Preaek Prasab 2 Area Program

One of six districts in northern Cambodia's Kratie province, Preaek Prasab 2 is a five to six hour drive from the capital Phnom Penh. Its population of about 74,000 people is majority Buddhist.

Preaek Prasab 2 is among the poorest regions in the country and the average income is US$777 annually. Most of the population works in agriculture, growing crops that include rice, tobacco, soybean and corn, as well as raising livestock. Some residents also work for Chinese cashew nut and rubber companies.

Health care is a leading issue in terms of both quality and access. Post-natal care and nutrition for babies is inadequate, leading to very high rates of stunting and underweight. The health centres that exist are hard to reach, especially during rainy season. The facilities also lack skilled staff. Schools are in similar condition—lacking enough qualified teachers and infrastructure such as water and sanitation.

While the local government lacks resources to enable behavioural change, the provincial level of government is supportive of development efforts and has expressed willingness to improve child well-being. Community organizations in various areas, such as healthcare and child protection, do exist. This civil and program infrastructure simply needs support and access to resources so that it can become more effective.

Preaek Prasab 2 faces the daunting challenge of being among the poorest regions in Cambodia. Access to clean water and adequate health care are issues with long-term negative effects if unaddressed. They lead to developmental barriers for children, which harms the community's future ability to overcome poverty. Rates of stunting and underweight are quite high, and educational performance is significantly depressed.

Health
Rates of stunting and underweight in children under age five are 38.5 per cent and 25.1 per cent, respectively. About 25 per cent of all children are malnourished. These outcomes prevail despite basic healthcare being free to the very poor. However, the level of care at these often distant facilities is inadequate. For example, only 58 per cent of pregnant women receive four antenatal visits by health staff. The relatively high incidence of disease is linked to a lack of clean water and basic hygiene. Common diseases include acute gastritis and typhoid fever. There is no systematic water delivery system, so residents with any means pay privately. As a result 43 per cent of the community uses unsafe water and only 30 per cent of residents have access to latrines.

Education
Education results at the primary level are very poor in terms of literacy with 25 per cent of children unable to write. This culminates in a drop-out rate that reaches 55 per cent by age 17. Children typically leave school to help their families work in the fields, which is an issue rooted in poverty but also with parents who undervalue the importance of education. Recently, school closures related to COVID-19 have significantly impacted learning since online learning is out of reach for everyone. Infrastructure is inadequate, with 71 per cent of schools having no water and about 29 per cent having no toilets.

Child Protection & Participation
The community has a poor understanding of child protection mechanisms. Half of all children report having received a severe beating, one in four report emotional abuse and one in 20 report sexual assault. Child labour is present, particularly among those from the poorest households who work after school or drop out altogether. Since 2018 60 per cent of children have become involved in drug or alcohol abuse. Civil organizations for child and women protection do exist but are non-functional.

Health
To improve the health of children and their families, World Vision will:

• Implement a program to improve the capacity and functioning of both the Village Health Support Group and health-post services.
• Support home visits and health counselling for pregnant and post-partum women.
• Provide awareness about children's nutrition to community mothers, especially to those with children under age five.
• Increase access to an improved water source and treat the water for drinking.

Education
To help children develop the skills for future economic self-empowerment, World Vision will:

• Work with community partners and others to strengthen classroom- and school-based instruction in literacy.
• Utilize a technical program, and community actions and micro-projects, designed to get children back into school.
• Support Community Reading Facilitators and community-based reading camps to improve literacy.
• Provide technical support to raise awareness among parents about the value of education.

Child Protection & Participation
To promote child safety and children's rights, World Vision will:

• Strengthen the participation of children and adolescents in child protection mechanisms by using community engagement and micro-projects.
• Work with local organizations, such as the Commune Council for Women & Children, to prevent and respond to violence and protection issues.
• Work with local authorities to raise awareness about how to protect children from hazards and disasters.