This section of the website will describe how you can start and conduct the actual work of your peer initiative.

In the implementation phase, most of the work will be more routine and focuses on supporting the peer workers to perform their tasks.

The section will focus on:

  • Supervision. How to support workers to keep up with their work.
  • Potential barriers and challenges. What kinds of problems may arise, and what should be done about them?
  • External relations. How to deal with other actors in the field.
  • Relations with law enforcement. How to deal with the police.


Further reading

The International Harm Reduction Development Program (IHRD) has published an excellent guide to workplace policies, ‘Harm Reduction at Work’.

The book for instance covers the following topics:

  • Recruitment and hiring
  • Training of new staff
  • Discipline
  • Conflict resolution and boundary maintenance




Supervision is organised, ongoing support for the peer worker.  This section will describe in detail:

  • why supervision is important
  • the tasks of a supervisor
  • essential elements of the supervision process
  • important issues regarding supervision
  • and suggestions for additional support strategies.



Relevance of supervision

Supervision is important because:

  • it is essential for the performance and wellbeing of the peer worker
  • it makes sure that the goals of the work are met


Supervision is critically important for peer workers because of the nature of the work.  Peer work is on the edge, being in both worlds.  Peer work is inspiring and might lead to great aspirations, but might sometimes also be a source of isolation and frustration. Good supervision can reduce these tensions.  However good peer workers’ motivations and ambitions, they should not be overloaded with responsibilities and roles.

Supervision can be conducted during regular, scheduled sessions and on an ‘as-needed’ basis by project staff and intermediaries.  Supervision can cover both work-related issues, like how dealing with the death of a client affects a worker, and administrative issues concerning job performance.

Tasks of a supervisor

  • keeping track of all the peer workers
  • documenting all work-related matters, supervision sessions, work schedules, etc.
  • reporting back to the rest of the agency
  • helping guide peers to use/improve their personal and professional skills and suggesting training
  • providing direction and making sure that the peer workers’ targets and the agency's goals are being met.

Essential elements of the supervision process
Most agencies assign a staff member to coordinate/supervise peers.  Supervision for peer workers should be conducted regularly.  In these sessions, the peers receive support in planning how to go about their work, in further training and self-development, and in resolving conflicts and differences of opinion. 

The sessions also provide:

  • Technical support in the form of information, skills training, answers to questions, help in setting up presentations and activities, and funding for ongoing training and equipment.
  • Social and community support in maintaining links and liaisons with partners, other NGOs and peer projects, and support in resolving problems between peer workers and intermediaries, social network gatekeepers and community members.
  • Personal support assistance in the form of emotional support on an ‘as-needed’ basis for both project activities and personal growth;  the maintenance of a positive atmosphere among workers;  and support in times of personal and/or group crisis.

Supervision:  important issues
Important issues surrounding supervision are:  (source: Open Society Public Health Program, ‘Harm reduction at work’):

  • Peers need to communicate with their supervisor regularly.
  • Peer work is not regular nine to five work.  The agency needs to create a convenient time and place where the peer and the supervisor can meet.
  • The supervisor should be much more than just a boss.  He or she should create a safe environment to discuss personal and work matters, be a caring, experienced person who has a genuine understanding of marginalised communities, the life they are living and the struggles they might have.
  • An open ear and open door policy are helpful, so workers feel free to come in and share their concerns, insights or questions with their supervisor.
  • All supervision procedures should be as supportive and respectful as possible toward employees who use drugs.  Successes in job performance should be acknowledged (“I appreciate that you have seemed more focused and are contributing in meetings”).
  • Supervisors should be mindful of the language they use, avoiding positive reinforcement for non-drug using behaviours by saying things such as “I’m so glad you haven’t been using lately”.
  • The confidentiality of employees should always be respected, and private information about an employee’s work performance should never be shared with anyone else.
  • Supervision should be ongoing and consistent.  Supervisors and supervisees should find a format that works in their situation and stick to it.
  • Supervisors should be flexible and adjust their supervisory procedures to maximise positive returns for the programme and for employees who use drugs.
  • Employees should be encouraged to be truthful about any problems or achievements they may encounter in their work, without fear of prejudice or discrimination.
  • Discussions about an employee’s drug use should never be used against them.  Supervisors should focus on job performance, not drug use.
  • Positive reinforcement and problem-solving should be built into the format of supervision meetings.
  • Employees who use drugs, like other employees, should be recognised and rewarded for their good work.  Supervisors should be creative in giving rewards such as certificates recognising achievements, including special notes in a staff member’s file, or giving gift vouchers from local restaurants or entertainment businesses.
  • Supervisors should be prepared to recognise non-traditional forms of problem-solving by drug-using employees. The nature of peer work can frequently result in unconvential but effective solutions to complex problems for service users, projects, and staff.
  • Additional support strategies: Some suggested additional support strategies for peer workers (in addition to supervision) are: (source: Open Society Public Health Program, ‘Harm reduction at work’):
  • Get a counsellor from an agency not affiliated with your programme to facilitate a discussion group for staff who use drugs.  This will allow staff to discuss issues they may be afraid to talk about with supervisors and management in general.  Such topics include a move to more “chaotic” drug using behaviours;   personal crises, such as loss of housing or deteriorating personal relationships;   and issues related to confidentiality.
  • Participate as a team in other community-based initiatives that have overlapping political objectives with your programme.  HIV/AIDS projects, affordable housing support groups and anti-racist activist groups may host special events such as demonstrations, parties, fundraising initiatives, and other events.
  • Schedule regular staff appreciation events for your own organisation (like annual barbeque or group dinners).  Other events include activities through which staff bond by giving back to the community.  One example is a “community clean-up,” where staff go out as a group and clean up drug paraphernalia discarded in public spaces, or have a picnic, or do something not work-related together for fun.
  • If your programme has a fixed site or an office, promote support groups for drug-using staff from different organisations by allowing them to use your resources, including the space, coffee machines and kitchens, for example.
  • Encourage employees who use drugs to join other drug user activist organisations such as users’ unions, user- based community newsletters, etc.
  • Encourage and assist employees who use drugs to participate in drug user-specific events such as conferences and workshops.  Teach them how to write abstracts and biographies  and try to secure funding for them to attend these events.   Suggest an ‘advocacy event leave’ as a day off to participate in relevant demonstrations or other political events.



Barriers and challenges

Many years of experience, all over the globe show us that there are many hurdles and pitfalls when a peer work programme is implemented.  The most significant problems are: (source AIVL)

  • stress and burnout
  • over-ambition and over-motivation
  • problems around drug use
  • ‘professionalisation’ demands
  • high staff turnover
  • organisational issues
  • collaboration with other agencies
  • leaving the job


Each of the above will now be briefly discussed.

Stress and burnout.
Peer work can often be challenging for a drug user.  Their daily life has many issues (from supply droughts and police patrols all the way to treatment regiments and recurring health issues).  These issues come in addition to workplace issues such as demanding supervisors, annoying colleagues, ‘hard work, little pay’, and so on.  This mixture of issues are a lot to deal with and peers and the agencies they work for have to address them carefully.

Over-ambition and over-motivation
Commitment is great, over-commitment is counter-productive if not directed or channelled well.  Over-ambitious and over-motivated workers will sooner or later come up against their own or their agency’s limits.  Supervision is vital and should not only rely on advice to ‘take it easy’, don’t get so emotional’, but also positive reinforcement such as ‘Your commitment great, but it sometimes not making the impact you want. If you want we could sit a some time and talk how you could work on this.’

Problems around drug use

Relapse, increased drug use, initiating use of other drugs and switching to injecting are all issues can arise with a peer worker.  Workers and agencies need to be prepared for this.  Good supervision and support can  help to avoid, or certainly address them.

‘Professionalisation’ demands
Increasing (external) demands to professionalise agencies’ governance, operational activities, quality management and monitoring systems can lead to growing pressure on the skills of the peer worker.  He/she may be very good in making contact and building bridges to services, for instance, but his/her technical skills such as report-writing or giving presentations may not his/her cup of tea.

High staff turnover
Experience has shown us that there is a significant turnover among peer workers, which puts a burden on the shoulders of the more stable workers and the agency as a whole.  A shortage of workers due to turnover can also effect the smooth delivery of services.

Organisational issues
Having unstable or inadequate supportive management and lack of coordination will particularly negatively affect by peer workers.

Collaboration with other agencies
When working with other agencies that have different policies regarding peer work, the peer worker will expect loyalty and support from his/her own agency.  This builds respect and trust in the organisation the peer works for.

Leaving the job
At some point, peer educators will stop being involved in peer work.  After they have left, it might take a long while before people in the community they used to work in realise that they are no longer connected with the agency and are no longer a formal source of information and support.   However the ex-peer worker will always carry the knowledge, information and respect he/she has gained from being a peer worker.



External relations 

Building external support for your initiative is crucial.  This section will describe:

The key messages regarding external relations are be open and proactive; 
let people know what you are doing;  and involve them from day one.

An important issue is building a ‘culture of partnership’.  This is a culture where everyone (other agencies, law enforcement agencies, community members, policymakers) is recognised as being in a collaboration, seeking similar goals and outcomes.  Such collaborations should shared, open communication to new ideas, insight and new partnerships.

Prior to the start of your activity, it is important to get adequate information on all relevant organisations, their aims, approaches, start dates, and a contact person, etc.  It is advisable to inform representatives of the most relevant organisations what you intend to do before the actual start of a project.  A personal talk or an invitation is more effective than sending written information.  In this first meeting or discussion, the goals and the approach of the peer support project can be outlined and explained.  The occasion can also serve as part of the needs assessment see INITIATE/Collecting information.

Key points
Some important key points when working with other initiatives, agencies and actors (stakeholders) in the field are: (source:  HIV/AIDS Alliance

  • Have a clear objective about what kind of role stakeholders will play in the programme and why they need to be involved.
  • Keep stakeholders informed.
  • Plan and budget for stakeholder involvement (resources, time, and so on).
  • Conduct a stakeholder mapping – who, why, where, how?
  • Identify common ground, goals and objectives among different stakeholders.
  • Develop a memorandum of understanding as a statement of commitment to co-operation or partnership.
  • Educate stakeholders about drug use, HIV and harm reduction by cultural sensitivity and educational workshops, study tours, and so on.
  • Integrate the programme within existing services, local plans and targets so that community stakeholders understand how your new programme fits in.
  • Build relationships and networks with key stakeholders using both informal and formal means.
  • Develop relationships with local as well as senior officials, such as local police officers and senior police chiefs.  Police harassment or abuse often happens at the ground level, so local street-based police are just as important stakeholders as the senior decision-makers.
  • Develop activities to demonstrate that stakeholders are valued and have important contributions to offer the programme.  Build a sense of ownership of the issues and the harm reduction response.
  • Keep stakeholders continually informed.  Establish regular scheduled meetings and share reports, research, evaluation findings and success stories with them.
  • Set up community advisory committees made up of different stakeholders.
  • Invite stakeholders to see the programme in action.



Relations with law enforcement agencies

Agencies will absolutely benefit from good working relations with law enforcement agencies.  Two good reasons for this are:

  • Good working relations with the police will enable them to work properly without involvement from the police (without proper knowledge of the issues the agency is working on, police may target the agency and their clients.)
  • Law enforcement agencies may also become unexpected allies and source of support for your initiative.