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Multi-country study on harm reduction and community involvement

Funded by Bridging the Gaps, this study aimed to understand how involvement of people who use drugs can influence the quality and availability of harm reduction services. The study took place in three countries - Indonesia, Kyrgyzstan and South Africa.

The group of researchers was an interesting mix of (community) researchers based at AFEW Kyrgyzstan, Rumah Cemara (Indonesia) and SANPUD/University of Pretoria (South Africa), complemented with researchers from King’s College London, Mainline, INPUD, and AFEW International.  

Each country study was led by a team consisting of experts from the local community of people who use drugs and academic experts.

People who use drugs were involved in all aspects of the research, including design, data gathering, analysis, and writing of articles and reports.

The three studies in Indonesia, South Africa, and Kyrgyzstan were complemented with a (global) literature review about the impact of community involvement on services.

Based on our research the group has four core messages:

  1. More ambitious support is needed for expanded community involvement in harm reduction services
  2. Community involvement can support increased access and quality of harm reduction services
  3. Community leadership delivers research with impact
  4. Research agendas need to expand and methodologies need to adapt


Our current projects


internationaal

Women who use drugs

Nepal

Mainline is asked to review the current harm reduction programmes in Nepal from the perspective of women who inject drugs. Based on interviews with women we hope to formulate recommendations to improve service delivery. 

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internationaal

Services for Vulnerable Migrants who use Drugs in the EU

Netherlands, Belgium, Spain, Greece, Germany, France

Several risk factors increase the vulnerability of (new) groups of migrants to engage in problematic drug use. These risk factors include traumatic experiences, disengagement with society, unemployment and poverty. Services and municipalities throughout the European Union are faced with the urgent challenge to address these migrants’ needs. 

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internationaal

Love Alliance

Burkina Faso, Burundi, Egypt, Kenya, Marocco, Mozambique, Nigeria, South Africa, Uganda, Zimbabwe

Mainline is a partner in the Love Alliance programme. The Love Alliance brings together organisations led by communities most affected by HIV and AIDS.

> Read more
internationaal

Chemsex

Global

The use of drugs during sex is a growing worldwide phenomenon among men who have sex with men (MSM). Mainline has built a unique track record while working in the frontline of the Dutch 'chemsex' scene. Now, we also apply this expertise in an international context.

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internationaal

harm reduction for people who use crack cocaine

Brazil

Mainline is starting a two-year project in Recife, Brazil, together with LANPUD, and the Free School for Harm Reduction (ELRD). The project aims to expand harm reduction and HIV care and support for young people who use crack cocaine.

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internationaal

Stimulant Harm Reduction - Field Lab

Vietnam

In 2021 and 2022, SCDI in Vietnam and Mainline can continue to strengthen and expand the available harm reduction offer for people who use meth-amphetamines. After establishing the regional field lab in 2019 and 2020 we now have the opportunity to push this innovative initiative to the next level. One important element: to improve and expand the community mental health response. Moreover, the skills that were built in Hanoi's field lab are ready to be further disseminated across the South East Asian Region.

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internationaal

Quality Harm Reduction

Iran

Iran is renowned for its harm reduction programme. It was one of the first countries in this geographical region to adopt a harm reduction approach. Government supports and funds the programme. But the drug scene in Iran has changed over the past 20 years. More people are using stimulant drugs and, due to economic circumstances, more people who use drugs have become homeless. Mainline sets out to see whether the current programme in Tehran still fits the needs of the local people who use drugs.

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internationaal

Assessing the drug scene

Zimbabwe

Mainline have been asked to assess the drug scene in five provinces in Zimbabwe. A team of three researchers worked in close collaboration with the Zimbabwe Civil Liberties Drug Network throughout 2022. The goal: to gain an insight into which drugs are commonly used and to recommend health interventions.

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Mainline - Technical Advice

Did Mainline become a supplier? Yes: a supplier of technical advice for the Global Fund. Harm reduction organisations and networks of people who use drugs across the world can now request a Mainline training or capacity building. Read more about how this works.

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internationaal

Mindful Muscles

United Kingdom, Finland, Greece, Estonia, Serbia, Portugal, the Netherlands

Harm reduction approaches are rarely applied in a recreational sports setting. And why would we - sport equals health, right? Not always. Research shows that the use of performance and image-enhancing drugs (PIEDs) is quite common in various recreational sport scenes. And for those people who use frequently and in high doses, harm reduction can make a big difference.

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Our finished projects

internationaal

Size estimation and service mapping: introducing harm reduction

Zambia

Harm reduction is new in Zambia. Mainline was asked to estimate how many people inject drugs in the country and to map the already existing harm reduction and HIV services for people who use drugs. Based on this information, we drafted practical service guidelines. In doing so, Mainline hopes to have contributed to the introduction of harm reduction in Zambia.  

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internationaal

Women Who Use Drugs & Peer Workers

South Africa

Women Who Use Drugs face additional problems compared to their male counterparts. The harm reduction field far too often neglects the needs of women. To some extent, the same is true for peer workers: incredibly valuable staff in any impactful service. How can local services make sure that peer workers are valued, supported and living up to their full potential? And how can access for women who use drugs be improved?

> Read more
internationaal

Gender-based violence

Kenya

Women who use drugs in Kenya face violence every day: At home. On the streets. By the police. In their communities. A unique study - conducted in Mombasa, Kenya - sheds light on the tough realities these women encounter. Urgent action is needed.

> Read more
internationaal

Young, Wild and... Free?

Kenya, South Africa

Young people use drugs - including minors. It's an inconvenient truth: societies usually seek to prevent young people from damaging their health and there is a big taboo on drug use among young kids. But are stigma, legislation or moral judgement keeping young people away from harm reduction services? This project aims to find and improve access to services.

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internationaal

Prison Health

Indonesia

Prisons in Indonesia are overcrowded and health services are limited. Is quality prison health too expensive? Not according to findings from Atma Jaya University, who applied the method of 'economic modelling' to prison health services, including drug dependency programmes. The findings fed important advocacy messages to improve the prison system in 2021. Moreover, Atma Jaya - via a 2021 implementation study - succesfully introduced motivational interviewing into the prison setting: an evidence-based method to assist people who are dependent on drugs and would like to reduce or quit their drug use.

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internationaal

Reducing harms in the work environment

South Africa

Together with activists and peer- and outreach workers in South Africa, Mainline worked on a practical guide about involving peers in harm reduction work.

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