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Home Care - 1.1 HIV/AIDs in Cambodia
1. Background: 1.1 HIV/AIDS in Cambodia
Cambodia has one of the fastest growing HIV prevalence rates in the world. Results from the latest Surveillance Survey (1) indicate that approximately 170,000 Cambodians are now infected with HIV, giving an adult HIV prevalence rate of around 3.5%.
Cambodia has also one of the lowest rates of health utilisation in the world. Lack of funds for salaries, supplies and maintenance severely limits the amount of care and medicines which can be provided by the health system. For the poorest Cambodians, costs of health care account for approximately 28% of household expenditure (2) . The AIDS epidemic will further exacerbate this cost burden on many households.
The impact of the rapid spread of the epidemic in Cambodia is drastic. During the year 2000 an estimated 12,000 people with AIDS will seek care and support, thus increasing the pressure on a health care system that currently provides a total of only 8,500 beds for all medical conditions (3) .
The HIV/AIDS epidemic in Cambodia is still relatively recent. HIV was first reported in Cambodia in 1991 and the first cases of AIDS were diagnosed in late 1993. During that year the first 5-year National AIDS Plan was developed and the HIV/AIDS Co-ordinating Committee (HACC) was established by a consortium of international, national and local NGOs.
In 1998 the Ministry of Health established the National Centre for HIV/AIDS, Dermatology and STDs (NCHADS). The mandate of NCHADS is to oversee the response of the MoH as well as to provide technical support to other government agencies and national partners. The National AIDS Authority (NAA), which replaced the National AIDS Committee (NAC) and National AIDS Secretariat (NAS), was established in January 1999 to oversee the national response, a key component of which is close co-operation between government and non-government agencies.
A 2-year National Strategic Plan for STD/HIV/AIDS was developed in 1998, under the co-ordination of MoH/NCHADS. This plan, which was a joint effort involving ministries, multilaterals and NGOs provides a framework for implementation and co-ordination for all partners contributing to the national response (4) . While Care and Support for PLHA is one of the 12 strategic areas, much of the focus is on policy, protocols, guidelines and mobilisation of donor support. The plan made no reference to government supported home care programmes.
In March 2000, MoH/NCHADS developed the first draft of their Strategic Plan for HIV/AIDS and STI Prevention and Care 2001-2003 (5) . AIDS Care, including Institutional and Home-based Care, is one of the eight areas of primary focus. Home-based Care has its own set of strategic goals, which include supporting the extension and expansion of the Home-based Care programme nation-wide, and the establishment of co-ordination mechanisms for its implementation. This Strategic Plan, which indicates what can and should be done in the health sector, is a significant step towards institutionalisation of Home-based Care in Cambodia.
Footnotes
(1) Report on Sentinel Surveillance in Cambodia, NCHADS/MoH, 1999
(2) Ministry of Health, 1998, The demand for health care in Cambodia: Concepts for future research, National Public Health and Research Institute
(3) UNAIDS (2000) Country Profile, "The HIV/AIDS/STD situation and the national response in the Kingdom of Cambodia", 3rd Edition - February 2000
(4) National Strategic Plan STD/HIV/AIDS, Prevention and Care in Cambodia, 1998 - 2000
(5) Ministry of Health/NCHADS Draft Strategic Plan for HIV/AIDS and STI Prevention and Care n Cambodia, 2001 - 2003
Cambodia has one of the fastest growing HIV prevalence rates in the world. Results from the latest Surveillance Survey (1) indicate that approximately 170,000 Cambodians are now infected with HIV, giving an adult HIV prevalence rate of around 3.5%.
Cambodia has also one of the lowest rates of health utilisation in the world. Lack of funds for salaries, supplies and maintenance severely limits the amount of care and medicines which can be provided by the health system. For the poorest Cambodians, costs of health care account for approximately 28% of household expenditure (2) . The AIDS epidemic will further exacerbate this cost burden on many households.
The impact of the rapid spread of the epidemic in Cambodia is drastic. During the year 2000 an estimated 12,000 people with AIDS will seek care and support, thus increasing the pressure on a health care system that currently provides a total of only 8,500 beds for all medical conditions (3) .
The HIV/AIDS epidemic in Cambodia is still relatively recent. HIV was first reported in Cambodia in 1991 and the first cases of AIDS were diagnosed in late 1993. During that year the first 5-year National AIDS Plan was developed and the HIV/AIDS Co-ordinating Committee (HACC) was established by a consortium of international, national and local NGOs.
In 1998 the Ministry of Health established the National Centre for HIV/AIDS, Dermatology and STDs (NCHADS). The mandate of NCHADS is to oversee the response of the MoH as well as to provide technical support to other government agencies and national partners. The National AIDS Authority (NAA), which replaced the National AIDS Committee (NAC) and National AIDS Secretariat (NAS), was established in January 1999 to oversee the national response, a key component of which is close co-operation between government and non-government agencies.
A 2-year National Strategic Plan for STD/HIV/AIDS was developed in 1998, under the co-ordination of MoH/NCHADS. This plan, which was a joint effort involving ministries, multilaterals and NGOs provides a framework for implementation and co-ordination for all partners contributing to the national response (4) . While Care and Support for PLHA is one of the 12 strategic areas, much of the focus is on policy, protocols, guidelines and mobilisation of donor support. The plan made no reference to government supported home care programmes.
In March 2000, MoH/NCHADS developed the first draft of their Strategic Plan for HIV/AIDS and STI Prevention and Care 2001-2003 (5) . AIDS Care, including Institutional and Home-based Care, is one of the eight areas of primary focus. Home-based Care has its own set of strategic goals, which include supporting the extension and expansion of the Home-based Care programme nation-wide, and the establishment of co-ordination mechanisms for its implementation. This Strategic Plan, which indicates what can and should be done in the health sector, is a significant step towards institutionalisation of Home-based Care in Cambodia.
Footnotes
(1) Report on Sentinel Surveillance in Cambodia, NCHADS/MoH, 1999
(2) Ministry of Health, 1998, The demand for health care in Cambodia: Concepts for future research, National Public Health and Research Institute
(3) UNAIDS (2000) Country Profile, "The HIV/AIDS/STD situation and the national response in the Kingdom of Cambodia", 3rd Edition - February 2000
(4) National Strategic Plan STD/HIV/AIDS, Prevention and Care in Cambodia, 1998 - 2000
(5) Ministry of Health/NCHADS Draft Strategic Plan for HIV/AIDS and STI Prevention and Care n Cambodia, 2001 - 2003