khana livelihoods programs for improving health and

KHANA LIVELIHOODS PROGRAMS FOR IMPROVING HEALTH AND QUALITY OF LIFE OF PEOPLE INFECTED AND AFFECTED BY HIV: A QUALITATIVE PROGRAM REVIEW

Kouland Thin, Samedy Suong, Karishma Kumar, Sovannary Tuot, & Siyan Yi

August,

2014

DISCLAIMER : This document was made possible by the generous support of the American People through the United States Agency for International Development (USAID). The contents are the sole responsibility of KHANA and do not necessary reflect the views of the USAID or the United States Government. 2

KHANA Livelihoods Programs for Improving Health and Quality of Life of People Infected and Affected by HIV: A Qualitative Program Review

CONTENTS Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Acknowledgement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 1. Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 2. Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 3. Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 3.1 Program sites and sample selection . . . . . . . . . . . . . . . 11 3.2 Tool development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 3.3 Data collection training and fieldwork . . . . . . . . . . . . . . 14 3.4 Data collection and management . . . . . . . . . . . . . . . . . 14 3.5 Ethical considerations . . . . . . . . . . . . . . . . . . . . . . . . . . 14 4. Findings and discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 4.1 Village saving and loan (VSL) . . . . . . . . . . . . . . . . . . . . 15 4.2 Skill training (ST) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 4.3 Cash grant (CG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 5. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 6. Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Annex: Survey tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

LIST OF TABLES Table 1: Number of KHANA’s beneficiaries from 2010 to 2013...... 12 Table 2: Summary of sample selection . . . . . . . . . . . . . . . . . . 13 Table 3: S ummary of number of participants attended FGD, IDI, and KII by province . . . . . . . . . . . . . . . . . . 13

LIST OF FIGURES Figure 1: Process of village saving and loan . . . . . . . . . . . . . . 16


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ABBREVIATIONS AIDS ART BWAP BFD BSDA CCASVA CG CPR CSV EU FGD HIV KBA KT KLLC KSP IDI IGA IDA IP KII KOSHER MARPs MHC MHSS MODE NAPA NAS NECHR MoH OVC PC PLHIV SCC SEADO SHG SIT ST USAID VSL WOMEN WOSO 4

Acquired Immunodeficiency syndrome Antiretroviral Therapy Battambang Women’s AIDS Project Buddhism for Development Buddhism and Society Development Association Cambodian Children against Starvation and Violence Association Cash Grant Community Poverty Reduction Community Support Volunteer European Union Focus Group Discussion Human Immunodeficiency Virus Khmer Buddhist Association Kaksekor Thmey KHANA Livelihoods Learning Center KHANA Strategic Plan In-Depth Interview Income Generation Activity Indradevi Association Implementing Partner Key Informant Interview Key of Social Health Education Road Most-At-Risk Populations Mental Health Cambodia Men’s Health Social Service Minority Organization Development Economy National Prosperity Association Nak Akphivath Sahakum National Ethics Committee for Health Research Ministry of Health Orphans and Vulnerable Children Partner in Compassion People Living with HIV Salvation Center Cambodia Social, Environment, Agricultural Development Organization Self-Help Group Save Incapacity Teenagers Skill Training United States Agency for International Development Village Saving and Loan Women Organization for Modern Economy and Nursing Women Service Organization


ACKNOWLEDGEMENT Our research team would like to express our thanks to the KHANA livelihoods program team, especially Mr. Sron Samrithea and Ms. Sea Sokuntheavy for their supports from the beginning to the end of this study. We would also like to thank the KHANA livelihoods center manager, and all of KHANA’s implementing partners for facilitating field work as well as participating in this study. Without their advance arrangement at the field sites, our data collection team would not have been able to interview all of the selected individuals for this study. Our thanks also go to all participants that took the time out to participate in this study. Special thanks are also extended to the interviewers who committed their time to collect all of the information needed for this study. Our team would like to thank Dr. Oum Sopheap, Executive Director of KHANA, and the management team for their leadership and guidance throughout the study. Thank you all individuals who were involved in this study.


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EXECUTIVE SUMMARY BACKGROUND

METHODS

In 2003, a small-scale grant for income generation activities (IGAs) was started to support individuals who were infected and affected by HIV including people living with HIV (PLHIV), orphans and vulnerable children (OVC), and most-at-risk populations (MARPs). This project was expanded to the livelihoods program in KHANA strategic plan (KSP15) 2011-2015. Through this program, KHANA has envisaged that living conditions and health outcomes of households under support can be improved.

This study was conducted in August 2013 in four provinces where the livelihoods programs have been implemented. Qualitative methods were utilized. Key informant interviews (KII), in-depth interviews (IDI), and focus group discussions (FGD) were primarily utilized as the means of acquiring information from the study participants.

The KHANA livelihoods program focuses on maximizing household assets using community saving and loan schemes, skill building, small cash and livestock grants, and ongoing support through home garden dialogue. From 2010 to mid-2013, a total of 2,063 infected and affected household members including PLHIV, OVC, and MARPs have received supports from the KHANA livelihoods programs. Thirty-nine livelihoods skill trainings (STs) were delivered to 1,109 participants; 522 households received cash grants (CGs) from livelihoods program; 119 village saving and loan (VSL) groups were initiated, with 1,881 VSL members.

STUDY OBJECTIVES Since the full implementation of KHANA livelihoods program began in 2010, a review of the program implementation has not been conducted. This study aims to: (1) document the process of each program; (2) assess each component of livelihoods program in terms of strengths, weaknesses, opportunities, and threats; and (3) make appropriate recommendations to livelihoods programs for future program planning.

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FINDINGS This report goes into the details of the livelihoods program, an umbrella program that funded three separate programs in order to improve the livelihoods of PLHIV and OVC. The three programs, VSL, ST, and CG, have had varying degrees of acceptance and success in the communities in which they were implemented.

Village saving and loan (VSL) The VSL has been well received in comparison to the other two programs, as there has been little internal conflict, secondary issues have been resolved as a side effect of the VSL structure, and more communication has been occurring between the members of the VSL group as a whole. The amount of money borrowed through this VSL is small, but it helps them with their family urgencies, especially when family members are sick or kids are in need of money to attend school. The interest rate is lower than other microloan institutions, the process is much faster as it is a small group, and no collateral is required. Beneficiaries also reported feeling financially safe and independent, due to the fact that they know they have access to a monetary safety net now. Domestic violence occurrences


were even reduced, due to the fact that household members no longer have to worry so much about money and financial security. And while there were some issues associated with the specifics of running a saving and loans program that required calculating interest and capital, most VSLs were self-sustaining within one year.

Skill trainings (STS) The skill training program was also rather well received, although the location of the training sites and the lack of proper funds for transportation were points that were considered hindering by the beneficiaries. Beneficiaries liked that they could learn skills that would make their lives better, and were sometimes even able to teach those skills to other people in their home provinces. However, some beneficiaries did not think the time and effort was always worth it. There was a report of someone having a difficult time selling their chemical free vegetables because they did not look as appealing as their competitor’s products. So there were some problems associated with whether or not the trainings were relevant to all cases. A few people reported that they did not have enough money to buy all required materials as shown during the trainings. So there are still points to be considered when amending this program.

Cash grant (CG) The cash grant was put in place to support PLHIV or OVC families to start or expand business, but there were quite a few flaws and points of confusion for beneficiaries. Not all of the grantees received skill trainings, and applicants mostly relied on implementing partner (IP) livelihoods staff or group appointed leaders to fill in the application for them. They did not understand the process clearly, and there were a lot of misunderstandings between which programs were affiliated with KHANA and what the requirements were. Despite these flaws, many beneficiaries revealed that the income generated from this grant helped to support their children schooling fee and allowed them to

consume more meat, buy appropriate clothes for their family members, and travel to pre-ART/ART site as scheduled.

CONCLUSIONS All of the programs have helped PLHIV and OVC individuals and families live with reduced stigma, enhanced monetary means, and increased their individual productivity. There was an overwhelmingly positive response from these programs that shows they should be extended. All of them have been rather successful at bettering PLHIV and OVC’s livelihoods, and should thus be continued so as to make the difference these people need.


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1. BACKGROUND

In 2003, a small-scale grant for IGAs was started to support individuals who were infected and affected by HIV, including PLHIV, OVC, and MARPs. This project was expanded to the livelihoods program in KHANA Strategic Plan 2011-2015 (KSP15). Through this program, KHANA has envisaged that living conditions and health outcomes of households under support can be improved. This will lead to the reduction of households’ dependencies on external supports and stigma being held against these populations. Livelihoods programs, documented in several studies, play an important role in upgrading the living standards of vulnerable households who live in resource-limited countries. In Cambodia, PLHIV who participated in this program showed increases in income and consumption of micronutrient-rich foods; in addition, the discrimination toward them and their families was significantly reduced [1].

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Studies on livelihoods programs with PLHIV from African countries provided similar findings [2]. In many instances, HIV and livelihoods programs are mentioned to be strongly associated [3]. The attempts to reduce the spread of HIV epidemic are unlikely to be achieved if household livelihoods are not taken into account. Similarly, the attempts to make livelihoods more secured and sustainable for vulnerable households cannot be reached if the HIV epidemic is not settled [3].This is one of the main reasons that livelihoods were integrated into KHANA’s program in the early 2000s. KHANA is currently seeking additional support to expand and strengthen its livelihoods programs to the majority of households who are under KHANA’s integrated care and prevention programs. To establish livelihoods and rebuild assets for infected and affected households, KHANA initially provided small CG ranging from 15 to 50 US dollars


to its beneficiaries for IGAs. VSL and ST were added to the program at the end of 2010 following a micro finance project evaluation in 2008 and a livelihood economic study in 2010 [4, 5]. The KHANA livelihoods program focuses on maximizing household assets using community saving and loan schemes, skill building, small cash and livestock grants, and ongoing support through home garden dialogue. Under boosted KSP 2013-2015, KHANA and its IPs have scaled up support for VSL groups, which promote financial literacy and self-reliance. The KHANA Livelihoods Learning Centers (KLLC) were established as ‘Centers of Excellence’ under the Flagship project, providing practical livelihoods and resource management trainings, and demonstration gardens where clients or beneficiaries could

gain practical skills in agriculture and business. The centers will become independent technical support providers to assist with capacity building in livelihoods and social protection for KHANA/IPs and other civil society organizations [6]. Starting from 2010 to mid-2013, a total of 2,063 affected and infected household members including PLHIV, OVC, and MARPs have received supports from the KHANA livelihoods programs.1 Thirty-nine livelihoods skill trainings were delivered to 1,109 participants; 522 households received CGs from livelihoods program; 119 VSL groups were initiated, with 1,881 VSL members (68% of which were female).

1

These data provided by the livelihoods program unit; there were only a few EWs and MSM participated in this livelihoods program.


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2. OBJECTIVES An overall purpose of this review is to demonstrate both the achievements and potential issues that the livelihoods programs experienced.

This study aims: 1. T o document the process of each program (VSL, CG, and ST) 2. T o assess components of each livelihoods program in terms of strengths, weaknesses, opportunities, and threats 3. T o make appropriate recommendations to livelihoods programs for future program planning

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3. METHODOLOGY 3.1 PROGRAM SITES AND SAMPLE SELECTION Table 1 presents the number of beneficiaries that received supports from the livelihoods programs, broken down by province. The number of beneficiaries by province varied from a maximum of 529 persons to as small as 2 persons, with Kampong Cham and Kampong Thom having the highest and lowest number of beneficiaries, respectively. The high disproportionate number of beneficiaries was due to uneven funding support for livelihoods activities. Funding for livelihoods activities depended solely on the donor’s decision as to which province to support, so equal dispersions of funding can be difficult.

This study was conducted in August 2013 in four provinces where the livelihoods programs have been implemented. Qualitative methods were utilized. KII, IDI, FGD were primarily utilized as the means of acquiring information from the participants. KII were used to elicit detailed information about the livelihoods program implementation and challenges faced by program implementers. KHANA/IP livelihoods staff and KLLC staff were invited to participate in this interview, as they were integral members of the program implementation. Individuals with specific stories were invited to do the IDI. FGD were set up to discuss issues that participants had in common, along with providing a space to share their expectations from the programs. This approach allowed for more active participation and discussions that were greater in depth. Guided questions for each session were developed to help stimulate the discussions.

KHANA livelihoods program worked in 13 provinces, through 23 IPs. Four provinces were selected for this study: Kampong Cham, Kampong Chhnang, Kampong Speu, and Battambang. Selection was agreed upon consultation with the livelihoods program team, taking into account the number of beneficiaries and availability of funds to support livelihoods activities in each province. When this study began, some of the provinces were no longer financially supported for these activities. Those provinces were then not selected as it would have been hard to see the program’s long term impact and the issues that were encountered afterwards.


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Table 1: Number of KHANA’s beneficiaries from 2010 to 2013 PROVINCE Kampong Cham

IP Mental Health Cambodia (MHC)

NUMBER OF HOUSEHOLD 57

Buddhism and Society Development Association (BSDA)

186

Nak Akphivath Sahakum (NAS)

239

Kaksekor Thmey (KT)

27

Takeo

Partner in Compassion (PC)

Banteay Mean Chey

Community Poverty Reduction (CPR)

77 65

Pursat

Khmer Buddhist Association (KBA) Social, Environment, Agricultural Development Organization (SEADO) CPR

139

PC

103

Siem Reap

255

102

Buddhism for Development (BFD)

67

Salvation Center Cambodia (SCC)

20

MHC

78

Minority Organization Development Economy (MODE)

17

Pailin

Battambang Women’s Aids Project (BWAP)

Kampong Chhnang

Men’s Health Social Service (MHSS)

25

CPR

61

PC

37

Women Service Organization (WOSO)

64

National Prosperity Association (NAPA)

34

MHSS

22

MHSS Cambodian Children against Starvation and Violence Association (CCASVA) Women Organization for Modern Economy and Nursing (WOMEN)

24

BWAP

44

BFD

40

Kampong Speu

Prey Veng

Battambang

Phnom Penh Kandal Kompong Thom

153

46 36

SCC

13

Indradevi Association (IDA)

17

Key of Social Health Education Road (KOSHER)

3

Save Incapacity Teenagers (SIT)

4

IDA

6

MODE

2

TOTAL

2,063

Abbreviation: IP, implementing partner Kampong Cham and Battambang were recommended as livelihoods sites since the two provinces were financially supported. In addition, Kampong Cham had more beneficiaries than most of the other provinces, which would make it easy to observe the impact of the programs. Kampong Chhnang and Kampong Speu were the provinces selected for the locations of KHANA’s livelihoods centers. Despite

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the fact that funding from the European Union (EU) ended in December 2011, KHANA has continued to make an important impact to the livelihoods of beneficiaries through the use of the USAID grants. KII, IDI, and FGD were employed to extract information to document as well as to make assessment of each program implemented. The


three interview tools were applied in each program to ensure that all necessary information was extracted for this study. Two IP livelihoods staff were invited for KII in each selected province; three beneficiaries who participated in one of the livelihoods programs were selected for the IDI; eight beneficiaries who either participated in all livelihoods programs or one of the programs were selected for FGD. Table 2 shows the total number of participants in each category. Only beneficiaries who were over 18 years old and participated in one of the livelihoods

programs in the past two years were invited to join this study. IP livelihoods staff were invited for KII to express their views about the livelihoods programs they were implementing. PLHIV and OVC families were selected and arranged by KHANA/IPs to participate in IDI and FGD. Basically, the selection was channeled through KHANA/IPs with instruction from KHANA’s research team to make sure that the right participants were approached for this study. Participants were again screened at the interview sites to ensure the eligibility.

Table 2: Summary of sample selection METHODS

RESPONDENTS

FGD IDI KII

PLANNED

3 activities*4 provinces*8 persons 3 activities*4 provinces*2 persons 4 provinces *2 persons

TOTAL

ATTENDED

96 24 8

71 25 9

128

105

Abbreviations: FGD, focus group discussion; IDI, in-depth interview; KII; key informant interview. Table 3 presents the total number of participants who were eligible to participate in this study. There were fewer participants in some FGDs as some of them were either too sick to join or too busy with their daily household chores. In Kampong Chhnang, FGD on skill trainings was not done because there were only a few beneficiaries who attended skill

trainings in town. The team in general was able to interview 105 out of 128 beneficiaries selected, which constituted about 82 percent of the original plan. For IDI and KII, the team was able to interview all participants as planned (34 persons). However, only 71 participants out of the 91 expected samples were able to participate in FGDs.

Table 3: Summary of number of participants attended FGD, IDI, and KII by province METHODS FGD IDI KII

TOTAL

KAMPONG CHAM 3 groups (5, 6, 4) 6 persons 2 persons

23

KAMPONG CHHNANG 2 groups (10, 6 ) 6 persons 2 persons

24

KAMPONG SPEU

BATTAMBANG

3 groups (7, 10, 5) 6 persons 2 persons

3 groups (6, 7, 5) 7 persons 3 persons

30

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3.2 TOOL DEVELOPMENT Three separate study tools for KII, IDI, and FGD were developed based on the existing tools from previous studies [4, 5] and in consultation with the livelihoods program team. Each tool consisted of three main sections. The three study tools mainly assessed the services rendered by KHANA livelihoods program staff and its IPs, household living conditions after

receiving supports, current health status of the beneficiaries, as well as barriers faced by KHANA/IPs and beneficiaries. The study tools were developed in English, translated to Khmer, and then pre-tested with the data collectors to ensure that the wording and content were culturally suitable and understandable. Inputs from the pretest were used to revise and refine the study tools before data collection began.


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3.3 DATA COLLECTION TRAINING AND FIELDWORK Four interviewers were hired to conduct KII, IDI, and FGD. Two interviewers were freelancers with many years of experience collecting various types of data in the field; another two were university students who had engaged in a few qualitative studies before joining this study. The two experienced interviewers were assigned to conduct FGD while simultaneously supporting the other two. Before field work began, the four interviewers were required to participate in a one-day training arranged by KHANA’s research unit. The main objective of this training was to make sure that all of the interviewers understood the content of the study. This was to make sure that they could capture the important points of the programs during their interviews. Interviewers were encouraged to go through the study protocol and study tools beforehand, in order to allow time for clarification of any unclear points with the research team during the training day. The training began with an overview of study objectives and was followed by going over each individual study tool. The research team went through each study tool in detail and addressed all questions that were not clear. Additional time was spent on interview techniques, informed consent, and confidentiality assurance. After all sessions were covered, mock interviews were conducted to ensure that interviewers followed the same procedures and standards, so that the integrity and quality of the collected data were maintained. Regular review sessions with the interviewers were conducted during the study period to review progress and communicate any problems related to the data collection.

3.4 DATA COLLECTION AND MANAGEMENT Data collection began a day after the training was conducted. The four interviewers together with two staff from research unit spent seven days regardless of weekend in the four identified study sites. To ensure confidentiality, participants were informed to gather at pagodas, KHANA/IP offices, or IP

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livelihoods staff’s houses. Before interviews began, participants were led to specific locations around the compound that were selected in order to make sure that their communications were not heard, and that the beneficiaries felt at ease expressing their views. A few interviews were done at the interviewees’ houses because the data collection team arrived in the evening. Beneficiaries were first informed about the objectives of the study and asked whether they agreed to provide the information. Interviews began right after informed consent was obtained. Including informed consent process, interviewers took approximately one hour for KII and IDI, and two hours for FGD. Eleven university students, who were trained on qualitative studies, were hired to transcribe the interviews from audio files to text files. In total, there were 44 transcribed files from the three livelihoods programs, with 40 to 50 pages each on average. All files were organized by types of interviews: KII, IDI, and FGD and coded into three main categories: VSL, ST, and CG. The information was then divided into sub-categories and coded according to guided questions developed for each interview. NVivo was used to group the codes, which were subsequently exported into word files for analyses. The final word files consisted of three KII, three IDI, and three FGD files. The data were then analyzed based on the objectives which were outlined above. The first section focused on the process of each livelihoods activity, followed by the SWOT analysis of each livelihoods programs.

3.5 ETHICAL CONSIDERATIONS This study was an internal program review. It was not submitted to the National Ethics Committee for Health Research (NECHR) at the Ministry of Health (MoH) for approval. Anonymity and confidentiality of all study participants were strictly maintained throughout the study. Names of study participants were not recorded during the interviews. All collected questionnaires and field notes were kept at the research department under the responsibility of the research team. Participation in this study was voluntary, and all participants were informed of their right to refuse to participate and to stop the interview at any time.


4. FINDINGS AND DISCUSSION

The livelihoods programs of KHANA involved three separate programs: VSL, ST, and CG. Each of these programs has their own set of processes, strengths, and weaknesses within the areas that they were implemented. This portion of the report is to showcase all of these points for each individual livelihoods program. It is important to note that an individual could have been a part of all three livelihoods programs or just one, depending on what resources they had heard of, what province they lived in, and what they felt would be most beneficial for them. Therefore, beneficiaries were interviewed according to the livelihoods programs they participated, and IP livelihoods staff selected for KII were interviewed all three livelihoods programs.

4.1 VILLAGE SAVING AND LOAN (VSL) VSL program was included as part of KHANA livelihoods programs at the end of 2010. Over the past two years of its implementation, this program has received substantial attention from donors as well as villagers who were not under KHANA’s program interventions. The following section discusses the process of this project, followed by the SWOT analysis.

4.1.1 PROCESS OF VILLAGE SAVING AND LOAN (VSL) All participants attended KII, IDI, and FGD were


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generally asked to report the process of VSL to access the information flow from KHANA head office to IPs and from IPs to the beneficiaries. From the three interview tools, most participants noted that information about VSL was circulated to village households through IPs during education sessions or self-help group meetings. IPs and village households who wanted to start this project were invited to join the VSL trainings, which were offered by KHANA livelihood program officers. The VSL trainings for IPs and village households were done separately due to knowledge gap. VSLs were started with IPs support that eventually phased out in order to make the group self-sustaining (see Figure 1). Each VSL team was advised to create rules and regulations to avoid conflict which could have impacted the flow of work in the group. VSL groups were generally formed right after trainings. Group size varied, ranging from 10 to 30 people, but there was no requirement other than those imposed by the group itself. Members of the VSL elected a

chair, treasurer, and two other committee members to run the monthly meetings, manage the savings and borrowing book, and secure the safe by holding the safe box. The safe keeper and key holders were different people; it was secured with three locks and three different members were selected to hold those keys. The cycle of each VSL committee was one year. Each member of the VSL put in any amount between 3,000 KHR ($0.75 USD) to 5,000 KHR per month ($1.25 USD), and all loans had to be paid back within three months. Members could purchase more shares but could only borrow three times larger than their share amount. If an individual requested more money, the committee discussed about whether the individual had the ability to pay the loan back, and then granted or denied the request based on that discussion. Interest rates also varied from group to group; anywhere from one to five percent per month was common.

Figure 1: Process of village saving and loan Circulation of VSL from livelihoods officer

Implementing partners

Beneficiaries

Group formation

VSL training

In KII with IP livelihoods staff, these groups were supported by an IP for the first year in order to ensure that the money was being handled and calculated correctly. After the initial year, the VSL members were in charge of calculating their principles and interest rates for the amount of savings that were in place. Training for how to run a VSL was initially difficult to start up as mentioned by participants who attended FGD. There was generally low knowledge among beneficiaries of why the VSL were in place, but everything improved with clarification during trainings. A training took about one and a half days to complete, and most people found that the procedure was generally easy to follow and understand.

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4.1.2 SWOT ANALYSIS FOR VILLAGE SAVING AND LOAN (VSL) Strengths There were many observed strengths for the VSL program from the majority of the study participants. Within the monthly meetings, the group discussed what their issues were and why they needed the money that they were borrowing. These discussions were not limited to strictly monetary topics, thus everyone involved in the VSL gained a group of allies with whom they could discuss their problems. In addition, IP livelihoods staff who facilitated the


monthly meeting were able to provide additional advices to VSL group members on top of supporting interest calculation. This was reflected in an IDI with a beneficiary who said, “During the meeting, IP livelihoods staff explained me to relieve anxiety, do not think to commit suicide, forget what others had thought about me, and live happily with my family.” On the other hand, participants from FGD indicated that this monthly meeting provided them additional information on crops growing, ART, traditional remedies for some diseases, and household hygiene tips, which were very essential for their families. An interviewee who participated in IDI said, “After talking about saving, IP livelihoods staff asked whether we had taken ART regularly this month. In addition, they reminded us to do blood test regularly and asked about our CD4 counts.” The loans from VSL team were used for numerous reasons, including paying for their children to go to school, in case of emergencies, health expenses,

expanding their businesses, buying staple food, and travelling expenses to pre-ART/ART sites. The process to get loan was fast, as it was only among the group members, and no collateral was required. According to beneficiaries who attended IDI, the interest rates offered in the VSL team were much lower than micro finance agencies and money lenders, allowing the members to make smart financial decisions that enabled them to enhance their financial needs without leading them into debt. With this low interest rate, some beneficiaries reported that villagers wanted to join their VSL team. Beneficiaries appreciated the fact that they had a safety net of money, a growing amount of funds, and a group that took their personal lives into account. And because most people paid their dues and loans back on time, the group had reported no internal conflict, and foresees further positive associations with the project. In FGD, one participant mentioned that, “Now we started to admire each other for creating this saving group. We could borrow from


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the group without having to run to others for money. Sometimes, they did not lend us money as they did not know us well.” With less financial constraints, some beneficiaries who joined IDI mentioned that domestic violence in their families was somehow reduced.

do not learn how to do these tasks themselves, then they will always require the use of an official, thus preventing the program from becoming long term and sustainable in their community.

Weaknesses

There were several opportunities afforded to people who had become a part of a VSL program. They could now borrow money to buy more piglets or hens to raise around their household compounds, buy the materials they would need to grow rice or vegetables, or just help their families get to school. The majority of the beneficiaries who joined IDI and FGD said that they felt healthier and mentally secured because they knew that they had access to the money they would need to pay for travelling to their preferred ART site. And the fact that PLHIV were sharing in community activities involving the rest of the village members helped to take away some of the stigma associated with the disease. Such opportunities have helped PLHIV feel more integrated in their villages, while also helped educate other people about HIV and how it was transmitted. According to beneficiaries who attended IDI, discrimination towards them and their families was significantly reduced after education efforts from the KHANA/IP took place. One beneficiary said that, “He now could participate in ceremonies in the village and share tables with others. They were not allowed to do so before.” Some beneficiaries mentioned that if people did not allow them to go to their house, they just called them. KHANA’s beneficiaries now know how to respond to people in their community. So, the progress made has been apparent and widespread. In FGD, one participant revealed that, “joining this VSL group allowed me to know more people, especially people who lived further from my house. Slowly, I got close to them and our relationship improved.”

While there were a number of strengths to this program, there were also several weaknesses reported. Most beneficiaries said each monthly meeting was held in a different location, so as to allow the meeting places to be closer to certain individual’s houses. Sometimes, depending on how far that meeting place was during a certain month, the meetings might have taken a long time to start, because the group waited for everyone to arrive. Due to this, some people could not join monthly meeting and instead sent their shares through other members who live nearby. In KII, IP livelihoods staff revealed that group members were likely to show up late during the harvest season. Another weakness stated was that the money borrowed could not make any significant changes to the beneficiaries’ life. Several beneficiaries joined IDI said that they had to get money from several sources as the amount borrowed from VSL team was too small to buy grocery stock for their shops or their crop lands. In this instance, they had to pay higher interest rate for loans outside VSL team. This association was reflected through an FGD with a beneficiary who said, “The demand was high; the amount that I could borrow from this group was not enough; so, I turned to private lender for additional money.” Another key weakness was that the meetings and calculations for interest payments and principles were majorly completed or supported by the IP livelihoods staff which took away from the beneficiaries the opportunity to learn how to operate a VSL on their own. While this was not an intended purpose of the initial program, it was reported as happening quite often from the majority of the study participants. The VSL members did not show a strong commitment to take this responsibility. Participants from FGD said that they wanted IP livelihoods staff to support them after the first year as they were not clear on how to calculate the interest rate. However, if they 18

Opportunities

Threats There were no major threats reported during the interviews with beneficiaries or IP livelihoods staff, except a small proportion of the beneficiaries who claimed that they did not yield any profit from their hard work and some expenses related to what they borrowed from the VSL were considered a waste.


Despite experiencing unexpected difficulties, all people involved still managed to pay back their loans and maintain the group’s reputation. There were also environmental factors that heavily dictated whether or not someone would be able to pay back their loans. As many of these members were farmers, droughts or rains were indicative of their ability to make money. In rainy season, many VSL members were late to their meetings because they were busy trying to get their fields in line to reap the most benefits. Or, if there were a drought, then they would not make enough money to pay their loans back. While these kinds of problems were internally solved, a laid out plan for exceptional cases should be discussed as part of the VSL implementation. In conclusion, the VSL program seemed to be very successful. It encouraged people to save money, which was a large part of the intent of the program. It helped encourage people to talk more openly about their issues at home and take more initiatives in solving their own problems. The only true weakness was that it might not be a self-sustaining venture if it is not taken over by the local members. If the IP livelihoods staff continue to run and calculate the principles and interest rates of these VSL, then the beneficiaries will not learn how to do so themselves.

This could harm the program’s longevity potential and should thus be addressed before continuing this endeavor. In addition, beneficiaries should participate in the monthly meeting regularly, in order to know what the status of the issues and team progress are, rather than getting that information from their relatives or neighbors. A fleshed out plan for how to handle exceptional cases would be a good addition to the implementation strategies, in order to prevent future problems from occurring.

4.2 SKILL TRAINING (ST) Skill training program was included in KHANA livelihoods program at the same time as VSL program. This training is considered crucial as it was designed to support beneficiaries who wanted to improve their skills related to their current work or those who wanted to start new business but lacked of basic skills.

4.2.1 PROCESS OF SKILL TRAINING (ST) The summary of the process of receiving skill trainings was taken from FGD and IDI with beneficiaries as


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well as KII with a KHANA livelihoods officer and IP livelihoods staff. According to the KHANA livelihoods offer, there were certain selection criteria for this skill training. It required that applicants had to be PLHIV, joined VSL team, and were willing to share this knowledge to others in their village. However, the selection criteria varied according to types of trainings and household situation. For example, applicants who were selected to participate in fish raising trainings had to at least have a small fish pond at their home to be able to utilize the skills learnt. Beside, IP livelihoods staff had to determine which population was the most vulnerable. This was to make sure that the available resources were majorly used on this group. After this selection process, applicants registered with just their names and type of trainings desired with the IP livelihoods staff. Once this determination had taken place, the groups were sent to the KLCC in Kampong Chhnang, where they were trained on the requested subjects. There were several different skill types offered at the center, including animal husbandry, fish raising, vegetable or rice growing, and dessert or food making. Participants were supported by KHANA for the whole trainings, including a travelling fee to the center. Trainings lasted two to three days, depending on the topic area. The type of training each individual requested determined what kind of financial support they received. Each training consisted of 20 to 30 participants. On the first day of training, the trainers taught about techniques using Power Point and oral presentations, as some attendants were not literate. If there were any questions throughout the process, participants were allowed to interrupt and ask. The subsequent days were used for practicing the skills.

4.2.2 SWOT ANALYSIS FOR SKILL TRAINING (ST) Strengths There are several strengths that could be associated with the ST program. For one, the members learned new skills that were applicable to their immediate lives, such as the need for vaccinating their animals or using mosquito nets. One beneficiary attended IDI revealed that knowledge on vaccination helped reduce animal deaths in his farm, and he was

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able to identify sick chickens and separated them on time. Some were taught about the benefits of composting over chemical fertilizers, thus making their outputs larger and healthier for consumption. Chicken farmers were taught to make their chicken feed instead of buying chemical food. Cutting down on expenses that were used to make the output helped each member make more money overall. As noted from FGD, the majority of the participants used this composing knowledge after attending trainings as it was relatively cheap and easy to apply. And, if there were any hints or teachings that they might have forgotten, the take home documents that were provided at the trainings helped people remember what they were taught. The majority of the beneficiaries said that the training materials given were not difficult to understand. Some people even shared their new found knowledge with other village members in monthly meetings, making skill trainings a resource that not everyone has to attend in order to benefit from it.

Weaknesses There were some problems associated with the ST program. Some participants, especially from FGD, said that the distance to the livelihoods center was too far from home for their liking. They were uncomfortable being in a new environment, but they admitted that they found a way to make it work. Some were noted as saying they had a difficult time finding food that they preferred as there was no local market around. Food was provided during the trainings, but some did not like it. The center was also far from the city, so there was no electricity. This was particularly problematic during the very hot seasons. The travelling fee given was not enough for those who travelled from provinces which were very far from the center. And one of the biggest problems was that there were only a few check-ups after the trainings. This was illustrated through a KII with KLLC manager who noted that, “He was able to do a few check-ups nearby his working area because he was busy with the center core work and the preparation for the next trainings.” So there was no way to tell if the people were able to properly identify quality inputs to produce their desired outputs. Since there was no check-up system, if a person was not able


the center also helped several other beneficiaries within the same skill training area to exchange experiences that could help cultivate alliances and positive experiences with the program. And trainees learned new techniques that might help them gain more outputs than their previous techniques were. Some participants who successfully used this skill to support their family said that their families were more financially stable and had more food to eat. Most beneficiaries mentioned about raising chickens which took shorter time than before they attended the skill trainings. Further, not all of their children were able to finish high school, but at least younger children were able to attend primary and secondary school. In addition, their children did not have to skip classes to help them earn money to support the family. In DID, a participant said that “I just sold one or two chickens if my children needed money to go to school.”

Threats

to come up with the initial start-up costs associated with their new skills, then they would not have been able to put their new skills to use once they got back to their own provinces. This was illustrated in a FGD with a participant who said “I understood what they taught me at the KLLC, but I did not have land to practice these skills. Now, I almost forgot what I had learnt.”

Opportunities This program definitely provided a wide array of opportunities to improve family financial situations by giving members of the households key skills that could help them make money via business opportunities and expansions. The fact that beneficiaries from other provinces congregate at

During FGD, some beneficiaries reported that their chemical free vegetables did not sell well at the market because they did not look as good as the other local vegetables. Their prices ended up being lower than other vegetables of the same types. People tended to pick what look good, rather than giving value to their efforts of growing vegetables without using pesticides. So there was a large difference between what was marketable and what was taught as a skill to be used at home. Also, the fact that the training center was so far away from home made it particularly difficult for women to participate. Since there are a large number of women who are the primary contributors to their family’s income, it is important that these resources be made available to them as well. One of the main suggestions given was that trainings should take place in each province rather than at the training center. That way more people could attend, especially women who are the primary contributors to their family’s income, and the travelling cost and food for trainees would no longer be a concern. The types of trainings available should also be expanded, so as to allow people with a different set of skills find a new way to integrate these skills into their


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line of work. Adhering to these recommendations will help PLHIV work in these kinds of jobs, rather than at a factory. If PLHIV have their own business or grow their own crops, it would allow them to take time off one day a month they need to go get their ART, whereas a job in a factory would mean they would have to lose a day of pay. The idea of a revolving center, that is set up in different areas in order to accommodate other people’s needs with the location has also been discussed. And, based on these findings, it is an idea that is worth looking into further.

4.3 CASH GRANT (CG) Cash grant was started since 2003 but in a very small scale. Basically, beneficiaries received 15-50 US dollars for IGAs. When the grant was increased up to 120 US dollars at the end of 2010, the procedure to get grant were a bit more complex for beneficiaries with limited knowledge. Therefore, supports from IP livelihoods staff and group appointed leaders are needed to complete the process.

4.3.1 PROCESS OF CASH GRANT (CG) The process to receive grant was a bit complex as noted by the majority of the study participants during FGD and IDI. The CG process started with informing members of the participating provinces that it was available. IP livelihoods staff circulated information about this grant through monthly meeting or asked each VSL group in order to see if anyone was interested in using the funds to expand their business, which could help lead to reducing financial burden for their family. All members who were interested in receiving a CG formed a group, elected a group appointed leader, and filled out the paperwork together. Beneficiaries who did not want to form a group could apply individually with support from IP livelihoods staff. If a need for the grant was agreed upon, the beneficiaries provided IP livelihoods staff with their family book and state identification card, and they filled out the paper work together. The funds were made available to the beneficiaries within the next few weeks. The requirements surrounding the CG approval included the beneficiary coming up with a fleshed

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out business plan, including a budget. After this plan and the paperwork were completed, they were given to IP livelihoods staff. Their fund requests were considered based on how much money was available to give them, and how in depth their budget requests were. The IP livelihoods staff visit was also used to assess whether the people would use the funds appropriately, which was followed up on afterward. The amount given ranged from 50 to120 US dollars per applicant and was not expected to be paid back as this was a grant.

4.3.2 SWOT ANALYSIS OF CASH GRANT (CG) Strengths According to IP likelihood staff who were invited for KII, beneficiaries who were denied could reapply for this grant again with a better business plan, thus allowing them to still have a chance at receiving the grants. Many beneficiaries revealed that the income generated from this grant, despite its small amount, helped support their children schooling fee and allowed them to consume more meat, buy appropriate clothes for their family members, and travel to pre-ART/ART site as scheduled. Beneficiaries participated in FGD mentioned that their statuses in the village were enhanced after receiving the funds. Less discrimination was faced, as more people in the village understood what PLHIV had and how the virus was transmitted, thanks to the presence of the KHANA/IPs that were handing out the CG. In FGD, a participant mentioned that “Since I had shares in the group, people in his village respected me more, and I could express my views in the community.”

Weaknesses The majority of the participants raised concerns regarding the amount of the CG. Since grants were small, there was not much they could take advantage of. In addition, not all borrowers received skill trainings, and some did not use this grant effectively due to insufficient capital and skills. The major concerns raised during FGD and IDI were


about the form itself, as some people might not be able to read or understand them fully without help from IP livelihoods staff or group appointed leaders. Most applicants were confused about the terms of the grant, whether they were supposed to pay it back, and whether it was separate from the VSL. While most of the beneficiaries were chosen from the VSL group, not all of them were. And the payback options were rules imposed by the CG group themselves, so as to make the group self-sustaining, rather than as a stipulation for receiving the funds. Many beneficiaries also misunderstood how the money was granted, as the only requirement was a drawn out sound business plan. During IDI, some beneficiaries claimed that they had to have their papers signed off by the village chief, which was explicitly not a part of the process. They sometimes just signed the required documents without fully knowing what were written in there. As observed in KII with IP livelihoods staff and IDI and FGD with beneficiaries, the terms of CG circulated from KHANA/IPs to beneficiaries was not clear from the beginning. The majority of the beneficiaries just treated this as loans not grants. Generally, they understood that they had to pay this money back despite facing difficulties.

Opportunities People who used this grant did so to expand their businesses: buying more animals, raising more fish, buying additional fertilizer, or creating a new business entirely. Since the CG amount was rather small, other sources needed to be used for larger endeavors. However, this grant allowed the borrowers to have some of their money without additional interest rates, which would not have occurred had they borrowed that money from the VSL or a micro finance institute. And, since people expanded their businesses, they were also expanding the resources available for the village as a whole. In IDI and FGD, the majority of the beneficiaries mentioned that they did not have to worry much about their daily food consumption and children schooling fee.

Threats There were many threats to this program. During IDI, some beneficiaries said that they bought sick piglets or hens, which caused them to not make a profit out of their investment. In return, they had to work harder to pay back the money they considered a loan. However, since paying back the CG was not a part of its issuance, it is clear that one of the largest threats to this program is actually the recognition of its separate processes and stipulations. There seemed to be a clear source of confusion for the beneficiaries, and future endeavors with this program need to clear those up. Most beneficiaries who attended IDI reported the involvement of the village chief, which was never a part of KHANA’s ideals for this program. So it is clear that if this were to be continued, many factors need to be reevaluated before reissuing any more money. There have been many suggestions regarding what could make the CG program better. The main one was that the amount should be raised, as the amounts being given now are considered not enough to render the kind of results that are being expected. The fact that this is not a loan, but a grant, should be made clear, so as to avoid having someone pay money that was intended to not be given back. All grantees should receive skill trainings to make better use of this grant. Without proper skills, beneficiaries sometimes bought sick animals which imposed more difficulties to their family. And retraining of IPs livelihoods staff is heavily recommended, as there were several other sources of confusion for this program. If IP livelihoods staff were told to make sure that there is a clear distinction between this program and the many other micro financing programs that these people obviously see, then it is much more likely that everyone involved would be able to take advantage of the opportunity much better. KHANA livelihoods program has to ensure that return of the loan reported by the majority of the beneficiaries is not imposed by KHANA. Roles and responsibilities of KHANA/IPs should be reiterated as reported in KII, IP livelihoods staff did not only provide support but also purchased shares from VSL teams. Therefore, the chance to get grant are not equally given.


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5. CONCLUSION There are many aspects associated with the livelihoods programs discussed in this study. Out of all of them, the VSL seems to be the most successful and have the least amount of weaknesses associated with it. The VSL allows people engaged in it to share their struggles with their village peers, ask for help, get the money they need for emergencies, and ultimately, make their lives healthier, happier, and more financially secured. While all of the livelihoods programs were geared towards this goal, the VSL seemed to accomplish this task the best. ST helped people gain new skills, but they could only do so at specified locations, which was hard for some beneficiaries to accomplish. The CG were good for people who utilized the money wisely, but some beneficiaries claimed that the money was not enough to sustain a solid backing for any real business endeavor, and most were confused as to what requirements were actually needed to get the grant in the first place.

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6. RECOMMENDATIONS

These programs should be continued because they have helped a number of beneficiaries become more financially sensitive and secured. However, if that is the case, then several measures should be put into place in order to ensure that the programs help the beneficiaries participating in them as much as possible. The VSL members should learn how to calculate their own interest rates and principles, so as to lessen the effect that IP livelihoods staff have on their meetings. The demonstrating center for skill trainings should be provincially based, and KLLC staff should ensure that the trainings they are offering are relevant to the populations that are completing them. And the CG process should be looked over to make sure that the money given is understood as a grant, and that all confusion around the terms of agreement for receiving the grant are made clear. This will be most possible by retraining the IP livelihoods staff in charge of informing beneficiaries about the CG. If all of the recommendations from these participants are taken into account, there is no reason that these programs could not be expanded to become much more fulfilling and encompassing of the PLHIV and OVC’s needs than they already are.


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REFERENCES

1. H elen Keller International (HKI): Homestead food production program. Phnom Penh, Cambodia: HKI; 2012. 2. M azzeo J, DePaul U: Triple treat in rural Zimbabwe: How drought, HIV/AIDS and poverty endanger food security. Anthropology News 2008. 3. CARE: Household livelihood security through an HIV and AIDS lens: Uncovering and Influencing the two-way link. Geneva, Switzerland: CARE; 2006. 4. E valuation of microfinance pilot project for HIV affected families. Phnom Penh, Cambodia: KHANA; 2008. 5. K HANA network household economic livelihoods survey analysis. Phnom Penh, Cambodia: KHANA; 2010. 6. M id-term review of KHANA’s strategic plan 2011 – 2015. Phnom Penh, Cambodia: KHANA; 2013.

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ANNEX: SURVEY TOOLS

DISCUSSION GUIDE FOCUS GROUP DISCUSSION (FGD) Introduction I am ____________________ from KHANA. We are conducting a survey for KHANA livelihoods program (LP) in order to know the impact of KHANA/LP on beneficiaries. Thus, we would like to seek cooperation from you. The information given from you will help KHANA/LP to plan and improve its services. The survey will take lesser than 60 minutes. A digital recorder will record what is said so that we have accurate information of your views. Your name will not be recorded and all information given from you will be kept secret. Participation in this survey is voluntary. However, we hope that you will participate in this survey because your views are important. Are you willing to be interviewed?

Yes

No

Objective 2: To assess each livelihood program component in terms of strengths, weaknesses Objective 3: To study beneficiaries’ current living conditions and health status Location: Village…………………………Commune………………………………… District…………………………Province…………………………………..

Occupations: CODE

SEX

OCCUPATION

CODE

SEX

OCCUPATION


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VILLAGE SAVING AND LOAN (VSL) (The points below only to guide participants in case interviewees do not provide enough information. Please let the interviewees talk first and shape them with these guided questions)

Strengths • Advantage in participation in this program • T raining modules are simple and easy to understand/trainers explained clearly • G roup were created with less difficulty and less problems occurred in the group • Interest is low, the procedure is easy, save time • IPs or CSV provide support when ask

Weaknesses • A re there any loopholes or potential problem in the program? • T he demonstrations during the training session are not clear/cannot remember • V SL group formed encountered many problems/no support from IPs or CSV • T he monthly/quarterly group discussion is not so useful/member tend to discuss other issues/members argue more often during the meeting

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• Member do not pay interest on time • T he saving plus borrowing in the group are so small, cannot do anything so they have to borrow from MFI with higher interest rate.

Opportunities • Have some saving/have own business • H ave more skills and confident/learn from other group members • C an afford to buy meat/go see health care providers/health status better than before/ able to send kids to school and fix house • E xpand small businesses/vegetable and orchids’ gardens • F amilies have enough food to eat in the past 12 months/less worry about family food security in the future • Have more hope for the future of the family

Threats • Group will end before the due date • Member will take money away

SKILL TRAININGS Strengths • Advantage in participation in this program

• N o new business/agricultural activities have been created

• E xplanation was clear/step by step/easy to understand

• L iving status remains the same/nothing has changed since the beginning till now/ lack of money to buy food/ cannot go see health care providers/health condition has not been improved/ no ability to send kids to school

• A dded up to the existing skill/leant something new • S pent less time and input/ received more productivity


• N o enrolment fee/free of charge for study materials • T he training topic is of interest and very useful.

Weaknesses • A re there any loopholes or potential problem in the program? • H ad to travel to the centers to attend training/ far from home

Threats • Do not have market for products • Outputs are based on weather condition • Do not have enough money to buy inputs • Less land to extend their work

SMALL CASH GRANTS Strengths

• In class discussion and demonstration at the garden were too short/did not understand the procedure clearly

• H elped start up or expand small business/ agriculture activities

• Have not applied skill after training

• T raining was given before the grant was delivered

• N o technical support from IP/CSV after training was completed

• Procedure is easy, not complicated, fast,

• L iving status remains the same/nothing has changed since the beginning till now/ lack of money to buy food/ cannot go see health care providers/health condition has not been improved/ no ability to send kids to school

Opportunities • I mproved productivity with new skill/Increased family income • C an afford to buy meat/go see health care providers/health status better than before/ able to send kids to school and fix house • E xpand small businesses/vegetable and orchids’ gardens • F amilies have enough food to eat in the past 12 months/less worry about family food security in the future

• Share knowledge with others • Illiterate people is eligible to apply for grant

Weaknesses • A re there any loopholes or potential problems in the program? • The amount is too little/ could not do much • It is not used productively. • No technical support from IP/CSV • T he procedure is so complicated and takes long time to receive grant.

Opportunities • H elp their families to sustain during difficult time

• Have more hope for the future of the family


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• C an afford to buy meat/go see health care providers/health status better than before/ able to send kids to school and fix house • E xpand small businesses/vegetable and orchids’ gardens • F amilies have enough food to eat in the past 12 months/less worry about family food security in the future

Threats • Land is too small, cannot produce much • Outputs depend on weather (rainfed) • No market for outputs • Health issue/ natural shock

• Have more hope for the future of the family

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DISCUSSION GUIDE KEY INFORMANT INTERVIEW (KII) Introduction I am ____________________ from KHANA. We are conducting a survey for KHANA/livelihood program (LP) in order to know the effect of the services they have provided to their beneficiaries. Thus, we would like to seek cooperation from you. The information given from you will help KHANA/LP to plan and improve its services. The survey will approximately take lesser than 60 minutes. A digital recorder will record what is said so that we have accurate information of your views. Your name will not be recorded and all information given from you will be kept secret. Participation in this survey is voluntary. However, we hope that you will participate in this survey because your views are important.

PS/IP/CSV ROLE OF PS/IP/CSV IN EACH PROGRAM VILLAGE SAVING AND LOAN 1. W hen did you participate in this livelihood program? 2. When was the program started? 3. C an you describe the whole process of VSL? When was it established? How to choose participants? Number of training conducted? Number of participants in each training? Number of women? How long was the training?) 4. H ow long did it take to create a VSL group after training? 5. D id IP/CSV help in pre, during and post-VSL group establishment?

Are you willing to be interviewed?

Yes

No

Objective 1: To document the process of each program (VSL, small cash grant, skill trainings) Objective 2: To assess each livelihood program component in terms of strengths, weaknesses

6. H ow many villages have you worked with? Number of groups initiated per village? Number of members per group? 7. Any groups terminated? Why? 8. Were there members who quitted? Why? 9. H ow long have the technical support lasted? What support have you provided?Were you able to solve all the problems arising?

Location: Village………………………………………… Commune…………………………………….. District………………………………………… Province…………………………………….... Age……………………..……..…..………….. Sex:…………………………………………... Occupations:…………………………………….

10. Are there people who are eligible but do not participate? What are the reasons? Any solution? 11. Do you think this VSL program benefit household in your village? (Health, livelihood, education, social relation…) 12. Have you tracked their progress?How? 13. What are the challenges in operating/ supporting this program? How did you solve? 14. What are the strategies to sustain/improve this program?


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SKILL TRAINING

SMALL CASH GRANT

1. C an you describe the whole training process? When was it established? How to choose participants? Number of trainings conducted? Number of participants in each training? Number of women? How long was the training?)

1. C an you describe the whole process of a small grant? When was it established? How to choose grantees?

2. H ow do you decide what training should be conducted?

3. H ave they received training after getting grant?

3. H ow was the training taken place? (Group discussion, demonstration, field practice, etc…)

4. How many people have applied for the grant?

4. W hat were the challenges encountered during the trainings?

2. D o you provide the training to those who were granted?

5. How many people have been offered the grant? 6. How many women?

5. Do you think this training benefits them? (Economic livelihood, health, social relation…)

7. Why did some of them fail to receive grant?

6. H ave the trainees applied what they had learnt?

9. H ave you contacted them or they contacted you after getting grant?

7. H ave they contacted you or you contacted them after the training? Why?

10. Do you think this grant benefits grantees? In what way?

8. W hat are the major obstacles for this training program?

11. How to improve this program in the future?

8. How to ensure that grant is used productively?

9. How to tackle? 10. What is the strategy to sustain this program and to make it more productive to the participants?

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DISCUSSION GUIDE IN-DEPTH INTERVIEW (IDI) I am ____________________ from KHANA. We are conducting a survey for KHANA/livelihood program (LP) in order to know the effect of the services they have provided to their beneficiaries. Thus, we would like to seek cooperation from you. The information given from you will help KHANA/LP to plan and improve its services. The survey will approximately take lesser than 60 minutes. A digital recorder will record what is said so that we have accurate information of your views. Your name will not be recorded and all information given from you will be kept secret. Participation in this survey is voluntary. However, we hope that you will participate in this survey because your views are important. Are you willing to be interviewed?

Yes

No

Objective 2: To assess each livelihood program component in terms of strengths, weaknesses Objective 3: To study beneficiaries’ current living conditions and health status

GENERAL INFORMATION (VSL, CASH GRANT, AND SKILL TRAINING) Province: Kompong Chan, Kompong Speu, Kompong Chnang, BTB District:………………………….….……. Village…………………………..….….…. Sex of interviewee: M or F Age:…………………………….….….…. Marital status: Married/ Widow/ Divorced/ Single Education:………………………….….…. Career:..…………………………….….… Interviewer observes what the household have Type of house…………………………………….. ( Hatch/ Tile/ Brick) His/Her health…………………………………….. ( Weak/ Normal/ Energetic)

LIVING CONDITION (VSL, CASH GRANT, AND SKILL TRAINING) (IDI) A. How many persons in your household? B. 18 and over…………………………. 17 and younger…………………….. C. For school-aged children, how many are in school……………how many are not in school…….…………. D. In case, the children dropped out, what grade? Why? E. How much your household spent on school expenses for this year compare to what you spent last years? Decreased/ stayed the same/ increase: Why? F. H ousehold income in the past 12 months? Decreased/Stayed the same/Increased? Why? How to solve if you have shortage problem? G. During the past 12 months, do you experience food shortage? If yes, how many months? How to solve this issue? H. During the past 12 months or less, do you extend or create new business (Agriculture/ small business) activities? I. D uring the last 12 months, were any repairs, improvements or additions made to your homeor buy something new?

HEALTH STATUS (VSL, SMALL CASH GRANT, AND SKILL TRAININGS) A. How is your health? B. How about your family members? C. Did you go see health care provider in your region in the past month? Symptom?


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a. How much you paid?

10. How much money did you save per cycle?

b. Where did you get the money?

11. How did you afford this amount of saving per month?

D. Are you on ART? Where did you get it? E. Are you taking ART regularly and consistently? Why? F. D id you have any negative experiences when people know that you have HIV/AIDs?

VILLAGE SAVING AND LOAN (VSL) 1. How were you aware of the VSL program? 2. W hat is your role? When did you participate in VSL training program? 3. W hat do you understand about this program/ is it clear? 4. When was your VSL group started? 5. H ow many members in your VSL group? Number of male/female? Married/single/ widow/ 6. How many PLHIV? OVC?Who are they? 7. H ow often does your group have meeting? How do you fix the date of the meeting? Who have the authority to decide? What was the meeting about? 8. H ow much time did you spend on each meeting? Was the discussion useful? Did you express your opinion in the discussion or others talked more? Why? 9. How many cycle has you attended?

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12. Have you borrowed from the group? How much did you pay the interest per month? 13. What did you do with this money (saving/ additional borrowed money)? 14. How did you manage to pay back? Tell me the process? 15. How much can a member in the group borrow? 16. What challenges you faced in your VSL group or during training? (internal conflict/ shortage of cash/ in need to borrow more/ less saving) 17. How were those solved? Who solved those issues? 18. Do you understand this VSL procedure clearly? 19. Did IP’s staff help you and your group? How? 20. Now do you need support from IP staff or not? 21. What did you benefit from the VSL training and VSL group? 22. What/how the program should be improved further? 23. Have you borrowed from other sources (MFI)? 24. Have you participated in other programs with other NGOs in your village beside VSL program?


SKILL TRAINING 1. How to be able to receive the training?

SMALL CASH GRANT (IDI) 1. H ow did you get this cash grant? How many times have you applied to get his grant?

2. How many skill trainings have you attended? 2. What were the challenges? 3. What were the trainings about? 4. How many people participated?

3. H ave you received some skill trainings before receiving this grant?

5. How long did it take in average?

4. How much did youreceive?

6. Were you able to fully participate? If not, why?

5. How was the cash grant used for?

7. H ow was it carried out? (in class and at the field)

6. D id this grant help you and your family? Have there any changes in your household (Living status, health, education, etc….)? If not, why?

8. D o you like the proposed methods in this training? Why?

7. W ithout this cash grant, what would you do when you are in need of financial support?

9. Was it what you like to learn for your living? 8. How do you think about the program? 10. Have you applied what you had learnt into practice? If not, why? 11. If yes, have you got more outputs? Have you living standard changed?

9. W hat were the challenges in receiving the cash grant? 10. What would you like to suggest to the program for their future improvement?

12. What were the weak points of this training? Why? 13. How should it be improved? 14. Is there any training you would like to suggest? How would it help you?


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#33, Street 71, Sangkat Tonle Bassac, Khan Chamkarmon, Phnom Penh, P.O.Box 2311 Phnom Penh 3, Kingdom of Cambodia Tel: 023 211 505 | Fax: 023 214 049 Website: www.khana.org.kh

Khana is a linking organisation of the global partnership International HIV/AIDS Alliance Supporting Community Action on AIDS in Developing Countries The International HIV/AIDS Alliance (Alliance Secretariat) Preece House, 91-101 Davigdor Road, Hove, BN3 1RE, UK Tel: +44(0) 12 7371 8900 | Fax: +44(0) 12 7371 8901 E-mail: [email protected] | www.aidsalliance.org