Note: This document may not always reflect the actual appropriations determined by Congress. Final budget allocations for USAID's programs are not determined until after passage of an appropriations bill and preparation of the Operating Year Budget (OYB).
CAMBODIA
FY 1998 Economic Support Funds . . . . . . . . . . . . . . . . . $37,000,000 Introduction
The United States national interest in Cambodia is defined through our commitment to support democracy and promote human rights, assist the nascent nation building process, deal with important global issues, and promote an enduring peace.Cambodia is slowly emerging from one of humanity's most brutal episodes of social, political and economic destruction. Consequently, the country continues to be one of the world's poorest nations, lagging well behind its Southeast Asian neighbors in terms of key development indicators. The Government remains weak, and depends heavily on foreign assistance, which provides nearly half of its operating budget. Nevertheless, the increased stability of the region, in part brought on by Cambodia's move to democracy and market economics, is leading to expanded trade and investment opportunities, and to reduced tensions throughout this region.
Cambodia will have additional opportunity to reconfirm its commitment to democracy and the rule of law through local and national elections scheduled for 1997 and 1998 respectively. USAID, in partnership with other donors, is supporting the development of the new elections framework, and intends to help finance selected elections preparations depending on the identification of satisfactory and effective interventions and the anticipation of satisfactory progress.
The Development Challenge
While many of the other countries in East Asia have enjoyed three decades of growth and improvements in social welfare, Cambodia has been torn by strife and civil war. In this developing country of approximately 10.5 million people, per capita income is estimated at approximately $280 a year and infant mortality is 115 per 1,000. Life expectancy is 49 years, and literacy among adults is only about 35% (48% for males and 22% for females). These problems are compounded by HIV/AIDS, which is spreading rapidly and has the potential to become the most severe in Southeast Asia. In addition, decades of war and fratricide have left Cambodia with a population skewed in age and gender such that approximately 47% of the population is under 15 years of age and more than 55% of the adult population is female. This imbalance creates high dependency ratios, a source of instability. In addition, years of war and neglect have ravaged the physical infrastructure and sustained poverty, both of which have had a highly negative impact on human health and well-being. Productivity in agriculture and other sectors has declined for a number of reasons, principally poor rural infrastructure, landmines, restrictions on foreign investment, lack of inputs and information, and the absence of on-farm management skills. Cambodia is a country with natural resources suitable for rapid economic development, yet a lack of government legislation and enforcement, coupled with widespread corruption, is resulting in rapid environmental degradation. With fertile alluvial soils, abundant but unharnessed irrigation water, and a tropical monsoon climate with excessive rainfall, Cambodia was once a rice-exporting country and is believed to still have significant unexploited agricultural potential. The Mekong River is a major source of untapped capacity in irrigation and hydroelectric power. The Tonle Sap River and coastal areas are rich sources of marine life, with promise for expanded catches if managed prudently.
At present, an estimated 85% of the population is rural, and the country enjoys one of the lowest population densities in East Asia. Cambodia has some of the last remaining tracts of virgin rain forest in Southeast Asia. However, where Cambodia is rich in natural resources, it is poor in human resources. The current population aged 18 to 36 lacks the basic skills necessary for more than subsistence living. The education system, totally destroyed along with the educated cohort ofteachers, managers, and other skilled professionals, remains in critical condition today, unable to provide the resources necessary to support sustained development.
The Royal Cambodian Government (RCG) has combined donor resources with improved macroeconomic management to improve Cambodia's economic performance. Growth in 1995 accelerated to 7.6%, up from 4% in 1994 and 1993. Growth has been led by a rapid increase in investment. The investment rate rose from 9.4% of GDP in 1991 to 19% in 1994 and further to over 20.6% in 1995. The flow of external resources amounted to over 15% of GDP while savings amounted to only 5.3%. The fiscal deficit has been reduced as the RCG has improved its controls on expenditures. Revenues have increased, but have still fallen short of targets, primarily on account of lower than expected customs receipts and a shortfall in receipts from the auction of felled wood, royalties and fees from joint ventures and concessions; the International Monetary Fund has imposed restrictions on lending related to apparent corruption in this sector. Inflation declined from 18% in 1994 to 3.5% at the end of 1995, though it increased to around 7% percent in early 1996. The 1996 budget projected using increased revenue and containment of military expenditure to increase investment in health and education, but actual benefits from reduced military expenditures have fallen short of targets as the size of the army has increased. The RCG has begun providing incentives to increase the value-added component of exports. The medium-term outlook for the economy is good if donor inflows continue as projected. Real GDP is expected to grow at 7.0-7.5% in 1996 through 1998, and inflation is likely to be contained at around 7% based on the assumptions that weather conditions will be normal and that the government will continue to pursue sound macroeconomic policy in line with targets set jointly with the IMF.
Other Donors
Donor agencies and nations showed continued support for the nation-building process in Cambodia at the July 1996 Consultative Group meeting in Tokyo by pledging over $900 million in new assistance. The United States remains the second largest bilateral donor. Other major donors include Japan, France, Australia, the Netherlands, and Sweden, which together provide sizeable programs over a wide spectrum of development sectors. Major multilateral contributors include the Asian Development Bank, the IMF, and the World Bank.
FY 1998 Program
In FY 1998 USAID's program in Cambodia should formalize the beginning of its transition from one of emergency relief and rehabilitation to one building the foundations for sustainable development and economic growth. USAID's current strategy will be re-thought with an anticipated approach of moving toward a more focused development strategy aimed at having a longer term, sustainable impact on key areas of Cambodia's economic, political, and social development.
Agency Goal: Building Democracy
Strategic Objective 1: Strengthening Democratic Institutions
Consolidating democracy is widely recognized as an important element in the process of economic development and nation building. Recovering from over two decades of civil war, Cambodia has a fragile democracy. Donor resources have been essential to the growth and evolution of democracy in Cambodia by providing assistance to democratic institutions and processes, including elections, the judiciary, legal education, indigenous non-governmental organizations (NGO), and the National Assembly. USAID's resources will focus in two main areas, support for national elections in 1998 and longer-term support for the rule of law and respect for human rights.
National elections planned for 1998 are crucial for solidifying the democratic gains made thus far in Cambodia. USAID plans to take a leading role in supporting election monitoring, in voter education,and in the provision of technical experts to the Ministry of Interior, to the electoral commission, and to NGOs involved in the election process. Limited commodity support may also be provided in collaboration with other donors. Through this assistance, USAID hopes to foster an electoral framework that supports free and fair elections and includes the participation of civil society; a viable, established electoral and elections monitoring system; and increased knowledge and awareness by the Cambodian public of election procedures and campaign issues.
Underpinning USAID's democracy and governance strategy in Cambodia are efforts to strengthen the rule of law and respect for human rights. At present, Cambodia's legal system is based on laws from the old pre-peace State of Cambodia, the UN support period and laws of the current government. Following the destruction of previous systems and the establishment of a fledgling democracy, an entirely new set of laws and regulations must be written, and there are few Cambodians who are qualified to undertake the task. Likewise, there are only a few lawyers and university graduates with any background in common law capable of working in a business community increasing its links with Association of Southeast Asian Nations (ASEAN) countries and others in the broader international market. At the provincial level, the court system is badly in need of rehabilitation, with only minimally trained judges, prosecutors and court administrators. The courts also are burdened by lack of independence from the Administrative branch and a reputation for corruption, incompetence, and lack of respect for human rights, especially toward women, minorities, and the poor. There is growing evidence, however, that the Cambodian government understands the requirements of a modern legal system and is taking steps toward necessary reform.
Agency Goal: Encouraging Broad-based Economic Growth
A. Strategic Objective 2: Implement and Strengthen Sustainable Rural Economic Growth
Rural Economic Growth. USAID's proposed strategy for Cambodia includes implementation of a new program, initially in three provinces of the Cambodian northwest, to raise household incomes through increased rice production. Expected results would also include environmentally sound infrastructure improvements to increase productivity, production, and market access; improved access to and utilization of appropriate agricultural inputs, technology, and financial services (e.g., micro-credit); and improved policies for agricultural development, environmental protection, and the maintenance of essential infrastructure. To help insure that Cambodia develops its natural resources in a sustainable fashion, USAID is also supporting adoption and implementation of a national environmental action plan (NEAP).
B. Strategic Objective 3: Improved Ability of Schools and Clusters to Support Quality Classroom Instruction.
Cambodia's tragic experiences of the last several decades have rendered its people among the poorest and least educated in the world. Coordinated and sustained assistance is needed to improve the human resource base, beginning at the primary level but reaching to the secondary and tertiary levels as well. At present the primary education system can be characterized as ineffective, inefficient, and, because of the low skill level of teachers, incapable of teaching Cambodia's children even basic skills. USAID is making a vital contribution to improving the foundation for economic growth in the future by upgrading the quality of classroom instruction at the primary level now, and by strengthening community involvement in the most populated areas of Cambodia through school "clusters." Projected results include improved quality of classroom instruction, better trained teachers, increased interaction between teachers, schools, and communities, and better, more appropriate primary education policies.
C. Special Objective 1: Humanitarian Needs of Targeted Vulnerable Groups Met.
This portion of USAID's program in Cambodia addresses the needs of vulnerable groups such as land-mine victims, orphans, the very poor, female heads-of-households, the internally-displaced, and thementally-ill. USAID provides services to these groups through international PVOs and NGOs, as well as by strengthening the technical and organizational capacities of local NGOs themselves to provide such assistance. Thanks to USAID's program, about 10,500 amputees have been fitted with prosthetic limbs and have received physical therapy; and 520 orphans and desperately poor teenagers are being trained in marketable skills such as engine repair, secretarial and computer skills, tailoring, and printing. Over 1,276 mentally-ill Cambodians have been successfully treated at a USAID-supported clinic in Siem Reap province, and 50 primary care physicians and medical assistants are being trained to recognize, diagnose, and treat mental health problems in patients they see around the country. To date, USAID has funded and trained 25 local NGOs that assist Cambodian communities in providing basic human services to rural and urban vulnerable groups.
Cambodia will be unable to support the costs of assisting its most vulnerable groups for many years to come, given their large numbers and the country's limited resources. Although statistics are unreliable, it is estimated that over 200,000 children in Cambodia are orphans, that 158,000 Cambodians are disabled, and that 2% of the population suffers from acute mental illness, with many more thought to suffer debilitating depression or anxiety disorders as a result of years of genocide and civil war. It is estimated that women heads-of-household--many of whom are abysmally poor--constitute 35% of the population. USAID, through its NGO and PVO partners, will continue to integrate vulnerable groups into our program wherever possible and to train local NGO and government staff to assume responsibility for the delivery of needed services in this area.
Agency Goal: Stabilizing Population Growth and Protecting Human Health
Strategic Objective 4: Improved Maternal Child Health
Cambodia's health sector statistics are among the worst in the world, and easily the worst of any country in southeast Asia. The impact of years of conflict is evident in infant mortality rates of 115/1,000, under-5 mortality at 181/1,000, and maternal mortality as high as 500/1,000. On top of this, HIV/AIDS is spreading rapidly, with approximately 100,000 Cambodians already recorded as being HIV positive. It is estimated that by the year 2000 there will be 12,000 people a year with full blown cases of AIDS, and that the cumulative number of AIDS cases will reach 40,000. Finally, there is a strong need for improvements in the delivery of family planning services. Unmet demand for birth spacing services, for example, is estimated at 75%. In the face of these statistics, both USAID and the RCG have targeted the health sector for priority attention. Building on experience gained through pilot programs with local NGOs, in USAID 1996 elaborated an integrated maternal-child health (MCH) strategy focused on reproductive health and child survival. The program includes interventions in birth spacing, STD/HIV prevention, safe motherhood, and the prevention of childhood diarrheal diseases and acute respiratory infections. Through this program USAID hopes to increase the public sector's leadership in providing quality MCH care, improving the human resource base of MCH service providers, and improving the management and distribution and needed commodities. The program targets an increase in modern method contraceptive prevalence to 17%, a reduction in infant mortality to 100/1,000, and a lowering of the under-5 mortality rate to below 155/1,000. USAID also seeks implementation of national-level policies and programs for birth spacing policy and HIV/AIDS testing and counseling.
Although birth spacing services have been available in Cambodia for only three years, dramatic successes have already been achieved. The contraceptive needs of some 85,000 Cambodian women are being addressed through USAID-funded programs. The USAID-supported condom social marketing program is widely viewed as the most effective intervention currently underway in the battle against HIV/AIDS. Prior to the launch of this program, total annual condom sales in Cambodia were between two and three million. In 1996 sales are estimated to reach 8.5 million, exceeding previously established targets by 500,000.
CAMBODIA
FY 1998 PROGRAM SUMMARY
Strategic Objective
Encouraging Economic Growth
Stabilizing Population Growth and Protecting Health
Protecting the Environment
Building Democracy
Total 1. Strengthen democratic institutions 10,000,000 10,000,000 2. Strengthen sustainable rural economic growth 8,000,000 2,000,000 10,000,000 3. Improve schools' and clusters' ability to support quality classroom instruction 8,000,000 8,000,000 4. Improved Maternal Child Health
7,000,000 7,000,000 5. Meet humanitarian needs of vulnerable groups
2,000,000 2,000,000 Total (ESF) 18,000,000 7,000,000 2,000,000 10,000,000 37,000,000 USAID Director, Gordon H. West
ACTIVITY DATA SHEET PROGRAM: Cambodia
TITLE AND NUMBER: Strengthen Democratic Institutions, 442-SO01
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1998, $10,000,000 (ESF)
INITIAL OBLIGATION: FY 1995 ESTIMATED COMPLETION DATE: FY 2000
Purpose: To reinforce democratic gains by further strengthening the capabilities of public interest NGOs, processes, and institutions, and to strengthen Cambodia's capacity to govern by helping to establish legal, regulatory, and judicial systems.
Background: U.S. national interest is to assist the Royal Cambodian Government (RCG) in building a nation based on democratic principles and practices, including respect for human rights. Following two decades of civil war and purposeful dismantling of civil society, the major institutions of democratic governance have been systematically destroyed. Rehabilitation of the rule of law, the judiciary, electoral processes, and a national legislature are all fundamental prerequisites for Cambodia's transition into a sustainable and economically viable democratic society. At present, prospects for building a nation under democratic rule are hopeful, as evidenced by a gradual transition to peace. Strengthening key democratic institutions will promote the participation of all Cambodians and deepen their commitment to their emerging nation, rendering it less fragile.
USAID Role and Achievements to Date: USAID's $50 million Cambodia Democracy Initiatives project has played a pivotal role in supporting the transition to a more stable and prosperous democratic nation. Grantees funded by USAID have established a successful community legal education program and continue strengthening the 120-member National Assembly, provincial court system, newly established Cambodia Bar Association, professional media organizations, and an array of human rights and public policy organizations. These local entities interact with marginalized populations, especially women and minorities, and are striving to reduce corruption and to promote government accountability and a strengthened civil society. USAID has helped introduce internationally recognized fair business practices, fair labor practices, and the presence of public defenders in court. USAID-supported non-governmental organizations (NGOs) were prominent in supporting preparations for the May 1993 elections, and have taken an effective lead in the early preparations for subdistrict and national legislative elections scheduled for 1997 and 1998, respectively. A USAID-supported elections expert at the Ministry of Interior has played the lead advisory role in the formulation of the framework for both elections.
Description: The majority of FY 1998 funds will be used to strengthen rule of law activities. The Asia Foundation, currently the largest USAID grantee, will continue working towards improving the capacity of the National Assembly; expanding legal education; supporting local organizations engaged in human rights, public policy and the development of an independent and responsible media. The Mission is in the beginning stages of implementing a rule of law sector strategy assessment to determine what other areas are best suited for USAID involvement. Once a strategy is developed, the second phase of the rule of law program will commence in October 1997 and continue through September 2000. Limited funding has been set aside to facilitate the completion of the national elections process slated for 1998.
Host Country and Other Donors: The United States and France are the major donors working to establish the rule of law. Coordination of assistance plans and activities between the donors is increasing. Australia, Sweden and Denmark are increasing their involvement in this sector. The broader donor community has an interest in the elections, although donors have not yet outlined the scope of their planned support. NGOs, assisted by USAID, collaborate closely with RCG counterparts.
Beneficiaries: Improved legal institutions, a stronger rule of law and free and fair elections will benefit the entire Cambodian population. Beneficiaries directly involved in grant-funded training activities include 7 Cambodian human rights and public policy NGOs, 2 women's media associations, 2 journalism associations containing more than 60 media organizations, and 120 members of the National Assembly. Other beneficiaries will be determined following an assessment of rule of law needs and priorities in the spring of 1997.
Principal Contractors, Grantees or Agencies: The Asia Foundation, the International Foundation for Electorial Systems (IFES), others to be determined.
Major Results Indicators: USAID may rely on qualitative data concerning systemic improvements to a greater extent than quantitative data in this sector, due to the nature of the programs, and the absence of adequate baseline data. Selected results indicators include:
%
An established institutional framework for national elections, to be contested by viable political parties in place, followed by elections which are widely acclaimed to be free and fair;%
A legislative process that is better coordinated, more responsive to the expressed needs of the electorate, and a National Assembly which functions more independently and effectively;%
Increased access to, and tolerance of, public information and organizations providing services that affirm and promote human rights; and%
Other rule of law results indicators to be determined following the rule of law assessment.
ACTIVITY DATA SHEET PROGRAM: CAMBODIA
TITLE AND NUMBER: RURAL ECONOMIC GROWTH PROGRAM (REG), 442-SO02
STATUS: New
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1998: $10,000,000 (ESF)
INITIAL OBLIGATION: FY 1998
ESTIMATED COMPLETION DATE: FY 2002
Purpose: To achieve a sustainable increase in average farm household incomes in target rural areas of Battambang, Banteay Meanchey and Siem Reap. The program will track increases in household incomes and in agriculture productivity, particularly rice production.
Background: Cambodia ranks 124 out of 157 on the U.N. Human Development Index. Annual income per capita is estimated at $280, with rural incomes lagging urban incomes. Health statistics are the worst in Asia. The population growth rate is running at an unsustainable 2.7%. Over fifty% of the population is below 15 years of age, and approximately 85% of the population resides in rural areas. Access to and quality of education in the rural areas is extremely poor. A balanced, multi-sectoral approach addressing key constraints in health, education, governance and agriculture will be necessary to accelerate growth in the rural economy and improve the rural standard of living. The Rural Economic Growth Program (REG), together with on-going programs in primary education, maternal/child health care, democracy and the environment, constitutes the core of the USAID program in Cambodia.
Increasing rice production to a level of food self-sufficiency must be the central focus of agricultural development for the near future. Agriculture accounts for 80% of total employment, and rice production represents 90% of Cambodia's total agricultural production. Present day rice farming practices and technologies reflect a pronounced deterioration from 30 years ago. Both the area of production and overall production levels fall below those of the mid-1960's. Recent average rice yields are estimated at 1.3 MT per hectare with annual production of paddy at 2.5 MT. Rice yields in neighboring countries are two to three times higher than Cambodia's. For the next five years, Cambodia will be working toward equaling or surpassing production levels achieved more than 30 years ago when the country had a population of roughly 7 million versus almost 11 million now.
USAID Role and Achievements to Date: USAID has provided assistance to international and local NGO's to foster rural community development, agriculture and health under the PVO Co-Financing Project, in these three Northwest Provinces. CARE is reconstructing over 300 kilometers of secondary and tertiary roads; under the USAID funded PVO Co-financing Project. USAID, under its previous cross-border programs; has developed the capacity of numerous local NGO's to participate in program activities.
Description: USAID will provide assistance in three inter-related and supporting areas. First, USAID will provide assistance in improving rural infrastructure, including resolution of land tenure issues. This will also entail reconstructing water control and small scale irrigation systems in all three provinces. REG will provide for appropriate hydrology studies, as well as providing assistance in water management. Rural roads will also be a key component of REG in order to break down the isolation of rural areas, many formerly under Khmer Rouge control, and provide access for agricultural inputs, marketing and services.
Second, REG will foster efficient private sector seed and fertilizer distribution networks in the three provinces, as well as provide information to farmers on appropriate amounts and types of seed and fertilizer to be used. The program will provide financial counseling to target farmers and upgrade existing microfinance channels to meet the needs for increased rice production and to increase secondary household incomes. Finally, REG will work with farmers and farmer organizations to provide information needed for farmers to improve on-farm management. This will involve the integration ofall aspects of technological inputs and outputs and will impart hands-on training to farmers so they are in a position to manage their farms effectively. Third, appropriate agricultural, environmental and maintenance policies will be fostered at the regional and national levels to ensure the sustainability of program interventions.
Host Country and Other Donors: Increasing the standard of living in rural areas is a key objective of the RCG. To this end the RCG plans to shift approximately 65% of its budget allocations to the rural sectors. USAID will work with key national, provincial and district entities of the RCG to implement REG. There are a number of donor programs which are planned or active in the three target provinces, which will support REG. These include the U.N./Carere Program, AUSAID support of IRRI Rice Research and the Ministry of Agriculture's extension service, the World Bank, the Asia Development Bank, and the FAO/IDRC National Integrated Pest Management Project, as well as the ILO training programs for road construction.
Beneficiaries: Beneficiaries include small and medium sized farm households in the target provinces. The three provinces together account for approximately 19% of the nation's population. Special attention will be focussed at the needs of women farmers, who constitute over a quarter of farm households. Secondary beneficiaries will be RCG and NGO staff that benefit from training programs geared to increase regional capacity to deliver services to farmers.
Principal Contractors, Grantees, or Agencies: USAID plans to enter into a performance based contract with a competitively selected firm or consortium of firms.
Major Results Indicators: REG calls for three Intermediate Results in target areas:
%
Environmentally-sound infrastructure improvements which increase productivity, production, market access and land security;%
Improved access to and utilization of appropriate agricultural inputs, technology, and financial services; and%
Agricultural, environmental, and infrastructure maintenance policies implemented which are essential for sustaining production increases.
Activity Data Sheet
PROGRAM: Cambodia
TITLE AND NUMBER: Improved Ability of Schools and Clusters to Support Quality Classroom Instruction, 442-SO03
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1998: $8,000,000 (ESF)
INITIAL OBLIGATION: FY 1995 ESTIMATED COMPLETION DATE: FY 2001
Purpose: Improved ability of schools and clusters to support quality classroom instruction.
Background: The limited human resource base is one of the most serious constraints to future development in Cambodia. During the reign of the Khmer Rouge, the education system was dismantled, and a large majority of the educated population was either killed or forced to flee. This led to the loss of one generation of educated Cambodians. Attempts to rebuild the education system in the 1980s, though considerable, fell far short of expectations. Today, much remains to be done; however, unlike the 1980s, there is now considerably more donor support. Extraordinary steps--requiring the coordinated efforts of bilateral and multilateral donors, as well as NGOs--will be required to "jump start" the education system, to get the basic building blocks in place so the next generation of Cambodians can learn the basic skills needed to operate in an expanding and dynamic economy.
USAID Role and Achievements to Date: Since September 1994, USAID has worked closely with the Ministry of Education, Youth and Sports (MoEYS) to develop and refine the RCG's Investment Plan for the education sector. This was needed to ensure that USAID's in-service teacher training activities, which began in earnest during the fall of 1996, were coordinated with related activities undertaken by other donors and NGOs. The methodology used under USAID's program of assistance builds upon pilot activities pioneered by the MoEYS, with assistance from UNICEF, in teacher training and cluster school development. USAID's assistance combines elements of these programs in a fashion that is effective, low cost, and which enhances the MoEYS's capacity to continue skills enhancement on its own after USAID assistance terminates. Insofar as sparsely populated areas do not lend themselves to "clustering," alternative means to deliver teacher training are being devised for remote areas. Similarly, studies are scheduled to be conducted in 1997 to examine the factors constraining participation of girls in primary school, and to develop and implement strategies to increase their participation.
Description: USAID, the implementing NGO consortium, and the MoEYS will work together to select school clusters and then train all primary school teachers in that cluster in improved pedagogic practices for math and Khmer language (over the life of this activity, USAID plans to retrain nearly all primary school teachers and administrators in Cambodia). The course of study comprises a series of two 3-week workshops, four 4-day workshops, weekly tutorials, and weekly classroom observation over the course of an entire academic year. For cluster school development, technical assistance and training is being provided to the new school cluster for a period of two years. Together, the assistance should provide teachers with improved skills to teach, and a community-based support structure to support the primary education system generally. This will be combined with targeted assistance at the central level so education planning and policy are better coordinated and implemented.
Host Country and Other Donors: USAID's assistance to the primary education system builds upon RCG initiatives to enhance teacher skills and to develop school clusters. It is complementary to other assistance being provided by UNICEF, the Asian Development Bank, the European Union, UNESCO, Japan, Australia, Great Britain, and France, as well as various NGOs, who are providing a range of assistance in cluster schools, curriculum, textbooks, capacity building, teacher training, and language. USAID's activity articulates well with these activities by being dynamic and by recognizing that change will occur throughout the life of the activity. For instance, new textbooks being developed/published with other donor financing will necessitate constant modification of the teacher training curriculumbeing used under USAID's activity. Mechanisms, therefore, are in place so that these modifications can be incorporated as new textbooks come on line.
Beneficiaries: The beneficiaries of USAID's assistance under this activity are numerous. First will be Cambodia's children, who will be better able to learn through improved teaching techniques taught by more qualified teachers, and better access to quality teaching materials. Girls of school age will also benefit as studies are conducted, and strategies are developed and implemented, to increase participation of girls in primary education. Finally, selected Ministry of Education staff will benefit as they receive hands-on training to conduct data collection and policy analysis.
Principal Contractors, Grantees, or Agencies: Teacher training and cluster school development is being implemented through a cooperative agreement with a consortium made up of World Learning, World Education, and Save the Children. Capacity building in education policy is being provided through the G/HCD/FSTA Advancing Basic Education and Literacy, Phase 2 (ABEL2) activity. Technical assistance to review gender issues in primary education will be provided through the G/WID Girls' and Women's Education activity.
Major Results Indicators:
%
Schools and clusters able to support quality classroom instruction (i.e., improved teacher knowledge and practice; reduced constraints on teachers' planning and performance; improvements in communication among and between teachers, schools, and parents; and improvements in decision-making and problem-solving by teachers, schools and clusters);
%
Effective teacher training (improved math and Khmer competency; increased use of student-centered teaching methodologies; and increased access to teaching resources);%
Effective school clusters (increased interaction between teachers, schools, clusters, and PTAs; resource centers set up and functioning; and increased community involvement); and%
Appropriate primary education policies.
ACTIVITY DATA SHEET
PROGRAM: Cambodia
TITLE AND NUMBER: Improved Maternal Child Health, 442-SO04
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 98: $7,000,000 (ESF)
INITIAL OBLIGATION: FY 1998 ESTIMATED COMPLETION DATE: FY 2000
Purpose: To improve Cambodian's reproductive health and child survival as evidenced by an increase in contraceptive prevalence from 7% to 17% modern method use; a decrease in infant mortality from 115 per thousand to 100 per thousand; and a decrease in mortality rates of children under 5 from 181 per thousand to 155 per thousand.
Background: Cambodia has some of the highest maternal and child mortality rates in the world, the region's highest population growth rate (2.7) and one of the fastest growing HIV/AIDS epidemics in the world. According to some estimates, less than 50% of rural Cambodians have access to any health care. Survey research continually highlights the high priority the Cambodian population places on their needs for access to essential health services particularly for family planning and child survival. The Royal Cambodian Government has recognized the urgency of the situation and the Ministry of Health (MOH) has designated maternal child health as a top priority. The MOH is also undertaking major sector reform, instituting a minimum package of activities for services at the lowest level of the health care system and introducing pilot cost recovery schemes.
USAID Role and Achievements to Date: The USAID program builds on the Agency's comparative advantage and works with the MOH, NGOs and the private sector as implementing partners to improve the health of Cambodians. As USAID's program gains focus in the area of Maternal Child Health, the Agency is increasingly perceived as a leader in the sector in Cambodia. Achievements to date have occurred at several levels. At the policy level USAID has directly contributed to the elaboration and implementation of policies in reproductive health, specifically for birth spacing and in the area of HIV/AIDS; in child survival, through the integration of Vitamin A activities into national systems and the development of a Dengue Hemorrhagic Fever program at the MOH; and in sustainability through the introduction of community participation schemes at the lowest levels of the system, the launching of the first private sector reproductive health center in Cambodia, and the introduction of social marketing programs. Programs oriented towards improving service delivery have reached over 100,000 women with contraceptive services, sold over 8 million condoms a year for the prevention of STDs and HIV, and trained hundreds of health care workers in the basic elements of reproductive health and child survival services.
Description: The Maternal Child Health SO focuses on developing the leadership role of the MOH in the policy arena, improving the human resource capacity in the public and private sector, and increasing access to quality MCH commodities in the public and private sector. Technical areas covered include birth spacing, STD/HIV management and prevention, safe motherhood, and child survival with a focus on diarrheal diseases, acute respiratory infections and micronutrient deficiencies.
Host Country and Other Donors: UNICEF, with assistance from Japan and WHO, supports the national immunization program. UNICEF and other bilateral donors support the essential drug system. United Nations Family Planning Agency (UNFPA), Japan and Germany are partners with USAID in the area of reproductive health. WHO provides technical advisors to the MOH, with particularly strong support from ODA, in health systems planning, human resources, and management information systems. Both the Asia Development Bank and the World Bank are about to launch large projects oriented to improving health infrastructure. In the area of HIV/AIDS the World Bank is the major donor with smaller programs funded by the UN Agencies and, potentially, the European Union. The RCG supports MOH salaries, select institutional costs and major reform efforts.
Beneficiaries: Primary beneficiaries include an estimated 2.1 million children under the age of 5 and 2.6 million women of reproductive age. Secondary beneficiaries, particularly for STD and HIV interventions, include 2.7 million men of reproductive age.
Principal Contractors, Grantees or Agencies: USAID implements the above activities through U.S., international and local NGOs, the Ministry of Health and USAID centrally-managed grants and cooperative agreements. Grantees include CARE, Family Planning International Assistance, Helen Keller International, Doctors without Borders, WHO and Population Services International. Global Bureau projects include (SEATS), (BASICS) and the Association for Voluntary Surgical Sterilization. Family Planning Service Expansion and Technical Support (SEATS) - Basic Support for Institutionalizing Child sURVIVAL (basics)
Major Results/Indicators by 2000:
%
Increase in births attended by trained health personnel from 38% to 50 .%
Increase in the proportion of children under the age of 5 who have received oral rehydration therapy.%
Key policies in place for reproductive health, child survival and program sustainability.%
Increase in the % of service providers in target areas who are correctly managing STDs from 0 to 40%.%
Increase in the % of service providers in target areas who are correctly managing diarrhea cases in children under 5 from 0 to 80%.%
Increase in the % of women desiring family planning receiving contraceptives.%
Increased high sales of Number One condoms from 0 in 1994 to 12 million.
ACTIVITY DATA SHEET PROGRAM: Cambodia
TITLE AND NUMBER: Humanitarian Needs Met for Targeted Vulnerable Groups, 442-SpO01
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1998: $2,000,000 (ESF)
INITIAL OBLIGATION: FY 1995 ESTIMATED COMPLETION DATE: FY 2000
Purpose: To increase access to quality relief assistance and improve the capacity of local NGOs.
Background: Cambodia has an alarmingly high number of citizens who suffer from grinding poverty and physical and mental impairments related to 25 years of war. Given the country's poor economy and low human resource capacities, it is not currently possible for Cambodia to care for these vulnerable groups, nor will it be for years to come. Yet vulnerable populations, which in Cambodia consist of men, women, and children across the spectrum, have much to contribute to the country's reconstruction and development, if only they can be provided with basic rehabilitative services. Many local community groups are willing to provide these and other services, but lack the funding and technical and management know-how to do so effectively.
USAID Role and Achievements to Date: USAID has provided 8,581 prosthetic limbs and 2,565 wheelchairs; mental health care and training to 1,276 patients and health care providers; vocational skills training to an estimated 1,500 orphans, amputees, and very poor children. Just as importantly, USAID supports capacity-building training to local NGOs and the Royal Cambodian Government to improve their ability to provide quality care in a sustainable and cost-effective way.
Description: USAID will continue to support the efforts of our international and local NGO partners in meeting the needs of vulnerable groups, to include social and psychiatric counseling, credit, job skills, prosthetics, and a sense of increased personal empowerment.
Host Country and Other Donors: The Royal Cambodian Government funds and staffs 20 orphanages around the country, and through its line ministries supports programs for women, mental health care training, and, with the assistance of international NGOs, prosthetics and vocational training for the disabled. Donors such as Japan, the UK, Germany, Canada, the European Union, World Food Program, UNICEF, the International Committee of the Red Cross, ILO, and the United Nations High Commissioner for Refugees support modest programs (often implemented by NGOs) targeting vulnerable groups.
Beneficiaries: It is estimated that over 200,000 children in Cambodia are orphans, 158,000 Cambodians are disabled (landmines continue to claim 150-200 civilian victims every month), and 2% of the population suffers from acute mental illness, with many more thought to suffer debilitating depression or anxiety disorders. Approximately 600,000 women are widows, and 35% of the country's households are headed by women. As such women often lack sufficient (male) labor to help with farming tasks, and they usually join the ranks of the very poor, which in Cambodia are estimated to comprise 36% of the population.
Principal Contractors, Grantees, or Agencies: USAID implements the activities under this Special Objective through US, international, and local NGOs, working collaboratively with the Ministries of Social Action, Health, Womens' Affairs, and Rural Development. Grantees include the American Red Cross, the Harvard School of Public Health, the Vietnam Veterans of American Foundation, Salesian Missions, and Participating Agencies Collaborating Together (PACT).
Major Results Indicator: Percentageage of vulnerable population with needs met.
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