1. M&E indicators for trafficking
in persons: A perspective on
gender and health
American Public Health Association
Annual Meeting
November 18, 2014
Abby C. Cannon, MPH, MSW
Jennet Arcara, MPH, MPP; Shelah S. Bloom, ScD;
Kristen Wares, MPH, Ana Djapovic Scholl, MPH, MSW

2. Presenter Disclosures
The following personal financial relationships with
commercial interests relevant to this presentation
existed during the past 12 months:
Abby Cannon
No relationships to disclose

3. 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.

4.  Injuries from physical and sexual violence
 HIV exposure, poor reproductive health
outcomes
 Mental health symptoms (e.g. depression,
anxiety, suicidal ideation)
 Forced substance abuse or substance use as a
coping mechanism
 Headaches, fatigue, and weight loss
Health implications of TIP
Zimmerman C, Yun K, Shvab I, et al. The health risks and consequences of trafficking in women
and adolescents: findings from a European study. London, United Kingdom: London England
London School of Hygiene and Tropical Medicine; 2003.

5.  Limited measurement of policy or programming impact
 Limited availability of data
o Each sector provides a small and biased subset of
all cases
o Few indicators to monitor and evaluate TIP
o Lack of standardization of indicators
o Lack of consensus on key areas to measure at the
intersection of health, gender, and trafficking
Existing Gaps and Challenges

6. Collaborative Process
The consultation included leading experts in TIP
and health representing:
 USAID, US State Department, NIH
 UNICEF
 International Organization of Migration (IOM)
 International Labor Organization (ILO)
 NGOs: IRC, Free the Slaves, Geneva Global
 Leading consultants & top researchers

7. Consultation Objectives
Discuss challenges in data collection
& research
Gain consensus on the critical areas
of measurement
Small group work on developing
indicators

8. Conceptual framework for TIP, health, and gender
Recruitment Exploitation
Integration
Re-
integration
Travel & Transit
(if applicable)
Adapted from: Zimmerman C, Hossain M, Watts C. Human trafficking and health: A conceptual
model to inform policy, intervention and research. Soc Sci Med. 2011;73(2):327–335.
Gender (in)equalities

9. Areas of Measurement
 Health sector response
 Post-trafficking Assistance and
Outreach Programs
 Health Status and Care Received
 Referrals
 Policy

10. Indicators: Health Sector Response
1. Proportion of health care units that have personnel that have
been trained to identify and refer trafficked persons
2. Proportion of health care units that have personnel that have
been trained to provide trauma-informed care for trafficked
persons.
3. Proportion of health units that have evidence of trafficking
awareness and response materials visibly available
4. Proportion of health units that have documented a protocol for
caring for trafficked people that includes informed consent and
stigma-free services.

11. Areas for further development
 Risk factors for trafficking
 Education
 Community awareness
 Migration and transnational border crossing
 Social welfare services
 Shame and stigma
 Special populations

12. Challenges
 Narrow vs. wide focus on health
 Lack of existing evidence base to build upon
 M&E capacity
 Maintaining group engagement remotely
 Trafficking is a contentious area

13. Thank you!
Questions or comments:
Abby Cannon: accannon@unc.edu
Trafficking in Persons and Health: A compendium of Monitoring and Evaluation
Indicators: https://www.cpc.unc.edu/measure/publications/ms-14-97

14. MEASURE Evaluation is a MEASURE project funded by
the U.S. Agency for International Development and
implemented by the Carolina Population Center at the
University of North Carolina at Chapel Hill in partnership
with Futures Group International, 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.