Social Return on Investment, “Doing more with less”: Evidence based Operational Research on the KHANA Integrated Care and Prevention Project in Cambodia

With funding support from the EC, KHANA has been providing focused prevention and comprehensive care and support for MARP, PLHIV and OVC through community based care team since 2007. Since 2010, KHANA has been implementing the new Home and Community Based Care approach adapted from the SAHACOM model; which provides a more sustainable and improved management and coordination of the services. The Social Return on Investment study uses an innovative form of cost benefit analysis to monetize the project outcome.
Quantitative and qualitative methods were employed. The findings showed that for every $1 invested in the ICP project generated a return on approximately $2 worth of social, health and economic values. The ICP yielded the significant impact notably in the area of food security, wellbeing, improved health and improved productive capacity which enable greater economic return for the households.

End project evaluation: Change in HIV Integrated Prevention, Care and Impact Mitigation Efforts from 2009-2011

With funding support from European Commission, the “Increasing Community Action on HIV/AIDS Prevention, Integrated with Care and Impact Mitigation Efforts in Cambodia” project has been implemented since 2007 in Prey Veng, Kampong Chnnang, and Kampong Speu. The end project evaluation aims to evaluate the efficiency and effectiveness of the program and measure the impact of the program on the beneficiaries and community as a whole.
Quantitative and qualitative methods were employed. The findings showed the high level of overall satisfaction with services for both PLHIV and OVC. PLHIV reported undergoing ART nearly 90%. Increased OVC regularly access schooling, social support and health condition. Consistent condom use among entertainment workers with client remains high but still relatively low when with their sweetheart. HIV test among MARP has significantly increased.

Baseline Documentation: Sustainable Action Against HIV and AIDS in Communities (SAHACOM)

Baseline documentation has been conducted to enable measurement and evaluation of program achievements. Quantitative and qualitative methods were employed. Result showed implementing partners adapted the SAHACOM model based on local context particularly in relation to ratio of community support volunteers and peer facilitators. Integration of SRH services undertaken so far has resulted in increased awareness and understanding among MARP, PLHIV and OVC.

Baseline Survey on HIV/AIDS Knowledge, Attitudes, Practices, and Related Risk Behaviors among Most At Risk Populations

The baseline survey was conducted with funding support from the Global Fund Round 7 and the European Commission (EC). Quantitative methods were used to identify and determine the magnitude of prevention indicators. Results showed there is still gaps in condom use among the three target populations, entertainment workers (EW), men who have sex with men (MSM) and drug users (DU). Target groups were found to be at high risk of HIV infection due to shortage of knowledge and information. Discrimination was found to be a barrier preventing MSM and DU from accessing health services and information.

Mid-term Review of the Integrated Care and Prevention Project (ICP) regarding People Living with HIV (PLHIV) and Orphans and Vulnerable Children (OVC)

KHANA implemented an integrated care and prevention program since 2007 in Prey Veng, Kampong Chnnang, and Kampong Speu provinces with EC funding support. The mid-term review aims to monitor progress and provide feedback to improve program design and implementation.

Quantitative and qualitative methods were used. Study findings included: 70% of PLHIV in the program were women; 83% of PLHIV were on ART; 84% of OVC attend school, however about 60% suspended study at some point to earn extra household income; levels of stigma and discrimination have dramatically declined; 15% of PLHIV had ever sold farmland, rice-fields or houses to cover food, clothing, medical care and debt repayment. PLHIV and OVC reported high satisfaction with the ICP program.

Mapping the Pattern of Sex Workers, Entertainment Establishments and Men who have Sex with Men in Cambodia

KHANA implemented a focused prevention program targeted to most at risk populations (MARP) with funding support from EC and USAID. The mapping study incorporated both a situation and response analysis. The study showed that both sex workers and MSM both faces stigma and discrimination from the community as a result of societal attitudes towards sex and sexual preference.

Evaluation of Microfinance Pilot Project for HIV Affected Families

KHANA has been providing income generation activities (IGA) through community based implementing partners to HIV affected families. Small scale grants of USD30 were provided which can have only a limited impact on household economies.

As a result, KHANA piloted a microfinance project for HIV affected families partnering with VisionFund. The evaluation aims to measure the impact, identify lessons learnt and challenges encountered, and identify best practices from the pilot.

Qualitative and quantitative methods were used to collect data from selected respondents. Results showed most of HIV affected families who received microfinance had improved living conditions in terms of food security, health condition, child school attendance, and saving. Notably, PLHIV who accessed microfinance reported higher adherence to anti retroviral therapy (ART). There is a need to sustain momentum of the positive effects of microfinance provision among HIV affected households. It is strongly recommended the pilot continues and is expanded to other communities.

Income Generation for People Living with HIV and Orphans and Vulnerable Children

The report summarises finding from a brief study of the successes and, challenges of KHANA and local partners in Income Generating Activities (IGAs) for people affected by HIV/AIDS. The study covered ten partners in five provinces so only represents a subset of the whole KHANA IGA program. Most partners are providing small grants or loans to PLHA and OVC families for IGA. The approach has been deliberately flexible and partners have tried many different schemes, including: grants, small loans with flexible repayment requirements, grants linked to savings and grants or loans to self-help groups.

Compounding vulnerabilities: Result of Participatory Assessment and Response on Drug and Substance Use and HIV/AIDS in Phnom Penh, Battambang, Siem Reap and Sihanoukville

At the time of the study, illicit drug use had only been recently recognized by the Cambodian government as having the potential to accelerate the HIV epidemic in Cambodia. Responses to this issue had been focused, at best, on arresting dealers and sending users to military style camps for rehabilitation.

The study aimed to identify the most vulnerable people at risk to HIV related to drug use. Participatory approaches were used to generate qualitative information. Results showed relatively high levels of drug use within certain populations including out of school youth and sex workers. These groups already have a high HIV risk which is therefore compounded by the use of behavior changing drugs such as amphetamine type stimulants. The study recommends that drug related programs need to fully understand the personal and social factors that lead to drug use. A lack of services relating to drug use was found and therefore improvements to services and information availability and community involvement are needed.