Traffickers often operate within their own communities and use personal and social networks to lure victims.

Community Resilience and Protection: Anti-Trafficking in Northern Vietnam

From 2019-2020, GFEMS funded anti-trafficking programming in Northern Vietnam, led by implementation partners Blue Dragon Children’s Foundation and the Sustainable Hospitality Alliance. This briefing document presents the consolidated learnings from interventions conducted in Ha Giang Province, where communities are at high risk of trafficking due to socio-economic vulnerabilities including low-levels of educational attainment, high poverty rates, and a reliance on low-margin agriculture. Members of these communities predominantly live in remote and rural areas and belong to disadvantaged ethnic minority groups. These characteristics, coupled with the proximity of a long and porous land border with China, result in high levels of migration through irregular channels, leaving individuals vulnerable to threats, deception, exploitation, and lack of legal protections.

The intervention model comprised three key components aimed at building community resilience through early identification and support to at-risk households, facilitating comprehensive rehabilitation and reintegration support for trafficking survivors, and impeding traffickers through strengthened legal response.

Select Key Findings

Traffickers operate within their own communities.


The majority of traffickers belong to the same vulnerable communities as victims, have relatively low levels of educational attainment, and face a lack of viable livelihood opportunities.

Traffickers use personal and online social networks.


Traffickers are using social media, smart phones, and other forms of technology to identify, groom, lure, and traffic victims.

Risky migration can be reduced if community-led awareness campaigns are combined with targeted livelihood support:


Compared to residents in control communities, residents of intervention communities within Ha Giang were less likely to migrate without a contract, less likely to have their documents confiscated, and less likely to migrate with debt at project endline.

For more findings and to see our recommendations, download the briefing.

The nature of sex trafficking is rapidly changing. Use this report to understand the positive practices, policies, and procedures used to work with victims and survivors.

Get Involved

Practitioner note: Supporting victims and survivors of sex trafficking

In August 2020, GFEMS commissioned the Rights Lab at the University of Nottingham to conduct policy and practices to address commercial sexual exploitation in India and Bangladesh. This summary examines and documents current CSE policy in India and Bangladesh across three specific areas:

  • Repatriation of victims
  • Survivor rehabilitation
  • Livelihood support.

This summary also aims to identify positive practices on victim care policies and procedures related to rehabilitation, livelihoods, and cross-border support (between India and Bangladesh) for repatriation and reintegration.

For more information, download the report:

Nearly 30% of individuals engaged in the sex industry in Kampala, Uganda are under the age of 18.

Characteristics and Prevalence of Child Sex Trafficking in the Kampala Region

Through March and April 2021, ICF and the Department of Social Work and Social Administration, Makerere University, undertook a respondent-driven sampling (RDS) study, involving in-person interviews, in Kampala to measure the characteristics of commercial sexual exploitation (CSE) and to estimate the prevalence of children among all people engaged in CSE. This study, along with our simultaneous CSEC study in the Karamoja region of Uganda, is the first to offer a prevalence estimate of CSEC for any region of Uganda.

Likewise, it is one of the first studies in Uganda to systematically explore the characteristics of CSE among children in Kampala and to include males who engage in the sex industry. The study offers insights into the experiences of those engaged in the sex industry to allow for more relevant and effective programming targeting this population.

Our research shows increased vulnerability to forced labor conditions among migrant workers, and increasing pressure on children to participate in the commercial sex industry.

The Impact of COVID-19 on trafficking in Kenya and Uganda

Responding to COVID-19 in Uganda and Kenya: In the spring of 2021, GFEMS commissioned a series of interrelated studies to assess the short, medium, and long-term impacts of COVID-19 on vulnerable populations in key sectors in Kenya and Uganda and identify ways in which GFEMS-funded programming can be adapted to better support them. The studies revealed increased vulnerability to forced labor conditions among migrant workers as well as limited access to economic alternatives for returnee migrants, prompting remigration. The studies also revealed increasing pressure on vulnerable children to engage in the commercial sex industry, primarily driven by economic necessity and school closures. Children already engaged in the industry experienced an increase in economic insecurity and violent abuse as well as reduced access to support services.  

Partners: ICF, Makerere University, NORC at the University of Chicago, Kantar Public


Situational Analysis: Impact of COVID-19 on Overseas Labor Recruitment
Situational Analysis: Impact of COVID-19 on Commercial Sexual Exploitation of Children


Situational Analysis: Impact of COVID-19 on Overseas Labor Recruitment

Our research provides the first probabilistic estimate of child sex trafficking in Uganda, with unexpected results.

Estimating the Prevalence of Child Sex Trafficking in Uganda

Karamoja is a rural region in northeast Uganda. The majority of internal trafficking child victims in Uganda are ethnically Karamojong. Karamoja’s extremely high rate of multidimensional child poverty (84%) and a traditional acceptance of migration for livelihood increase children’s vulnerability to commercial sexual exploitation of children (CSEC).

Although child sex trafficking is believed to be a serious problem in the Karamoja region, there have been no previous studies of the knowledge, attitudes, and practices regarding child trafficking and child migration in the region. The prevalence of CSEC and a thorough identification of vulnerabilities and risk factors among certain populations have not been fully studied in Uganda more broadly. No prior studies offer an estimate of the prevalence of CSEC in Uganda based on a probabilistic sample.

This population-based survey explored the knowledge, attitudes, and practices of Napak children and adults related to child migration and child trafficking as well as the prevalence of CSEC. This study provides baseline estimates and findings to inform the GFEMS-Funded Community Action to End Child Trafficking and Sexual Exploitation project.

This study, conducted in collaboration with Makerere University of ICF, offers the first CSEC prevalence estimate for any region in Uganda that is based on a probabilistic sample. The data reveal interesting insights on the scope of CSEC in the region and adults’ and children’s calculation of the risks and benefits regarding migration.

To learn more about our findings and see our recommendations, download the briefing.

Trauma-informed care is critical to the wellbeing of survivors of trafficking.

From Repatriation to Reintegration: Centering Survivors to Effect Systemic Change

Every year, approximately 50,000 girls and women are trafficked to India across Bangladesh’s western border. In India, they are forced to labor, sold into prostitution, or trafficked out to be exploited and abused in another country. Around 500,000 Bangladeshi women and children from 12-30 years old have been illegally trafficked to India in the last decade.

Despite a common understanding of the problem, efforts to eradicate trafficking and repatriate victims of modern slavery are failing thousands of women and girls. Communities in Bangladesh’s Khulna Division have proven especially vulnerable to trafficking. Situated at the border with India, Khulna Division is already a high-risk community with overpopulation, extreme poverty, and remoteness of location exacerbating these risks. Criminals are only emboldened by extremely low conviction rates for trafficking cases. Even when trafficking victims are identified in India, they languish in shelter homes for years before they are able to return home. 

When survivors return to Bangladesh, they remain susceptible to re-trafficking. They are often ostracized by their communities or burdened with a social stigma that hinders recovery and reintegration efforts. These challenges, combined with a lack of employment and educational opportunities, leave survivors vulnerable to further exploitation. In a recent study, our implementing partner in Bangladesh found that 30% of the survivors they currently support had been trafficked multiple times before.

As has been seen across the globe, COVID-19 takes its heaviest toll on those who are the most vulnerable. In Bangladesh’s Khulna Division, there has been no exception. According to the US State Department’s most recent TIP Report, increasingly widespread job loss, wage cuts, and poverty in Bangladesh’s rural areas and urban slums due to the pandemic has forced some children into begging and commercial sex. In 2020, NGOs in Bangladesh reported traffickers lured victims with promises of “COVID-19 free” locations.

Justice and Care, an international nonprofit, has been supporting survivors, pursuing justice, and securing at-risk communities for over a decade. In partnership with GFEMS, Justice and Care is implementing programming in Bangladesh’s Khulna Division to provide trauma-informed and survivor-centric care, train border guards and law enforcement officials to identify and respond to cases of human trafficking, and build the capacity of government and aftercare service providers. In other words, we are working together to provide end-to-end support for survivors and to change the systems that enable human trafficking. 

A holistic care model

Trafficking can take many forms and not all individuals experience trauma the same way. While working with governments and institutions to prevent further traumatization through timely and survivor-centric repatriations, Justice and Care remains focused on the individuals that experience trafficking and exploitation.  When possible, the same caseworker that is introduced to a survivor in an Indian shelter supports and guides a survivor through repatriation and reintegration in Bangladesh. This individualized pairing helps establish trust between survivor and caseworker and supports a more comprehensive and accurate assessment of a survivor’s needs.  In Bangladesh, a survivor is provided immediate shelter and psycho-social counseling while survivor and caseworker together draw up a longer-term individualized care plan. 

Justice and Care have helped me in more ways than I can count. My family got grocery when we did not have any food during the lockdown, and I am also getting support in pursuing a case against my trafficker.

— Survivor participant

Reforming systems to achieve sustainable change

With survivors at the center of all of their programming, Justice and Care works with various stakeholder groups to ensure a coordinated and survivor-centric response to trafficking. Having piloted a successful initiative to train border guards on victim identification and care before partnering with GFEMS, GFEMS support enabled an expansion of this program. Over the last 12 months, more than 200 staff from Border Guards Bangladesh (BGB) have been trained to identify, intercept, and refer victims of trafficking. As a result, 40 individuals have been intercepted and identified as victims by the BGB at the border and referred to Justice and Care.

Programming does not just target law enforcement, however. Justice and Care works to build the capacities of government stakeholders as well as aftercare service providers on both sides of the border.  Supporting survivors even before their return to Bangladesh, Justice and Care is committed to reforming a repatriation process that can strand a survivor in an Indian shelter for up to six years.  Victims of trafficking in India, when fortunate enough to escape exploitation and abuse, find that escape is just the first step in a long journey home. A complex and bureaucratic system prolongs the process as judges require survivors to stay in country until testimony is given or Bangladeshi officials stall in confirming a survivor is a Bangladeshi citizen. Survivors must gain approvals from police, border officials, social workers, and local and federal officials before they can be repatriated.

Survivors must be a voice in determining survivor care.

Their individual stories may differ, but survivors share a lived-experience of surviving a certain type of trauma and abuse that is essential to the development of effective trauma-informed survivor care programs. In partnership with GFEMS, Justice and Care conducted a Caregivers’ Empowered training session to prepare survivors for mentorship and counseling roles.

Since October 2020, these champion survivors have conducted mentoring sessions with 44 survivors. While providing information on services and care activities for newly repatriated victims, they also assess peers’ mental and physical health and work to address any challenges that survivors are confronting. In follow-ups with participants, “the recipient survivors reported that they felt the peer mentors had understood their problems perceptively, listened attentively and demonstrated empathy- that they felt better emotionally as a result of the session and all asked for ongoing sessions.”

India and Bangladesh have taken steps to speed up the repatriation process, but survivors still wait 18 to 22 months to return home.  With an understanding of the traumatic effects of a prolonged shelter stay, Justice and Care is taking steps to expedite return and ensure survivors are repatriated within 12 months. They have forged partnerships with government officials, government-run institutions, and aftercare providers in India and Bangladesh.

Furthermore, they have convened bilateral repatriation stakeholders including Bangladeshi and Indian Rescue, Recovery, Repatriation, and Integration Task Forces to sensitize them to victim-centric and trauma-informed practices, including timely repatriations. They continue to advocate with the Ministry of Home Affairs to push through the adoption of the Standard Operating Procedures to shorten the timeline for repatriations, enhance cross-border coordination, and center survivors in the process. After a recent meeting with the Bangladeshi Ministry of Home Affairs and U.S. government officials, Justice and Care was invited to provide input into a training manual being developed by the US Department of Justice for law enforcement agencies in Bangladesh. Currently working with 44 referral partners in India including the Rescue, Recovery, Repatriation and Integration Task Force in Pune and West Bengal, UNODC, and the Department of Women and Child Development, Justice and Care is building a network of support that centers survivors from the point of first contact. In strengthening local capacities, they are also ensuring that that support is sustainable and scalable beyond program end. 

This spring, Justice and Care hosted a special event for survivors. “Season of Wingspread” brought together 34 survivors to share their experiences and to recognize and celebrate what each had achieved towards stable recovery and reintegration. Until systems change and recovery and reintegration support is no longer needed, Justice and Care remains a model of care to replicate.

Our work with Blue Dragon has successfully raised awareness of trafficking for hundreds of at-risk individuals.

Raising Awareness and Centering Survivors: Anti-Trafficking Programming in Northern Vietnam

Stretching to include Vietnam’s northernmost point, Ha Giang is often referred to as Vietnam’s final frontier. Steeped in rugged mountains and grand landscapes, Ha Giang is an overwhelmingly rural province, and home to a large ethnic minority population. Its long porous border with China makes migration a way of life for many in the region. While high poverty rates and a reliance on low-margin agriculture spur migrants to cross the border, these conditions also leave many vulnerable to trafficking and exploitation. The majority of people trafficked in Vietnam are from regions characterized by high rates of poverty and unemployment; they also disproportionately belong to ethnic minority groups. 

In the remote villages of Ha Giang, risks are exacerbated by a general lack of awareness of trafficking across the province. Many respondents of a household survey conducted in the region understood trafficking as something that happened by force, by abduction or threat of violence. But traffickers are not often so bold. Case research in the same province revealed that the majority of trafficking survivors knew their traffickers before they were exploited, underscoring the importance of awareness-raising to anti-trafficking programming.   

We partnered with two local civil society organizations, Blue Dragon Children’s Foundation and Sustainable Hospitality Alliance (the Alliance), to implement comprehensive anti-trafficking programming in Vietnam, in Ha Giang province and Hanoi respectively. With an understanding of the particular vulnerabilities to trafficking in northern Vietnam, Blue Dragon and the Alliance developed programs that focused on prevention, survivor support, and deterrence. While providing support and resources for vulnerable individuals and communities, together, these programs also target the systems that enable trafficking in persons. 

Lured by False Job Offers and Fake Marriages

The Vietnamese government estimates 90% of people trafficked from Vietnam are trafficked into China. Eighty percent are sexually exploited. In an analysis of court records from prosecuted trafficking cases in Vietnam, Blue Dragon found that deception was the most common recruitment strategy employed by traffickers. Over a third were lured by fraudulent job offers, 25% by false relationships, and another 25% by fake offers of marriage to Chinese men. “The main trick,” according to a member of a local NGO, “is ‘cheating or luring’ by pretending to build a relationship with victims gradually. Then traffickers trap victims by inviting them to hang out, go shopping at markets, trips near border areas, etc.” The overwhelming majority of these cases (97%) were for commercial sexual exploitation or forced marriage.

The main trick is ‘cheating or luring’ by pretending to build a relationship with victims gradually. Then traffickers trap victims by inviting them to hang out, go shopping at markets, trips near border areas, etc.

The More You Know: Raising Awareness of Trafficking Risks

To help raise awareness of the risks of trafficking and ultimately minimize those risks, Blue Dragon conducted a series of events across Ha Giang province, in collaboration with community stakeholders including village leaders, Women’s Union members, commune police officers, teachers and students. While screening at-risk households and providing support to at-risk individuals, Blue Dragon also led village-, community-, and school-based interventions to increase awareness. Each of these interventions explained the risks associated with irregular migration abroad, including sexual exploitation and forced labor. They also warned against actions, such as migrating without a contract or indebtedness before migration, that might increase one’s vulnerability. To raise awareness of support mechanisms should a case of trafficking be suspected, programming included guidance on who to contact and information on the anti-TIP hotline.

While targeted at prevention, these local interventions included a message of deterrence. The same analysis of court data revealed that traffickers commonly operate in the same impoverished and vulnerable communities as those they traffic.  When confronting a lack of viable livelihood options, traffickers frequently act opportunistically, looking to escape their own desperate circumstances. By including an emphasis on the severity of the crime and the penalties that it can incur in its programming, Blue Dragon aimed also to deter would-be traffickers. 

Raising Awareness, Decreasing Risk of Trafficking

Post-intervention surveys reveal that these efforts are making a difference. Generally, project findings show a positive relationship between being exposed to awareness-raising activities and understanding of trafficking risks and vulnerabilities. At baseline, for example, only 40% of migrant households in Meo Vac (an intervention district) reported migrating for work with a contract. At program end, 64% were more likely to migrate with a contract. Findings also demonstrate a significant rise in awareness of whom to contact with trafficking concerns, including the provincial anti-TIP hotline. At endline, 28% of respondents listed the hotline as a reporting mechanism versus just .04% at baseline. With a better understanding of the risks of trafficking, migrants are less at risk of exploitation. 

Findings also demonstrate a significant rise in awareness of whom to contact with trafficking concerns, including the provincial anti-TIP hotline. At endline, 28% of respondents listed the hotline as a reporting mechanism versus just .04% at baseline. With a better understanding of the risks of trafficking, migrants are less at risk of exploitation.

A Focus on Survivor Support

Despite the heightened risk of trafficking in Ha Giang province, no trafficking survivors reported receiving reintegration support prior to Blue Dragon’s intervention. Across government, law enforcement agencies, and social service organizations, efforts to identify and provide survivor support remained fragmented, making it difficult for survivors to access needed services and resources. Blue Dragon worked with each of these stakeholders to strengthen channels of coordination and information-sharing and to implement the National Referral Mechanism –a cooperative framework through which trafficking victims are identified and referred for services- at the provincial level.  Ha Giang authorities have since referred or directly provided reintegration support to thirty-five trafficking survivors,  but the mechanisms put in place will ensure many future survivors receive the resources and support they need.

Beyond enhanced coordination, Blue Dragon supported a training program to better prepare social workers engaging directly with survivors. Commenting on the usefulness of the intervention, one program graduate shared, “We used to attend training on the local policies and regulations relating to trafficking in persons, but this is the first time ever we have been trained on how to work with survivors to support them effectively.” 

This is the first time ever we have been trained on how to work with survivors and support them effectively.

— Training Participant

Social workers trained through the Blue Dragon program were locally-based. The social workers, as well as the service providers involved in the program, understood the socio-economic conditions in each community and almost all were able to communicate with survivors in their native languages or dialects. While this ensured services were accessible to survivors, the program’s emphasis on survivor-centric support empowered survivors to choose services that best supported their individual needs, whether that be housing, healthcare, or vocational training. When survivors are given agency to determine their own paths forward, their freedom becomes more sustainable. 46 of 52 survivors supported by Blue Dragon were “successfully reintegrated,” meaning their risk of re-trafficking was significantly diminished, they were effectively managing their trauma, and building a sustainable new lifestyle.

The Significance of Survivor-Centric Programming

The Sustainable Hospitality Alliance (the Alliance) program similarly supported survivor reintegration by providing livelihood training, specifically by helping survivors develop skills necessary for work in the hospitality sector.  As part of GFEMS anti-trafficking portfolio in northern Vietnam, the Alliance established a training program in Hanoi. Sixty-three percent of those who graduated from the program did in fact secure full-time employment in the hospitality sector. However, almost half of those who enrolled in the program did not graduate. Though disheartening, understanding this dropout rate is critical to building more effective interventions. The majority of students who discontinued the program lacked networks of peer support. Trainees, who were from rural provinces, including Ha Giang, had trouble adapting in Hanoi. This finding, combined with the positive response to Blue Dragon’s locally accessible programming, demonstrates the significance of tailoring programs to meet survivor needs. (From this learning, the Alliance and GFEMS shifted remaining funding to the Alliance’s programming in India.)

We partnered with Blue Dragon and the Alliance to combat trafficking in northern Vietnam. While programming directly impacted hundreds of individuals, many hundreds more will benefit from enhanced community awareness and improved social services. Moreover, lessons learned from these interventions will shape future interventions. From these programs, we can build stronger, more sustainable solutions to end trafficking in persons.

This article and the projects it references were funded by a grant from the U.S. Department of State. The opinions, findings and conclusions stated herein are those of the author and do not necessarily reflect those of the U.S. Department of State.

Trauma-informed care is crucial to the empowerment of survivors.

Making trauma-informed care the norm for survivors

Trauma-informed care is crucial to the empowerment of survivors. It ensures survivors are not re-traumatized during legal proceedings or while receiving recovery services; provides self-ownership over their own recovery; and helps them to lead safe and empowered futures. Yet, it is frequently not implemented by governments, law enforcement, judiciary, or care providers, who are frequently survivors’ first point of contact in the recovery process. GFEMS prioritizes trauma-informed care curriculum development and implementation to ensure that survivors have the tools and care they need for long term recovery and success.

In Maharashtra, India, GFEMS has partnered with International Justice Mission (IJM) to strengthen trauma-informed care in the state’s child welfare system. Child Welfare Committees (CWCs) are quasi-judicial bodies that support children in need of care and protection, including trafficking victims. IJM has trained all CWC members in Maharashtra on safe placement and case management, ensuring that stakeholders directly responsible for survivor rehabilitative care are equipped to make the best decisions in the interest of the child and operate as efficiently and responsibly as possible. To further build on this training, IJM has instituted a state-wide mentorship program with care experts, who have provided CWC members with guidance on over 260 cases. Facilitating regular case management roundtables, the project includes collaborative problem solving and case discussions for CWC members, ensuring that survivors receive comprehensive rehabilitation and support. The project has also made a series of infrastructure upgrades to selected CWCs, developing models for child-friendly spaces in the state.

By building the capacity of state institutions, including the CWCs, to deliver effective survivor care, the program is a blueprint for the provision of trauma-informed restoration that is replicable across other states in India and beyond. These types of care practices are needed globally to eliminate modern slavery and human trafficking for good.

This article and the project it references were funded by a grant from the U.S. Department of State. The opinions, findings and conclusions stated herein are those of the author and do not necessarily reflect those of the U.S. Department of State.

Making Modern Slavery Prevalence Studies Count (Accurately)

Making Modern Slavery Prevalence Studies Count (Accurately)

GFEMS recently funded a prevalence study in Karamoja, Uganda to determine the proportion of children in households (age 12-17) who have been sexually exploited for commercial gain. Although analysis is on-going, the data indicate that the prevalence of commercial sexual exploitation of children (CSEC) in Karamoja is gender agnostic. In other words, there is no statistically significant difference between the proportion of boys and girls that have experienced sexual exploitation. This runs counter to conventional thinking in the field of modern slavery (as well as a large body of evidence) that girls are more often victims of CSEC than boys (though researchers acknowledge that less is known about the scope and nature of CSEC among boys). 

So why are boys in Karamoja more vulnerable to CSEC? Why do findings in Karamoja seem to contradict those of other studies? 

The scope and nature of modern slavery varies greatly by geography and socio-economic context, so one simple answer could be that the region is an outlier. Another consideration is that this is the first study of CSEC in Uganda to use probabilistic sampling. Previous studies  have used convenience sampling, meaning that results are not representative of the population. Another possible cause (and the focus of this blog) could be the study’s use of Audio Computer-Assisted Self-Interviewing (ACASI). This interviewing tool is new to the field of modern slavery prevalence estimation and may address some long-standing challenges related to response accuracy.

While prevalence estimations are critical to understanding the scale and scope of modern slavery, ensuring their accuracy is inherently difficult. Prevalence estimates are derived from large-scale surveys in which social desirability bias (respondents’ conscious and unconscious desire to answer in a socially desirable way) presents a significant challenge. Respondents are asked about their involvement in what are considered culturally taboo and often illegal activities. In the case of this study, we are asking children from conservative, rural communities about sexual acts. The survey inquires on the exchange of sex for money, third party facilitation of sex acts, and sexual violence; concepts which are generally considered inappropriate to discuss with adults, even more so unknown survey enumerators.  

While there are no perfect solutions that ensure response accuracy to sensitive questions, ACASI offers an alternative approach to traditional face-to-face interviews (FFI), enabling respondents to share information independently and without having to directly engage with an interviewer. This additional degree of response confidentiality helps to reduce social desirability bias and can ultimately produce better estimates

Audio Computer-Assisted Self-Interviewing (ACASI): How It Works 

The most sensitive questions of the prevalence survey were grouped into a tablet-based, self-administered ACASI module. When the interviewer reaches this module, a tablet and a pair of headphones are given to the child respondent. The interviewer explains how the module will work and that the answers are completely confidential. Following this explanation, the tablet-based software guides the child through an interactive training. The training shows the prompts and images that will be used and explains how to proceed through the module (2).  The child must provide responses that show comprehension before proceeding to the module.

Once the module begins, the child hears an audio recording of each question. Potential answers are associated with neutral images on the screen and the child is instructed to select the image that corresponds with his or her answer. The child then clicks on an icon to proceed to the next question (3). 


Have you done sexual things in exchange for you or someone else receiving anything like money, a place to stay, food, gifts or favors?

Touch the green drum if your answer is “yes.”

Touch the red tree if your answer is “no.”


How well do your caregivers know your friends?

Touch the GREEN bowl if they know them “very well.”

Touch the BLUE bowl if they know them “somewhat well.”

Touch the YELLOW bowl if they know them “not very well.”

Touch the RED bowl if they don’t know them at all.

Once the child is finished with the module, he or she hands the headphones and the tablet back to the interviewer, and they continue with the rest of the questionnaire. The interviewer will not be able to access a child’s answers after they are recorded.

ACASI is adapted from the public health field where it’s widely used to gather data on sensitive topics like drug use and sexual risk behavior (4). Several studies indicate that ACASI can serve to reduce social desirability bias in survey responses. For example, a study of injecting drug users (IDU) in Sydney, Australia asked respondents a series of 5 questions relating to injecting and sexual behavior that could induce social desirability bias. These questions were first administered via FFI, then readministered to the same respondents within a week using ACASI. Researchers then measured the extent of discordance (i.e. difference) between the two response sets. The study found that FFI yielded what could be considered more socially desirable responses than ACASI. This includes a statistically significant higher mean age of first injection, a lower prevalence of recent syringe sharing, and a longer duration since the last occurrence of unprotected sex (5). Even more telling is that respondents who reported a history of sex work were more likely than other respondents to provide discordant responses on the duration since last occurrence of unprotected sex (42% vs 25% x2= 4.56, p<0.05).

To our knowledge, this prevalence study is the first time ACASI has been applied to the field of modern slavery, and more research is required to determine if it’s effect on social desireability bias will transfer across fields. However, we suspect that the use of ACASI is a contributing factor to our unique findings. CSEC buyers tend to be male, so in a conservative culture (like Karamojong) where homosexuality is not commonly accepted, there is likely a greater reluctance for boys to admit to sexual exploitation than girls. We believe the use of ACASI helped to mitigate this reluctance, leading to more accurate responses. This, in turn, revealed that CSEC in the region is as commonplace for boys as it is for girls. 

Although many challenges remain to ensuring the response accuracy of prevalence studies, ACASI represents a new and promising tool as GFEMS, its research partners, and like-minded organizations continue to expand the boundaries of modern slavery prevalence estimation. We encourage other CSEC and modern slavery researchers to employ ACASI, and if possible, test it experimentally. Doing so can provide us with greater insights into the efficacy of this tool and how to apply it optimally. This, in turn, can ultimately provide us with a more accurate and nuanced understanding of modern slavery and the socio-economic drivers that underpin it.

GFEMS looks forward to continuing to share our learnings with the anti-trafficking community. For updates on this project and others like it, subscribe to our newsletter, or follow us on Twitter and LinkedIn. 

  1. This study was conducted by ICF and Makerere University and made possible with funding from the Department of State Office to Monitor and Combat Trafficking in Persons (J/TIP) under the Program to End Modern Slavery 2 (PEMS 2).
  2. These images and prompts are also presented and explained to the child during the interviewer-administered portion of the survey using showcards to ensure that he or she understands how to proceed through the module.
  3. A small-scale pilot test of children aged 12-17 was conducted to assess developmental appropriateness and the ability to train children to use the instrument, and the social workers from Karamoja provided input into the cultural relevance of the shapes and colors.
  4. Willis, Gordon B, Alia Al-Tayyib, and Susan Rogers. 2001. “The Use of Touch-Screen ACASI in a High-Risk Population: Implications for Surveys Involving Sensitive Questions.” In Proceedings of the Annual Meeting of the American Statistical Association, 6; Falb, K., Tanner, S., Asghar, K. et al. Implementation of Audio-Computer Assisted Self-Interview (ACASI) among adolescent girls in humanitarian settings: feasibility, acceptability, and lessons learned. Confl Health 10, 32 (2016).; Villarroel, Maria A., Charles F. Turner, Elizabeth Eggleston, Alia Al-Tayyib, Susan M. Rogers, Anthony M. Roman, Philip C. Cooley, and Harper Gordek. 2006. “Same-Gender Sex in the United States Impact of T-Acasi on Prevalence Estimates.” Public Opinion Quarterly 70 (2): 166–96.
  5. M. Mofizul Islam , Libby Topp , Katherine M. Conigrave , Ingrid van Beek , Lisa Maher , Ann White, Craig Rodgers & Carolyn A. Day (2012): The reliability of sensitive information provided by injecting drug users in a clinical setting: Clinician-administered versus audio computer-assisted self-interviewing (ACASI), AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, 24:12, 1496-1503.

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