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Presentation of the impact of HIV and the findings of the national consultative process to review the HIV sensitivity of Cambodia's social protection schemes.
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Launch of HIV Sensitive Social
Protection Report
19th September, 2013
The impacts of HIV
Launch of HIV Sensitive Social
Protection Report
19th September, 2013
Household
Aim of the review
The impact of HIV in Cambodia
Economic Education Health Food security Stigma
Aim of the review
The impact of
HIV in Cambodia
Household
Source: UN/NAA (2011). The socioeconomic impact of HIV at the household level in Cambodia.
Households affected by HIV were much less likely to own their own home
Aim of the review
The impact of
HIV in Cambodia
Source: UN/NAA (2011). The socioeconomic impact of HIV at the household level in Cambodia.
People living with HIV still employed reported significant reductions in average monthly income after diagnosis of HIV
Economic
Aim of the review
Education
Source: UN/NAA (2011). The socioeconomic impact of HIV at the household level in Cambodia.
Children in HIV-affected households were more likely to miss school, particularly girls and children in rural areas
The impact of
HIV in Cambodia
Aim of the review
Members of HIV-affected households used ambulatory and in-patient services significantly more
Health
The impact of
HIV in Cambodia Source: UN/NAA (2011). The socioeconomic impact of HIV at the household level in Cambodia.
Aim of the review
Cambodia Viet Nam0
10
20
30
40
50
60
50.8
34.7
HIV-HH NA-HH
% H
Hs
whe
re M
embe
r was
Hun
gry
in
Last
12
mon
ths
HIV-affected household members more likely to be hungry
Source: UN/NAA (2011). The socioeconomic impact of HIV at the household level in Cambodia.
Food security
The impact of
HIV in Cambodia
Aim of the review
The impact of
HIV in Cambodia
Stigma
Guilt Low self-esteem Self-blame Suicidal thoughts
0
10
20
30
40
50
60
70
8073
51
37
29
75
41
65
6
Women Men
People living with HIV reported high levels of internal stigma
Source: UN/NAA (2011). The socioeconomic impact of HIV at the household level in Cambodia.
Aim of the review
The impact of
HIV in Cambodia
Special considerations
Source: UN/NAA (2011). The socioeconomic impact of HIV at the household level in Cambodia.
Impact of HIV on inheritance: widow property transfer rights
Findings and recommendations
Launch of HIV Sensitive Social
Protection Report
19th September, 2013
HIV-Sensitive Social ProtectionNSPS Special vulnerable groups
• Ethnic minorities• Indigenous peoples• The elderly• People living with chronic
illnesses• People living with HIV and AIDS• People living with disability
Social protection can address the impact of HIV and reduce vulnerabilities Hous
eholdEconomic
Education
Health
Food security
Stigma
Objective 1: Emergency basic needs provision
Objective 2: Vulnerable mothers and children
Objective 3: Working-age vulnerabilities
Objective 4: Affordable health care for the poor
Objective 5: Social protection for vulnerable groups
HIV and social protection
HIV-specific
HIV-relevant
HIV-sensitive
HIV-mainstreamed
HIV-focussed
HIV-Sensitive Social Protection
Siem Reap Principles
1. Aim for HIV-sensitive social protection rather than HIV-specific social protection
2. Involve multiple sectors and partners
3. Engage affected individuals, networks and communities, especially key populations
4. Protect and enhance human rights
5. Take into account sustainability
Eliminate stigma Eliminate
exclusions
Facilitate applica-
tion
Links with other
services
Increasing HIV-sensitivity
Expand entitlements
Reduce barriers
Overview of SP mechanismsExisting relevance of social protection to people living with and affected by HIV
Free primary health care and ART for people living with HIVBuddhist Leadership InitiativeTargeting mechanism: Identification of Poor HouseholdsHealth Equity FundsCommunity-based Health Insurance (CBHI)Emergency assistance, education scholarships, school meals programmes, health vouchers, maternal and child healthMicrofinanceTechnical and vocational education and training programmeFormal sector contributory social securityMaternal and Child Health and Nutrition Programme
HIV-specific
HIV-specific
HIV-relevant
HIV-relevant
HIV-relevant
HIV-relevant
HIV-relevant
HIV-relevant
HIV-relevant
HIV-sensitive
-
Challenges and barriers
HIV-specific HIV-relevant HIV-sensitive
• Uneven coverage• Other costs• Confidentiality
• Uneven coverage• Eligibility focusing on
poverty • Household-based can
exclude rejected individuals
• Other stigma• Minimum requirements
• Programme closure
-
Recommendations
HIV-specific HIV-relevant HIV-sensitive
• Define minimum package• Automatic qualification• Associated costs• Referrals
• Automatic inclusion• Sensitise providers• Confidentiality protocols• HIV special category
• Additional nutritional support
• Monitor impacts
• Awareness of schemes
Next steps
1. Implement NSPS and expand/sustain SP schemes
2. Review recommendations & identify opportunities to make existing/emerging schemes HIV sensitive
3. Generate strategic information on access and barriers to SP services for PLHIV and MARPs
Government
Next steps
Community Networks
1. Join dialogue2. Develop capacity & awareness3. Conduct baseline study on
access and barriers4. Monitor access and barriers
Next steps
Development Partners
1. Support RGC to expand and sustain schemes
2. Support TWGs and networks to review and implement the recommendations
3. Support capacity building, baseline study, monitoring
Summary• Multiple social protection mechanisms, most of which
need to be expanded and sustained over time• Strong leadership and coordination across sectors,
schemes and levels (from central to local. Some already meet the needs of people living with HIV and key affected populations)
• All have opportunities to increase their HIV-sensitivity• Strengthen generation and use of strategic information:
routine monitoring, special studies
Launch of HIV Sensitive Social
Protection Report
19th September, 2013
THANK YOU
