Geographic: Target area were selected
considering factors including: 1) Areas which are underserved and remote, 2)
Strong interest and support by authorities, 3)
and avoiding overlap with longer term NGO programs in the health and
livelihoods sectors. The selected target district of Trapeang
Prasat is in the Oddarmean Chey province, located 125 km to the east of Otdar
Meanchey town and 400 Km north of the capital. The district has 6
administrative communes with 59 villages. As of 2014 there was a total of
11,732 households, a population of 51,792 and land area of 184,194
hectares. The project has chosen the 33 neediest
of the 59 villages in close cooperation with the local officials using the
above criteria. The target area is
relatively flat and is a mixture of rice paddy and sparse jungle/forestry’s
land that is increasingly being utilized for both smaller and larger scale
agriculture and natural resource exploitation.
Life in Target Villages: This northern area was one of the last strongholds of the Khmer Rouge with
some authorities being often former military leaders with lower education
levels due to the former civil strife.
85% of households (HHs) now generate significant portions of their
income from agrarian work. Rice remains the
core crop and is the staple source of calories with some production of pepper, corn, soya, mung beans, cassava and
fruit trees. Larger scale companies are
expanding land concessions including rubber, cassava, and sugar cane. Many food items, including vegetables, are
imported from Thailand or other provinces as year around water supplies limit
local production.
The
provincial health system is organized into two health Operational Districts
(ODs, as opposed to Administrative Districts). Trapeang Prasat district has 6
local health centers though only 4 are significantly active providing
outpatient care and child deliveries.
Health centers provide local health care for between 6-15 villages with some
mobile services in more distant villages such as vaccinations. Health Centers have a volunteer system at the
village level but currently volunteer activity levels are minimal.
Child malnutrition remains a challenge and
priority in rural Cambodia though national stunting rates for children under 5
have reduced 49% in 2000 to now 32%. 2014
rates for Otdar Meanchey were 36% with recent surveys in nearby rural villages having
rates around 40%. Malnutrition usually
begins within the first 2 to 3 years of life with stunting rates 40% or higher
by age 24 months. The poor power
status of women and children, particularly between the mother and father, also
impact their health status. Poor nutrition leads to reduced quality of
life, increased mortality and an increased economic burden on the family and on
the nation. A CARD/UNICEF/ WFP report in
2013 estimated that Cambodia loses over $400 million in GDP annually to
malnutrition in the life cycle[1]. The Ministry of Health (MOH) Fast Track Road
Map for Improving Nutrition 2014-2020, calls intense efforts to address
malnutrition of children.
Very few households have an understanding of nutrition for themselves
and their child. White rice is
traditionally perceived as the comprehensive staple food. Daily meat or
vegetable based protein foods and vitamin sources are often not considered
essential to health and young children often lack sufficient total calories and
protein in diets. Compounding the
problem is the low educational level with over 67 percent of women of
reproductive age and 52 percent of me in the Oddar Meanchey Province (2010
CDHS) not completing primary school, or have no schooling resulting in
high levels of functional illiteracy (over 64%)[2]. Illiteracy leads to vulnerability and limits poorly educated farmers from modern agricultural techniques and protective health nutrition information. The CDHS showed stunting rates among mothers with no schooling (48 percent), primary schooling only (40 percent), and secondary and higher (31 percent) steadily declining as level of schooling increases. Climate change has resulted in more erratic weather patterns resulting in recent drought and flooding conditions. Local authorities expressed that the poorer families are the ones at greatest risk to food insecurity. Rice yields in the district for 2012-2014 have averaged only 1.5 tons/hectare which is well below the national averages ranging from 2.5 to 3.0 T/ht. Increased migration for work was also cited as a risk to children’s health as families’ travel often leaving children behind not and not ensuring that caregivers are properly caring for them.
high levels of functional illiteracy (over 64%)[2]. Illiteracy leads to vulnerability and limits poorly educated farmers from modern agricultural techniques and protective health nutrition information. The CDHS showed stunting rates among mothers with no schooling (48 percent), primary schooling only (40 percent), and secondary and higher (31 percent) steadily declining as level of schooling increases. Climate change has resulted in more erratic weather patterns resulting in recent drought and flooding conditions. Local authorities expressed that the poorer families are the ones at greatest risk to food insecurity. Rice yields in the district for 2012-2014 have averaged only 1.5 tons/hectare which is well below the national averages ranging from 2.5 to 3.0 T/ht. Increased migration for work was also cited as a risk to children’s health as families’ travel often leaving children behind not and not ensuring that caregivers are properly caring for them.
[1] Bagriansky J., Champal N., Pak K., Witney S., Laillou A. 2014. Economic
burden of malnutrition in Cambodia: more than half attributed to feeding
behaviour and food quality. Phnom Penh Cambodia.
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