Baseline Survey Results for the

Provincial Development Strategy

Odtar Meanchey Province

April 2005

CARE/MALTESER/ZOA
Written by Matthew Foster (matthewincambodia@hotmail.com)
 2005 Baseline Survey, Otdar Meanchey Province

Table of Contents
Page
A. Introduction and methodology 1-5

B. Results
1 Household data 6-7
2 Community development 8-17
3 Landmines/uxos 18
4 Land and natural resources 19-22
5 Agriculture and food security 23-32
6 Health 33-48
7 Education 49-50
8 Women 51
9 Human rights 52-53
10 Co-ordination 54

C. Recommendations 55-58

Annexes:
A. ToR
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B. Questionnaire
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C. Focus group discussion guide questions

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D. List of villages sampled in household survey and FGDs

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E. Comparison of logframes
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F. Presentation of results and interpretation

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A. Introduction and methodology
A.1 Introduction

In 2003, Care, Malteser, and ZOA decided to carry out a joint situation analysis and planning process to help define
the focus for their programmes and enhance co-ordination of their work in Odtar Meanchey. Key stages have
included the Need Assessment (April 2003) a province wide assessment, and in November –December 2003 a
multi-stakeholder planning process which helped to define a Provincial Development Strategy (PDS). The PDS is
a multi-sectoral strategy document which identifies objectives in 10 components (community development,
landmines, land and natural resources, agriculture, support to businesses, health and sanitation, education, women,
human rights and governance, and coordination) and specific strategies to achieve these over the next five years.
The three organisations will use the PDS to define programme activities and already joint funding proposals have
been submitted to raise the resources required to implement the strategies, and it is hoped that additional NGOs
working in the province will follow the PDS framework.

A.2 Objectives of the survey

The need has been identified to set a baseline within the province for the 10 components to enable achievements
towards the objectives in the PDS to be measured. A mid-term evaluation in January 2007 and an end evaluation
in January 2009 have been scheduled which will repeat the baseline survey to assess change related to the
objectives over time. The objectives of this consultancy as stated in the terms of reference (ToR) were (see annex
A for full ToR):

• to review all relevant project documents including the needs assessment, strategy document, project plan and
relevant proposals as well as essential documents of the participating organisations and give them suggestion
for the set up of the questionnaires appropriate for the baseline survey
• to give advice on setting up a database and ensuring accurate data entry
• to conduct refresher training to project staff in survey and interview techniques which will help prepare them
for conducting the survey
• to develop additional interview questions and conduct additional interviews with relevant stakeholders,
including government officials from village, commune, and district as well as provincial level, other NGO staff,
village representatives maybe using a RRA method
• to analyse the data and present the results in a comprehensive report

This resulted in three stages for the baseline survey; the household survey, focus group discussions (FGD), and
interviews with provincial government officials. It was determined that the household survey would generate the
majority of the information required for the baseline, and consequently the planning, implementation, and analysis
of this stage was the major task for the three participating organisations and the consultant. Focus group
discussions were used as a way to gather sensitive information, difficult to gather reliably from the household
survey, and also to gather data to compliment the household survey results; providing participant’s thoughts on the
situation in their villages on issues relevant to the PDS and ideas on explanatory factors. The interviews were
added to set a form of baseline for component 10 of the PDS, co-ordination. The methodology for each of these
stages is explained in detail below.

1
A.3 Household survey

a) Development of the questionnaire

The chosen household survey instrument was a structured questionnaire to gather quantitative data for statistical
analysis. The development of the questionnaire was carried out following a review of the objectives and indicators
within the PDS and the subsequent funding proposal submitted to EC (‘Community empowerment and
strengthening of government capacity for the development of Oddar Meanchey province 2005-2007, March 2004).
There was some uncertainly surrounding the compatibility of the objectives and indicators in the two documents
and attempts were made to refine these (including removal of output indicators). The table in Annex E attempts to
harmonise the objectives and indicators detailed in the logframes for both documents, and provides a useful way to
cross reference between the logframes and the results section in this report. The table also clarifies that the
household survey could not generate all the information required for the Monitoring and Evaluation (MandE)
purposes of the PDS and the results of the survey should be seen within the context of a broader MandE framework
(where additional information will need to be gathered this is indicated in the third column with ‘MandE
framework’). It is considered that the baseline survey is best suited to generating information at the impact level
i.e. changes in people life’s/socio-economic situations, the ultimate intention of the PDS, as well as for some of the
anticipated outcomes i.e. changes in the behaviour and practise of people and/or service providers. Additional
information will need to be gathered by staff or from existing sources to compliment the information generated by
the baseline survey and to form a complete Monitoring and Evaluation framework (MandE framework) for the
PDS.

The process for developing the questionnaire involved the ZOA advisor and the consultant working together to
draft questions to meet the expressed needs of the three organisations and the requirement of the logframes. An
existing questionnaire used for a previous ZOA community development project was used as a starting point as it
contained many relevant questions used previously to good effect, and an initial draft was distributed to the
participation organisations for comment. Revision were made and a first draft of the questionnaire was translated
into Khmer and back translated into English to check the interpretation of the questions, although this did not
eliminate all mistakes (see lesson’s learnt section). The final draft of the questionnaire was field tested twice as
part of the training (see below) and revised following suggestions from the interviewers related to interviewees
understanding of the questions and appropriateness of terms. In addition, during the survey alterations were made
to questions were it was found that mistakes persisted in the questionnaire. A final version of the questionnaire is
included in annex B. The table in annex E helps to demonstrate that the process of drafting workable questions
had the result of adapting the indicators from those originally contained in the logframe (the actual questions used
in the questionnaire should be considered as the indicators). The consultant consider this to be the correct
approach; allowing the MandE framework to be driven by the information that can realistically be gathered as
opposed to sticking rigidly to the indicators in the original logframes.

The consultant recommends that a review of the PDS takes place following the receipt of this report (see also
section C). This will allow programme design to be informed by the results of the baseline survey and also provide
the opportunity to formally integrate the two logframes and develop a MandE framework for the strategy.

b) Sampling frame and strata

The measurement unit for the survey was households, and the clusters were villages. The sample size was
determined to be 94 clusters (villages) x 10 units (household interviews), resulting in a data set of 940 household
questionnaires. The sample size was largely determined by availability of resources i.e. the number of interviewers
available over the two weeks timeframe of the survey. The difficulty determining sample sizes for multi-sectoral
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surveys is well documented (due to the diverse range of indicators) but 1000 units is considered to be a good rule
of thumb. ‘Representativeness’ is a crucial characteristic for effective sampling, and consultations were held with
the staff from the three participating organisations to consider how to make the sample size representative of the
situation throughout the province. It was decided to divide the province into two strata, a strata of eastern districts
(Anlong Veng and Trapeang Prasat) and a strata of western districts (Bantey Ampil, Chong Kal, and Samrong), to
create strata intended to minimised the variation in socio-economic indicators within and maximised variation
between the two groups of districts. The sampling effort was then divided proportionally by the relative
populations (from the Commune Database 2004) of each strata. The Commune Database 2004 was used as the
basis for the sample frame although it is important to note that a) villages where the three organisations did not
intend to work in the future due to their urban location/relative absence of poverty were removed from the sample
frame and b) due to the high level of migration to and within the province a number (approx. 20) new villages are
not recognised in the database. These villages do not form part of the sample frame for the baseline survey (the
villages included in the sampling frame are listed in annex D).

The number of households per cluster (i.e. 10 interviews per villages) was determined on the basis of logistics
(allowing a team of two interviewers completing 5 interviewers each per day to complete one village per day) but
also made good sense from a representative point of view with, typically, greater homogeneity within villages than
between them, and therefore ‘from a sampling precision point of view, smaller clusters are to be preferred over
larger one….a design with 30 clusters of 20 households each would be preferred to one with 20 clusters and 30
households’ (Magnani, FANTA Sampling guide 1997). The percentage of villages reached by the household
survey was approx. 40% of those within the sample frame.

c) Village and household selection

Villages within the sample frame were randomly selected using probability-proportional to size (PPS); giving each
household within the sample frame the same overall probability of selection (the selected villages are listed in
annex D). Household within each village were also selected randomly using the following technique:

• estimate the number of households in the village; the sampling frame listed families whereas the baseline
survey was assessing household indicators, and this required interviewers to discover the number of households
in the village (usually be asking the village chief) prior to household selection
• divide the number of households by number of sample units i.e. 10 = xth household
• generate a random number between 1 and the nth number = yth household and count to the yth household from
the first house along the main road
• locate each subsequent xth household working along the main road and then each smaller road/track in turn
until all households in the village have been counted

Non-response error (i.e. no respondents available within a selected household) was dealt with my moving the next
house until a present and willing respondent was identified. Respondents within the household were selected by
asking the member of the household to self-select from available household members (children less than 15 years
old were not considered suitable) to answer questions about the household. The respondents were predominately
women (75% of the total with similar percentages within each district).

d) Training

18 interviewers and three team leaders were trained in household selection, interview techniques, use of the
questionnaire, and checking questionnaires for error, over a three day period. Two aspects of the training proved
especially useful; practical use of the questionnaire in the form of field testing; and use of the questionnaire in a

3
controlled setting using a case study. The later in particular allowed the managers of the survey to get a good
understanding of the abilities of each member of the survey team (The group completed questionnaires in response
to the answers provided by one respondent enabling each questionnaire to be checked for accuracy). Guidance
notes were also produced providing explanations for ‘difficult’ questions and a reminder of the process of quality
control. Due to a lack of time, the guidelines were not translated into Khmer.

e) Supervision and quality control

The interviewers were divided into three teams of six to cover the following three areas based on the required
sample effort (1. Samroang and Chong Kal; 2. Bantey Ampil; 3. Anlong Veng and Trapeang Prasat). Interviewers
worked in sub-teams of two, allowing the coverage of one village per day by each sub-team (based on a target of 5
interviews each per day) from 31 January to 12 February 2005 (although in the first two days of the survey sub-
teams interviewed as a pair). Supervision of interviewers was carried out by three assigned team leaders with
responsibilities for logistics, supporting teams of interviewers, and quality control of the interview process. The
later involved checking all completed questionnaires for error, including missing or unclear responses, in which
case interviewers were to be instructed to return to the household to find the required information. Interviewers
were instructed to check their sub-team mates completed questionnaires before submitting to their team leader. In
addition, the ZOA advisor supervising the survey was required to carry out extensive checks on completed
questionnaires and quality control is discussed further in a lesson’s learnt paper produced by the ZOA advisor.

f) Data entry and analysis

Data entry was carried out by three staff from the participating organisations. Each data entry staff was responsible
for inputting the questionnaires results from one team. A separate PC and spreadsheet was used for each team, and
data was input into a template excel spreadsheet. A key problems encountered was the lack of columns available in
Excel which made input of multiple responses clumsy i.e. several responses in one column, preventing ease of data
analysis. A further problem was caused by the time taken to translate uncoded question responses. Analyse was
carried out by the consultant using both Excel and SPSS software. Further data cleaning (in addition to that carried
out by the ZOA Advisor) and the time taken to import the data suggest that data entry directly into SPSS would be
a more time efficient strategy for future surveys. The results of the analysis are presented in the next section and
the results for household data, community development, agriculture and food security, land and natural resources,
and health components were also presented back to field interviews and team leaders for interpretation on 22
March (comments have been documented in annex F).

A.4 Focus Group Discussions

Eight villages, four from each strata, were selected non-randomly (from those selected for the household survey)
for FGDs (see annex D for villages). Discussions with three focus groups; women, men, and community leaders
took place in each village, resulting in a total of 24 FGDs. The information required from the FGDs and a
suggested questioning route was developed by the consultant and the ZOA community development advisor
(included in annex C). A team of 5 facilitators participated in one day on refresher training on FGD techniques. In
addition, the team was made familiar with the information required from the discussions and the suggested
questioning route (although they were actively encouraged to modify the prepared list of questions), and developed
a number of participatory methods to use within the FGDs. A second day was spent carrying out practise FGDs
using the techniques developed the previous day.

The FGD team worked in groups of 2-3, with one facilitator and one recorder between 31 January and 10 February
with supervision provided by the ZOA community development advisor. The women’s discussion groups were run

4
concurrently with one of the other two groups to limit the number of unwanted observers potentially influencing
the group especially when sensitive questions were due to be asked. The teams were asked to type up their
transcripts from the FGDs and send to the translator the day following each discussion.

Limited time was available for training in recording and on reflection this would have been very useful. The
transcripts did not do justice to the quality of the FGDs, requiring the consultant to work through each transcript
with each facilitator or recorder to fill in gaps either in the recording or lost in the translation from Khmer to
English. The transcripts were analysed using standard qualitative techniques, grouping responses into common
themes. It is important to re-iterate that FGDs were not intended to provide data for statistical analyse but to
provide insights from a small number of case studies to compliment and possible provide explanation to the
quantitative data derived from the household survey. The results from the FGDs are therefore presented separately
from the household survey results within each section of the results chapter.

A.5 Key informant interviews

To set a baseline for the co-ordination components of the PDS is was considered essential to interview provincial
office directors and this was considered to be a more appropriate task for an ’independent’ consultant rather than a
staff member from one of the participation organisations. A questioning route, detailed below, was developed by
the consultant specifically focused on the co-ordination objectives and indicators and was conducted by the
consultant with 4 provincial officials (the Provincial Governor and the Director of the Health, Rural Development,
and Agriculture Departments) and the results are summarised in section C.10; Co-ordination.

Guide questions for informant interviews:

• Which organisations do you currently work with?

• What is their role?
• What needs to happen for your work with NGOs to be successful?
• How do you co-ordinate NGO activities?
• What data do you collect to help you measure progress?
• How could I get a list of NGO activities in the province related to your sector?
• How have you been involved in the development of the PDS?
• Can you provide any feedback on a) the process of developing the PDS and b) the content of the final plan
• What do you think the role of NGOs in the province should be?

A.6 Lessons learnt

During the baseline survey a series of reviews took place and this in addition to the reflections of individual staff
involved in the survey has enabled a paper on lessons learnt to be complied by the ZOA Advisor. See also section
C for recommendations on methodology.

5
B. Results

1. Household data
1.1 The sample population
A population of 5330 people in 940 households was covered by the household survey, as described by gender, age
group, and district in table 1 below.

Table 1: Population statistics for households surveys (n = 940)

Age Total Total

M<1 F<1 M 1-6 F 1-6 M 6-12 F 6-12 M 13+ F 13+ Total
group/gender M F
Anlong Veng 18 13 51 46 51 58 232 253 352 370 722
Bantey Ampil 17 23 86 96 151 130 521 574 775 823 1598
Chong Kal 17 13 47 63 66 76 242 278 372 430 802
Samroang 31 15 83 98 123 106 410 438 647 657 1304
Trapeang
14 8 81 51 85 89 297 279 477 427 904
Prasat
Total 97 72 348 354 476 459 1702 1822 2623 2707 5330

The population covered by the household survey accounts for approx. 4.95% of the total population within the
sample frame (based on MoP/SEILA 2004 Commune Database; using a mean of 5 people per household), see also
section A methodology. The sample population data is highly consistent with the data for the whole province
described within the 2004 database. There is a very close male: female ratio in the sample total and within each
district (approx 0.95 men: women) with the exception of Trapeang Prasat district which is the only district with a
greater ratio of men to women (the commune database also describes Anlong Veng as having marginally more men
than women). Household size varies between 1 and 14 people, with a mean size of 5.7 within the sampled
households. The mean value from the commune database is 5 people per family. This difference may be reflected
in the fact that the database is measuring families whereas the 2005 household survey is using households as the
ultimate sampling unit (approx. 2% difference per village). There are slightly larger household sizes in the east
strata (mean value of 6 people per household in both Anlong Veng and Trapeang Prasat) than in the west, with the
lowest household sizes in Bantey Ampil (mean value of 5.3 people). Approx. two-thirds of the population within
the sample are older than 13 years old (a ratio of 1:2 <12 years old : >13 years old), with the youngest population
in Trapeang Prasat (a ratio of 1:1.8 <12 years old : >13 years old).
Figure 1: The population appears quite stable with only 30
households having moved to their village in the last
year (3% of households in the sample). Samroang has
the highest rate of new settlers, with 6% (14
households) of its households arriving to live in their
village in the last year. The principal motive for those
who have moved to live in their village in the last year
has been to seek land (59% - 18 households).
83% of household are headed by males (780
households), and figure 1 shows that there is slight
variation by district with the highest percentage of male
headed households in Chong Kal (89%) and the lowest
in Anlong Veng (77%).

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1.2 Household roof type
Figure 2:
Interviewers were asked to make observations of roof
type as this is widely regarded to be a proxy indicator of
the relative wealth of a household (see for example
Participatory Poverty Assessment: Cambodia, ADB
2001).

The results (summarised in figure 2) show that 60% of

all households sampled have grass roofs (the 2004
Commune database records this figure as 63.5%). 38%
of households in the survey have metal roofs. There are
significant difference at district level, with the highest
percentage of grass roofs being in Trapeang Prasat
(83%) and the lowest in Chong Kal (41%) which is also
the district with the highest percentage of metal (53%)
and tile roofs (5%).

1.3 Household assets

Table 2 below summarised the responses to a series of questions about the ownership of household assets.

Table 2: percentage of households owning households assets by district (n = 940)

Asset Pans Bicycle Moto Oxcart Kuyorn car/truck Water Radio TV

pump
Anlong Veng 49% 68% 8% 14% 10% 0 4% 27% 32%
Bantey Ampil 50% 60% 11% 46% 9% 0 1% 28% 14%
Chong Kal 51% 53% 12% 57% 8% 0 0 27% 26%
Samroang 53% 70% 20% 37% 5% 1% 3% 27% 15%
Trapeang Prasat 58% 66% 15% 16% 5% 0 2% 35% 21%
Total 52% 63% 14% 37% 7% 1% 2% 29% 20%

The above data can be summarised as follows:

• Less than 1% of households own a car/truck (count = 1)

• Less than 10% of households own koyorns, and water pumps
• Less than 15% of households own a moto, ranging by district between 8% in Anlong Veng to 20% in Samroang
• 20% of households own a TV, ranging by district between 14% in Bantey Ampil to 32% in Anlong Veng
• 29% of households own a radio, with 27-8% of households in all districts owning a radio with the exception of
Trapeang Prasat where 35% own one
• Over 50% of households own pans with very little variation between district (the question asked about frying
pans due to a misinterpretation of the questionnaire)
• Over 60% of households own a bicycle, ranging from 53% ownership in Chong Kal to 70% in Samroang

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2. Community development

2.1 Awareness of VDC

Village Development Committees (VDCs) have been established with support from SEILA throughout the
province and provide a potential mechanism to organise and support community development activities. The
household survey asked a number of questions to gage the level of awareness of VDCs and to find out what actual
activities they carry out. Figure 3 below shows the 43% of the sample answered ‘yes’ to the question ‘do you have
a VDC?’. It also shows clear district variations, with over half the respondents in Samroang (51.7%) answering
yes, whereas less than one third of respondents
Figure 3: answered yes in Chong Kal (31%) and just over one-
third in Trapeang Prasat (38%). To test the level of
awareness of VDCs a following question was asked
'Do you have a VDC?';
percentage by district (n = 940) ‘can you name a member of the VDC?’. Table 3
100%
demonstrates that only a small percentage in each
47% 42% 31% 52% 38% 43%
district, and 5% in total (20 respondents) who
positively identified the presence of a VDC in their
75%
village could not name at least one of the members.
14%
This suggests that in a small number of cases VDC’s
Values

50% 12%
14%
13%
have been established but have been inactive and/or
55%
13%
13% 48% have little presence throughout their villages (discussed
46% 44%
41% further in section 2.8). It is anticipated that village
25% 36%
yes
level factors (especially commitment of individual
no
don't know
VDC members, attitude of VC, and local level
0%
Anlong Ve ng Chong Kal Trape ang Prasat
community development support provided by NGOs)
Bante y Ampil Samraong
District
Total are more likely to affect the presence of VDCs than
district level factors. It is therefore also interesting to
look at the variation in response to this question within
each village.

Table 3: Comparison of 'do you have a VDC? and 'can you name a member of the VDC?'; percentage of
households per district

Household responses
know name of at least one can not name a VDC don't have or don't know
District VDC member member if have VDC
Anlong Veng 43% 4% 53%
Bantey Ampil 38% 5% 58%
Chong Kal 28% 3% 69%
Samraong 44% 7% 48%
Trapeang Prasat 31% 7% 63%
Total 38% 5% 57%

Figure 4 below provides a description of the presence of VDCs within each village (i.e. the percentage of
respondents able to name at least one VDC in their village). The data suggests that VDCs are not widely known to
all households within each village. The median value (i.e. the middle value) is 30% of all respondents, which
means that in half of the villages sampled (46 villages) a maximum of 30% of respondents are able to name at least
one VDC member. In 4 villages (Am. Thmei, Chhou Stap, Kok Mon, and Peam Knong) 100% of the respondents
8
were not able to identify the presence of the VDC and/or name a VDC member, whereas in 1 village all
respondents could name at least one member (Sambour Meas). The variation within villages is markedly different
within Trapeang Prasat and Chong Kal which both have a median value of 20%, whereas Anlong Veng, Bantey
Ampil, and Samroang have a median value of 40%.

Figure 4: Percentage of respondants per village able to name at least

one member of VDC (n = 345)
25

20 21
No. of villages

15

13 13
10 12
10
8
5
4 4 4
1 1
0
0 10 20 30 40 50 60 70 80 90 100
Percentage of respondants per village

2.2 The role/activities of VDCs

In addition to presence of VDCs it is also important to understand the type of activities that they carry out within
their villages. Table 4 below summarises the number of different roles provided by households in response to the
question ‘what does the VDC do in your village?’ Over 70% of respondents (approx 278 households) were able to
name at least one role for the VDC (30.3% of the total household sample). There are slight variations between
districts, ranging between a maximum of 78.8% in Chong Kal and minimum of 66.1% in Trapeang Prasat of
respondents able to identify at least one role for their VDC. It is also interesting to note that although Chong Kal
has the lowest VDC presence indicators, the data suggests that where people are aware of their VDC, they see their
VDC as being active (as indicated by the number of active roles identified by respondents).

Table 4: Number of active roles of VDC identified by household respondent by district (n = 398)

Number of active roles of VDC identified by household respondent

4 roles Total can
District don't know None 1 role 2 roles 3 roles name role
Anlong Veng 10.7% 17.9% 46.4% 23.2% 1.8% 0% 71.4%
Bantey Ampil 4.1% 24.0% 38.0% 33.1% 0.8% 0% 71.9%
Chong Kal 4.3% 17.0% 66.0% 12.8% 0% 0% 78.8%
Samraong 11.0% 17.8% 33.9% 31.4% 4.2% 1.7% 71.2%
Trapeang Prasat 17.9% 16.1% 42.9% 23.2% 0% 0% 66.1%
Total 9.0% 19.3% 42.0% 27.4% 1.8% 0.5% 71.7%

It is anticipated that the actual variation between number of roles will be highly dependant on the probing skills of
individual interviewers, however, table 5 below suggests that a that high degree of generalisation can be made
about the type of roles for VDCs within the sample.

9
Table 5: Frequency of roles for VDC by district (n = 403):

Role of VDC Percentage by district

Bantey Anlong Trepeang
Samraong Chong Kal Total
Ampil Veng Prasat
Makes the VDP 36% 40% 34% 31% 39% 36%
Representing people 19% 30% 16% 21% 17% 19%
Nothing 13% 17% 18% 14% 13% 15%
Managing community
11% 4% 24% 8% 4% 13%
resources
Don’t know 8% 4% 3% 8% 16% 7%
Resolve conflicts within
9% 4% 3% 4% 9% 6%
households
Other 3% 0% 1% 10% 3% 3%
Resolve conflicts with
2% 2% 1% 3% 0% 1%
authorities

Table 5 above demonstrates that the most frequently provided role for the VDC is to make the Village
Development Plan (VDP), accounting for 36% of all responses (145 households). Representing people was the
second most frequently cited role, 19% of all responses, with the exception of Bantey Ampil where managing
community resources was the second most frequent accounting for 24% of all responses. The data demonstrates
that VDCs are generally not taking a role in conflict resolution (both within households and with authorities). A
key indicator of community development within the PDS is the level of consultation of people within the VDP
process (leading to the development of Commune Plans). 15% of the total sample (141 households) are aware of
the VDCs role in making the VDP and this is explored in more detail below.

2.3 The Village Development Plan

Those who identified the presence of a VDC in their village were later asked ‘do you know what is written in the
VDP?’ and the results are provided in figure 5 below. From this data we can not conclude if VDPs are being
produced, but it does show that only 35% of the sample (141 households) are able to identify at least one thing that
is included in the plan (15% of the total sample).
Figure 5: There is a small amount of district variation with the
highest level of awareness in Trapeang Prasat (41%)
and lowest in Bantey Ampil (28.5%). The 141
respondents provided the following details of what
they saw as the main benefits in the plans for their
household:
• 49 water related – 35% of responses
• 32 road/path related – 23% of responses
• 28 wells – 20% of responses
• 16 school construction – 11% of responses
• 10 improve life in family – 7% of responses
• 7 no use – 5% of responses
The majority of responses appear to be construction
related which suggests, as expected, that the VDP is
being used as a mechanism to request infrastructure
type projects via the commune development fund.

10
2.4 Village meetings
Figure 6: Interviewees were asked ‘do you attend village
meetings?’ 71% of the sample go to village
meetings and the results by district and gender are
displayed in figure 6. This provides an indicator of
the level of participation in decision-making and
also within the village development plan (although
people may not be aware of the VDP itself their
opinions may still be heard at the village planning
meetings and used in the formation of the plans by
the VDC). It is important to note that although
gender disparities appear at district level, the
overall sample showed only a slight difference
between men and women (with 75% and 74%
attending village planning meetings respectively).
The main gender disparities are in Chong Kal, with
significantly more women than men attending the
meetings (71% to 55% respectively). Whereas in
Anlong Veng and Bantey Ampil there are very high
attendance rates for men (87 and 88% respectively)
compared to those for women (73 and 71%
respectively).
Further data on attendance by gender is provided by the FGDs and is considered in section 2.8.3. It is a big step to
assume that attending meetings means that people actively participate within them. To explore this assumption in
more detail, a following question was asked ‘do you talk in the meetings?’. The results show that 54% of
respondents that go to the meeting also talk in them (39% of the total sample) and the results by district and sex are
provided in figure 7.
Again although there are gender differences at
Figure 7: district level, it is important to note that within
overall sample there was very similar results for the
percentage of men and women talking in the
meetings (54% and 53% respectively). The results
vary greatly at district level with only 34% of
respondents who participate in the meetings also
talking in them in Bantey Ampil, whereas in
Trapeang Prasat 73% of respondents talk during the
meetings. The main gender difference at district
level appears in Samroang where only 48% of
women who attend village meetings also talk in
them (compared to 74% of the men). Figures 8 and
9 below show the reasons provided by respondents
why they do not attend the meetings and reasons
why they do not talk in the meetings respectively.
The results measure the number of responses
provided separated by men and women.

11
Although the actual counts differ dramatically, the overall percentage for men and women are very similar (due to
the high percentage of women interviewed within the survey). It is clear that the most frequent reason given for
not attending the meetings is ‘not knowing about them’ (45% of respondents provided this reason). This supports
the data in section 1.1. showing the results for the levels of awareness of VDCs within each village.

Figure 8: Reasons for not attending village m eetings; num ber of responses by gender (n = 269)

120
Number of responses

97 men women
100
80
60 39
40 28 31
24 20 15
20 3 8 2 2 3 3 2 3
1 1
0
don't know not invited not no time too shy/not don't know other new to area relative goes
about them interested able to instead
speak in
group

The main reasons given for not talking in the meetings are that people are too shy to speak with 115 responses
(45% of respondents gave this reason), they do not feel it’s their role with 51 responses (20% of respondents gave
this reason) and they don’t understand the meetings with 42 responses (17% of respondents gave this reason). The
results shown in figure 7 above do not appear to be influenced strongly by literacy (when cross-tabulated with the
literacy indicators in section 7.3).

Figure 9: Reasons for not talking in village m eetings; num ber of responses by gender (n = 253)

120

96 men women
100
No. of responses

80

60

37
40 30
19 17
14 11 12 14
20
6 8 9 9
3 1 0
0
it's not my role no one will listen to me I'm not interested I don't understand the Too shy / can not speak don't know other nothing to say/ no ideas
meetings

2.5 Participation in community projects

The PDS considers that the number of community initiatives to be an indicator of self-help capacity. The results
of the household survey (figure 10) show that 65% of households included a member who participated in a
community project in the last year. The highest percentage occurred in Bantey Ampil (75%) and the lowest in
Samroang (55%). The remaining three districts have very similar results (61-65%).

12
Figure 10: It is useful to break this total figure down to village
level to allow increases in participation of
community projects to be measured on a per village
basis in the future. Figure 11 below shows the
frequency distribution (number of villages) by
percentage of households participating in a
community project in the last year per village. The
median value is 70% (in over half the villages at
least 70% of household participate in a community
project). The types of community projects that
respondents participate in are mainly construction
projects (roads, fences, schools, etc) which account
for 92% of household members’ participation in
community projects. This suggests that community
participation takes place to fulfil the co-funding
agreement for village development funding
provided by PDRD/SEILA.

Figure 11: Percentage of respondants taking part in community projects per village
(n = 588)
20

18
15
No. of villages

15
13 13
10
9
8
5
5
1 1 4 3
0
0 10 20 30 40 50 60 70 80 90 100
Percentage of respondants per village

2.6 Participation in self-help projects

A further indicator of self-help capacity is provided by the question ‘have you carried out any new projects in the
last year to improve life in your household?’ The overall results are provided in figure 12, which show that 38% of
the households sample carried out new projects in the last year to improve life in their households. The results by
district range from a low of 28% in Bantey Ampil to a high of 52% in Anlong Veng. It is again useful to break this
total figure down to village level to allow increases in self-help household projects to be measured on a per village
basis as this may be stimulated by village level factors (such as the presence of an NGO). Figure 13 below shows
the frequency distribution (number of villages) by percentage of households carrying out self-help projects in the
last year per village. The median value is 40% (in over half the villages at least 40% of households carry out self-
help projects). In 4 villages none of the households sampled carried out self-help projects in the last year.

13
Figure 12: The projects have been split into type in figure 14
below. It is important to note the broad
interpretation of self-help projects which is
dominated by livelihood activities not restricted to
in/around the household itself (the original intension
of the question) including growing new crops,
setting up a small business, improved existing
agriculture, and use of forest/forest products (within
this including chamkar rice cultivation and wood
cutting).

Figure 13: Percentage of respondants per village carrying out self-help projects
(n = 940)

16
14 15 15
14
No. of villages

12
12 12
10
10
8
6
4 5
4 4
2 1 0
0
0 10 20 30 40 50 60 70 80 90 100
Percentage of respondants per village

Figure 14: Number of new projects initiated for household self improvement
in the last year (n = 350)
160
136
140
No. of responses

120
100
80 65 64
60 47
35
40 19
7 11
20 3 3 1
0
Sta Sta Im Im Ot Ma Liv Us Im Sil Fis
rte rte p rov p rov he ki n es eo pro kw hin
d d r g t oc f v o g
g ro as ed ed ha kp for ede rm
win ma t
he h yg nd rod est xis f a
ll b ho ien icr / fo tin rmi
g ne us us aft uc res ga ng
w ine e e s tio
cro n tp gri
ss ro d cu
p uc ltu
ts re

2.7 Summary of community development indicators

14
The situation in each village related to the functioning of community development structure such as VDC is likely
to be dependant on village level factors and so care must be taken with summary statistics for the sample or on a
district level.

Table 6: summary of community development indicators

Anlong Veng Bantey Ampil Chong Kal Samroang Trapeang

Prasat
% can name VDC member 43% 38% 28% 44% 31%
% of above can name at least 1 71% 72% 79% 71% 66%
role of VDC
% aware of VDP 35% 29% 30% 39% 42%
% go to village meetings 76% 76% 67% 66% 72%
% of above talk in meetings 59% 34% 68% 54% 73%

Table 6 summarises by district from the sample a number of the community development indicators, which shows
that:

• approx. one third of respondents are aware of at least one VDC member by name
• approx. two thirds of those aware of the VDC members by name are also aware of at least 1 activity they carry
out
• approx. one third of respondents are aware of the VDP
• more than two thirds off households in all districts go to village meetings at which approx. half of these people
talk.

The most notable district variations are:

• in Bantey Ampil where a low percentage of the households sampled who attend meetings talk in them (34%)
• in Chong Kal where a low percentage of men interviewed attend village meetings (55%)
• in Samroang where a low percentage of women interviewed who attend village meetings talk in them (48%)

2.8 Data from the FGDs and the Needs Assessment

The FGDs specifically focused on the topic of community development within both the men’s and women’s group
meetings (a total of 16 FGDs), asking questions related to the establishment of the VDCs, their roles, participation
within decision-making, and any specific role towards supporting the poor. This data compliments and enriches
much of the data derived from the household survey. Consideration is also made of the data within the needs
assessment.

2.8.1 Establishment of VDC

All FGD groups explained that they had a VDCs which was established with support from SEILA, including the
election of members (between 1999 – 2001) by village members. It is clear from the FGDs that no subsequent
elections have taken place in the 8 villages (although some members have resigned due to lack of available time)
and in most cases have not been replaced by new members (or as in one case by unelected members). Members of
VDC also expressed the concern of a lack of support since their establishment and appeared to be lacking a sense
of direction, capacity and purpose. The length of time since establishment without subsequent elections may

15
provide the reason for only 38% of the household survey being able to name at least one member of VDC in their
village. Further potential reasons are identified by the Needs Assessment; many villagers may have moved into
their area since the establishment of the VDC and are therefore unaware of it’s existence. The later explanation
would also suggest that VDCs are not active or are not serving the entirety of the people in their villages. The
within village variation of awareness of VDC (see section 2.1) suggests that the people serving on the committees
and their work is not known by the majority of people within their villages. This can be further explored by
looking at the roles that the VDC take according to FGD participants.

2.8.2 The role of VDCs

The FGD responses overwhelming identified the role of the VDCs as communicating with NGOs. This is in
contrast to the household survey (see section 2.2, >10 responses identified this as a role contained within the other
category in table 5) which clearly identified the VDP as the main role for the VDC. This may be in part be down to
terminology with FGD responses including ‘making activity plans’ and describing planning for specific activities,
these type of responses will have been coded as VDP in the household survey, and suggests that the FGD also
identified VDP as a key activity for the VDC. 3 out of 8 villages in which FGDs took place (37%) talked
specifically about VDC led meetings with villagers, whereas in 6 villages the participants talked about the high
degree of consultation and joint decision making that takes place with the VDC and VC within their village which
indicates (as does the household survey) that in the majority of villages village meetings do take place and certainly
involve people beyond VDC members alone. It is important to note that much of the responses group the VC
with the VDC and (as identified in the needs assessment) the two often seem synonymous or even one and the
same.

There were few examples provided by the FGDs of VDCs providing specific support for the poor in their villages.
In Prasat Ibuek it was explained that ‘when villagers suffer starvation only ask neighbours, but also village has
united rice store bank to support suffering families’ and in Tamann it was explained that ‘if starvation or serious
illness occurs the VC and VDC write down the family name and sent to inform commune chief or red cross’. The
HC equity funds were recalled by 3 villages as a mechanism to provide free health care for the poorest people but
the important people identified to facilitate this were the VC and/or VHSG. The FGD data suggests that
neighbours are the main source of support for those suffering lack of food, whereas the household survey results
identify the main strategy to be to relatives (borrowing food and/or money from relatives) as described in section
5.1.

It is important to state that in 15 FGDs (out of 16 focused on VDCs) participants saw the role of the VDC as
important or very important, and only one group out of the 16 expressed the view that ‘they do nothing here’.
However, the FGDs clearly identified that they saw the most important role of the VDC as communicating with
NGOs, and a potential concern emanating from the FGD transcripts is villagers perception of NGOs, as one
women explained;

‘VDC activity is very important because they are the parents of the villagers in promoting and urging to make
relationships with other NGOs as a result of writing requests for NGOs to disseminate programs while having
meetings with NGOs that come for developing the village as promoters in the community and propose to continue
their obligations for ever’.

The above statements and others like them (together with the results from the household survey which shows that
one-third of respondents carried out a self-help project in the last year) resonate with the concerns identified in the
Needs Assessment that many people do not believe that they have the ability to improve their own lives which may
have been in part caused by the focus on relief approaches in the province and a lack of emphasis to date on
empowering communities to support themselves.
16
2.8.3 Participation in decision-making

The FGD data strongly suggest that VDCs are highly consultative with people in their villages, in 6 villages the
FGD respondents specifically mention their involvement in discussing actions and decision making with the VDC
at village meetings. This is consistent with the household survey which identified that over 70% of all respondents
attend village meetings. In most cases women appear more active than men in village planning and decision-
making (6 villages, including all in the east strata). It was explained in the FGDs that this was due to the lack of
time men had to participate in meetings due to their role in income generating activities such as leaving the village
for migrant work or being busy in the rice field, forest or as a policeman or soldier. This is consistent with the
household survey data which identified higher percentages of women’s participation than men’s in the east strata.
In all the 8 villages the women’s FGD also explained that they had the opportunity to take part in decision making
and share their ideas. The responses given seem to indicate that this situation has changed within recent memory,
many responses positively describing women’s participation and role in their village/society end with words such
as ‘now’ or proceeded by ‘nowadays’.

In terms of representation on the committees by gender, all VDCs in the FGD villages have both men and women
serving on the committee, and in most cases there is a good gender balance (certainly more balanced that the data
from PRDC, included in the needs assessment, suggests). There is one example of a male dominated committee
(Phnom Kor in Chong Kal) and two examples of female dominated committees, both in the east strata (Toul Tasek,
Thnal Tteng), the latter possibly for the same reason identified in the paragraph above (i.e. high female
participation in community life due to men being busy with income generation commitments). Regardless of
gender balance, the lack of subsequent elections (in some cases since 1999) questions the representativeness and
accountability of VDCs. This is extremely important when considering if people from different social strata are
represented on the committees (or if it is possible for them to be elected due to illiteracy, time, or social status), and
because there was little evidence from either household survey or FGD data that the role of VDCs includes helping
the poorest people in their villages (although there is no link between the group within the ‘poorest’ group
identified by the survey and attendance in village meetings, see section 5.8). VDCs are often established as a way
to empower communities, and to provide a mechanism to reach and support the poorest rural people, yet there is
the risk that their formation concentrates power and opportunity into the hands of a few. The needs assessment
summarised this predicament well; the poorest people often feel neglected by NGOs whilst NGO workers often
find it difficult to work with or target the poor. The PDS has a clear objective to decrease the marginalization of
vulnerable groups within its community development objective and its needs to plan carefully how the VDCs it
supports can be encouraged to fulfil the objective, if at all (see recommendations in section C).

17
3. Landmines and UXOs
According the household survey data, in the last year:

• 1 child was injured by a landmine/uxo, 1 had an amputation, and there were no reported deaths to
landmines/uxos amongst children (>15 years old).
• 10 adults were injured, the majority in the east strata (4 in Anlong Veng and 5 in Trapeang Prasat), 22 adults
had amputations due to landmines/uxos (more than half of these in Bantey Ampil) and 3 were killed

The household survey also attempted to measure the number of people within the sample population with a
landmine/uxo related disability. 99 people (53% of all people with disabilities) were identified by respondents as
having landmine/uxo related disabilities. This represents 1.9% of people in the sample (population of 5330) and
4% of households having a member who is a casualty of landmines/uxos (not including death). The greatest
number by population occurred in Trapeang Prasat district, where 3% of people in the sample have a disability
caused by landmines/uxos.

18
4. Land and natural resources

4.1 Land titles

17% of the sampled household responded ‘yes’ to the question ‘do you have a land title?. There are marked
variations between districts as shown in figure 15 below.

Figure 15: Figure 16:

The highest percentage of land titles exists in Samroang where 45% of respondents claim to have a land title
(although the data set is smaller due to an error in the wording of the questionnaire which discount the first 100
responses, therefore the number is 59 households), and low responses were recorded in Anlong Veng (7%),
Trapeang Prasat (7%) and also Banteay Ampil (9%). The following question, ‘is the title temporary or permanent?’
shows that 24% of those with a land title have a temporary title (142 households) and 76% have a permanent title
(638 households), as displayed in figure 16. There is a marked district variation in Trapeang Prasat district with
90% (9 households) of respondents having a temporary title and 10% (1 household) permanent, however it should
be noted that this result is based on a very small data set due to the low number of positive responses to the
previous question in this district.

4.2 Households with no land

Only 2% of households (21) do not appear to have access to land to grow rice, fruit or vegetables. The highest
number of these households are in Samroang (14), followed by Bantey Ampil (5), and 1 each in Anlong Veng and
Trapeang Prasat. 98% of households in the survey therefore have access to land for agricultural production, quite
how stable this situation remains unclear due to the uncertainly surrounding the legal status of land titles as
described in annex F. It is also unclear if not having access to land is am accurate poverty indicator. In many of
the cases within Samroang it appears that households are not accessing land to grow rice, fruit or vegetables
because they are running a small business or employed as a professional worker or civil servant.

4.3 Deforestation

An explicit objective in the PDS is to protect the environment and reduce deforestation. The principle causes of
deforestation are commercial logging and clearance for chamkar rice production. The household survey asked

19
questions to allow us understand more about the important of chamkar rice production to households living in this
area and to estimate the extent of forest area being cleared.

The results show that a total number of 270 households are engaged in chamkar rice production. 27% (251
households) of the households sampled grew upland wet season rice (chamkar) in the last year on their own land
with an additional 2% (20 households) growing on borrowed or rented land. These figures include 1 household
growing chamkar on both their own and rented/borrowed land. The summary statistics presented in table 7 below
show that there is very small difference in the size of chamkar rice production according to ownership of land.

Table 7: Summary statistics for chamkar rice production (n = 270)

Own land Borrowed/rented land

Mean 0.88 hectares 0.86 hectares
Median 0.96 hectares 0.72 hectares
Mode 1 hectare 1 hectares
Sum (total area of land) 222 hectares 17 hectares

The data provided by the household survey is also useful to locate geographically the areas where deforestation
caused by chamkar rice production is the greatest. Table 8 shows the area of land used for chamkar rice
production in each district

Table 8: Area of land used for chamkar rice production (n = 270)

Number of % of household’s Total area of land % of total area Chamkar/househ

households sampled within (hectares) olds in sample
district (hectares)
Anlong Veng 78 65% 63 26% 0.5
Bantey Ampil 48 17% 24 10% 0.08
Chong Kal 12 8% 5 2% 0.03
Samroang 43 19% 37 15% 0.16
Trapeang Prasat 119 79% 109 46% 0.72
Total 270 29% 239 100% 0.25

The data shows that clearance of forest for chamkar rice production is most affecting deforestation in Trapeang
Prasat district (109 hectares of land cultivated for chamkar) and in Anlong Veng (63 hectares), a clear division by
strata (the eastern strata accounting for 72% of the total area of land used for chamkar cultivation within the
sample).

The data also allows us to pinpoint the locations of high chamkar rice production. The following 8 communes (of
which 7 are in the east strata) account for 175 hectares of chamkar rice production (over 73% of the total area of
land used for chamkar cultivation within the sample):

• In Anlong Veng; the communes of Anlong Veng and Trapeang Prey

• In Samroang; Kon Kriel commune (and specifically in Anlong Veng village)
• Trapeang Prasat; in 5 out of the 6 communes (all communes except Thlat)

4.4 Income from sustainable use of natural resources

20
The analysis of income sources for sampled households is provided in section 5.3. An indicator in the PDS for
assessing income from sustainable use of natural resource management is total and average per family income from
resin tapping increases in 15 villages. The household survey could not generate the level of detail required to set a
baseline for this indicator. However, the results of the income sources do show that resin tapping is a significant
income source for 14 households in the survey (1.5%), with most of these households being located in the east
strata (8 in Anlong Veng and 4 in Trapeang Prasat). In addition, 3 households responded with resin tapping as their
first significant income source.

4.5 Data from the FGDs and the Needs Assessment

The men and community leader’s groups (a total of 16 FGDs) were asked specific questions about use of natural
resources, and in particular about the importance of forests and fishing to their livelihoods. This information
compliments the data provided on deforestation in section 4.3 above as well as more generally the significant
income sources data described in section 5.3. Consideration is also made of the data within the needs assessment.

4.5.1 Forest resources

The participants in all groups in the west strata described the destruction of the forest in the period 1993-4, whereas
it appeared to be generally later in the east strata 1999-2000 (with the exception of Phdeak Chru group which
described the peak period of forest destruction in the early 1990’s). All groups explained that the destruction was
still continuing in the proximity to all villages by large scale logging but also by clearance to make chamkar.
Participants in one village also described a few cases of people in the village owning chainsaws for use in small
scale logging.

It is clear from the FGDs (as also concluded in the needs assessment) that the forests continue to play an important
role in people’s livelihoods strategies. Participants in all villages were able to name a high number of roles that
forest resources play in their lives including provision of rainwater, materials for building houses, vegetables for
eating, provision of quality farming land, charcoal, fertilizer (‘leaves especially make the best quality’), can keep
animals there, prevent natural disasters such as floods etc. In addition, all groups also demonstrated a high level of
understanding of the need and desire to sustainably manage forest resources. All the groups expressed their
concerns over illegal logging and the difficulty to control it due to the involvement of ‘power people’ and the army.
The FGD confirmed again the information in the needs assessment that large scale illegal logging continues to
happen with strong protection by perpetrators. However, 6 of the groups specifically talked about their desire to
establish community forests near their village (mostly with support from the government or NGOs). Two groups in
the east strata explained that the poor families rely of chamkar, with the view given in one of the groups that they
‘should continue do it this way because they are so poor’. In the other group they thought that enabling poor
households to access draught animals would be the only way to reduce deforestation, allowing these households to
farm the same plot of land over a longer period of time.

Despite the clear importance of forest resources, it is interesting that the household survey did not show forest
related activities as a significant income source for many households (see figure 28). This may be partly down to
coding and forest related activities are concealed within the ‘labourer’ and ‘other’ categories. Resin tapping
certainly only provides a very small number of responses, whereas the needs assessment identified this as ‘an
important source of income….with at least some families in almost all villages in he eastern districts (up to 30 per
village are involved’. In addition, charcoal production provided few responses but again is identified as another
significant income source in the needs assessment. These contradictions will need to be discussed with field staff
to better understand if the difference is due to survey error, a case of highly localised livelihoods strategies, or
demonstrating already the effects of deforestation (i.e. the cutting of resin trees).
21
4.5.2 Fishing

Fishing appears to be a generally less important livelihood strategy for participants in the groups. Only three of the
groups (Thnal Tteng, Tamann, Phdeak Chrum) stated the importance of fish but it is unclear from the FGD
transcripts if this refers to fishing as a livelihood strategy or the importance of eating fish (which may have been
bought from elsewhere as seems to be the case in the province). In addition, only one group identified availability
of natural resources such as fish in the strengths analysis (albeit with a rank of 4 and score of 3 out of 41).

The group in the east strata, and in Tamann and Romchek in west strata, explained that illegal fishing and an
associated decline in fish stocks started in 1999-2000, mainly being carried out by the army, soldiers, and ‘power
people’, although the group also added that most villages, having seen these techniques, now also used them but
not to the same extent due to the lack of weapons/equipment. The two remaining groups from the west strata
(Phoum Kor and Prast Ibeuk) recalled that illegal fishing and decrease in fish stocks started occurring much earlier,
since 1980-1. All groups identified that illegal fishing still continues and their descriptions of the situation confer
with the needs assessment which identified that ‘throughout the province fisheries resources are under heavy
pressure from people (usually soldiers or police) fishing with electronic gear and explosives over which there is
virtually no control’.

As stated above, fishing now appears to be less important to most of the groups, and this agrees with the household
survey which identified that 5% of responses for significant income sources were fishing. It is difficult to make
generalisation across the province because the importance of fishing is expected to be highly localised (as
described in the needs assessment), with 60% of households in the survey also reported to have eaten fish in the
day before the survey. However, this may also indicated that people are now buying fish from elsewhere such as
Seam Reap province or Thailand.

All the groups stated their desire to reduce illegal fishing, although again they identified their own, and the
fisheries authorities, lack of power to enforce the law or report offenders. Four groups suggested the establishment
of community fisheries (3 in the east strata) and two groups proposed making a pond in their village for fish
farming.

22
5. Agriculture and food security

5.1 Food security

74% of households in the sample have experienced food shortages in the last year (696 households) as shown in
figure 17. The data suggests that food shortage is widespread throughout the province, being slightly higher in the
east strata (both Anlong Veng and Trapeang Prasat the incidence is ≥80%), whereas in the west strata the incidents
ranges between 76% (Chong Kal and Samroang) and 65% in Bantey Ampil. The mean and median values for the
number of months of food shortage in the last year are both 4 months; with the maximum number of 6 months also
the most frequent accounting for 220 households (32% of households experiencing food shortages and 23% of the
entire sample).

Figure 17: Figure 18:

Table 9: Total number of months of food shortage per district

District Anlong Veng Bantey Ampil Chong Kal Samroang Trapeang Total
Prasat
Total months of
food shortage 456 716 407 634 535 2748
Mean number 5 4 4 4 4 4

Table 9 above shows that the total number of months of food shortage within the sample is 2748 months, with each
district having a mean value of 4 months, with the exception of Anlong Veng which has a mean value of 5 months.
The results in figure 17 show that Anlong Veng is clearly the district most severely affected by food shortages,
although food shortage also appears to be a highly significant issue throughout all districts. The main reasons for
food shortage perceived by respondents were low crop yields (511 responses), with lack of land (224 responses),
lack of access to credit (178 responses), illness (159 responses), and lack of draught animals (91 responses).
Together they account for 89% of all responses.

Figure 18 shows that the distribution of rice bank committee’s varies greatly throughout the districts, with the
greatest number located in the two districts experiencing the greatest problems with food shortage (Anlong Veng
and Trapeang Prasat). The lowest number, according to the data, are located in Chong Kal where only 3% of

23
respondents answered positively to having a rice bank committee. Only 24 household respondents could not name
could not name a member of the rice bank committee which indicates that where the committee’s exist they have a
strong presence throughout their village. The presence of a rice bank committee however does not appear to effect
coping strategies to food shortages. Figure 19 below shows responses to food shortages, with borrowing rice from
relatives being the strategy used by the majority of households (420 households; accounting for 34% of all
responses). Whereas borrowing from the rice bank accounts for only 6% of responses (used by 81 households).

Figure 19: 'When your family experienced food shortage last year, how did you try
to solve the problem?'; frequency of responses (n = 696)
Frequency of responses

500 420
400
300
200 102 81 83 82 110 81
68 70 67 39
100 5 18
0
Se Bo Bo Ea Ot
ll a rro Borro Bo
r rr o t le Fin
da
No
thi he Fis
hin
La
bo
Co
l lec
Ma
ke
ss
ets
wm w m row r wf ss n ng r g ur t/u /s e
on o ic r om f oo ew se ll h
ey ne e( r ic d fo na an
(le y( rel eb od tur di c
nd re l ativ c ro al r raf
er) ati es an p es ts
ves ) k ou
) rce
s

5.2 Household nutrition

5.2.1 Vegetable production

52% of households have land available for growing vegetables, however, only 64% of these households actually
grew vegetables in the last year (312 households), with slight variation by district ranging from 74% in Bantey
Ampil to 54% in Chong Kal. The majority of this land is owned by the households (98%) with only 12
respondents (2%) growing vegetables on borrowed or rented land.

Figure 20: Figure 21:

24
The size of land is typical of small scale production, predominantly <0.5 hectares in size (89% of those growing
vegetables in the last year). This date is important to
Figure 22: understand the role of vegetables as both an income
source (see also section 5.3) and for household
nutrition. The motivation to grow vegetables appears
to be mainly to sell rather than for consumption (as
also identified in the needs assessment); there is a
clear pattern within all districts of households
growing vegetables only to sell and to both sell and
for their own consumption (54% and 45%
respectively as shown in figure 22). The majority of
households growing vegetables are growing between
2-4 types (40% grow 3 types of vegetables, 27% grow
2 types and 16% grow 4 types). The number of types
of vegetables is higher in the east strata (58% grow 3
types in Anlong Veng and 50% grow 3 types in
Trapeang Prasat). It is also interesting to see that
there is a more year round vegetable production in the
Figure 23: east strata, as shown in figure 23. 75% and 64% of
households growing vegetables do so in the dry
season in Anlong Veng and Trapeang Prasat
respectively. Whereas in the west strata dry season
vegetable production is much lower (the east districts
accounts for 63% of households growing in the dry
season, and the three western districts account for
36%). The type of vegetable being grown is shown in
figure 24 below. 311 households are growing a total
of over 14 types of vegetables and generated 886
responses to the question ‘what type of vegetables do
you grow?’. 6 types account for over 75% of the
responses; mung beans (161 households are growing),
cabbages (125 households), cucumber (117
households), pumpkin (99 households), waxbottle
gourd (85 households) and eggplant (84 households).

Figure 24: Types of vegetables being grown;

frequency of responses (n = 311)

200 161
117 125
150 99
84 85
100 58 56 55
28
50 3 3 7 0 5
0
in

lli
ry
an

m
r

on
ze
nt
an

va
o
be

ge

hi
pk

or

or

lo

oo
la

at
be

ai

ni
sa
be

C
um

gu
gp

gu

ba

ot
m

O
hr
as
tp
g

Pu
ng

ng

ab
Eg

uc

us
ge

tle
un

C
ee
lo

ni
C

M
on

ot
M

or

Sw
rd

/b
Sp

M
ax
Ya

25
5.2.2 Fruit production

76% of households in the sample (714) have an area of land where they grow fruit trees as shown in figure 25. The
results are very similar in all districts, with the exception of Trapeang Prasat where 91% of the households have an
area of land for growing fruit. However, 12% of the households (117) don’t actually have any productive fruit
trees on their land, with a big difference between strata, in the east strata 47% and 28% don’t currently have any
productive fruit trees on their land for growing fruit in
Figure 25: Trapeang Prasat and Anlong Veng respectively. The
total number of fruit trees gown in the sample is 7939
trees; with a maximum number of 158 trees, a mean
of 11 trees, and a median value of 7 trees. In addition,
the 75th percentile is 15 trees which indicates that a
small number of households have a large number of
trees (possibly orchards) distorting the mean above
the median (making the later a more reliable measure
of the average value). There is marked variation in
the number of trees by district with a mean of 14 trees
in Anlong Veng and Chong Kal, 13 trees in Samroang,
9 trees in Bantey Ampil, and 8 trees in Trapeang
Prasat.

The number of types of trees grown has both a mean

and median of 2 types of tree, and a maximum value
of 9 trees.

Figure 26: Figure 26 shows that 76% of households growing fruit

within the sample do so for their own household
consumption. The only variation at district level in
Trapeang Prasat where 69% grow for household
consumption.

In total 12% of all households in the sample are

growing vegetables and fruit for family consumption.
14% of households in Anlong Veng and Samroang are
growing both for family consumption, 13% in
Trapeang Prasat, 12% in Chong Kal, and 8% in Bantey
Ampil.

5.2.3 Diet

99% of the sample (933 households) ate 2-3 times in the day before the survey (59% are twice and 40% ate three
times). There is only slight variation at strata or district level, with Chong Kal having the highest percentage of
households eating twice in the day before the survey (74% - 111 households) and Bantey Ampil having the highest
percentage eating three times (49% - 141 households). In terms of food eaten the day before the survey, 99% ate
rice, and <10% ate bor-bor (8.4%), noodles (2%), eggs (9.6%). Table 10 below summarises the results for fish,
prahok, meat, vegetables, fruit and oil.

26
Table 10: Summary results for food ate the day before the survey (n = 940)

Food type Percentage ate in No. of households Highest percentage by Lowest percentage by
day before survey district(s) district(s)
Fish 60% 567 Chong Kal – 73% Trapeang Prasat – 51%
Samroang – 69%
Prahok 65% 610 Chong Kal – 81% Anlong Veng – 52%
Samroang – 72%
Meat 18% 165 Anlong Veng – 23% Chong Kal – 10%
Vegetables 65% 613 Chong Kal – 77% Bantey Ampil – 53%
Fruit 15% 157 Bantey Ampil – 19% Trapeang Prasat 7%
Oil 29% 271 Samroang – 34% Anlong Veng – 19%

5.3 Financial status

Figure 27 shows the percentages of the number of different significant income source per household. The majority
of households have 2 significant income sources (55%, 517 households), followed by one income source (26%).
Chong Kal district shows the greatest variation from the
Figure 27: overall situation, with higher percentage of households
having more significant income sources (61% have 2
sources, and 27% have three). Households in Bantey
Ampil appear the most vulnerable to failures in rice
harvests, having the highest percentage of households
(38%) with only one significant income source
(predominately paddy rice production). The types of
household’s significant income sources are summarised
in figure 28 below. Paddy rice production dominates
the responses, with over 40% of the total responses and
a significant income source for 777 households (83% of
the sample). In addition, it is the first significant
income source given by 700 households (74% of the
sample). Other important income sources are selling
livestock (231 responses), labour (156 responses) and
selling fruit and/or vegetables (134 responses).
Figure 28: 'In the last year, w hich activities generated significant incom e for your household?'; frequency
of all responses (n = 940)
Frequency of response

1000
777
800
600
400 231
134 156 116
200 77 34 23 49 52 75 18 10
3 2 7 3 9 14 6 7 6 2 15 0 2 2
0
Ric Ric Ho La Pro Sh Sm Ta Mo Fis Pro Fo Ch Re Se Bu Buy Tha Sew Ric Ric Ba Ma G e Buy Re O th
e p e p me bo u f./G o p all xi to p he c e res arc s in l li n yin in tc i n e e tt tt t / st e
rod rod g a rer ov (b u bus od rma ss in t /w o al tap g l i g/s g/se h m g win mi ll ery c we a mone s ell r ./Bar r
uc uc rd e ( da ern ys / i ne n g f oo ma pin ve s el li n l li n ak i e m ing h a vi n y i ce /C
rg i g fro as
tion tion n c y - . w sel s s is h d c k in g toc g g n ak
- ri - c rops to -d ork e ls go utt
i g k ve g ric e g ing ng m
rel
ino
c e ha ay r o ng / fru at i
(
pa mk veg wo d s) it ve
d d ar /fr rk) s
y ui t
)

27
Figure 29: Figure 30:

Figure 29 shows that 23% of households (216 households) have experienced increased income over the last year,
whilst 26% feel that their income has decreased (244 households). Income appears to have increased for the most
households in Samroang (25%), and the least in Chong Kal (19%). Income has decreased the most in Trapeang
Prasat (36%) and the least in Chong Kal (16%) of households. Improved rice yields (52%) and increased livestock
production (17%) are the two main reasons given by respondents for income increasing. Conversely the main
reasons for those experiencing decreasing income are decreased rice yields (39% of responses), lack of land (19%
of responses), lack of access to credit (14%) and illness (12% of responses).

In 13% of households, members contributed to household income through migrant work, with fewer in the east
strata (8% in Anlong Veng and 5% in Trapeang Prasat), as shown in figure 30 above. Table 11 demonstrates that
the main types of migrant work are non-farm work in Thailand (42%), farm work in Thailand (23%) and non-farm
work in Otdar Meanchey (19%).

Table 11: Count/percentage of type of migrant work by district (n = 124)

Type/location of migrant work?

Farm work Farm work Other work Other work
in Otdar in another Farm work in Otdar in another Other work
Meanchey province in Thailand Meanchey province in Thailand
Anlong Veng Count 0 1 2 4 1 1
% in District 0% 11% 22% 44% 11% 11%
Bantey Ampil Count 3 2 17 3 1 20
% in District 7% 4% 37% 7% 2% 43%
Chong Kal Count 2 0 1 1 1 18
% in District 9% 0% 4% 4% 4% 78%
Samraong Count 3 1 7 13 4 11
% in District 8% 3% 18% 33% 10% 28%
Trapeang Prasat Count 0 0 2 2 1 2
% in District 0% 0% 29% 29% 14% 29%
Total Count 8 4 29 23 8 52
% in District 6% 3% 23% 19% 6% 42%
5.5 Improved rice yields

28
90% of households grew rice last year (see figure 31). The situation in each district is very similar with the
exception of Samroang where 74% of households grew rice last year. There were only two households in the
sample growing rice during the dry season.
The production of wet season paddy rice varies
Figure 31: significantly between strata as demonstrated by the %
of district row in table 12 below. Wet season paddy rice
production is significantly more widespread in the west
strata, whereas chamkar production is significantly
more widespread in the eastern strata. For district level
variation in chamkar rice production also see section
4.3.

In term of total yields by rice type:

• Of the 640 households (68% of the sample) growing

wet season paddy rice there is a mean of 1580 kg
• Of the 304 households (32% of the sample) growing
chamkar wet season rice production there is a mean
of 1066 kg.

Table 12: summary statistics of rice yields by district

Paddy wet season yields (n = 640) Chamkar wet season yields (n = 304)
District Chong Bantey Anlong Trapeang Chong Bantey Anlong Trapeang
Samroang Samroang
Kal Ampil Veng Prasat Kal Ampil Veng Prasat
No.
152 142 248 51 47 45 12 48 78 121
households
% in
66% 95% 86% 43% 31% 20% 8% 17% 65% 81%
district
Mean 1588 1264 1914 1375 976 882 458 877 1128 1238
Standard
1337 1003 1781 1276 571 712 290 658 1028 1002
deviation
Maximum 7500 8000 17850 5000 2800 2400 1200 3600 6400 5400
Minimum 113 160 80 100 180 150 160 40 100 200
Median 1230 955 1467 960 1000 700 355 850 855 1000
Sum 241403 179558 474620 70135 45870 39675 5500 41220 87990 149852
Area of
production 304 298 936 59 37 37 5 24 63 109
(hectares)
Yield
kg/per 794 603 507 1189 1240 1072 1100 1718 1397 1375
hectare

Total yields for paddy wet season rice production are the lowest in Trapeang Prasat (with a mean value of 976kg),
which conversely is the district with the highest total yields for chamkar rice production (mean value of 1238kg).
There is a clear divide by strata for chamkar rice total yields with Anlong Veng also having a mean of 1128 kg,
whilst the mean west districts total yields range between 458kg in Chong Kal to 882 in Samroang. The highest
total yields for paddy wet season rice production are in Bantey Ampil with a mean value of 1914 kg and the lowest

29
in Trapeang Prasat with a mean value of 976kg. The statistics also suggest a high degree of variability within the
rice yield distributions, the standard deviation values are very low for the low yielding districts (Trapeang Prasat
for paddy rice, Chong Kal and Bantey Ampil for chamkar) and high for the high yielding districts (Bantey Ampil
for paddy rice) indicating that a small number of high yielding households are distorting the mean value (this is
further indicated by low median values compared to the mean). In terms of rice yields per hectare, table 12 also
demonstrates that the highest yields for wet season paddy rice production are in the east strata (which is interesting
as Trapeang Prasat also has the lowest total yield), whereas the highest yield per hectare for wet season chamkar
rice production is in Bantey Ampil.

The household survey data is in agreement with the needs assessment which identified that for people with land
rice farming is central part of their livelihoods strategy. Although the ownership of land can not be reliably
established, the household survey can conclude that for the vast majority of people growing rice, it is a central part
of their livelihood strategy (83% of households growing rice in the last year gave rice production as their first
response to significant income sources as described in section 5.3 above).

5.6 Soil improvement

992 responses were received from 604 households for the question ‘in rice, vegetable, or fruit production what do
you do to improve the soil?’ 64% of households are therefore using a form of soil improvement in crop
production, and the types by district are presented in table 13 below:

Table 13: number of households using soil improvement techniques

Produce Use Use Use Use Use Use Total

Compost manure green organic chemical chemical chemical
manure pesticides pesticides fertilizer fertilizer
(rice) (veg.)
Anlong Veng 7 31 0 0 0 5 13 56
Bantey Ampil 1 202 1 1 86 113 16 420
Chong Kal 0 103 0 0 3 110 5 221
Samraong 2 118 2 3 9 59 11 204
Trapeang Prasat 4 52 3 4 4 11 13 91
Total % of
households in 1% 54% 0.6% 0.8% 11% 32% 6% -
sample using

There is very little use of compost, green manure organic pesticides and use of chemical fertilizers on vegetables
crops throughout the districts. The main soil improvement technique is the use of manure which is used by 506
households (84% of those using soil improvement techniques). As a percentage of all households, the use of
manure is most common in Bantey Ampil (70% of households) and Chong Kal (69% of households). The use of
chemical fertilizer on rice fields also appears widespread in these two districts, with 39% of households using this
technique in Bantey Ampil and 73% in Chong Kal. The use of chemical pesticides is only used widely in Bantey
Ampil, where it is used by 39% of households. There is no direct link between rice yields and use of soil
improvement techniques; for example, within the three western districts which are the major paddy rice producing
districts (total yield >100,000kg), Samroang has the highest yield per hectare but the lowest use of chemical
fertilizer (25%) and manure (50%).

5.7 Ownership of livestock

30
89% of households own livestock (as shown in figure 32). There is a small degree of variation at district level with
Bantey Ampil having the highest percentage of households owning livestock (92%). Household ownership of
livestock can be broken down into the following types:
• 48% own pigs
Figure 32: • 75% own chickens
• 17% own ducks
• 50% own cows
• 6% own buffalos
• 32% own draught cows
• 5% own draught buffalos

Table 14 shows that Bantey Ampil’s high percentage of

households owning livestock is accounting for by over
70% of households owning pigs and chickens. It also
has the highest percentage of duck ownership (21%),
and buffalo ownership (10%). The two eastern districts
have lower percentages of ownerships by livestock type,
especially for pigs and draught cows, with the exception
of chickens.
Table 14: Summary statistics for livestock by district (n = 940)

Pigs Chickens Ducks Cows

Dist. SR CK BA AV TP SR CK BA AV TP SR CK BA AV TP SR CK BA AV TP
Freq. 103 82 174 39 55 171 104 213 94 120 37 28 62 12 23 125 92 148 47 61
% 45 55 76 33 37 74 69 73 78 80 16 19 21 10 15 54 61 51 39 40
Mean 2 2 2 1 2 8 6 6 4 5 5 5 5 4 4 3 3 3 3 3
S,d. 1 2 2 1 2 8 8 7 4 5 3 4 3 2 4 2 1 2 2 2
Max 8 15 25 6 13 40 70 35 20 50 15 20 15 8 22 10 10 13 7 12
Med. 1 1 1 1 1 5 1 3 3 4 5 2 5 3 3 2 1 2 2 2
Sum 192 145 326 54 104 1338 681 1281 383 591 179 139 332 45 91 355 241 395 126 183

Buffalos Other Draught Cows Draught Buffalos

Dist. SR CK BA AV TP SR CK BA AV TP SR CK BA AV TP SR CK BA AV TP
Freq. 11 14 28 1 2 5 0 1 0 0 85 77 104 12 22 9 11 24 0 2
% 5 9 10 1 1 2 - 0.3 - 37 51 36 10 15 4 7 8 - 1
Mean 3 2 3 7 1 3 - 1 - - 2 2 2 2 2 2 2 2 - 1
S.d. 1 1 1 - - 2 - - - - 1 0 1 0 0 0 0 1 - -
Max 5 3 6 7 1 7 0 1 0 0 4 4 5 2 2 2 2 4 0 1
Med. 2 1 3 7 1 2 0 1 - - 2 1 2 2 2 2 1 2 - 1
Sum 32 26 82 7 1 15 0 1 0 0 172 153 211 24 41 20 20 51 0 1

Chickens are the most frequently owned livestock type (over 73% of households in all districts) as well as the
highest number of livestock with a mean value of 6 birds per household. Buffalos are the least frequently owned
livestock type, owned by 6% of all households, with a mean of value of 3 animals per household owning buffalo.
Households owning livestock in the two eastern districts also generally own a lower number of livestock, having
lower mean values for chicken and duck ownership. In addition, 30 households own a fish pond (3.2% of the
sample), with very slight variation by district ranging from a low of 2.7% of households in Trapeang Prasat to 6.7%
of households in Anlong Veng.
The figures for ownership of pigs and chickens above are lower than those produced by UNICEF is a baseline
survey of the eastern districts in 2000 (56% owned pigs, 93% and 81% raised chickens in Anlong Veng and

31
Trapeang Prasat respectively). The figures for chicken and duck ownership are also lower than ZOA’s previous
baseline survey in Samroang and Bantey Ampil (81% of families have chickens and 24% have ducks).

5.8 Crop diversity

Figure 33 shows that 27% of households in the survey grew rice, vegetables and fruit in the last year (as an
indicator of crop diversity). The results show a marked difference at strata level, with 49% and 39% of households
growing rice, vegetables, and fruit in the last year in Trapeang Prasat and Anlong Veng respectively. The lowest
percentage of households growing all three crops is in
Figure 33: Bantey Ampil (17%). It is interesting to compare the
results for crop diversity with the food shortage data.
There does appear to be a close association between
crop diversity and food shortage in all districts (with the
exception of Trapeang Prasat). The greatest difference
is in Bantey Ampil where 15% of those who grew rice,
vegetables, and fruit in the last year suffered from food
shortage whereas 85% of those who did not grow all
three did suffer from food shortage. The difference is
also >50% in Anlong Veng, Chong Kal and Samroang.

There is no clear association between crop diversity and

change in income.

5.9 Identifying the poorest of the poor

An analysis of the household survey data was made to see if it was possible to identify a group within the survey
which could be categorised as the ‘poorest of the poor’. A combination of indicators was used to identify this
group; grass roof, ≤0.5 hectares of land for rice cultivation, no draught animals, and more than 3 months food
shortage a year. This identified 45 households from the survey (5% of households). The majority of these
households are located in the east strata (25 in Anlong Veng and 15 in Trapeang Prasat), with only 5 located in the
west strata (4 in Samroang and 1 in Chong Kal). Within Trapeang Prasat these household are widely distributed
amongst the villages sampled whereas in Anlong Veng the following 6 villages in 3 communes have at least 3
households (30% of sample within each village) which fit the above definition of the poorest of the poor:

• in Trapeang Tao commune; Trapeang Tao and Ou Angre

• in Anlong Veng commune; Romcheck and Yeang Kang Cheung
• in Trapeang Prey commune; Cheung Phnom and Toul Sala

When cross-tabulating the households fitting the definition of poorest of the poor there is no clear association with
any of the following variables; female headed household, number of years lived in the village, literacy indicators,
knowledge of VDC, attendance and talking in village meetings, number of times ate in the day before the survey,
or infant mortality. There is however, a close association between this group and reduced ownership of many of
the household assets, in comparison to the results shown in section 1.3, with 0% of this group owning a kuyon or
water pump, less than 5% owning a motorbike or oxcart, and 8% owning a TV.
6. Health

32
6.1. Impact indicators

6.1.1. Severe illness

This section of the report will begin by presenting some of the health impact indicators (i.e. the actual health status
of people) before working through a series of outcome indicators included in the PDS.

Figure 34: Figure 34 shows that 52% of households (487) had a member
who had a serious illness in the last year. There is distinct
district variation, with Chong Kal having the highest
percentage of households with a member having a severe
illness (64%), followed by Anlong Veng (61%). The lowest
percentage severe illness was in Samroang (51%).

Table 15 shows more specific data for the number of adults and
children (by gender) suffering from severe fever and severe
diarrhoea in the last six months. When compared to population
data derived from the survey, rates of illness can be calculated.
The results in table 16 show the highest rates of sever fever to
be in the east strata (15% of total sample population in both
Anlong Veng and Trapeang Prasat) and the lowest in Chong
Kal (9% of the sample population). There is very little
variation by gender.

Table 15: number of people with severe fever/diarrhoea in the last 6 months and 2 weeks respectively
District Severe fever Severe diarrhea
Men Women Boys (<15) Girls (<15) Men Women Boys (<15) Girls (<15)
Anlong Veng 40 38 16 17 4 13 8 7
Bantey Ampil 50 71 34 37 19 23 26 21
Chong Kal 13 27 17 12 4 9 12 14
Samroang 40 55 30 32 13 11 23 14
Trapeang Prasat 42 38 28 24 9 13 15 7
Total 185 229 125 122 49 69 84 63

Table 16: rates of severe fever and severe diarrhoea in the last 6 months and 2 weeks respectively
Severe fever Severe diarrhea
District
% of male % of female % of total % of male % of female % of total pop.
pop. pop. pop. pop. pop.
Anlong Veng 16% 15% 15% 3% 5% 4%
Bantey Ampil 11% 13% 12% 6% 5% 6%
Chong Kal 8% 9% 9% 4% 5% 5%
Samroang 11% 13% 12% 6% 4% 5%
Trapeang Prasat 15% 15% 15% 5% 5% 5%

Total 12% 13% 13% 5% 5% 5%

5% of the total sample population have suffered from severe diarrhoea in the last 6 months, with very little
variation between districts and by gender. The highest rates are in Bantey Ampil (6% of district sample
population) and the lowest rates are effecting males in Anlong Veng (3%).

33
6.1.2 Mortality

Information on maternal and child mortality was also collected and is presented in section 6.2 below. In addition,
information on deaths caused by landmines/uxos in included in section 3.

6.1.3 Disability

4% of people in the sample had a disability, with large gender variations; 157 males had a disabilities (6% of the
male population in sample) and 47 women had a disability (1.7% of the female population in the sample). 53% of
these disabilities (99) were caused by landmines/uxos, 18% (34) are described as physical disability, and 13% (25)
as related to ‘seeing’.

6.2 Maternal and child health

The PDS aims to improve maternal and child health and the household survey asked a series of question both to
establish a baseline for maternal and child health indicators and also to understand more about pregnant women’s
health seeking behaviour. The survey results show that there have been 214 pregnancies in the last year in 212 of
the households sampled (23% of households). A higher percentage of households had a pregnancy in the east strata
(33% in Anlong Veng and 27% in Trapeang Prasat, 40 households in each district). It is very difficult to assess
fertility rate based on the household survey because the population statistics described in section 1.1 grouped all
females over the age of 13 together rather than separately counting women of reproductive age. It should therefore
be made clear that table 17 below is displaying the rates of pregnancies in females over the age of 13 to allow
comparisons to be made between districts. It appears that higher rates occur in the east strata, Anlong Veng has the
highest rate with 17% of females over the age of 13 becoming pregnant in the last year and a rate of 14% in
Trapeang Prasat, whereas the rates in the west strata range between 9-12%.

Table 17: percentage of females (over 13 years old) pregnant in the last year

District Population count (F 13+) No. pregnancies % of pregnancies in

F 13+
Anlong Veng 253 42 17%
Bantey Ampil 574 49 9%
Chong Kal 278 33 12%
Samroang 438 50 11%
Trapeang Prasat 279 40 14%
Total 1822 214 12%

The survey recorded that one woman died as a result of child birth in the last year (in Trapeang Prasat) and 20
children died (widely distributed with at least 1 death in each district). The data set is too small for meaningful
comparison between groups or districts; however, it is possible to estimate the infant mortality rate for the survey
population. There are 169 children under the age of one year living in the household survey area which means that
10% of children have died in the first year of life (calculated from a total of 189 births). The infant mortality rate
would therefore be 106 deaths in the first year of life per 1,000 live births.
Figure 35 below shows that 62% (126) of pregnant women visited a health facility prior to giving birth. The high
number of responses indicates that women recently pregnant have also answered this question; this may have had
the effect of lowering the actual rate as they may not yet have needed to visit a health facility. The lowest rates are
found in the east strata (44% in Trapeang Prasat and 58% in Anlong Veng), whereas in the west districts the rates
are all >66%.

34
 Of the 126 women visiting a health facility, the majority
Figure 35: visited health centres (81% - 102 women or 50% of all
pregnant women). The number of times visited ranged
between 1 – 3, with 52% visiting 3 times, 25% twice
and 24% once. The lowest number of visits occurred in
Chong Kal and Trapeang Prasat (33% and 35% of
women respectively have visited once). 202
respondents answered the question ‘who supported the
pregnant women during her last delivery?’ This
question assumes that the women pregnant in the last
year have already given birth, which may explain the
lower number of responses (out of 212 households with
a pregnancy) or more likely the responses include the
anticipated action for a number of respondent who have
yet to give birth. 84% of women are (or expect to be)

supported in delivery by TBAs. This is slightly lower in Samroang (79%), which along with Bantey Ampil has the
highest number of deliveries in the HC (both 13%). Chong Kal has the highest number using private clinics for
delivery (9%, although the count is only 3 women).

Figure 36 shows when women who have given birth within the last year start to breastfeed. 62% of women (123)
started breastfeeding within 24 hours of giving birth. Within this number 45% started breastfeeding immediately,
which indicates that mothers gave their baby colostrum, although this was not specifically researched. The only
significant variation at district level is in Bantey Ampil where 15 out of 48 mothers (31%) either started
breastfeeding after 2 days (25%) or not at all (6%).

Figure 36: Figure 37:

Figures 37 shows the length of time that mothers in the sample exclusively breastfeed. 13% of mothers from the
total sample breastfeed for < 4 months, with 87% of women (170) exclusively breastfeeding for ≥ 4months. These
figures are very similar within each district, however, there is large variation in the length of time beyond 4
months, especially in Bantey Ampil where 33% of mothers exclusively breastfeed for more than 1 year. Figure 38

35
shows the responses to the question ‘what type of weaning food did you give to the baby between 6 months – 2
years?’ The responses are shown as a percentage of all responses and it is clear that bor-bor, rice, and fish are the
most common foods given to babies between 6 months - 2 years (41%, 21%, and 12% of responses respectively).

Figure 38: Figure 39:

Types of w eaning food given to baby
betw een m onths and 2 years; perecentage
of responses (n = 193)

50
percetnage of responses

41

21
12
8 6 6 5
1 1
0
Ri

Fr tab

Eg
M
Bo
Ve bor

Fi

No Po w

O in g r
ilk

th
c

u i le
sh

gs
r-
ge

th de
e

er
s

The responses to the question ‘do you use birthspacing in your household?’ are shown in figure 39. 32% of the
sample (299 households) use a form of birthspacing, and at district level the percentage is much higher at 47% in
Bantey Ampil, and lower rates in the east strata (19% and 17% in Anlong Veng and Trapeang Prasat respectively).
Two methods of birthspacing are most frequently used, the pill (accounting for 63% of responses) and injection
(34% of responses).

6.2 Capacity of communities to monitor and improve family health

For communities to have the capacity to monitor and improve family health they need the knowledge to prevent
illness and to be able to know how to act when they become ill, and to be able to access reliable health services. To
understand the level of capacity the household survey asked questions about:

• the presence of village health volunteers (VHV) or village health support groups (VHSG) in villages which are
seen as key mechanism to provide health education and a link between people and health services
• awareness and use of health services

In addition section 6.3 below provides specific indicators for health education and health seeking behaviour,
including boiling drinking water, covering water jars, and defecation.

6.2.1 Village Health Volunteers / Village Health Support Groups

Figure 40:

36
 Figure 40 shows that 63% of households (570)
responded positively to the question ‘do you have a
VHV or VHSG in your village?’ The percentage of
positive responses was higher in Anlong Veng (76%)
and lowest in Trapeang Prasat (51%). A following
question was asked ‘what are the names of the VHV or
VHSG?’ which revealed that 7% (41 respondents) of
the households responding positively to the previous
question could not name any of the members. Figure
41 below shows the responses to ‘what role do the VHV
/ VHSG carry out in your village?’

Figure 41:

'What do the VHV/VHSG do in your village?' (n = 566)

Don't know 4
P rovide health education 14
Help people with diseases 1
P rovide first aid 2
Sell medicines 1
P rovide medicines 1
Sell condoms 0
P rovide information about HC/RH 20
Support new mothers 8
Support pregnant women 21
P rovide vaccinations 28
0 5 10 15 20 25 30
Percentage of responses

It is clear that the main roles for the VHV/VHSG are providing vaccinations (28% of responses), although this is
interpreted to mean supporting in the delivery of vaccinations. The next most frequently cited roles are supporting
pregnant women (21% of responses), and providing information about the health centre or referral hospital (20%)
and health education (14%).

6.2.2 Awareness and use of health services

Households were asked where they go when they need to seek medical treatment, generating 625 responses from
490 households, and the results are shown in figure 42. Health centres received the most responses (30%),
followed by private clinics (23%) and the provincial hospital in Samroang (16%). 25% of respondent’s first
response (assuming this shows their first priority in terms of health seeking behaviour) identified the HC and 25%
responded private clinics as the health facility they would visit if they were seriously ill. A further 20% identified
the RH in Samroang and 13% identified a hospital outside the province. The lowest percentage for visiting HC
was in Samroang (14%), but it also had the highest percentage visiting the RH (39%). Chong Kal had the highest
percentage using private clinics (30%) and a corresponding low percentage of people using the HC (17%). The
east districts had a total of 1% of respondents visiting the RH in Samroang as their first response.
37
 Figure 42: 'When a household member is seriously ill where do they go to seek medical
treatment?'; percentage of responses (n = 490)
30
30
23
Percentage of responses

20
16

12

10 6 7
4
1
0
0 P rovincial P rovincial P rivate Kru Khmer Health Centre Local P harmacy Market TBA Other
Hospital Hospital (outside Clinic/ hospital
(Samroang) province)

Households were then asked if they know where the health centre is and if a household member had been to the
health centre in the last year. The results are provided in figures 43 and 44 below. 82% of households (770) know
where the health centre is. The results are slightly higher in the east strata with 90% responding positively in
Trapeang Prasat and 83% in Anlong Veng. The lowest results are found in Chong Kal where 77% of households in
the sample know where the health centre is. 58% of households (356) that know where the health centre is, have a
household member who has visited the centre in the last year. The results shown in figure 44 are highest in Bantey
Ampil (69% of households who know where the health centre is) and lowest in Chong Kal (43% of households
who know where the health centre is).

Figure 43: Figure 44:

The 356 households who have members who visited a health centre in the last year were asked ‘how did you rate
the service?’ and the results are provided in figure 45 below. A very small number found the service to be excellent
(1%), 71% found the service to be ‘good’’, 21% found it to be average and 7% found the service to be ‘bad’. The
main variations by district are in Bantey Ampil where 87% found the service to be ‘good’, and in Trapeang Prasat

38
where 17% found the service to be ‘bad’. Households were asked for their reasons for their responses and the
positive responses can be summarised as (unless indicated responses are evenly distributed by district):

• good attention (99 responses, with over 50% of these coming from Bantey Ampil)
• friendly (35 responses)
• take care (26 responses)
• good relationships (15 responses)
• don’t take money (14 responses)

The negative responses tend to be the opposite of the above with 28 feeding back that staff do not care (the
majority from Samroang), 22 responding that staff do not pay attention (50% of these from Chong Kal), and 14
that they have to pay a lot of money.

Figure 45: Figure 46:

Figure 46 shows that 32% of households in the survey used a hospital in the last year. This was highest in
Samroang where 45% of household used the hospital and lowest in Trapeang Prasat where 13% of households used
the services of a hospital in the last year. It is important to note that he question was intended to ask specifically
about usage of the Referral Hospital in Samroang, but due to an error in the questionnaire, the results include all
hospitals (expected to include hospitals in Seam Reap and Thailand).

6.3 Improved health and quality of life through access to potable water supply,
sanitation, and hygiene education

6.3.1 Access to health education

39
Figure 47: 43% of adult household members (401) have received
health education messages in the last six months. Figure
47 displays the results by district, with the higher
percentage in Anlong Veng (61% of adult household
members) and the lowest in Bantey Ampil (34% of adult
household members).

The 401 households provided 482 responses to the

question ‘from whom did you receive the message?’ with
39% of responses being from HC staff, 36% by NGO
staff, and 13% by VHV/VHSG.

6.3.2 Access to drinking water

Figure 48 below shows that in the dry season, the majority of households take their drinking water from a bore hole
(24% - 226 households) or traditional well (23% - 216 households). In addition, lakes and river/canal/drainage
channels are the source for >10% of households (16% - 150 households and 11% - 103 households respectively).
During the rainy season the primary water source is rainwater (45% - 423 households) and traditional wells (19% -
179 households). The remaining rainy season drinking water source each account for ≤ 5% of household drinking
water sources.

Figure 48: ‘what is the main source of drinking water for your household?’ (n = 940)
bought - truck 1 3
rainw ater 0 45
river, canal, drainage channel 4 11
lake 5 16
community pond 3 8
community pond/filtered 12
borehole 15 24
8 Dry season
ring w ell and pump 3
traditional w ell 19 23
Rainy season
open ring w ell 45

0 5 10 15 20 25 30 35 40 45 50
Percentage of households

Figure 49 below shows percentage of households accessing ‘safe’ drinking water sources in the dry and rainy
seasons. For the purposes of this analysis, the following drinking water sources are considered to be ‘safe’ water
sources; boreholes, ring wells with pumps, filtered community ponds, rainwater, and bottled water.

40
 There is a marked difference between the percentage
Figure 49: safe drinking water sources by district of households accessing safe drinking water sources
in the dry (36%) and rainy season (65%). The extent
Dry season Rainy season of this variation is caused largely by only 9% of
100% households in Bantey Ampil accessing safe drinking
75% 78% water sources in the dry season. The highest
80% 69%
60%
65% percentage is found in Trapeang Prasat at 78% of
56% 55%
60%
54%
households. The highest percentage of houses
40% 36% accessing safe drinking water sources in the rainy
40% 28%
season are found in Bantey Ampil (75%) and
20% 9% Trapeang Prasat (69%) and the lowest in Chong Kal
0% (55%).
al
ng

al
at
g
pi

on
K

Trapeang Prasat has the highest percentage of

t
as
m
Ve

To
ng

ra
A

Pr
g

households accessing safe drinking water sources

ho
ey
on

g
Sa
t

an
C
an
nl

throughout the year (dry and rainy season both >69%

pe
A

a
Tr

of households). Figures 50 and 51 below show the

distance to water sources in the dry and rainy
seasons. The percentages for distance from households to dry season drinking water sources are highly variable by
district. In the east strata a large number of households gain their drinking water within 100m of the house (65% in
Anlong Veng and 61% in Trapeang Prasat). This is significantly higher than the districts in the west strata where
the percentage gaining drinking water within 100m ranges between 39% in Samroang to 19% in Bantey Ampil.
The east strata has only ≤10% of households gaining their drinking water over 500m from the house whereas the
figure is >26% of households in each of the three western districts.

Figure 50: Figure 51:

The distance to rainy season drinking water sources are much less variable by district than the dry season distances.
81% of households (760) get their drinking water within 100 meters from their house. This is due to the high
percentage of households drinking rainwater during the rainy season (45%) which is generally collected from

41
 nearby houses with metal roofs.
Figure 52:
Figure 52 shows that 56% of households identified
that they have a Water Point Committee (WPC) in
their village. The highest percentage is in Samroang
(69% - 159 households), and the lowest is in Bantey
Ampil (42% -122 households). However, the results
for the following question ‘can you name a member
of the WPC?’ (see figure 50) suggest that the
committee’s are inactive or not well-known in some
villages. This appears to be especially the case in
Samroang where 39 households who identified a
WPC in their village could not name a member
(25%). The highest percentage of households able to
identify WPC and name at least one member is in
Trapeang Prasat – 61% (92 households). The lowest
percentage is in Bantey Ampil – 35% (101
households). The role of WPCs according to
responses provided by respondents is shown in figure
53. 30% of responses were safe water education,
21% to help clean the water point and 19% to maintain the water point. 20% of respondents (100 households) did
not know what the WPC does, and a further 5% (20 households) thought they did nothing.

Figure 53:

6.3.3. Storage and boiling of drinking water

Figure 54 shows that 34% of households always boil their drinking water (319 households), and that there is
marked variation by strata. The percentage of households always boiling their drinking water in the districts within
the eastern strata are much higher (59% in Trapeang Prasat and 50% in Anlong Veng) than the districts in the
western strata. 862 provided responses to the question ‘why is it necessary to boil drinking water?’ and the
responses are provided in figure 55. Killing microbes accounted for 37% of responses (648 households) and
preventing diarrhea accounted for 23% (409 households). It is interesting to note that preventing malaria or dengue
accounted for 13% of all responses. In terms of the percentage of respondents who think that boiling water can
prevent malaria or dengue, this varied from 31% of household respondents in Trapeang Prasat, 28% in Bantey
Ampil, 23% in Samroang, 22% in Anlong Veng and 13% in Chong Kal.

42
Figure 54:
Figure 55: 'Why is it necessary for families to
boil their drinking water?' (n = 862)

40 37

percentage of responses
30
23

20
13 12
11
10
2 2 1 0
0
0 Kill Prevents Prevent Prevent Improved Good For Habit Don't know Other
micr obes diar rhoea malar ia or gener al taste hygiene visitor s
dengue disease

83% of households own water jars (780 households), with 41% owning one (385 households), 30% two (282
households) and 12% (112 households) three or more (see figure 56). The situation in each district is very similar
to the total sample, with marginally more water jars being owned per households in Bantey Ampil (87%, 252
households).

Figure 56: Figure 57:

Figure 57 shows the proportion of water jars with proper covers as observed by interviewers. It reveals that 38%
of households fully covered their water jars at the time of the survey (357 households). There are distinct
difference at strata level, with the eastern districts having a higher percentage of households fully covering their
water jars (59% in Anlong Veng and 50% in Trapeang Prasat), whereas in the western district the percentage is
down to 23% of households in Bantey Ampil. Households were also asked if they thought it was necessary to
cover their water jars. with 95% responding yes (887 households) with very little variation between districts. The
887 households were then asked why they thought it was necessary to cover their water jars. 2055 responses were
recorded from 881 respondents with the main reasons being, to prevent dust/dirt (35% of responses, 719
households) and to prevent mosquitoes/larvae (29% of responses, 597 households).
43
6.3.3 Sanitation

Interviewers were asked to observe if the household has a latrine and if it looked used. The results for observation
of latrines is shown in Figure 58 with 10% of households (93)
Figure 58: observed to have a latrine. Only 9 latrines appeared to be
unused. Households were also asked ‘where do your
household members usually defecate during the daytime?’ and
the results are shown below in figure 59. 67% of households
defecate in a field/forest away from the house, and 24%
defecate in the house plot area. There are distinct variations by
district with higher percentages defecating in the field/forest
away from the house in Trapeang Prasat and Chong Kal (87%
and 83% respectively). In addition, Bantey Ampil has the
highest percentage defecating in the house plot area (39%).
Figure 60 shows that 50% (443 households) of those without
latrines bury the faeces in the soil. Chong Kal district varies
from the others, having the lowest percentage to bury the faeces
is in Chong Kal, where 20% do not bury it and 43% only bury
it sometimes.

Figure 59: Figure 60:

'Where do your household m em bers usually
defecate during the day?'; percentage of
responses by district

Total 8 24 67
TP 4 9 87
AV 9 23 68
BA 3 39 57
CK 6 9 83
SM 17 21 61
0% 50% 100%
Ow n latrine
In house plot area
Field/forest aw ay from house

6.4 Data from the Needs Assessment

The FGD provides data related to health from 16 discussion meetings (women’s and community leader’s groups)
and is detailed below both to help provide explanations for the above results but also in the case of HIV/AIDS to
provide additional data that was not possible to obtain from the household survey. Comparison with the needs
assessment is also made throughout this section.
6.4.1 HIV/AIDS

44
HIV/AIDS was discussed with all the women’s groups in detail. All groups believe that HIV/AIDS is now
decreasing in Cambodia due to the information that has been disseminated on the radio, TV, from NGOs and MoH.
There certainly appeared to be a high level of understanding how the disease is transmitted amongst all the focus
groups (although this was specifically tested with men). However, two groups also described the practical
problems in putting their knowledge into practise. One women explained that men feels that using condoms is ‘not
romantic, like eating fruit with a pill’, and a women in a separate group explained that men did not use condoms
and they (the women) were too shy to ask them to do so. In two groups they explained that they did use condoms.
In total three groups reported that men did not use condoms, with a woman in one of these groups explaining that
women ‘don’t want HIV/AIDS training anymore because know all the issues, instead we need training for the
men’. This is in contrast to the needs assessment that concludes that there is a low level of understanding of
HIV/AIDS throughout the province. Whilst this in part may be true, it certainly does not appear to be the case
amongst the women participants in the 8 Focus Groups.

The FGs identified that people have died of AIDS in 3 villages (total of 7 people according to the respondent’s
memories). In an additional 2 villages, the respondent’s suspected men had died of AIDS outside the village
(because they work outside the village or because when they’re ill they return to the home of their families outside
the province in the case of those who have recently settled) but could not be certain why they had died.

In view of the number of deaths and the apparent reluctance of men in some villages to use condoms, the apparent
widespread belief that HIV/AIDS is decreasing in Cambodia could be a potential danger to protect against the
disease. This is especially true in a province such as OM which as the needs assessment identified there is reasons
to suspect the risk from the disease is significant because soldiers constitute such a high percentage of the
population and their apparent frequent use of prostitutes. The presence of temporary populations, such as
contractors for road construction, traders from outside the province (especially at the borders), as well as migrant
workers frequently moving away from home to work, are all anticipated to increase the risk of OM to the spread of
HIV/AIDS.

6.4.2 Illness

The FGD gathered data on trends in malaria, dengue and TB to better understand the extent to which these diseases
form part of the severe fever and sever illness data recorded in the household survey. The situation with each
disease is described below:

a) Malaria; according to FGD data the prevalence of malaria varies between villages. 3 villages talked about
people dying of malaria, in Tamann (5 people died in 1990), in Thnal Tteng (many people died in 1999), and most
recently in Toul Sala (2 women died in 2003). Malaria is still prevalent in the east strata (having reduced since
2002 in Tamann and not being seen as a serious problem in the other 3 villages) Toul Tasek also reporting
reductions since 2002.

There was a general perception that malaria was decreasing even in the east strata, with the reasons for reduction
being health education being provided through NGOs and MoH trainings. Although in Thnal Tteng and Phdeak
Chour participants explained that it still happens because people are not using nets in the forest, drinking dirty
water, not boiling their water, and also due to a reduction in forests which has consequently reduced the number of
mosquitoes. Certainly the use of forests, including for chamkar rice production is much higher in the east strata
(and incidentally also in Tamann) where the incidents of malaria is the highest. The needs assessment also
identified that mosquito nets are often left at home when a family member goes to work in the forest for the
children to use.

b) Dengue; many villages reported high cases of dengue fever in the following specific years:
45
•2001 – Tamann (2 children died), Phoum Kor, Romcheck (3 children died)
•2003 – Tamann, Phdeak Chroum, Prasat Lberkg, Pdkeak Chrum, Thnal Tteng, Toul Sala
•Toul Tasak also in 2004

However, all groups reported that this was currently not a problem due to a better understanding how to prevent it
such as use of bed-nets and improved living standards.

c) TB; high rates of TB were described, including deaths in three villages (Tamann and Toul Sala in 2002 and in
Phoum Kor in 2003). In addition, two other villages reported individual cases of TB. There are no reported cases
of TB since 2003, and in Tamann this was thought to be due to increased understanding amongst the people
because of both the information sent by MoH and NGOs to the village and also an increased understanding
amongst HC and RH staff of how to treat it.

6.4.3 Maternal and Child Mortality (MCM)

5 groups could recall deaths to mothers due to child birth and/or children in the first year after birth, which is
summarised in the table 18 below.

Table 18: MCM according to FGDs

Village Description provided in FGD

Tamann •In last 4 years – can remember 1 women and 3 children
Prast Ibeuk •1 mother died in 1993
Romcheck •in 2001 a mother and baby died
•in 1997 a mother died
Phdeak Chrum •2003 one women and baby died
•1993 were one woman died
•1990 two women and children dead
Toul Sala •2004 two new born baby died
•2002 one delivery mother died with baby
•There were high mortality and child dead rate in 1991; 4 mothers and baby died

It is not possible to compare these figures reliably with those gathered by the household survey, because the recall
periods differ and participants have only reported the cases they are aware of. However, all groups certainly felt
that the MCM rates had decreased in the last few years (only one trendline was completed for MCM and this
showed sharp decline from 2003 onwards). Reasons for this change or previous occurrence were provided in 6
villages as follows:

•4 due to presence of HC and improved TBA skills

•1 because before could not afford hospital fees and improved TBA skills
•1 due to lack of HC in the past

The role of HC appears important in at least 5 of the villages for the perceived reduction in MCM, however, its
specific role is not clear in all of these villages. In Rom Chek and Prast Ibeuk participants specifically explained
that HC are used for ANC and for delivery whereas in Toul Sala participants explained ‘they now knew about high
risk and if there is a problem they can go to HC’.

46
The above is consistent with the needs assessment which explained that ‘Malterer found that reproductive health
services have increased considerably in the whole province’. However, the assessment also described that in
general women do not go to HC for examinations during pregnancy. The household survey data indicates that 50%
of pregnant women visit HC before pregnancy (81% of those visiting a health facility, with little variation by
district), and the use of HC by pregnant women is also verified in the FGDs as described above.

The needs assessment also includes the results of a UNICEF baseline survey which found that almost no women
fed their babies colostrum (only 3% started breastfeeding immediately after birth). The household survey indicates
a much higher rate of 13% starting to breastfeed immediately, although the assumption that this means they feed
their babies colostrums needs to be explored further.

6.4.4. Water Supply

The findings of the household survey are consistent with the needs assessment with the exception of boiling
drinking water. Data from both agrees that boiling drinking water in the east strata is more common than in the
west, however, the whilst the needs assessment found that ‘in the western districts almost no-one boiled water’ the
results from the household survey range from between 16% of households in Bantey Ampil and 36% in Samroang.

6.4.5 Sanitation

The findings of the household survey are consistent with the needs assessment, although it appears that the number
of latrines has increased in Bantey Ampil and Samroang (6% and 21% of households respectively) from the date of
the ZOA baseline survey which identified that 2% of households in these districts had latrines. In addition, the
household data varies considerably from the UNICEF baseline survey in the eastern districts described in the needs
assessment which identified that 80% of households had their own latrine (according to families own responses),
whereas the household survey based on observations recorded a figure of 5% of households in Trapeang Prasat and
11% in Anlong Veng.

6.4.6 The use of health services

Both the household survey and the needs assessment identified that people use a variety of health services for
serious illness (see section 6.2.1), and it certainly can not be assumed that all people will use the state provided
health services. It is clear from the FGD data that the provision of state health services has increased dramatically
in the last 5 years within the province, including the construction of HC, use of HC services during pregnancy (see
MCH section above) and provision of training and information related to health seeking behaviour. The service
provided by HC appears to vary between centres, as the following table, which summarises responses to questions
form the FGDs about the use of health services, shows:

Village/District Comments from FGD

Phoum Kor - ‘use private service, they care for and respect patients’
Chong Kal ‘feel unwelcome at HC, if you have no money the staff don’t care’
Tamann - ‘When there was someone sick they went to get the treatment at the Health Center and only paid 5 bhts in case of
Samroang serious illness the health center staff would refer the patients to the Samroang hospital.’
Prasat Lbergk – ‘When get sick go to Kok Mon HC 8m away, but in rainy season road is difficult to travel. HC staff are cordial
Bantey Ampil and in good serving especially the poor with ID don’t need to pay. If severe illness send to be treated at Samroang
hospital and required to spend much’.
Toul Tasek - ‘when they got sick the villagers they go to Trapeang Prasath HC if severely sick they go to Seam Reap or Anlong
Trapeang Prasat Veng. The good attitude of Trapeang Prasath health centre staffs popular for the people’
‘HC use also but have to pay’
Phdeak Chrum - ‘When they have disease, they go to Health Canter that far from village 4 Km, but we need to have pay 30000 Riel

47
Trapeang Prasat to sleep at Anlong Veng Health centre. When some one ill seriously we take them to the Health center’
Thnal Tteng - ‘For the Anlong Veng health center is not require the poor people pay money for Health center, if have letter from
Anlong Veng village heath support group or village chief’
‘Women with problem referred to Seam Reap hospital by neighbors – via motopod or truck’.
‘Anlong Veng HC don’t care if have no money’
Toul Sala - ‘when people get sick they go to health centre, sometime go to private clinic in ALV health centre poor people no
Anlong Veng need to pay for service fee if some one not so poor they need to pay some. They which one is poor or not so poor
by VHSG write a letter for them when they go to health centre’.

The HC staff at Chong Kal received negative feedback from the Phoum Kor group which may explain why this
district has the lowest use of HC services (see section 6.2.1 above). The attitude of staff is also commented on in
Thnal Tteng, but this does appear (from the household survey results) to affect use of the HC services to the same
extent as in Chong Kal, whereas the good attitude of staff at Trapeang Prasat HC is commented on by the
participants from Toul Tasek. Many of the groups talk about cost (the needs assessment identified that cost
appeared to be a key factor in people’s choice of health services) and in three groups exemption fees for the poor
were described positively, although it is unclear if this actually exempts clients from all costs.

The needs assessment also identified that VHSG have been established to play a key role in providing feedback to
HC and training to people. The assessment discovered that some members ‘have used their positions to start
private health practises and are learning to give injection’. The household survey also identified that the main role
of VHSG according to the household respondents was giving injections (see section 6.2.1), although this is
interpreted to mean supporting the delivery of injections as community facilitators.

48
7. Education

7.1 School attendance

The data from the household survey shows that 416 boys (aged 6-12 years old) and 382 girls (aged 6-12 years old)
attend government school. Comparing this to the population data in section 1.1 above this represents school
enrolment rates of 87% for boys and 83% for girls aged 6-12 years old.

The rapid rate of school construction in the province may help to explain the relatively high school attendance data,
and it certainly is a factor in explaining why children older than the official enrolment age are entering the
education system (see below). For children aged over 12 years old, 366 boys and 258 girls attend government
school. The attendance rates are very similar when broken down by district for boys and girls in both age groups.
These results can not be compared with the population data derived from the survey as this combines all people
aged 13 years and above or the 2004 Commune database which measures school attendance by age group 6-14
years. There are also 47 children below the age of 6 who attend school. The data suggests that this is more likely
to be due to children attending primary school early rather than the presence of pre-schools due to the wide
geographical spread of the children. In age group 6-12 years old 131 boys (31% of boys attending school in this
age group) and 95 girls (25% of girls attending school in this age group) started in the last year. Over 70% of
children starting school in the last year were aged between 6-8 years old (33% were 6 years old, 24% were 7 years
old, and 13% were 8 years old).

There were 143 responses (15% of the sample), to the question ‘if they are older than 6 years old, why did they
start school last year?’, with the main reasons for starting school described in table 19 below:

Table 19: Main reasons for starting school

Reason Reduced Child too No school/ No school Greater Afraid Need to help
cost small too far before involvemen at home
away t in school
Count 26 25 19 16 11 9 9
Percentage 18% 17% 13% 11% 8% 6% 6%

It is difficult to draw firm conclusions for the data because it is a very small data set and in addition, the question
proved difficult for the interviewers to use. Some of the responses do not all seem to fit the question – in view of
this ‘child too small’ has been interpreted ‘as child was too small before’ and no school/too far away’ as before
there was no small/or it was too far away’ (and could be integrated with its adjacent category to become the main
reasons for starting school later than the official enrolment age).

386 households responded to the question; ‘If there are any children under 12 who do not attend school, why not?’
and this provided a total of 400 responses. The main reasons are described in table 20 below:

Table 20: Main reasons for not attending school

Reason Child too small Need to help at School too far Other Too expensive
home away
Count 236 81 27 26 17
Percentage 59% 20% 7% 7% 4%

49
The results for this question may contain errors because respondents might have included children below school
enrolment age when considering that their child is too small.

7.2 Role of the PTA

27% of the respondents have a PTA in their village and can name at least one member of the association. This
varies by district from a high of 34% in Samroang to a low of 19% in Bantey Ampil (In addition, 32% in Trapeang
Prasat, 28% in Anlong Veng, and 24% in Chong Kal). The PTAs appear to be relatively inactive at village level; of
304 responses to the question ‘what role does the PTA do?’, 34% of responses were ‘do not know’. The other main
responses were ‘encourage students to go to school’ (17% of responses) and ‘school management’ (15% of
responses).

7.3 Literacy rates

To assess respondent’s literacy rates they were asked to read and write a sentence (‘I love Cambodia’). The results
are presented in figures 61 and 62 below which reveal slightly contradictory results; 39% of respondents can read
the sentence yet 72% can write the sentence. There is some variation by district but all within 10% of the total
percentage figures.

Figure 61: Figure 62:

The literacy rates indicated by the above data show a slight increase from the previous ZOA baseline in Samroang
and Bantey Ampil (January 2001) which discovered that 35% of people could read a sentence.

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8. Women

• See section 2.4 for women’s representation in VDC, and attendance and participation in village meetings
• See section 9.2.1 for domestic violence

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9. Human rights and governance

9.1 Conflicts

96 households (10% of the sample) reported serious conflict in the last year within the household survey, and
figure 63 describes the type of conflicts. Of the 96 cases of serious conflict 33 were land related cases, 31 were
cases of domestic violence and there were 32 coded as
Figure 63: others (these mainly relate to children such as conflict
caused by punishing other people’s children, theft,
animals eating crops, and being drunk). According to
the data 31 households experienced serious conflict in
the form of domestic violence (3% of all households
sampled).

The total number of counts are low and it is therefore

difficult to make any firm judgments about difference
between district, however, Bantey Ampil has the highest
percentage of households with domestic violence (7% -
20 households) and Anlong Veng has the highest
percentage experiencing land conflict (7% - 8
households).

85% of the conflicts were with other village members

or household members (48% and 37% of conflicts
respectively). A very small number of conflicts were
reported to be with the military or government (4 and 3 cases respectively). 45% of the 96 serious conflicts
identified by the household survey were not resolved by anyone (this may also include conflicts that as yet remain
unresolved), and 32% were resolved by the Village Chief. 7 cases were resolved by the Commune Council and 6
by the police. This data (together with FGD data described in section 9.2 below) identify the Village Chief as the
main person villagers turn to if they need assistance in resolving conflict.

9.2 Data from the FGDs

9.2.1 Domestic violence

According to the FGD data there are cases of domestic violence in all the villages although this is not particularly
seen as a big problem in most of these villages (this could mean that cases were not reported in the household
survey because it is not perceived to be a ‘serious conflict’ by some respondents). Only 2 villages suggested
resolving domestic violence in the proposed solutions to conflicts in the villages, which again indicates that it is not
seen as a big problem throughout all villages. Estimates of the number of households affected by domestic
violence range from 3-5 households (estimates were provided in 5 of the villages) which is similar to the estimates
derived from the household survey (see section 9.1 above) and also the needs assessment which estimated 3 cases
per village. The causes of domestic violence provided by the FGD participants include drunkenness, lack of
income, gambling, and jealousy. As described in the needs assessment, there did not appear to be any mechanism
for resolving domestic violence, but in contrast to the needs assessment no examples were provided of victims
reporting abuses to the VC or other authorities. Participants explained that it is usually left to be resolved within
the household (although in two villages parents in law and neighbours were also reported to get involved in

52
resolving the conflict). One woman described the difficulties in reporting the problem, explaining that when she
suffers domestic violence she can not go to police due to threats from her husband.

9.2.2 Conflict between neighbours

Conflict between neighbours does not appear to be a significant problem according to most of the FGD
participants. It was reported in all villages, but was described as ‘not happening much’, ‘if it does happen it is not
acute’; and ‘have but not serious’. The main causes suggested are speaking badly about other families, livestock
eating vegetables/crops, and land disputes. All conflicts appear to be resolved either by both parties or with the
support of the VC, especially in the case of land disputes. In two FGD it was explained that the VC has a list of
boundaries and will use this to measure boundaries on the ground to resolve the conflict. Only one case of land
grab was highlighted, with chamkar rice fields being taken away from a participant from Anlong Veng.

9.2.3 Conflict involving youth

In all villages this was described in being the most serious conflict, even resulting in 1 death in Tamann village.
This appears to be an issue throughout all the villages when parties or ceremonies are taking place; groups of youth
come from other villages (described as ‘big brother’ by FGD participants) and fight with youth from the village,
which often starts during dancing or because of a girl. Only one village thought they had resolved this type of
conflict, although the women’s group appeared to disagree. In other cases, the FG participants thought the police
were even too scared to intervene in fear of revenge attacks from the youth (it was explained that the police no
longer have weapons whereas the gangs often do). FGD participants suggested several strategies for reducing this
type of conflict, including:

•Parents educating their children

•Permission for ceremonies to be sought from local authorities to help prevent the conflict
•Involvement of police and military in controlling the ceremonies
•Formation of youth association with support of NGO and involvement of youth in preparing ceremonies and
listening to expert speakers during the ceremony
•Communicating to people during the ceremonies by local leaders to help prevent conflict

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10. Co-ordination
It is very difficult to generalise about the co-ordination of development activities in the province because only 4
interviews could take place in the time available and these were all with government officials. Therefore, although
the following information may provide some insights it should be stressed that it is not a complete analysis and
does not include the perspective from all government department or the NGO community.

All line ministry departments interviewed appeared to have a good understanding of the development activities
taking place relevant to their sector within the province, and could recall the organisations/location/type of projects.
These interviewees each described 10+ working relationships with IOs/NGOs, most of whom sent reports to
update the departments on their activities. There also appears to be some systems in place to assist co-ordination of
development activities in the province including; Excomm, Prococom, and a number of health related meetings
(monthly PHD/RH/HC staff management meeting, Health Centre Management Committee meetings). In addition,
the establishment of agriculture and water/sanitation networks are also imminent. However, how these forums are
used to promote government/CSOs engagement, beyond reporting on activities, is unclear. All interviewees
thought that NGO representatives should participate within all the above forum, and one interviewee felt that
NGOs should be using the meetings to a greater extent as an opportunity to raise problems, allowing solutions to be
discussed within the meetings.

The role of NGOs in the province according to the interviewees is principally to implement projects to support the
government and to support the people, and also to provide financial support to the province. Advocacy was not
mentioned by any of the interviewees as a role for NGOs. Most NGOs appear to be viewed as working partners of
the government, and there is generally a very high level of appreciation for their work in the province; all
interviewees felt they have very good working relationships with their partner NGOs. Concerns were raised by
two interviewees related to a lack of awareness on the part of some NGOs of the context in which they are working
and specifically:

• a lack of understanding of MoH national policy in the delivery of their projects

• examples of income generating projects not being linked to the market resulting in failure
• inappropriate approaches resulting in the lack of sustainability of projects (including lack of maintenance of
water points)

With regard to the PDS, although most interviewees could confirm and explain how they had been involved in the
process of the developing the strategy, there was uncertainly amongst most interviewees of its purpose. This
uncertainly appeared to be because:

• the presentation of the final PDS had not taken place at the time of interview
• each department generally maintains relationships/partnerships with >10 organisations, and the PDS is one of
number of partnerships in which interviewees are involved.

Recommendations based on this data are provided in section C.

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C. Recommendations

C.1 Methodology

As mentioned previously in section B, a paper capturing the lesson’s learnt from the survey has been compiled by
the ZOA Advisor. The paper includes:

• suggested changes to specific questions and a revised questionnaire ready for the mid-term evaluation in
January 2007
• the suggestion from the consultant to reduce the number of questions in the questionnaire including
identification of specific questions to delete
• the use of a dedicated full-time translator to support questionnaire design, back-translation, testing and review,
and data entry in future surveys
• the potential use of SPSS for data entry for future surveys (depending on time available to train data entry
team)
• suggestions on reducing the time required for quality control
• more time included for the production of survey guidance notes for the interviewers, to provide the basis for
training and a source of reference for interviewers in the field (including translated into Khmer)

In addition, to the above the consultant also makes the following recommendations for the use of FGDs in the next
survey:

• to stagger the FGDs to follow the analysis of household survey data. This will enable the questioning route to
be based on the result of the survey, identifying additional information needs or allowing the results to be
interpreted/explained by a small number of focus groups
• greater emphasis to be placed on recording discussions within the FGDs through both additional training on
recording and the use of tape recorders to capture the entire discussion in each group.
• to hold FGDs with young people. It is known, due to the demographics of Cambodia, that young people
comprise a significant proportion of the rural population. In addition, young people are also seen as the main
source of conflict in villages by the adults who were consulted in the FGDs. These two points provide a
reminder that there is a need to listen to and understand the perspective of this age group generally in
community development projects, and also within future FGDs.

C.2 Programme management cycle

The consultant recommends:

Logframe
• the development of one logframe for the PDS. The logframe in annex E is an initial attempt to integrate the
logframes, and further work will be required by the three organisations to complete this process. The process
required could involve a joint meeting of staff to review the PDS based on the results of the survey and ensure
that the programmes/strategies are clearly articulated in the logframe. The resulting logframe should provide
an effective communication tool to summarise, and build understanding of, the PDS amongst all stakeholders
(staff, government/NGO partners, and village representatives).
• In addition, the logframe could separate aim/impact (related to actual changes in people’s health and/or socio-
economic status); objective/outcomes (changes in people’s/organisations behaviour and practise); and outputs

55
 (things built/delivered). It could also be merged with the MandE framework to provide a more practical
working document; table 21 below provides an example that could be used for the format.
• the logframe should be seen as a dynamic tool, reviewed and modified if required following each planning
cycle using the information gathered for the MandE framework (see below)

MandE framework
• An important step will be to work up an MandE framework to ensure that all information required for
assessing progress in the PDS is being collected and there is a plan for using the information. Once the
indicators have been finalised in the logframe, this will consist of deciding how (which tools), when and by
who data will be collected and when the data will be analysed, documented and used e.g. for programme
planning or advocacy purposes. The indicators and data collection procedures can be captured in a logframe
format such as the example provided below. Guidance information on storage of information (i.e. where to file
it once gathered), process for analysis, documentation, and use of the information could be added at the end of
the table to complete the MandE framework.

Table 21; suggested format for revised logframe

Aim Impact Indicators: Method(s) for data Data collection –
collection who/when
Aim: To Self-help capacity
stabilize and • % of households participating in village planning meetings
improve • % of households carrying out community projects
socio-
economic • estimate of amount of time given to community projects
conditions of • % of households initiating self-help projects in the last year
vulnerable
communities
through Health (Maternal and child health)
improved self • maternal mortality rate (number of women dying of childbirth per
help capacity, 100,000 of women of reproductive age per year)
maternal and • infant mortality rate in the first year of life per 1000
child health, • incidents of severe fever in the last 6 months
food security,
income
• incidents of diarrhoea in the last 2 weeks
generation and Food security
access to • % of households with shortage of food in the last year
education
• Mean number of months of food shortages
• % of households with access to rice banks in times of food shortage
Income generation
• household assets/house construction materials
• households diversity of sources of income generation (not impact or
it is reduced vulnerability)
• Use of non-rice crops (vegetables and fruit) – not impact
• % of households experiencing increasing income in the last year
Access to education
• Estimate of Primary school attendance rates
• % of respondents literate
Objectives Outcome indicators (one row for each component) Method(s) for data Data collection –
collection who/when
Community • % of households aware of VDC and can name at least one person
development • As above for VDP
outcomes

etc…..

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C.3 Programme strategies
The purpose of the baseline survey was not implicitly to review the PDS, however, the results do help to confirm
that many of the strategies in the document are grounded in the situation within the province. In particular, the
following strategies appear to be well matched with the priorities highlighted by the survey results:

• the emphasis on community development (1.1), with the baseline survey showing that VDC are not highly
representative within their villages and the need to improve the transparency of the village planning process as
a mechanism to lead and mobilise people towards their own development
• the lack of existing targeted support for marginalised people suggests that strategy 1.8 (direct targeting of
particular groups) is a necessary component of the PDS
• the emphasis on rice banks (1.5) is essential due to the high number of households effected by food insecurity
• Cattle banks (1.4) targeted in the eastern districts they could provide an effective strategy to reduce the forest
clearance for chamkar rice production
• Support for alternative and sustainable livelihood strategies such as community forests and community fisheries
(3.13) meets the demand expressed in many FGDs, as well as the household survey which showed natural
resources making a relatively small contribution towards household income within the sample population
• support to land titling (3.5) appears imperative to mitigate against an issue that appears likely to emerge in the
future (due to low percentage of household with official land titles and the confusion surrounding this issue).
In addition, although land conflict appeared to be a relatively uncommon problem according to the baseline
survey results, the inclusion of land related conflict resolution strategies (3.11) appears to be important to
anticipate the significance of this issue in the near future
• continued support to TBAs (6.5) and improvement of public health service (6.8-9) to continue the recent
reductions in infant mortality
• working with the PHD to find ways to regulate private health services (6.1) is important due to the number of
household using the private sector when they face serious illness
• the baseline results demonstrate (percentage of households boiling water, understanding reasons for boiling
water, and covering water jars etc) that continued health promotion is required (6.7)
• with 36% and 65% of household accessing drinking water from safe sources in the dry and rainy seasons
respectively the focus on water point development (6.13) appears a priority

The baseline results also suggest that a greater emphasis within the PDS could be placed on

• initiatives that will support the personal development of young people in the province such as the formation of
youth groups to carry out community based activities
• initiatives focused on reducing the risk of HIV & AIDS in the province, especially targeted at men and migrant
workers, a well as supporting the integration of HIV & AIDS considerations into other organisations projects
within the province (such as road construction projects).
• consideration of alternative community development approaches – essentially to answer the question –
‘can/how can VDCs be used effectively for community development in Cambodia?’ – by looking at other
examples within the country

In addition, the results suggest that to meet the objectives of the PDS there is the need for intensive, sustained and
widespread support to villages throughout the province. It is currently unclear in the PDS how/where this support
will be provided or prioritised, and so it is recommended that the results of the baseline survey are used to

57
develop/prioritise plans for the implementation of the PDS. In addition, although support to LNGOs and CBOs is
contained within the PDS, it is felt that this could become a more explicit set of strategies to increase the
availability of resources, ownership in the province, and the provision of long term support required. A continued
focus on developing partnerships with INGOs and CBOs to work as part of the PDS is therefore recommended. If
the PDS increases the number of partner organisations, it becomes increasingly imperative that a planning cycle is
developed which will allow for the regular review of strategies/approaches and to give new partners a voice within
this process.

Furthermore, the baseline survey provides a potential opportunity to move towards participatory planning and
evaluation approaches. If the results of the baseline survey are presented back to target villages, this will allow
villages to both verify the results and use them as a basis for planning. The NGOs who facilitate this process can
provide guidance and suggestions (using the results of the baseline survey) but ultimately hand-over decision
making to the villages, asking them to determine what they would like to achieve in their village over a given
timeframe. This could lead to the development of objectives and indicators for each village based on their own
aspirations (these will probably fit within the broad MandE framework). Villages could also develop ways to
monitor the achievement of their objectives which would move the PDS to adopt the use of participatory
monitoring and evaluation. The feasibility of moving to such an approach will need to be considered by staff of
Care, Malteser and ZOA.

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Annexes:

• Annex A. ToR

• Annex B. Questionnaire

• Annex C. Focus group discussion guide questions

• Annex D. List of villages sampled in household survey and FGDs

• Annex E. Comparison of logframes

• Annex F. Presentation of results and interpretation