HIV-Sensitive Social Protection Cambodia

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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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  • The health impacts of HIVMembers of HIV-HHs were reported to be in worse health than those in NA-HHs. [GRAPH] People living with HIV used significantly more ambulatory and inpatient health services and were significantly more likely to seek care in the public sector, than members of Non-affected households
  • Stigma impacts[GRAPH] Internal stigma was high, with 16% of people living with HIV reporting suicidal thoughts and 65% reporting low self-esteemSome 23% of women living with HIV reported having been verbally attacked, and 7% had been physically threatened or attacked, because of their status
  • HIV-Sensitive Social Protection Cambodia

    1. 1. Launch of HIV Sensitive Social Protection Report 19th September, 2013
    2. 2. The impacts of HIV Launch of HIV Sensitive Social Protection Report 19th September, 2013
    3. 3. Household Aim of the review The impact of HIV in Cambodia Economic Education Health Food security Stigma
    4. 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. 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. 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. 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. 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. 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. 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. 11. Findings and recommendations Launch of HIV Sensitive Social Protection Report 19th September, 2013
    12. 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. 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. 14. HIV and social protection HIV-specific HIV-relevant HIV-sensitive HIV-mainstreamed HIV-focussed
    15. 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. 16. Eliminate stigma Eliminate exclusions Facilitate applica- tion Links with other services Increasing HIV-sensitivity Expand entitlements Reduce barriers
    17. 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. 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. 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. 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. 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. 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. 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. 24. Launch of HIV Sensitive Social Protection Report 19th September, 2013 THANK YOU

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