Framework for the Integration of HIV/AIDS Services in Public Health Systems in Cambodia

The Royal Government of Cambodia has shown a strong commitment to integrating HIV/AIDS services into the broader health system, with a focus on ensuring efficiencies and sustainability. In February 2019, the Cabinet of Ministers issued a six-point policy circular, SorChorNor #213, which emphasizes the importance of integrating HIV/AIDS services into existing health systems. The National AIDS Authority (NAA) and National Centre for HIV/AIDS, Dermatology and STDs (NCHADS) have developed strategic plans for HIV/AIDS that recognize integration as key for sustaining the national HIV response. The proposed framework for integrating HIV/AIDS services into public health systems in Cambodia is based on the health system-strengthening frameworks suggested by the World Health Organization (WHO) and the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund). The framework identifies seven key domains for integration: Service Delivery, Human Resources for Health, Procurement and Supply Management, Health Management Information Systems, Governance, Leadership, and Accountability, Health System Financing, and Community Participation, Systems, and Response. Each domain suggests clear actionable recommendations for achieving the integration of HIV/AIDS services into public health systems in Cambodia. For example, in the Service Delivery domain, the framework recommends continuing existing action-oriented strategies for case finding, including the implementation of the Community Action Approach Framework. This approach involves engaging civil society organizations (CSOs) in sites with a high number of cases lost to follow-up. The framework also emphasizes the importance of strong political will, leadership, accountability, commitment, and ownership in achieving the integration of HIV/AIDS services into public health systems in Cambodia. A detailed operational plan needs to be prepared by the NAA/NCHADS, with the help of development partners, to functionalize the framework. This plan should outline clear actionable recommendations for each of the seven domains, including timelines, responsibilities, and resources required. The plan should also ensure that the integration of HIV/AIDS services into public health systems in Cambodia is aligned with the country's national HIV response and the broader health system. The integration of HIV/AIDS services into public health systems in Cambodia has the potential to improve the efficiency and sustainability of the national HIV response. By integrating HIV/AIDS services into existing health systems, the country can reduce duplication of efforts, improve coordination, and increase access to HIV services for those who need them most. The proposed framework provides a roadmap for achieving this integration and ensuring that the national HIV response is sustainable and effective in the long term.