Serving women who use drugs in Delhi, India: challenges and achievements.
BACKGROUND
Sharan and Sahara, two NGOs working in Delhi, India, in the field of drug use and HIV/AIDS, present some key challenges as well as lessons learned in working with women who use drugs. Although there is no official estimate of the number of women drug users in Delhi, outreach reports indicate a hidden population of women users in the slums and streets of Delhi. A rapid situation assessment (RSA) conducted in 2000 by Sharan found urban poor women using drugs in Delhi with multiple issues related to their health, livelihoods, and relationships that put them at risk of severe health problems including HIV. The findings of the RSA led to intensified and focused intervention for women users by Sahara and Sharan.


METHODS
This is a discussion on a gender specific intervention ongoing in Delhi by delineating the particular achievements and challenges faced in working with women who use drugs. The article also looks at broader challenges that are outside the scope of this particular intervention but which nevertheless affect the well being of women who use drugs.


RESULTS
Out of the 3700 women who have been rehabilitated in Sahara, 40% have found employment, while another 10% have been reintegrated into their families. There is however, an overdependence on its services that impedes their successful transition to mainstream life.


CONCLUSIONS
One of the biggest limitations in the design of drug treatment interventions in Delhi is that there is a lack of diverse treatment options for women users. Only indoor detoxification and rehabilitation facilities are available for women; even these not offering a quality of care commensurate with the needs of the women. Lack of mental health care in drug treatment centres is felt to be a huge gap in services. Finally, NGOs like Sharan and Sahara are obliged to take up the entire continuum of care services which limits their ability to provide optimal care and services to women who use drugs. Lack of funds and lack of understanding among funding agencies about issues of women users are additional limitations in service provision. A multi-sectoral response is a viable response to the multi-dimensional problem of women drug use.
Sarin
Enisha
E
Johns Hopkins University Bloomberg School of Public Health, N. Wolfe Street, E5039, Baltimore, MD 21205, United States. esarin@jhsph.edu
Selhore
Elizabeth
E
D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007194:India; D009939:Organizations, Nonprofit / Q000458:organization & administration; D011203:Poverty / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care; D012307:Risk Factors; D012737:Sex Factors; D016320:Substance Abuse Treatment Centers / Q000592:standards; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D014505:Urban Population / Q000706:statistics & numerical data; D014932:Women's Health Services / Q000592:standards*