Many of the solutions to problems with HIV and SRH service access and quality of care for people from Key Populations lie in developing a better understanding between people from health planning and delivery services and people from Key Populations about the reality of their lives, about the things that matter to them and about the difficulties they experience in developing and maintaining a positive engagement with services.
For this reason it is essential that people from Key Populations are included as active participants in the discussion and in the development of these solutions.
The fragmented and siloed nature of health service planning and delivery in many countries is often at odds with the way that individuals see their needs. Programmes targetting sex workers, for example, often focus in a very narrow way at HIV and STI prevention and treatment, whilst the woman, transgender person or man being 'targetted' will often see themselves as having a wide range of health and welfare needs - "I want to be healthy, have food, shelter, security and education for my children, live without violence, make my own decisions about whether or when I have more children, about my future and so on."
Bringing people from Key Populations into the discussion in a very real way makes sure that there can be a broader discussion about health in their lives, and an opportunity to develop solutions to the problems that most affect their ability to maintain health.
In the same way, having people from Key Populations gain a better understanding of the genuine motivations of health planners and services providers and the very real constraints that they work under in many settings can assist in building collaborative partnerships that move away from angry advocacy towards joint problem-solving.
For each workshop we established a clear and logical Flow of Learning. We returned to this diagram several times throughout the workshop to remind participants of what we had already covered and where the discussion would go next. This logical flow also helped to demonstrate how individual issues and problems could be worked through. This helped people who were new to the planning process to follow what was going on and to participate more fully.
We have tried to make these workshops as interactive as possible - there is plenty of evidence to show that people learn more and engage better when that are actively involved in a process that they see as relevant to their work and their lives.
We tried to make sure that the Workshop was conducted in a language that most of the participants could freely express themselves in. We are not only dealing with facts in this workshop, but with feelings, thoughts and ideas. We wanted people to be able to talk as freely as possible. We often had English-speaking co-facilitators from the region in the workshop, so always tried to ensure that we had simultaneous translation in place so that people could use the language they were most comfortable with.
We also took account of issues of power. People from Key Populations have often been marginalized by people with more power, better education and better access to resources. We tried to set up a discussion and learning environment that allowed everyone to contribute without fear of being ignored, patronized or humiliated.