XVII International AIDS Conference: Theme: Universal Action Now!

1. Using Micro-Finance to Mitigate Impact of HIV and AIDS on Affected Families: Experience from a Pilot Project in Cambodia XVII International AIDS Conference: Theme: Universal Action Now! 3-8 August 2008, Mexico City, Mexico Presented by: Choub Sok Chamreun, Team Leader: Technical Support, KHANA

2. Epidemiological Overview Source of Information: HIV Sentinel Survey (HSS)- NCHADS 2006

3. Why a Pilot Project? • Change of HIV- success of response; • Availability of health services including access to ART, OI and other AIDS related services; • Limited access of multiple approaches addressing the change needs of PLHIV and OVC • Mitigating socio-economic impact of the epidemic is an increasingly important priority in Cambodia • KHANA and implementing partners lack of experience in addressing the socio-economic efficiently and effectively

4. How it is happened? • Identified and signed partnership with VisionFund Cambodia a micro-finance provider for a twelve month piloted project; • The project targeting 108 PLHIV and OVC household in one selected site in Kampong Cham province; • One KHANA’s Implementing Partner (IP) selected to work closely with this particular micro-finance institute; • The recruitment of beneficiaries started and loan provided

5. About the project • Reached more female than male clients; • Female-headed households were more prevalent amongst PLHIV & OVC households than amongst non-PLHIV households; • More PLHIV and OVC households without microfinance reported a high dependency ratio than either PLHIV or OVC household with microfinance or non-PLHIV; • All respondents had a low level of education with a mean of 2-3 years of school completed

6. About the project: Loans & Small Enterprises • Average size of loan is USD180 for individual PLHIV and OVC household and USD150 for non PLHIV and OVC household; • Loan were used for running enterprises on a self-employed basis; • Most common enterprises were crop production, animal husbandry, petty trading and food vending; • A small proportion of loan used on immediate household needs (food supplies, family emergencies and repaying loan etc…)

7. About Evaluation • Aim to measure impact, identify lessons learned, challenge encountered and best practice • Explore characteristics and experiences of PLHIV and OVC households as microfinance clients; • It is an independent evaluation • Evaluation carried out in which • 30 randomly selected PLHIV and OVC microfinance clients were compared with 30 non-PLHIV microfinance clients and 30 PLHIV and OVC households who had not accessed microfinance

8. Informed Findings • More than half of respondents from the three cohorts reported an increase in income. • Microfinance clients attributed to a range of reasons: • Starting up or expanding an enterprise • Being able to buy inputs for an enterprise and selling their product at higher price • Personal savings had increased • PLHIV and OVC households without microfinance attributed increases in income to securing paid employment.

9. Findings “Cont’d” • 15 respondents from both PLHIV and OVC and non-PLHIV microfinance clients reported having a second income generation activity, with combined profits from both enterprises ranging from USD66 to USD88 per month; • PLHIV and OVC households had not accessed microfinance reported a monthly profit of USD48 per month from a single income generating activity; • All three groups reported profits were used primarily to secure food and secondly to pay for children’s school attendance

10. Findings “Cont’d” • PLHIV and OVC households who had not accessed microfinance were more likely than those who had received loans to report that health related expenses were a major expenditure; • In term of food security, families who accessed microfinance were in better situation: • 87% of PLHIV and OVC households accessing loans • 90% of other microfinance clients reported their food consumption increased or stayed the same and • Over one third of PLHIV and OVC households who did not access microfinance reported that their food consumption decreased

11. Findings “Cont’d” • Households who accessed loans were more likely than those who did not and reported that they have spent more than USD50 on home improvement (this ranging from fixing the roof to installing of electricity) • Both PLHIV and OVC and non-PLHIV respondents ranked savings at home as their first choice of recourse together with mobilizing their social assets; • PLHIV and OVC households who had not accessed microfinance identified grants from NGO and loans from neighbors as their most likely options; • Adherence to antiretroviral therapy was high amongst people who accessed microfinance with 100% reporting that they always take their medication;

12. Findings “Cont’d” • People who on ART and did not access microfinance showed slightly lower adherence with two out of fifteen women reporting that they did not take their medication (one cited being busy as a reason while the other reported selling her medication to provide food for the families) • Respondents were satisfied with the friendliness and compassion of the microfinance institute and collaborating NGO, training and technical assistance and the fast service and easier loan guarantees that were provided. However some clients expressed dissatisfaction with the interest rates of loans and the small size (Interest is 2% per month)

13. Key Messages • Partnership between a specialist microfinance institution and NGO with HIV expertise was effective and productive; • People living with HIV were viable customers for microcredit and repaid their loans; • People with HIV were slightly more likely to use loans for ‘non-entrepreneurial’ purposes including health costs; • Education was a priority for household spending suggesting potential for a microfinance product to support education costs; • PLHIV’s choice of business was limited by stigma and discrimination. Some women were reluctant to add value to agricultural products by cooking food for sale as they feared people would not buy it;

14. Key Messages- Cont’d • Microfinance helps improving in household welfare such as food security and housing condition and this momentum of the positive effects of credits provision amongst PLHIV and OVC households need to be sustained; • People are more likely to be able to use microfinance to move out of poverty if they are able to profitably use larger loans; • Microfinance institution and NGO are encouraged to provide resources to look at sub-sector approach as this may facilitate the development of alternative sources of income to the target groups

15. Thanks for your attention!