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.

1. Launch of HIV Sensitive
Social Protection Report
19th September, 2013

2. The impacts of HIV
Launch of HIV Sensitive
Social Protection Report
19th September, 2013

3. Household
Aim of the review
The impact of HIV in Cambodia
Economic Education Health
Food
security
Stigma

4. 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

5. 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

6. 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

7. 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.

8. Aim of the review
50.8
34.7
0
10
20
30
40
50
60
Cambodia Viet Nam
%HHswhereMemberwasHungryin
Last12months
HIV-HH NA-HH
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

9. Aim of the review
The impact
of HIV in
Cambodia
Stigma
73
51
37
29
75
41
65
6
0
10
20
30
40
50
60
70
80
Guilt Low self-esteem Self-blame Suicidal thoughts
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.

10. 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

11. Findings and
recommendations
Launch of HIV Sensitive
Social Protection Report
19th September, 2013

12. HIV-Sensitive Social Protection
NSPS Special vulnerable groups
• Ethnic minorities
• Indigenous peoples
• The elderly
• People living with chronic
illnesses
• People living with HIV and AIDS
• People living with disability

13. Social protection can address the impact of
HIV and reduce vulnerabilities
Household
Economic
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      

14. HIV and social protection
HIV-specific
HIV-relevant
HIV-sensitive
HIV-mainstreamed
HIV-focussed

15. 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

16. Eliminate
stigma Eliminate
exclusions
Facilitate
applica-
tion
Links with
other
services
Increasing HIV-sensitivity
Expand
entitlements
Reduce
barriers

17. 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 HIV
Buddhist Leadership Initiative
Targeting mechanism: Identification of Poor Households
Health Equity Funds
Community-based Health Insurance (CBHI)
Emergency assistance, education scholarships, school meals programmes, health
vouchers, maternal and child health
Microfinance
Technical and vocational education and training programme
Formal sector contributory social security
Maternal 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

18. -
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

19. -
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

20. 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

21. Next steps
Community Networks
1. Join dialogue
2. Develop capacity & awareness
3. Conduct baseline study on
access and barriers
4. Monitor access and barriers

22. 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

23. 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

24. Launch of HIV Sensitive
Social Protection Report
19th September, 2013
THANK YOU