hiv-sensitive social protection cambodia

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