IntroductionTransgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach.MethodsWe used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks.ResultsThere were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, p<0.001) and condom use at last anal sex with both regular (18.1%, p<0.001) and casual (8.1%, p<0.001) male partners. Access to HIV outreach education and testing and counselling services significantly increased (20.10%, p<0.001; 33.7%, p<0.001). In addition, significant increases in access to emergency crisis response (19.7%, p<0.001), legal support (26.8%, p<0.001) and mental health services (33.0%, p<0.001) were identified. Finally, we note that the Pehchan programme successfully provided a platform for the formation, collectivization and visibility of peer support groups.ConclusionsThe Pehchan programme's community involvement, rights-based collectivization and gender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains.

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This paper reports on experimental investigations of a switched inertance hydraulic system (SIHS), which is designed to control the flow and pressure of a hydraulic supply. The switched system basically consists of a switching element, an inductance (inertance), and a capacitance. Two basic modes, a flow booster and a pressure booster, can be configured in a three-port SIHS. It is capable of boosting the pressure or flow with a corresponding drop in flow or pressure, respectively. This technique makes use of the inherent reactive behavior of hydraulic components. A high-speed rotary valve is used to provide sufficiently high switching frequency and to minimize the pressure and flow loss at the valve orifice, and a small diameter tube is used to provide an inductive effect. In this paper, a flow booster is introduced as the switched system for investigation. The measured steady-state and dynamic characteristics of the rotary valve are presented, and the dynamics characteristics of the flow booster are investigated in terms of pressure loss, flow loss, and system efficiency. The speed of sound is measured by analysis of the measured dynamic pressures in the inertance tube. A detailed analytical model of an SIHS is applied to analyze the experimental results. Experimental results on a flow booster rig show a very promising performance for the SIHS.

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