The
research branch of the NGO Khana has argued in a new peer-reviewed study that
livelihood programs for people living with HIV – which address recipients’
economic rather than medical needs – could be the key to significant
improvements in quality of life for the estimated 74,000 Cambodians living with
the disease.
However,
despite the programs’ promise, one of the study’s authors and others in the
field yesterday cautioned that such programs could be threatened by dwindling
donor funds as Cambodia transitions from a “least-developed” to a “lower
middle-income” country.
According
to the new report in this month’s American Journal of Public Health Research –
conducted by the Khana Center for Population Health Research and universities
in Cambodia, Japan and the US – people in Cambodia with HIV/AIDS generally have
their basic health needs met, but poverty, compounded by social stigma, low
self-esteem and a lack of skills, proves to be the most persistent challenge.
People
participating in Khana-led livelihood programs – which teach people living with
HIV/AIDS how to support themselves and their families – for three years or more
had a monthly income 13.6 per cent higher than their peers who did not
participate, the researchers found. The participants were also less likely to
experience food insecurity, or to report feeling worthless, ashamed, dirty or
guilty because of the disease.
The
positive results suggest the programs – which were implemented in Battambang,
Kampong Cham, Kampong Speu, Pursat, Siem Reap and Takeo provinces – should be
implemented on a wider scale throughout the country.
But
experts said yesterday the World Bank’s recent decision to bump up Cambodia’s
economic ranking is threatening funding for the disease.
“Funding
is an issue even to sustain the programs. [Money] for HIV is going down now
that Cambodia has been categorised as a lower middle-income country,” said
Siyan Yi, director of the Khana Center for Public Health Research, and one of
the report’s main authors.
Meanwhile,
Tim Vora, executive director at the non-profit HIV/AIDS Coordinating Committee,
said livelihood programs would become especially crucial as the donor money
dried up.
“These
programs are really important because the HIV/AIDS money is decreasing but the
people are still very vulnerable,” said Vora, who was not involved with the
Khana study. For example, he noted, people could obtain medicine for free at
the hospital, but they often did not have enough money to travel to the
hospital to get it.
“As we
become a lower-middle income country the development organisations are focusing
on different things,” Vora said. “So it’s very important for people to have
livelihoods in the long run.”
Tia
Phalla, of the government’s National AIDS Authority, said yesterday that the government
recognised the need for the programs and was starting to initiate its own.
But the
government-sponsored programs, which were implemented in eight provinces in
2016, also needed to expand.
“People
can’t just rely on food handouts; they have to go beyond that and make an
income for both health and dignity,” Phalla said. “Right now we are working
hard with the Ministry of Planning to support income-generation for people with
HIV/AIDS, but we need to increase the number of programs.”
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