factors that are associated with this decision. Currently, there appears to be a strong case for exiting the sex industry on health and safety grounds, but not as much support for programmes that are solely designed to empower women economically (Mayhem and Mossam, 2007). Successful models, therefore, include a combination of comprehensive and holistic support services, including basic harm reduction strategies, on-site counselling and advice, health screening, safety plans, and assistance with housing and childcare. According to Mayhew and Mossam (2007), the three most common provisions on best practices include drug treatment, housing, training, education, and employment (2007). It is also critical to consider the motivation of sex workers when they exit the sex trade as this will assist in establishing the required support services, help match skills and interests, and strive to avoid issues that might be considered barriers to employment. As was also noted in the MTR report, the research literature on economic strengthening interventions is limited. There are few studies that analyze the relationship between economic strengthening interventions for sex workers and the impact on capacity to leave sex work or reduce time spent working in the industry (Stephens 2014: 9).
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A review conducted in 2014 found that “economic need is associated with decreased bargaining power and decreases in the likelihood that FSWs will refuse clients who insist on sex without a condom. It is also associated with higher levels of debt, and, in turn, violence” (Moret, 2014:11). The review found that the impact of microfinance interventions on HIV prevention was mixed; it concluded that economic strengthening interventions result in approximately half of the participants leaving sex work. It also suggested that successful interventions feature a combination of microfinance and health approaches rather than vocational training alone (Moret, 2014). This is consistent with the research by Torri (2014) who suggested that entrepreneurship programs should be embedded in health and safety education and prevention. Torri (2014) examined the impact of integrating health education with microentrepreneurship training for sex workers in Cambodia, and found that combining entrepreneurship training with HIV/AIDS prevention and education was a critical step in the right direction for improving the overall health of women who want to exit the sex trade. This study found that improvement in overall health knowledge, combined with micro-finance is the most effective way to create positive outcomes for women who want to exit from prostitution (Torri, 2014). Overall, successful empowerment programmes must be integrated and structural in nature (Ouspenski, 2014). Multi-agency partnerships allow for the ongoing collaborative efforts of various agencies such as NGO’s, governments, and other social services agencies. Such coordinated and integrated responses are critical for programme success. As the goal is to serve all populations, programmes should be outreach and netreach based, voluntary, non-judgmental, and should ensure confidentiality and anonymity at all times during access to services. Researchers have also noted that, in an effort to achieve these goals, it is important to provide awareness training to acknowledge the range of mental health, substance abuse, vocational, and employment training issues that FSWs encounter in their daily lives. It is also important to recognize that participation in vocational programmes increases self-esteem, results in stronger social ties to the community, and increases motivation and a positive attitude for the future. This multidisciplinary approach recognizes the diverse needs of sex workers and aims to provide services that target the various issues that they face. A review of the best practices literature also suggests that the most successful intervention models tend to be driven by peers and FSWs themselves. In fact, sex worker led research is noted as a ‘gold standard in empowering women to leave sex work’ (Ouspenski, 2014:48). Further, Oselin (2014) suggested that prostitute-serving organizations (PSO’s), especially those that offered women housing and isolated them from their previous lives had the most success. These organizations are often run by former sex workers and provide opportunities for capacity building and for sharing experiences with others who understand the unique experiences and circumstances of FSWs. As a result, women develop enhanced social networks and stronger social ties. Research on best practices for exiting the sex trade is limited. However, what we do know is that exiting sex work is a process, not an event. Sex workers are not a homogeneous group, and they all have very unique challenges and needs. As such, it is important to remember that these unique identities must be met with approaches that enable sex workers universal access to comprehensive services, provide ongoing peer support and mentorship, and continue to build on existing relationships. Dedicated services for sex workers are required to prevent further physical or emotional harm associated with their continued involvement in prostitution. Finally, programmes
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offering support to sex workers should ensure that they do not just help to maintain them in prostitution but proactively seek to assist them to exit and rebuild their lives (Bindel et al., 2012).
6.
Project Outputs and Outcomes: Sex Workers’ Access to Support
The project achieved its objectives and produced the two expected outcomes: (1) FSWs accessed community-based social and economic reintegration services and made use of these services; and, (2) relevant government agencies, NGOs, and civil society promoted and supported the social and economic reintegration of FSWs. The first expected outcome had been formulated by the project as follows: “Sex workers have access to community-based social and economic reintegration services and make use of its services”. The project has evidently achieved its goal of providing sex workers access to community-based social and economic services. All representatives of project partner organizations agreed that, from their point of view, the project had achieved its stated objective of providing sex workers access to relevant services. The project took place at the “right time”, but also at a difficult time because of changes in national policies and in the law. The overarching goal was to support FSWs as they were exiting sex work. The evaluation was not able to confirm how many FSWs actually exited sex work as a result of the support they received from the project. a) The sex workers reached by the project The project was able to reach some of its targeted primary beneficiaries; in particular, some of the older sex workers, often with children, who were considering leaving the sex industry. Four hundred and nine (409) FSWs were reached and assisted to different extent by the project. The project’s initial outreach strategy was to recruit FSWs from the re-education centres where they were being detained. However, this was no longer feasible after the changes in the law on administrative offences in 2012 abolished detention as a sanction for this kind of administrative violation. The project relied instead on peer counsellors (peer network) to recruit participants. This was efficient, but only to an extent. For various reasons, younger women were not easily convinced to participate in the project and the project was unable to reach adolescent girls. This was obviously not because girls and adolescents are not involved in sex work in Hanoi. There is ample evidence that there are many children and adolescent girls who are commercially exploited sexually in Hanoi even if they are largely “invisible”.17 In fact, it is often estimated that at least 15% of female sex workers are under the age of 18. (Plan in Vietnam, Country Strategic Plan: 16; see also MOLISA - UNICEF, 2011: 38; Duong, 2002). There are many possible reasons for the project’s apparent inability to recruit younger sex workers. From the point of view of peer counsellors, this was due to the younger sex workers’ unwillingness or inability to quit sex work, perhaps because it is too profitable or the lifestyle is agreeable to them, perhaps because they are not free to do so, are addicted to drugs or are coerced by others, or perhaps because they are not aware of the risks involved in this kind of work. The police also suggested that younger 17
The “invisibility of child prostitutes” is frequently noted and deplored (MOLISA - UNICEF, 2011: 38).
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sex workers were not interested in leaving that occupation because of the kind of income they can still make. They also mentioned that younger sex workers who are coerced or abused do not dare ask for police protection. Another possibility is that these younger sex workers were not reached by the outreach method used by the project. It is not possible to determine the exact reasons for the project’s lack of success in recruiting younger sex workers, but it fair to assume that its outreach methods should be reconsidered and diversified. The Institute for Social Development Studies (ISDS), during the course of its own study on violence against FSWs in Hanoi, also reported considerable difficulty in reaching young FSWs, especially those under 20 years of age. This was due, in part, to their unwillingness to commit to an interview or discussion. In fact, the research team was unable to invite any younger street-based sex workers who work under protection of pimps. It seems as though the most vulnerable group was the most difficult-to-reach group and this possibly limited the research team’s access to some of the most severe cases of violence against FSWs (ISDS, 2015). As mentioned previously, there are outstanding questions about the outreach method used by the project and whether it could be improved or diversified in order to reach out to a broader segment of the population of FSWs in Hanoi, in particular adolescents. HNDSVP and Hanoi Police are currently working on a communication and data management software that will make it possible for the police to communicate basic information to HNDSVP about sex workers who come into contact with the police. Hanoi Police indicated that it was already providing HNDSVP with information about sex workers, but that police officers were not currently referring sex workers to the project or to any other form of assistance. The police agreed, in retrospect, that they could have played a role in the project by referring sex workers to the services. The data management software currently under development may eventually provide an opportunity to develop a referral mechanism involving the police. It will also provide HNDSVP and its partners with better information on the various types of sex workers, their activities, and on how to reach out to them. b) Services and support offered to FSWs In total, 409 FSWs were reached and assisted by the project, and all of them had access to the health package offered by the project. Three hundred and forty seven (347) beneficiaries received some basic life skills (thematic) training. Ninety four (94) beneficiaries registered in a vocational training programme and eighty three (82) of them graduated. All graduates were offered job placement or business development assistance. Thirty six (36) beneficiaries received grants and/or loans to support their new business plan. Eighty three (82) beneficiaries were equipped with market oriented vocational training and entrepreneurship skills and received job placement support or loans for small business development. There were no readily available data on post-training employment record, although it was clear that many of the beneficiaries had been able to secure employment or start a viable business. It was noted by project staff, however, that employment or the economic situation of the beneficiaries always remained somewhat fragile and that many of them would continue to need long-term support in order to succeed. Given that only a very short period of time had elapsed since most of the beneficiaries completed the programme, it was not possible to speculate how many of the new small business ventures will eventually prove successful.
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Fifty eight (58) FSWs were recruited and equipped with psycho-social counselling and communication skills (including on women’s, labour and sexual health rights) for their task as peer counsellors. Peer counsellors (sometimes referred to as peer educators) are FSWs identified and recruited by LIGHT. The role of the peer counsellors is to contact the female sex workers, build relationships, provide information on health and other project services and offer support to those who want to explore alternative employment and or reduce the level of sex work they are involved in. Some of the peer counsellors were linked to other self-help groups in Hanoi and had been trained on peer education and outreach by other projects. Eighteen (18) peer counsellors were recruited in 2013; twenty eight (28) in 2014; and, twelve (12) in 2015. Some specific “criteria for peer educator recruitment” were developed by CSAGA and LIGHT. The peer counsellors were provided with training on communicating with clients, working with groups, basic counseling skills and orientation on the services provided by the project. At the end of the project, the project team could rely on ten (10) peer counsellors. The level of commitment of various peer counsellors to the project varied considerably. Some beneficiaries received psycho-social support and counselling services, legal assistance and sexual health care treatment. CSAGA was responsible for providing psychological support and legal information services. CSAGA staff noted that the needs of FSWs are different from those of other groups they generally work with. Although the uptake of the psychological counselling service was fairly low at the beginning of the project, more beneficiaries later benefited from this particular service. Beneficiaries were generally referred to CSAGA by the peer counselors. They arrived with great expectations, usually for a quick solution, but eventually understood that they had to confront some of the deeper issues they were facing. Counsellors noted that the beneficiaries were often confused and ambivalent about the prospect of leaving sex work; their plans were very short-termed; and, they struggled with the obstacles and frustrations they encountered during the difficult transition. c) Retention rate A concern was raised during the mid-term review (MTR) about the number of beneficiaries who dropped out of the programme, particularly the vocational training and psychological counselling activities. The MTR report noted that the proportion of women who left vocational training before finishing their courses, or otherwise dropped out of the project, was a challenge (Stephens, 2014: 17). The dropout rate was noticed by project staff during the project’s early stages and measures were taken throughout the project to improve its retention and completion rates. The Second Report on the Project (April 2013 to March 2014) deplored the frequent lack of commitment on the part of many of the beneficiaries, particularly as it related to completing vocational training or participating in activities designed to offer them some psychological support. This was interpreted as a perceived lack of self-confidence on the part of beneficiaries and attributed to a lack of determination on their part to leave the sex trade. Many workers had apparently not yet reached a point where they could make a firm decision to exit the sex trade or to act resolutely on that decision. They also continued to face difficult challenges. Many of the beneficiaries had apparently underestimated the difficulties they would encounter in completing the programme and eventually exiting the sex trade. In September 2014, a Review of Trainees’ Perceptions after Completion of Vocational Training Programme at REACH (Phase 1) was conducted by the Project. This had
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been recommended by the MTR in order to understand the reasons behind the high level of drop-outs from the training programme. As it was not possible to contact the beneficiaries who had who dropped out of the vocational training courses supported by the project, project staff gathered perceptions and opinions from participants who might have an understanding of the reasons some beneficiaries may have had for abandoning the course and who might be able to make suggestions on how to improve the vocational training offered in the future. Several practical suggestions were made on how to improve and enrich the training programme. The main reasons offered to explain dropping out of the course were: lack of commitment, financial difficulties and the difficulty of generating an income while being trained, and medical issues interrupting or disrupting the training programme. Given the ambivalence of the beneficiaries about leaving the sex trade and what we know about the pathways and the challenges involved in the process of exiting prostitution, the “drop out” rate should be considered a normal part of the complex process of exiting prostitution, rather than a negative reflection on the quality of the support and assistance received by the beneficiaries. There are lessons to be learned about how to increase programme retention in this kind of context. One of them is obviously that participants must receive continuous support throughout the transition process and after to help face the numerous challenges that such a transition entails. Another lesson is that many of these women have suffered from various traumatic experiences and this must be taken into account in designing supportive interventions. The need for trauma-informed interventions and assistance is something that was repeatedly observed by project staff and is also well documented in the research on prostitution exiting programmes. For example, a study that examined the trauma symptoms and life experiences of 49 women in a residential prostitution-exiting program identified differences among women who completed the program and women who drop out of the program prior to completion. It revealed the importance of incorporating trauma-informed intervention early and addressing the traumatic symptoms related to childhood and adult trauma histories (Roe-Sepowitz, Hickle, and Simino, 2012). This has implications for government policies relating to how to offer effective assistance to FSWs. Government officials frequently point at the fact that many of the assistance programmes and credits available to members of vulnerable groups are open to sex workers who qualify. Although this is sometimes true, it is also true that very few of these programmes and services are accessed by FSWs. Expecting FSWs to spontaneously access services available to other vulnerable groups does not acknowledge the fact that FSWs usually fear discrimination and stigmatization and that they encounter unique difficulties in accessing and using these services. For example, some of the current programmes available to FSWs require them to acknowledge their past involvement in sex work and to formally declare that they are no longer involved in it. Given what we know about the process of exiting prostitution, it is obvious that such requirements would pose a formidable obstacle to access these services. A more effective way of reaching this vulnerable group is through the provision of dedicated and comprehensive programmes that accompany the individuals through the difficult transition to a different life. d) Inter-agency collaboration
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An important factor in achieving the desired outcomes was the partner organizations’ ongoing commitment to achieving the project’s objectives and desired outcomes while remaining flexible about the means and process used to achieve them. Good problem solving methods were used when difficulties arose during the project’s initial implementation stage. The effective, collaborative and transparent governance and management of the project, as a result of the close collaboration between all partner organizations, and in particular the collaboration between the HNDSVP and the project staff, were determining factors in ensuring the project’s success. That experience of collaboration led to a greater level of trust between government and civil society organizations signifying a new phase in their relationship and a very positive basis for future projects where NGO participation is necessary. e) Impact of the interventions on the life of the FSWs The project was credited by many of its beneficiaries for having transformed their life. The beneficiaries generally noted an improvement in their overall well-being. For example, they felt that their life was safer and that some of the risks they used to live with (e.g., violence, diseases) were no longer part of their life. However, they explained that they then faced other challenges. It was not possible to measure the extent to which project beneficiaries were involved in sex work during or after their participation in the project. Based on the information provided by beneficiaries and by the peer counsellors still involved in the project, it appeared that many beneficiaries were able to leave the sex trade as a result of the assistance they received through the project. Some beneficiaries were able to reduce their reliance on sex work to earn a living. Other beneficiaries developed the skills and the self-confidence that they will need to exit the sex trade when they eventually decide to do so. Among those who had exited the sex trade, some beneficiaries stated that they would never go back to sex work, while others were not so certain about whether they ever would. FSWs are a vulnerable group of women with multiple and complex needs and difficult life circumstances. The beneficiaries expressed a need for long term support and accompaniment once they had decided to consider leaving the sex trade. There is no particular reason to believe that the changes generated in the lives of the beneficiaries will not be sustained after the end of the project. However, their new livelihood remains precarious. The project duration was short and most of the beneficiaries who have benefited from the full project intervention (approximately 82) are just settling into their new life. The success of their transition cannot yet be fully evaluated. A general conclusion that can be drawn from this is that the project offered a realistic pathway out of sex work for some sex workers. That pathway was ostensibly based on an economic empowerment (livelihood) approach, but that intervention would not have been as successful had it not been part of a more comprehensive and dedicated assistance package.
7.
Project Outputs and Outcomes: Capacity Building
The second expected outcome of the project was stated as follows: “relevant government agencies, NGOs, and civil society promote and support the social and economic reintegration of sex workers”. There is consensus among participating
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organizations that the project significantly improved their collective understanding of the needs of FSWs and how to support their social and economic reintegration. One of the lessons learned by the partners was to not underestimate the challenges and difficulties encountered by sex workers who are contemplating the possibility of exiting the sex trade. It also became clear that desistance from sex work should not become a precondition to access to services. All participating organizations confirmed that the project had a considerable impact on building their respective capacity to work with FSWs. Representatives of government partners agreed that they had learned more about the challenges and relevant techniques involved in providing effective support to sex workers and working with peer counsellors. They were exposed to international best practices in that regard and were supported in elaborating programme policies and adapting their practices to recent changes in Vietnamese laws and policies concerning sex workers. In the longer term, project partners will need to continue to develop the necessary skills and competencies and may be best able to do so as part of a collective and collaborative experimentation and exchange of information process. The project delivered some training to police officers in Hanoi and, although the police service was not an official partner in the project, the role of the police in hindering or facilitating the sex workers’ social reintegration can be quite important and is beginning to be acknowledged by the police. The role of the police in helping prevent prostitution and is protecting sex workers against violence and exploitation is also important. Partner organizations have gained a greater appreciation of the importance of the role of peer counsellors (and the peer network) in supporting the transition of sex workers out of the sex trade. This is consistent with the research literature that identifies the participation of sex workers as a best practice. A lot of thinking has gone on in terms of how to recruit, screen, support and train these peer counsellors and the project has gradually refined its approach in that regard. Peer counsellors could not be recruited and managed directly by a government agency, but NGOs were able to do so and to support the entire initiative in that regard. Even though some of the partners were initially inclined to over-emphasize the importance of the economic empowerment and livelihood aspects of the project, they now realize that what is required is a dedicated, multi-pronged comprehensive approach to supporting sex workers during the exit process. The social and economic reintegration model is used for lobbying in favour of greater and more effective support for FSWs. A description of the model was communicated to DSVPs in 63 provinces and members of the project team have been actively involved in developing and delivering training materials about the model. The experience gathered in the project has contributed to the development of a policy proposal developed by the DSVP (MOLISA) and is currently under consideration. In its second annual report on the project, Plan Vietnam noted that, due to the social sensitivity of the issue of sex work and to prevailing attitudes and practices in Vietnam with respect to FSWs, the dialogue on the rights of sex workers and the responsibility of legal duty bearers, including various government agencies, to respect, protect and defend the rights of sex workers remains a difficult one. In Hanoi, the dialogue has started, in part due to the advocacy and training activities undertaken as part of the project. It is essential to ensure that this dialogue continues and to provide ongoing support,empirical evidence, collaborative experimentation, and learning.
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There may not yet be agreement on how to define the broad objectives of policies and interventions concerning prostitution in Vietnam. There is also some uncertainty about the prioritization of various goals (e.g., eradicating prostitution; encouraging exit from the sex trade; harm reduction – STD/HIV prevention; protecting the sex workers against violence; defending the rights of sex workers). However, there now is a greater understanding among project partners of the importance of dedicated and comprehensive interventions to support sex workers, whether or not they are immediately prepared to exit the sex trade. As had been suggested in the MTR report, the project team produced detailed documentation on the methods and approach used to assist FSWs. Two training manuals were produced and fairly widely disseminated by Plan and its partners: (1) a manual on how to support the business model18; and (2) a manual on setting up and supporting the operation of a peer educators’ group.19 The first of these two manuals provides guidance on how to sustainably offer support and assistance to vulnerable women wishing to start up, operate and manage a small private business. It contains specific guidance on how to help beneficiaries develop, test and implement a business plan. The second manual was developed on the basis of the experience of LIGHT and Plan in establishing and supporting peer groups as well as the lessons learned from other organizations. It provides practical guidance on the process of recruiting volunteers and establishing, training, operating, managing, and monitoring peer groups. The manuals could be of interest to organizations outside of Vietnam but have yet to be translated into English. In addition, one of the partner organizations, CSAGA, was able to further develop its own methods of psychological and practical counselling and is now in a position to offer training to other organizations wishing to develop that capacity. With respect to advocacy, the project and its partners have produced various videos, training materials and articles to publicise the project’s concept and mobilize the community in supporting sex workers who desire to change their lives. The project’s many advocacy activities included: offering training to 29 journalists on media communication concerning FSWs; a contest on FSWs for journalists; various communications to the mass media; a photo-voice and a photobook exhibitions; the development of documentary films on the sex workers’ lives and their effort to change their lives and exit the sex trade; various consulting and experience sharing events and workshops organized by DSVP, including publishing information in DSVP’s national and widely circulated magazine.
8.
Impact on Policy
At this stage, it is difficult to determine the extent to which the project was successful in advocating for legal or policy change. It is expected that some of this advocacy work will be reflected in programme policy decisions that will be made at both the national and local levels in the near future. In the minds of many, the project demonstrated the
18
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Plan International in Vietnam (2015). Dự án “Hỗ trợ nghiên cứu xây dựng chính sách và thí điểm mô hình hòa nhập cộng đồng cho nữ thanh niên bị bóc lột tình dục” tại thành phố Hà Nội. Hà Nội, 2015. Plan International in Vietnam (2015). Dự án “Hỗ trợ nghiên cứu xây dựng chính sách và thí điểm mô hình hòa nhập cộng đồng cho nữ thanh niên bị bóc lột tình dục” tại thành phố Hà Nội. Hà Nội, 2015.
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effectiveness of the “economic empowerment model” when accompanied by other support services. The project took place at a very opportune time when the government was not only implementing its national action plan (NPAAP) but also when the City of Hanoi and MOLISA were in the process of proposing an action plan for the next planning period. The fact that DSVP and HNDSVP were major partners in the project ensured that the lessons learned in the project could be reflected in the government’s national and local planning process. A plan of action has been submitted at the national level which prioritizes assistance to FSWs, the prevention of violence against FSWs, and the prevention of prostitution. One of the many objectives of Plan in Vietnam’s Country Strategic Plan is to build partnerships with authorities and alliances with other relevant organizations that can be used to protect children in special circumstances; that result was clearly achieved and could be built upon to deliver interventions targeting girls and very young adults.
9.
Efficiency
The planned outputs were delivered on time and within budget. Importantly, the project was managed collaboratively and with sufficient flexibility to meet emerging challenges and changes in circumstances. For example, the project helped build the capacity of partner organizations to assist sex workers, and it also offered some initial training to the police. Some key advocacy and awareness activities were also completed. The quality of the outputs, in particular the services delivered to beneficiaries, improved over time as the project team gained a better understanding of the needs of the beneficiaries and the challenges that they face in attempting to transition out of the sex industry. The project’s baseline survey and its needs assessment survey, conducted in 2013, helped the project refine its interventions and served as a basis for training initiatives. Project activities were delivered as efficiently as possible in the context of a project designed to experiment with a new model of services delivery. The project found ways to offer some of its activities in a more cost-effective way, in part by discovering synergies with some of the other planned activities. The small grants component of the project was replaced by a hybrid grant/loan component that reduced the costs and increased financial sustainability.
10. Sustainability The long term sustainability of the project’s model of intervention has not yet been established. Project partners did not have enough time to develop a financially sustainable approach to the delivery of comprehensive services to FSWs who are transitioning to a different life. Partner organizations are actively considering various ways in which they may continue to offer some limited services to FSWs through existing programmes. However, this may not be sufficient to ensure the future delivery of comprehensive services. Unless the project is continued, the capacity developed during the project among the partner organizations is at risk of dissipating. There is evidence that some of the changes in practices initiated by the project are slowly becoming institutionalized, but that process is just beginning. There appears to be some support at the CP level and in government for continuing the work to support
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sex workers. The end of the project will hopefully force participating organizations to reflect on how they might continue to support FSWs trying to exit sex work. Some of them expect to find ways to continue to offer some of the same services, but on a reduced scale. All project partners agree that the project was a success and they wish to see it continue for at least two years. The process of reintegration is a long one and current beneficiaries need continued support. Thirty eight (38) months was not sufficient to establish the project on a financially sustainable basis. An extension would allow the project to target groups of FSWs that are typically more difficult to reach. The project could also be extended to another geographical area. The question of funding and resources continues to be a concern. The government may not be in a position to support NGOs; all partner organizations recognize the importance of “socializing” the financial basis of the model. Should adequate funding be secured for the project continuation or expansion, HNDSVP could play a management/coordination role. Because project continuity is crucial in order to preserve the gains achieved by the project, one of the partner organizations should assume the responsibility of coordinating the effort of partner organizations while additional funding for the project is being sought.
11. Lessons Learned Some of the key lessons learned as a result of this project are as follows:
The process of exiting the sex trade is more complex than might have been anticipated;
The importance of using varied methods for reaching out to different groups of FSWs;
The importance of delivering long term assistance and support, within a dedicated programme, to help the beneficiary exit sex work;
The use of peer counsellors was essential to the success of the project; that role evolved and must continue to be further developed and researched;
There are also learned lessons about how to increase programme retention. One suggestion is that participants must receive continuous support throughout the transition process, and later, in order to help them face the numerous challenges that such a transition entails. Another lesson is that many of these FSWs have suffered from various traumatic experiences and that this must be taken into account in designing truly supportive, trauma-informed interventions. The project was able to offer a realistic pathway out of sex work based on an economic empowerment (livelihood) model because the intervention was part of a more comprehensive assistance package. This has implications for government policies relating to the delivery of effective assistance to FSWs. Expecting FSWs to spontaneously access services available to other vulnerable groups, even if they are technically eligible to receive these services, does not acknowledge the facts that FSWs usually fear discrimination and stigmatization, and that they encounter unique difficulties in accessing and using these services. A more effective way of reaching this vulnerable group is through the provision of a dedicated and comprehensive programme that accompanies individuals through the difficult transition to a different
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life. It is also clear that desistance from sex work should not become a precondition to access to services. There are many more lessons that have yet to be learned about how to empower FSWs and support them through the transition into a different, less risky, life. Project partners need to continue their formal collaboration to better understand the various pathways that may lead FSWs to a successful transition to a new life.
12. Conclusions Exiting the sex trade is a difficult and precarious process. The intended impact of the project was to demonstrate the effectiveness of a complex model of intervention that addresses the multiple needs and challenges of FSWs and can be delivered through effective collaboration between relevant government agencies and NGOs. As such, the study found that several support systems must exist in order to ensure a successful transition. The role of peer counsellors, access to relevant vocational training, job placement services, and small business loans are crucial. The model supported the efficient delivery of community-based social and economic services and assistance to FSWs, and it is clear that the project had an immediate life-transforming effect on many of its beneficiaries. However, as we know, there are also outstanding questions about the outreach method used by the project and whether it could be improved or diversified in order to reach a broader segment of the population of FSWs, including adolescents. The credit line programme administered by the Vietnam Bank for Social Policies to which FSWs are eligible is fact not accessible to them. Yet, it will continue to be important to maintain a capacity to support FTWs’ social reintegration and business development plans by a mix of small grants and loans. The project may consider approaching the VBSP for a “group loan”, to be managed DSVP or another project partner in order to extend small loans to FSWs. In terms of relationships with partner organizations, the project significantly improved the capacity of these organizations, especially as they helped to understand the needs of FSWs and how to best support their social and economic reintegration. The project also allowed participating organizations to better understand some of the pathways involved in exiting sex work and to tailor their services to support workers as they engage in these pathways. There is evidence that some of the changes initiated by the project are slowly being institutionalized, but the process is just beginning. The potentially abrupt ending of the project forced participating agencies to reflect on what they can do after the project has ended. Some of the partner organizations may find ways to continue to offer some services to FSWs, but on a reduced scale. Further, the Hanoi Police recommended that the project should continue to deliver comprehensive support services to FSWs who wish to exit the sex trade. Finally, although the project team actively engaged in advocacy activities for policy change, the project’s policy impact is hard to measure at this point. The relatively short duration of the project may have limited its future impact on legal policy, but the project certainly demonstrated the effectiveness of the “economic empowerment model” when accompanied by other support.
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13. Recommendations 1.
The Government and MOLISA should formally adopt and develop the supporting model developed through this project and seek to implement it progressively throughout the country
2.
It is important to determine which state organizations will assume the leading role in implementing a dedicated and comprehensive support programme for FSWs
3.
In implementing the comprehensive intervention model developed by the project, the Government should recognize the important role of NGOs in delivering such an intervention and seek to involve civil society in the delivery of key services
4.
Partner organizations are not finished learning about this type of intervention and the demonstration project should attempt to secure funding for an additional two years or more
5.
The project should be replicated in at least one other urban community in Vietnam
6.
The project should continue to rely on peer counsellors to reach out to female sex workers but also diversify its outreach mechanisms so as to reach a broader spectrum of potential beneficiaries 6.1 HN DSVP and Hanoi police are currently working on a communication and data management software that could make it possible for the police to communicate basic information to HNDSVP about sex workers who come into contact with the police. The police agreed that it could have played a greater role in the project by referring sex workers to the services offered by the project. 6.2 HNDSVP and Hanoi Police should agree on a referral procedure to direct FSWs to the services that are available to them
7.
The next phase of the project should focus on improving how it reaches different target groups of any age, and in particular younger FSWs and adolescent girls involved in the sex industry
8.
The project should seek to diversify the types of vocational training it offers to beneficiaries
9.
The project needs to further develop the role of peer counsellor as one of the key support elements in the empowerment model
10. Ongoing training should be offered to peer counsellors 11. The issue of violence against FSWs, as further revealed in the recent study of the ISDS and Plan, must be addressed more directly in future support programmes for FSWs 12. Additional training should be offered to all project staff and peer counsellors on trauma-informed interventions 13. Capacity building activities must be further developed in order to consolidate the important gains already achieved by the partner organizations 13.1 LIGHT should endeavour to maintain the current network of peer counsellors
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13.2 CSAGA now has a capacity to offer training to counsellors who have not yet had experience working with FSWS; it should plan to systematize and deliver this training to agencies that require it 13.3 It is essential to ensure that the inter-agency dialogue continues and is supported by empirical evidence, collaborative experimentation and learning 14. Because the project’s continuity is important, one of the partner organizations should assume the responsibility of coordinating the efforts of partner organizations to seek renewed funding for the project 15. The project, in collaboration with a partner organization with a capacity to offer effective recovery and addiction treatment to women with an addiction issue, should explore the possibility of reaching out to FSWs facing a substance abuse problem 16. The next phase of the project should aim to develop more direct collaboration with the police and to offer additional training to police officers. 16.1 In addition to the investigation training, police need specific prevention and educational training to deal with the complexities associated with sex work. 16.2 The training should include information on how to refer FSWs to programmes/treatment when necessary. 17. The project team may consider approaching the VBSP to negotiate a loan that would serve to finance an ongoing micro-loan programme to assist FSWs with a workable business development plan 18. Beneficiaries should be offered long-term entrepreneurial support and coaching designed to accompany them through the various challenges of building a new business 19. Plan Vietnam must continue its advocacy activities in relation to the prevention of prostitution, the protection of migrant women who find themselves at risk of being recruited into the sex industry, and support for FSWs wishing to exit sex work 20. Plan Vietnam must continue its advocacy role in relation to the development of support programmes for FSWs, in particular adolescent FSWs 21. Plan Vietnam must ensure that the findings of the present evaluation and the documentation concerning its project model are made available as widely as possible
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