PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
This amount is the prorated portion of the "cost of doing business" attributable to this program area. The
total amount that HHS/CDC Cambodia is being billed by HHS/CDC Headquarters to support the Information
Technology Service Office is $69,420.
New/Continuing Activity: New Activity
Continuing Activity:
Table 3.3.01:
Table 3.3.09:
Program Budget Code: 13 - HKID Care: OVC
Total Planned Funding for Program Budget Code: $853,785
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
The 2005 Cambodia Demographic and Health Survey indicates that 8.8% of children 0-17 years of age or an estimated 553,000
children are orphans in Cambodia. These children have lost one or both parents due to a range of causes, and an unknown
proportion are orphans due to HIV. Cambodia remains one of the poorest countries in the region, with a rural population of over
80% and no social welfare system, which leaves many orphans, children and families economically and socially vulnerable.
Identifying and distinguishing HIV OVC from the multitude of other orphans and vulnerable children is difficult. There are no
current estimates of the number of Cambodian children orphaned or vulnerable as a result of HIV/AIDS. As of mid-2008 the
National Center for HIV/AIDS, Dermatology and STDs (NCHADS) had 4,659 children 0-14 years old registered for OI/ART
services (i.e. living with HIV). Based on a USG partner that provides support to a large number of NGO home based care (HBC)
teams that support both people living with HIV/AIDS (PLHA) and OVC the ratio of OVC to People Living with HIV/AIDS (PLHA)
was about 1.4 in 2006-2007. If this ratio is applied to all known PLHA as of mid-2008, it would imply that there are about 60,000
HIV OVC in Cambodia. This figure can only be taken as a very rough estimate, since there have been no studies validating
whether OVC in these communities are either over-estimated (although the partner works to exclude non-HIV affected children)
or, what is more likely, under-estimated (particularly when a parent dies and there is no longer a PLHA in the family) or whether
this ratio can be applied to PLHA who do not receive (HBC). However it is the only estimate available at this time. Currently,
through the integrated HBC OVC program more than 30,000 children either with HIV/AIDS or in HIV/AIDS families or orphaned by
AIDS receive care and support in Cambodia. This shows that there is a substantial gap in service coverage for OVC even using
what is likely to be a conservative estimate of their numbers.
Most OVC programs in Cambodia serve to alleviate poverty and enable children to access health care and schooling. While the
USG agrees that a community and family-based assistance approach is the most appropriate for OVC, the needs demand a more
holistic rural development and poverty alleviation framework, including food security. Over the past year, the cost of locally
produced rice has doubled, as have the prices of fuel and fertilizer, and the cost of meat and fish has increased by as much as
60%. Skyrocketing food prices are affecting vulnerable populations in both urban and rural areas. Since 1998, the USG has been
a major supporter for the OVC program through an integrated HBC OVC approach. The emphasis is primarily on children who lost
parents due to AIDS, those living with HIV infected parents or live with extended family or with caregivers in their communities or
in orphanages.
In FY 2007, Cambodia's second year under PEPFAR, the USG surpassed its targets for direct service provision to OVC, with
18,649 OVC served and 6,795 providers/caretakers trained. Positive outcomes include integration of OVC activities with other HIV
program areas such as pediatric Antiretroviral Therapy (ART); HBC and clinical palliative care; increased OVC access to HIV and
basic health services; nutritional, educational and vocational training services; increased skills of HBC teams and caregivers to
provide HIV-related and basic health care to OVC; OVC policy development at the national level with implementation at the
commune level; and establishment of community-led initiatives addressing OVC needs. USG OVC activities leverage funding
from the Global Fund and other donors, including food support from the World Food Program (WFP), though continued provision
of WFP support is uncertain given global demands due to food insecurity.
Some of Cambodia's strongest programs combine OVC care and support with micro-enterprise initiatives funded by other donors.
USG partners have also been successful in leveraging other donor and private funds to support access to clean water in rural
areas. Cross sectoral work engages schools and teachers so OVC can access education and not be stigmatized.
In FY 2009, given the limits of USG funding, USG OVC activities will continue at current levels with no further expansion planned.
The emphasis is primarily on improving the quality of community services targeted at the most vulnerable OVC affected by
HIV/AIDS. The USG's OVC and HBC interventions are integrated to develop a more comprehensive family focused approach.
Efforts to transition current OVC activities to host country mechanisms and Global Fund resources will continue where possible.
With inadequate data to determine the true numbers of OVC infected or affected by HIV/AIDS, it is difficult to limit assistance to
these populations given the enormous educational, nutritional and health care needs of most rural and many urban Cambodian
children.
The USG will continue to support OVC activities in all key HIV/AIDS prevention, care, and treatment service areas and mitigate
the impact of HIV where possible. The USG will continue to support programs that enhance the quality of community and facility-
based services for OVC through training of government health center staff and HBC teams to deliver critical HIV care and social
support services to OVC, train health center staff and HBC teams to educate OVC caretakers in the provision of OVC care, and
provide transportation support for health care and HIV services, including Voluntary Counseling and Testing (VCT), and viral load
testing. Community activities will be supported to enable communities and caretakers to assume increased responsibility and care
for OVC and extended/foster families by ensuring they receive holistic care and access to critical community (non-clinical)
services. The USG's partners will implement activities that increase caretaker skills to assess OVC health status, and educational,
psychosocial, nutritional and basic needs; provide referrals for medical and support services; provide HIV prevention counseling
and legal protection for OVC; increase parenting skills; and reduce stigma against HIV positive OVC and their families. Efforts will
also be made to strengthen the links between OVC community-based interventions and those in health facilities in order to
increase access to services such as VCT, Prevention of Mother to Child Transmission (PMTCT), Opportunistic Infection (OI)
treatment, antiretrovirals (ARV) and pediatric AIDS care. In addition, strong links and partnerships will be established with
community development organizations that can support additional comprehensive economic activities and skills for beneficiaries.
On a limited basis, the USG will continue to support residential care when preferable options are not available. The USG will also
continue to support Faith Based Organization programs in pagodas, mosques and churches as they provide cost-effective,
community-based non-clinical OVC services.
The USG collaborates with the Ministry of Health and Ministry of Social Affairs, Veterans and Youth Rehabilitation, and National
AIDS Authority to implement OVC activities in accordance with the National Multi-Sectoral HIV/AIDS Strategy; and works with
National OVC Task Force to develop national policy and advocacy as well as a monitoring and evaluation system for OVC. At the
community level, in order to enable effective implementation, the USG links with a variety of partners, including provincial
authorities, commune councils, village chiefs, school authorities, legal bodies, pagodas and NGOs. The USG works with the
Global Fund and UNICEF, to enable implementing partners to expand OVC services to additional provinces and support
additional interventions (e.g. food provided by WFP). Collaborative relationships with Global Fund and UNICEF will also continue
at the national and provincial policymaking, advocacy and program coordination levels.
Table 3.3.13:
Table 3.3.16:
Table 3.3.17:
Table 3.3.18:
Table 3.3.19:
