Compiled by E. Mohamed Rafique and Rajen Varada, Resource Persons and Rituu B Nanda and Gitanjali Sah, Research Associates Issue Date: 20 July 2008
Explosion of media and proliferation of the internet has led to conflicting messages creating confusion around sexuality. Toll-free help lines are a vital tool for providing information in a confidential environment. Respondents shared interesting and relevant experiences on help lines and suggested ways for utilizing them better.
Members mentioned several help lines in India, which are providing telephonic counseling services. JSK initiative gives an opportunity to the youth to speak their mind. UNAIDS supported the Central Reserve Police Force (CRPF) in India to set up a toll free helpline on HIV. The initiative has boosted the morale of the force, besides bringing focus on wellness promotion and decreasing vulnerability to HIV. Talking About Reproductive and Sexual Health Issues (TARSHI) helpline provides confidential, anonymous and non-judgmental information, counseling and referral service. TARSHI website also provides a list of Help lines in Delhi. Chandigarh AIDS hotline, a computerized telephone counselling service is a joint venture of a NGO and the State AIDS Control Society.
Respondents reported on the profile of callers and evaluation of helpline services. The anonymity and confidentiality of the help lines has encouraged more calls. Most of the questions arise from a lack of basic information about one’s body, sex and sexuality, reproductive and sexual health. Hindustan Latex Family Planning Promotion Trust Toll Free Help line, deals with Reproductive and Sexual Health, and family planning issues of young married couples. Phones for Health uses the widespread and increasing mobile phone coverage in Africa to strengthen health systems.
The help lines cover, subscribers stated, mostly the residents of the city and its nearby surroundings. Most of the callers to the help lines are youth and men but the number of women callers has recently gone up. The duration of calls varies from as little as a minute to over an hour depending on the nature of the concern and the amount of time and privacy the caller has. Some help lines also provide a referral list of doctors, Psychologists, and NGOs. Most help lines operate on working days and have trained counseling staff. Whenever the regular staff is not available, other staffs help. Like in AIIMS, a doctor and two social workers take over the helpline in case of a contingency.
It is difficult for an anonymous Helpline based sexuality counseling service to track the outcomes of its service, participants acknowledged. Some callers do report follow-up actions in subsequent calls and few organizations record the feedback to maintain the quality of its service, deepen understanding of sexuality and reproductive health and collect data for future research. TARSHI has completed a few action researches. PSI help line generates daily data giving a profile of the callers. Zumbido has conducted a comprehensive follow-up survey enlisting the impact on the callers.
Contributors accepted that the toll free help lines are working well in some of the states, while they are defunct in most others. SACS generally outsource the help lines to NGOs. However, those managing help lines have to address several challenges. For instance, the software and methodology of dealing with the queries is outdated. Moreover, only a few have dedicated telephone lines for telephone counseling directly with a counselor. In addition, the toll free numbers of SACS help lines do not cover the entire state limiting the access of callers to these facilities. Besides, few help lines keep the profile of callers and the details related to the query and the reply given to the client. Furthermore, no formal comprehensive sexuality training for counselors exists. Likewise, some NGOs conduct sexuality training pertaining to their own primary issue of concern. Additionally, help lines do not give information on "available services" to the community and only general information about HIV is available. What’s more, in Haryana the Counselors switched off their Mobiles and many of them used the mobiles for their own use. Respondents also informed that Rajasthan State AIDS Control Society discontinued their project due to non-availability of funds in for this project.
To address the problems associated with HIV help lines, members gave some suggestions:
• Careful selection of counselors
• Regular refresher training along with hands-on training with the latest software helps counselors provide better services and prevent burnouts
• Close supervision and ongoing support. Saadhan Helpline has conducted "Mystery Caller" studies with the help of an external agency to ensure quality and adherence to helpline protocols.
• The response must be in accordance to the caller’s needs
• Avhan Technologies Ltd. worked on some applications for health and found that people like to use IVR and call centers more than kiosks and SMS services. For India, technologies must be multi lingual. Voice technologies such as speech recognition and text to speech are likely to find greater acceptance and adoption by Indian audiences
• Protocols to ensure high standards in sexuality related services developed and made mandatory
• Having a customized software with an exhaustive FAQ database
• Mass Media is key for promotion of helpline services
To sum up, toll-free help lines are a vital tool for the dissemination of correct information on HIV. Sex education in schools in India has run into serious problems because significant groups feel that sex education goes against Indian values. It is necessary to fill this lacuna with toll-free help lines that provide up-to-date and essential facts, rather than getting incorrect information from peers, members concluded.