Health & Well-being

Strategic Goal
Improving the sexual, reproductive and mental health (SRM) of marginalized, high risk and vulnerable groups representatives;

Strategic Aim

• Building and developing an integrated channel of comprehensive service delivery through the establishment of a network of health workers and direct providing of services;
• Identifying, evaluating, and responding to community sexual, mental and reproductive healthcare needs through sensitization of stakeholders and landing innovative services;
• Strengthening the capacity of the communities to promote the health, adopt and sustain healthy lifestyles.

Strategic Objectives

1. To prevent HIV/AIDS/STI among MSM, WSW and TG communities;
2. To raise awareness on SRM health issues among marginalized, high risk and vulnerable communities;
3. To ensure equal access to high-quality medical services, healthcare and treatment;
4. To monitor and conduct research, studies, surveys on marginalized, high risk and vulnerable groups health issues;
5. To develop an advocacy for marginalized, high risk and vulnerable groups inclusive healthcare national polices.

Package of Services

•  Lending individual and group medical and psychological counseling services; 
  
•  Providing hotline and online counseling services;
  
• Setting up self-support and support groups;
  
• Providing peer education and peer counseling; 
  
• Conducting outreach work;
  
• Distributing  safer sex packs;
  
• Providing VCT and accompanying to beneficiaries to take STI tests;
  
• Organizing informational and educational activities (training sessions, workshops, conferences etc.) on sexual and reproductive health and rights and safer sexual behavior;
• Elaborating, publishing and disseminating of IEC materials (books, brochures, booklets, leaflets etc.) on SRM health and rights; 
• Launching the first Armenian-language website on MSM;
• Establishing and constantly updating a library and video resources;
• Monitoring sexual behavior and carrying out thematic surveys and research;
• Identify legislative, practices and polices gaps in national healthcare infrastructure;
•  Develop marginalized, high risk and vulnerable groups inclusive healthcare national legislation, polices;
• Advocate for marginalized, high risk and vulnerable groups inclusive healthcare national policies and practices;
•  Creating friendly network of professionals (medical workers, psychologists, social workers).

Expected Results

Marginalized, high risk and vulnerable communities exhibit a safer sexual behavior and has an equal access to high-quality healthcare and psychological services.

WFCE Health Polices and Approaches

The World Health Organization defines health as: “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Following this definition, WFCE holds that the health needs of minority people are not adequately met and that improvements within health care are necessary.

Minority, marginalized, high risk and vulnerable individuals can experience discrimination, harassment and exclusion in their everyday lives. The stresses created by stigma, inequality and harassment can cause Minority people to be at a heightened risk of psychological distress. This is often referred to as minority stress, a term used to describe the mental health consequences of stigmatization, social exclusion, discrimination and harassment of minority groups. This results in the following for minority people:

• difficulty accepting their identity; 
  
•  denial and trying to keep their identity a secret through lying, pretending or leading a double life;
  
• damaged relationships or lack of support from parents, families and friends;
  
• isolation;
  
• low self-esteem and feelings of self-worth;
  
• post-traumatic stress disorder and depression from long-term effects of bullying.
  

Poor mental health and wellbeing have a profound effect on the wider health and wellbeing, and impact on self-efficacy and decision-making in relation to health. Feelings of stress, depression and isolation are among factors that may lead to a need to self-medicate and therefore reach for drugs, alcohol and tobacco in order to feel better or ‘escape’. An individual’s propensity to abuse substances is compounded by the role of alcohol and drug use in the social environment. Minorities are at a heightened risk owing to the fact that they may also experience additional pressures in relation drug, tobacco and alcohol use from their in the community. These problems influence on a worrying rise in the suicide rate in Armenia, which is coupled with a trend for younger people to take their own lives and increases 20% annually in general public.

Sexual preference is not the most important aspect in determining risk. It is behavior that determines the risk level for contracting sexual transmitted infections (STI). It is common for people to have questions and concerns about their sexual health and safer-sex practices. For minorities, lack of information or people to talk to about sexual health contributes to unsafe sexual behaviors and attitudes. It also leads to unwillingness to have regular check-ups and avoidance of health-care in general. Women who have sex with women (WSW) are a diverse group with variations in sexual identity, sexual behaviors, sexual practices, and risk behaviors. WSW, particularly women with both male and female partners are at increased risk for STIs and HIV as a result of certain reported risk behaviors.  Many factors contribute to the higher rates of HIV and STIs among men who have sex with men (MSM) and MtF transgender. These factors include high prevalence of HIV and other STIs among MSM/TG, which increases the risk of disease exposure, complacency about HIV risk, and difficulty in consistently maintaining safe sexual behaviors with every sexual encounter over the course of a lifetime. Lack of awareness and accurate data contribute to complacency and ignorance of the risk, especially for those who might have never received any information about prevention. High prevalence of commercial sex work in MSM/TG communities, because of unemployment and discrimination fosters the spread of STIs and HIV/AIDS within the MSM/WSW and TG communities.

Transgender people and often have distinct issues when it comes to healthcare and wellbeing. As transgender people often need or desire medical intervention, unbiased health care and appropriate treatments are extremely important for these people. Healthcare providers don’t have knowledge and experience on the subject of gender identity of transgender people, and therefore may react in a discriminatory manner or do not react at all. This leads to avoiding doctors as much as possible in fear of inappropriate behavior.

WFCE health targeted activities are oriented on:

• improvement of health and well-being by directly providing package of services related to sexual, reproductive and mental health;
  
• preventing STI/HIV/AIDS, care and support for PLHIV;
  
• raising awareness on sexual, reproductive and mental health issues; 
  
• equal access to high-quality healthcare services;
  
•  identify, monitor, evaluate and solve health problems and concerns. 
  

WFCE believes that the health and adequate healthcare is one of the most important staples of human life. Minorities have to be able to reach the appropriate segments of healthcare systems, without the fear of discrimination or wrongful treatment by unsympathetic and uneducated health care professionals.