2012 Cambodia: Buddhist Leadership Initiative Evaluation 2008-2012
Author: Jo Kaybryn
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The Buddhist Leadership Initiative originated in Thailand in 1997 as part of UNICEF’s regional strategy for Buddhist engagement in the response to HIV and AIDS in the Mekong Sub-region. It was launched in Cambodia in 2000 by the Ministry of Cult and Religion, with UNICEF support. An evaluation of Cambodia’s Buddhist Leadership Initiative was commissioned by UNICEF, in 2007. The programme expanded from seven to 14 provinces over its twelve years and currently 10 provinces participate reaching 2,300 adults living with HIV and 1,500 vulnerable children in 239 communes. These men and women regularly attend self-help group meetings at the pagoda which is preceded by a meditation session led by a monk at the pagoda, usually twice per quarter. The Buddhist Leadership component to reach vulnerable children takes the form of group sessions at the pagoda twice per quarter and children get their transport reimbursed, a small amount of cash support, and materials especially for school.
This evaluation aims to assess the organisational and programme performance between 2008 and 2012, including the Buddhist Leadership Initiative’s efficiency and effectiveness. It further sought to review the institutional capacity of the initiative; evaluate the outcome of the programme with regard to the provision of support to individuals and families affected by HIV at the household level; provide recommendations on how to include other areas of child protection; and draw lessons and recommendations for programme adaptation and revision. The evaluation was guided by the OECD DAC Principles for Evaluation of Development Assistance as well as the “UNICEF-adapted United Nations Evaluation Group (UNEG) Evaluation Report Standards”. It was implemented between July and September 2012 and collected quantitative and qualitative data in five of the ten participating provinces.
Field data collection took place over 15 consecutive days in August. The methodology included a comprehensive literature review, key informant interviews with policy makers, implementers and technical support staff, focus group discussions with women, men and children affected by HIV, focus group discussions with monks, surveys of adults affected by HIV, and observations of group interactions and individual behaviours during the data collection. A total of 357 adults and children participated in the assessment: 214 adults in the quantitative survey, 116 women, men, children and monks in focus group discussions, and 27 government, NGO, Buddhist leadership and UNICEF representatives. Preliminary evaluation findings were discussed with representatives from MoCR and Buddhist leadership.
The majority of the assessment participants were women aged between 30 and 49, which reflected the wider Buddhist Leadership Initiative demographic profile. In total 154 women and 60 men participated in the quantitative survey, which mirrors that generally more women participate in the initiative than men. Among the 20 focus groups there were 30 women, 30 men and 30 children (18 girls and 12 boys). Among the 214 survey participants there were noticeable demographic differences between provinces. A large proportion (43%) of the surveyed participants had been involved in the programme for five years or longer. Approximately a quarter had been involved for 3-4 years, another quarter had been involved for 1-2 years, and the remaining 9% had been involved for less than 12 months.
Findings and Conclusions:
The Buddhist Leadership Initiative seems highly relevant to the national HIV policy expectations of religious leaders to engage in the HIV and AIDS response. It has made a significant difference to most of its participants. With the HIV context in Cambodia changing dramatically since its launch, with lower rates of HIV prevalence, increases in access to treatment and an overall reduction in stigma and discrimination, the programme has an opportunity to re-focus its efforts on reaching the most vulnerable and the worst off, which is likely to include many people living with HIV but would also include people who are vulnerable for reasons such as other illnesses and extreme poverty. Monks have a positive influence on both external and internal HIV related stigma experienced by people living with HIV, while the cash support is very important to the poorest participants, at the same time it causes some limitations to the programme’s ability to include more people. The more dynamic self-help groups have skills and experience of microfinance mechanisms to share with other groups which create opportunities for learning within the programme. Overall the efficiency of the programme does not compare well with other organisations which are designed to implement similar activities, and its reliance on external donor funding raises challenges to its sustainability. It seems likely that efficiency and sustainability would be increased if ownership of the programme was with the monks implementing the activity at pagoda level, and with senior monks in the Buddhist hierarchy who have the authority and influence to institute its aims and objectives into its networks and education system.
Noting the rapid decline of HIV prevalence in Cambodia in recent years and the concentrated epidemiological context among key affected populations, the research findings question whether the main objectives are still appropriate given the changing circumstances. Overall, the support provided by the programme remains highly relevant to the most poor and vulnerable community members, but the narrow focus on people affected by HIV means those who are highly vulnerable for reasons other HIV do not qualify for support. Therefore an overall relevance recommendation is for UNICEF to review the objectives and the intent of the programme.
While the recommendations note the key actors for their implementation, it is important to note that the recommendations are intertwined and related to each other.
In total, the report includes 29 recommendation addressed to Ministry of Cult and Religion of Cambodia, Buddhist Leadership and Hierarchy and UNICEF. The full recommendations are articulated in the final section of the report.
The reliance of the initiative on external donor funding is detrimental to the initiative’s sustainability and there are a number of lessons learned from the programme’s experience which can help identify approaches to increase its sustainability. One of the most notable lessons was the need for greater ownership by the Ministry of Cult and Religion, and all the implementing partners, and the initiative’s reliance on external donor funding. In addition the lessons learned about the effectiveness of the spiritual support to both children and adults provided by monks in the initiative can be shared more widely by the Buddhist hierarchy within and beyond its networks.
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