Wednesday, June 13, 2012

Cambodia - “I Wish I Had AIDS”:

A qualitative study on access to health care services for HIV/AIDS and diabetic patients in Cambodia

According to the latest WHO data published in April 2011 Diabetes Mellitus Deaths in Cambodia reached 3,122 or 3.01% of total deaths in 2010.In the same year Deaths related to HIV/AIDS  in Cambodia reached 3,029 or 2.92% of total deaths. Diabetes Mellitus & HIV/AIDS rank No. 6 and 10 respectively of the top ten causes of Deaths within the country. Both diabetes and HIV/AIDS patients are suffering multiple, serious barriers to effective care. However, according the article published recently in Health, Culture and Society, it is found that the existence of supply-side barriers limit the access to free treatment or social assistance for the diabetes patients compare to HIV/AIDS. Below here is the abstract of the article.


Financially stricken Cambodian patients with diabetes and HIV/AIDS typically encounter multiple, serious barriers to effective care. This process may extend over many years and involve numerous rounds of diagnosis and treatment as the disease progresses from initial symptoms to longer term complications. Living with both the impact of the disease and this ongoing struggle for care can severely disrupt the everyday life of both sufferers and their families.

Our retrospective study adopted qualitative research methods to collect data from HIV/AIDS and diabetic patients enrolled and not enrolled in treatment programs at varying institutions in urban and rural settings. Using purposive sampling techniques, a total of 25 HIV/AIDS and 45 diabetic patients were recruited. Semi-structured and open-ended interviews were used to collect information on patient experiences of different phases in the on-going process of seeking care and treatment. The findings indicate that both HIV/AIDS and diabetic patients encounter multiple supply- and demand-side barriers to care at different stages of their illness. More strikingly, our research findings suggest that supply-side barriers, for example rationing systems or targeting strategies that limit access to free treatment or social assistance, are substantially higher for diabetic patients. This perceived inequity had a profound impact on diabetic patients to the extent that some “wished they had HIV/AIDS”.

These findings suggest that there is an urgent need to widen the focus of health care to address the substantial and increasing burden of disease resulting from diabetes and other serious chronic disorders in Cambodia and many other low/middle income countries.


C Men, B Meessen, M van Pelt, W Van Damme, H Lucas

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