Monitoring and Evaluation of Global Sex Trafficking:

What Do We Really Know? Focus on Gender and Health

Abby Cannon, Gender SpecialistEvis Farka Haake, M&E Associate

American Evaluation Association Annual ConferenceWashington D.C.October 17, 2013

Agenda

Overview of M&E of Trafficking

Question & Answer

Group work

Large group discussion

Objectives of the Presentation

Provide an overview of common forms of trafficking

Discuss the challenges for conducting M&E of trafficking

Discuss efforts and opportunities to advance the current state of M&E of trafficking

UN Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children (Palermo Protocol):

“The recruitment, transportation, transfer, harboring or receipt of persons, by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation.”

Definition: Trafficking in Persons

Source: UN (2000). Protocol to Prevent Suppress and Punish Trafficking in Person, Especially Women and Children, Supplementing the United Nations Convention Against Transnational Organized Crime.

Trafficking in Persons (TIP) Definitions

United States - the Trafficking Victims Protection Act (TVPA) definition:

“sex trafficking in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such an act has not attained 18 years of age; or the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.”

Size of the problem

Estimates range from 2.4 million¹ to 27 million trafficking victims worldwide

BUT

47,000 identified trafficking victims²

1. International Labour Organization. 2012. ILO Global estimate of forced labour: Results and methodology. Geneva. Accessible at http://www.ilo.org/wcmsp5/groups/public/---ed_norm/---declaration/documents/publication/wcms_182004.pdf

2. US Department of State. 2013. Trafficking in Persons Report. Washington, DC. Accessible at: http://www.state.gov/j/tip/rls/tiprpt/2013/index.htm

Forced labour exploitation14 200 000 (68%)

Forced sexual exploitation4 500 000 (22%)

State-imposed forced labour2 200 000 (10%)

20.9 million people in forced labour

1. International Labour Organization. 2012. ILO Global estimate of forced labour: Results and methodology. Geneva. Accessible at http://www.ilo.org/wcmsp5/groups/public/---ed_norm/---declaration/documents/publication/wcms_182004.pdf

Unintended Consequences

Equating TIP with illegal migration or sex work has created collateral damage for many victims.

Legal migration vs. trafficking

Sex work vs. trafficking

Exploratory Qualitative Study

A formative, qualitative study was conducted in 2012/2013 on the monitoring and evaluation of trafficking in persons as it relates to gender and global health, particularly HIV/AIDS. Aimed to identify and understand the successes

and challenges in the M&E of human trafficking

Methods Literature review

Qualitative research study

Semi-structured interviews with experts in: gender

global health

HIV/AIDS

counter-trafficking

M&E

Finding 1

A gender and health perspective is critical in TIP. acknowledges trafficking in both men and

women

includes those involved in the process of trafficking

Finding 2 Consensus that TIP has important impacts

on global health Higher HIV prevalence among individuals that have

been trafficked

Increased risk for:

mental health conditions including depression and PTSD

sexual violence, contraceptive failure, poor MNCH outcomes, gender-based violence, TB

Example: Sex trafficking and increased HIV risk

A study among repatriated women and girls in Nepal found several factors within trafficking to be associated with increased risk of HIV infection:

Age of trafficking (younger than 14 showed significantly increased risk)

Length of time in servitude

Serving in multiple brothels

Destination city

Nearly 9 in 10 individuals who developed TB were HIV co-infected.

. Silverman, J. G., Decker, M. R., Gupta, J., Maheshwari, A., Willis, B. M., & Raj, A. (2007). HIV prevalence and predictors of infection in sex-trafficked nepalese girls and women. JAMA : The Journal of the American Medical Association, 298(5), 536-542.

Example: Sex trafficking and increased HIV risk

2006 study in India

HIV prevalence of 22.9% among women and girls rescued from brothels in Mumbai. Association found between HIV status and age of trafficking

For every month in captivity, there was a 3% to 4% increased risk of HIV infection

No differences in HIV status based on nationality, marital status, or number of sex work clients per day were identified.

Silverman, J. G., Decker, M. R., Gupta, J., Maheshwari, A., Patel, V., & Raj, A. (2006). HIV prevalence and predictors among rescued sex-trafficked women and girls in Mumbai, India. Journal of Acquired Immune Deficiency Syndromes, 43(5), 588-593.

Finding 3

Evidence base is lacking

Improved monitoring and evaluation practices related to the effects of TIP are needed

Finding 4

Trafficking can be a contentious arena; however, improved discourse between gender, public health, HIV/AIDS, M&E, and TIP professionals could have profound impact on HIV and trafficking programs.

Main Recommendation

A meeting of experts from each discipline is needed to:

focus on opportunities and help create M&E frameworks, indicators, and best practices

identify promising approaches, methods and tools to be used in M&E of TIP as it relates to health and gender

formulate a learning agenda that would help in moving this field forward

Expert Consultation on Indicator Development for Monitoring and Evaluation of Trafficking in Persons within the Context

of Gender and Health

Washington, DC

October 1-3, 2013

Consultation Objectives

Day 1: Areas of measurement Attain consensus on the critical areas to TIP

within the context of gender and health

Days 2-3: Indicators Develop set of indicators of these areas for

program managers, policymakers, & others

Discuss strategy for dissemination, field-testing new indicators

Representatives from: International Organization for Migration

International Labour Organization

UNICEF

USAID

U.S. State Department

NIH/NIDA

Researchers from top universitieso 2 international universities

o 3 US universities

NGO representatives

Day 1

TIP Policies and Definitions in the International Context

Operationalizing sex trafficking in research and practice

Health and Human Trafficking

Child trafficking

Challenges of Sampling and Data collection

Overview from ILO and IOM on data collection

Days 2 & 3

Input on areas of measurement

Small group work on developing indicators

Plenary group session to build consensus on all indicators

Identification of victims Definitions of TIP vary Limited measurement of policy or programming

impact Limited availability of data

o Each sector provides a small and biased subset of all cases

o Data is not comparable

Existing Gaps and Challenges

Areas of Measurement Policies and Law

Law enforcement

Health Sectoro Health service providers

Non-health serviceso Education

o Community

Other areas:o Referral mechanisms

Preven

tion

Any Questions/Comments?

Discussion

Break into small groups

Select 1-2 discussion questions

Appoint someone to report back to the large group

20-30 minutes

MEASURE Evaluation is funded by the U.S. Agency for

International Development (USAID) and implemented by the

Carolina Population Center at the University of North Carolina at

Chapel Hill in partnership with Futures Group, ICF International,

John Snow, Inc., Management Sciences for Health, and Tulane

University. Views expressed in this presentation do not necessarily

reflect the views of USAID or the U.S. government.

MEASURE Evaluation is the USAID Global Health Bureau's

primary vehicle for supporting improvements in monitoring and

evaluation in population, health and nutrition worldwide.

www.measureevaluation.org