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Cambodia
>> Regional Overview >> Cambodia Overview ACTIVITY DATA SHEET
PROGRAM: Cambodia
TITLE AND NUMBER: Reduced Transmission of Sexually Transmitted Infections and HIV/AIDS in High-Risk Populations, 442-005
STATUS: Continuing
PLANNED FY 2001 OBLIGATION AND FUNDING SOURCE: $9,420,000 CSD; $750,000 ESF
PROPOSED FY 2002 OBLIGATION AND FUNDING SOURCE: $10,000,000 CSD
INITIAL OBLIGATION: FY 1998 ESTIMATED COMPLETION DATE: FY 2002Summary: Cambodia is facing the most serious HIV/AIDS epidemic in Southeast Asia. Some estimates place the overall adult population prevalence at 3.7%. More than 180,000 persons have been infected and approximately 7,000 to 8,000 people have AIDS. HIV is now a generalized epidemic, affecting men, women and children in all of Cambodia's 24 provinces and municipalities. The Cambodian government, donor, and nongovernmental organization (NGO) communities all recognize that HIV is no longer simply a health issue, but rather poses a serious threat to Cambodia's fragile national development. To head off an explosive spread of the epidemic in the general population, USAID's interventions focus on behavior change interventions in high-risk populations coupled with improved quality of and access to treatment of high-risk populations for sexually transmitted infections (STIs). A particularly important target group comprises the individuals (mainly men such as police officers and military personnel) who form "bridges" between the high-risk groups and the general population. In late calendar year 2000, under a new USAID-wide expanded response to the global HIV pandemic, Cambodia was identified as one of four countries worldwide-and the only country outside of Africa-requiring a rapid scale-up in HIV/AIDS assistance. Concurrent with this designation, funding for HIV/AIDS activities increased significantly from approximately $2.5 million in FY 2000 to nearly $10 million in FY 2001.
Key Results: The three key intermediate results for the special objective are as follows: (1) policy makers are informed about the HIV/AIDS epidemic in Cambodia; (2) high-risk behaviors are reduced in the target areas; and (3) reproductive health service delivery programs for high-risk populations are piloted and replicated in the target areas. Activities that will be added when the transition is made to a strategic objective include: provincial and district prevention and care activities, including programs for orphans and vulnerable children; implementation of community-based tuberculosis (TB) directly observed therapy, short course (DOTS) program; workplace interventions, policy and advocacy development; and continued surveillance activities.
Performance and Prospects: Overall performance on this special objective has been good. As a result of USAID's assistance to strengthen the surveillance system, Cambodia has one of the most advanced HIV surveillance systems in Asia. The system already adheres to many of the principles of the second-generation surveillance. There has been success in the area of STI services over the last year. Forty-six health care providers in 11 health facilities in Phnom Penh have been trained since May 2000. Over 2000 patients monthly have been treated for STIs since the training began. USAID's successful condom social marketing program once again exceeded its target. Sales for calendar year 2000 was 16 million (24% higher than 1999's sales). At the end of FY 1999, CSD-funded activities targeting children affected by and infected with HIV were initiated. During 2000, 14 NGOs throughout Cambodia, working with USAID and its partners, redesigned their projects to include support for orphans and vulnerable children.
In FY 2001 and FY 2002, USAID will continue institutional strengthening of NGO networks to deliver quality HIV/AIDS interventions and advocate for change. USAID/Cambodia has recently received approval to work with the Cambodian Government on HIV/AIDS. The Mission will increase linkages between local NGOs and provincial and district health authorities. This will increase the distribution of targeted educational materials that will address sexual behavior change, reduce HIV/STI/TB transmission; and increase symptom recognition, treatment, and safe-sex negotiation skills, especially to high-risk groups. In order to foster linkages to the for-profit private sector, resources will also be used to increase outreach activities for HIV/AIDS/TB in the garment industry and to work with the private sector to rationalize pharmaceutical use.
Possible Adjustments to Plans: USAID is assessing its current programs and will redesign its HIV/AIDS activities by the end of FY 2001.
Other Donor Programs: The USAID program is currently the largest HIV/AIDS program in Cambodia. The World Health Organization (WHO) supports nationwide expansion of the 100% condom use policy in brothels, modeled after the successful program in Thailand. WHO, with some USAID technical assistance, provides support to the technical bureau of the National AIDS Authority for the behavioral and HIV sentinel surveillance systems. The United Nations Children's Fund supports interventions targeting adolescents and street children. The World Bank provides technical advisors to the technical bureau of the National AIDS Authority. The Joint United Nations Program on HIV/AIDS works closely with the National AIDS Authority and its technical bureau to plan and coordinate activities with major international donors and implementing partners to maximize their benefits. A coordination committee of host government, donor, international, and implementing agencies meets monthly for joint review, planning, and monitoring of activities.
Principal Contractors, Grantees, or Agencies: USAID implements its STI/HIV prevention activities through Family Health International and its partners in the IMPACT project, Population Services International, Reproductive Health Alliance of Cambodia, and the Khmer HIV/AIDS NGO Alliance.
FY 2002 Performance Table
Cambodia: 442-005
Performance Measures:
Indicator FY97 (Actual) FY98 (Actual) FY99 (Actual) FY00 (Actual) FY00 (Plan) FY01 (Plan) FY02 (Plan) Indicator 1: Percentage of men in target areas reporting always using condoms with commercial sex workers in previous three months. 43 55 73 NA 70 75 80 Indicator 2: Percentage of female commercial sex workers in target areas reporting consistent condom use with clients over past 12 mos. 42 53 78 NA 80 83 85 Indicator 3: Percentage of men in target areas reporting always using condoms with sweetheart in previous three months. 0 5 13 NA 17 20 23 Indicator Information:
Indicator Level (S) or (IR) Unit of Measure Source Indicator Description Indicator 1: IR Percentage. National behavioral surveillance surveys (BSS). This indicator measures male condom use with commercial sex workers (CSW) in the three months before a survey. Only men who have been to a CSW over that time are included in the denominator. To be counted in the numerator, men must report always using condoms when having sex with a CSW in that timeframe. For our purposes, this indicator is tracked for men in the military, a major focus of our interventions. Indicator 2: IR Percentage. National behavioral surveillance surveys (BSS). The denominator is female commercial sex workers (CSWs) who report at least one client over the past week. The numerator is those CSWs who report they always use condoms during commercial sex acts with their clients over that time period. Indicator 3: IR Percentage. National behavioral surveillance surveys (BSS). The denominator includes only men who both have a sweetheart and who report having sex with their sweetheart in the three months prior to the survey. The numerator includes only men who report always using a condom when having sex with their sweetheart over that time frame. For our purposes, this indicator is tracked for men in the military, a major focus of our interventions. U.S. Financing
(In thousands of dollars)
Obligations Expenditures Unliquidated Through September 30, 1999 1,300 DA 666 DA 634 DA 1,000 CSD 0 CSD 1,000 CSD 500 ESF 168 ESF 332 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 0 DFA 0 DFA 0 DFA Fiscal Year 2000 2 DA 634 DA 2,370 CSD 347 CSD 0 ESF 332 ESF 0 SEED 0 SEED 0 FSA 0 FSA 0 DFA 0 DFA Through September 30, 2000 1,302 DA 1,300 DA 2 DA 3,370 CSD 347 CSD 3,023 CSD 500 ESF 500 ESF 0 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 0 DFA 0 DFA 0 DFA Prior Year Unobligated Funds 0 DA 0 CSD 0 ESF 0 SEED 0 FSA 0 DFA Planned Fiscal Year 2001 NOA 0 DA 9,420 CSD 750 ESF 0 SEED 0 FSA 0 DFA Total Planned Fiscal Year 2001 0 DA 9,420 CSD 750 ESF 0 SEED 0 FSA 0 DFA Future Obligations Est. Total Cost Proposed Fiscal Year 2002 NOA 0 DA 0 DA 1,302 DA 10,000 CSD 0 CSD 22,790 CSD 0 ESF 0 ESF 1,250 ESF 0 SEED 0 SEED 0 SEED 0 FSA 0 FSA 0 FSA 0 DFA 0 DFA 0 DFA
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Last Updated on: May 29, 2002 |
