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EXPANSIONOF THE HOME CARE PROGRAMMEPhasing the Expansion 7.3A key lesson learned by the evaluation aboutsetting up the existing home care programmewas the importance of careful planning toensure that the key components were in place.This included developing appropriate systemsand procedures, establishing effective partnerships,creating awareness and fostering ownershipat each stage. The time taken to do thisshould not be underestimated.In order to ensure that these elements are inplace at Provincial level, and given the limitationson human and financial resources, it issuggested that the planned expansion takesplace in several phases over the coming years.It might be appropriate to limit the expansion,at least initially, to the Provinces whichhave operation systems for VoluntaryCounselling & Testing (VCT). At present thisincludes Battambang, Siem Reap, KompongCham and Kompong Som. This will facilitateintegration of the programme into existing networks.It may also be appropriate to begin inAccelerated Development Districts (ADDs)which have operational Health Centres.Roles and Responsibilities of Programme Partners 7.4For an expanded model to be effective, severalkey institutional and structural questions need tobe addressed:-1. which institutions and/or organisationsare best placed to implement theexpanded programme?2. what mechanisms should be put in placeto co-ordinate and manage the expandedprogramme?3. which institutions and/or organisations arebest placed to provide technical support?As Government/NGO partnerships haveproved so successful in implementing the existingprogramme, this evaluation recommendscontinuing these partnerships in implementingthe expansion. There are sensitive issues relatedto funding and control of funds which willneed to be addressed as and when potentialfunding sources become clearer.It would be wrong to be prescriptive inidentifying institutions to manage and coordinatethe expansion, and in any case, this isbeyond the scope of the evaluation. However, itis clear that MoH/NCHADS are extremely wellplaced to manage and co-ordinate the expansionthrough existing MoH structures. In someProvinces the PAOs will be able to co-ordinatethe Home Care Networks which will play animportant role in providing support to theprogramme. In some Provinces, other mechanisms,such as PAC/PAS may be better placedto perform this role.It is recommended that MoH/NCHADStakes the main co-ordinating role in expandingthe Home Care Programme in Cambodia.With regard to support, KHANA has beenproactive and effective in providing both technicaland financial support to the existingpg 73