Reducing health risks by promoting behavioral change and improving quality of health services

In 2010 Cambodia received an award for its success in reversing the HIV/AIDS epidemic and its attainment of the 5th Millennium Development Goal. While the situation has greatly improved among the general population (HIV prevalence rate dropped from 2 % in 1998 to a 2010 projection of 0.6 %), HIV remains highly concentrated within the most at risk populations, namely direct and indirect sex workers, homosexuals and drug users. ACTED–PSF is committed to sustaining the strides achieved by rigorous prevention programs over the past two decades. By providing education and health support services, ACTED-PSF has continued to fight transmission among the most at risk populations.

HIV prevention among most at risk populations

Since the 1990s, ACTED–PSF has contributed to the 100% Condom Use Program of the Cambodian Government inciting positive lifestyle behavioral change for entertainment workers (women working in karaoke bars, massage parlours and beer gardens), men having sex with men and drug users. Our program has progressively developed into a multidimensional approach which serves as an informational and medical support system, as well as a link to additional sexual reproductive health and family planning services. In 2010, ACTED-PSF responded to the challenges brought by the 2008 Law on Suppression of Human Trafficking and Sexual Exploitation and continued to follow our beneficiaries into their context. The law resulted in women moving from brothel based to non-brothel based establishments. To gain access to these establishments, ACTED-PSF improved cooperation with national authorities who in turn exerted pressure on establishment owners to continue to grant access to these vulnerable women. Our well trained outreach educators and medical staff have continued to provide regular STI/HIV consultations, counselling and health education sessions at 220 entertainment establishments and 6 clinics in Phnom Penh. The staff also targets high risk locations such as parks to reach independent sex workers and their clients, and drop-in centres for youth, homosexuals and drug users.

Strengthening health services and supporting logistic management of drugs

In 2010, in collaboration with the Logistic Unit of the National Centre for HIV/AIDS, Dermatology and STD (NCHADS), ACTED-PSF worked to strengthen the quality of care in 41 public health services across the country in terms of their management of antiretroviral and opportunistic infection drugs. In the Cambodian context, logistics management is a critical issue and the provision of medication to those affected by HIV is an essential component to fighting the spread of HIV. Support of the already established National Programme proved to be a decisive strategy in achieving optimal use of the resources and sustainability. Training and regional workshops transferred the skills of ACTED-PSF staff in stock management and drug knowledge to more than 40,000 stakeholders, mainly pharmacists and drug dispensers working in health facilities providing treatment to people living with HIV as well as key staff from NCHADS. In order to further improve quality of drug information flow between peripheral and central level, a computerised Logistic Management Information System is being finalised. It will allow accurate ordering and quantification and avoid drug overstocks/shortage, and should be handed over to NCHADS in early 2011 for country wide implementation.

Nowadays

ACTED-PSF continues to provide HIV prevention support to health services and most at risk populations. Over the years we have developed a unique understanding of the needs of our target populations and plan to continue to work to improve their lives through interventions in other sectors such as elimination of violence and provision of economic alternatives. The number of entertainment workers reached and empowered by our interventions continues to grow and ACTED-PSF is using this network to strengthen its impact and to improve the lives of this population. Going further, we have started to tackle the root causes of the sex industry which continues to expand, by initiating interventions targeting poor rural youth/women before they move to the city and to better equip them with knowledge on gender based violence, family planning and reproductive health. Drawing on the experience of ACTED throughout the world, we are progressively incorporating new interventions into our country mission, and as a member of the Alliance2015, we continue to support the Cambodian civil society in contributing to aid effectiveness in Cambodia.