Policy process for children and AIDS in Cambodia: Drivers and obstacles

Abstract

What are the drivers and obstacles in policy for 'children and AIDS' in Cambodia? We compare three processes by their (a) discourse and evidence, (b) actors and networks involved, and (c) institutional contexts. In the Policy for Alternative Care for Children, change was driven by global discourses and impeded by formal institutions (with limited participation). For the process of developing a national plan for orphans and vulnerable children under the National AIDS Strategy, progress was driven by actors and institutions (via more participatory structures), but impeded by gaps in evidence and disagreements on framing discourse. For policies on paediatric antiretroviral treatment, strong leadership, management and consultation were crucial to success and ownership, while the specialised health sector focus, low profile and its strategically invited consultation allowed its rapid progress with less 'contestation'. Generally, conflicting discourse, bureaucratic inertia and interests presented obstacles, while leadership, cross-sectoral consultation, local evidence creation and iterative revision drove success, Child participation remains lacking. © Institute of Development Studies.