Performance
Background: The Kingdom of Cambodia has made progress
in its difficult transition to democratic governance
after decades of war and lack of democratic experience.
Cambodia's first election after the Peace Accords of
1991 was conducted entirely by donors. With each election
since then, Cambodian organizations and institutions
have gained expertise in conducting elections that represent
the will of the people. In the July 2003 national assembly
elections, activities funded by USAID helped create the
most open political environment in the past decade, with
Cambodia's first public candidate debates ever held for
national elections, televised and broadcast on radio.
Also in 2003, Cambodia was the first developing country
to successfully bid for membership in the WTO. The challenges
to political and economic progress are many: a narrow
and vulnerable economic base of garments and tourism;
limited foreign and domestic investment; low levels of
education and literacy; and wide-spread corruption. The
judicial system is weak and generally unable to protect
human rights or fairly resolve commercial disputes.
Cambodia's social indicators, among the worst in the
region, reflect lack of access to basic health services.
Life expectancy is in the mid 50's; population growth
rate is 2%, and infant mortality 95 per 1000 births.
Cambodia has successfully reduced the estimated HIV prevalence
among adults aged 15-49 from 3.3% in 1997 to 2.6% in
2002 with support from donors, including USAID. According
to a 1999 survey, only 37% of the population is literate.
Development progress in rural areas, where 82% of Cambodians
live, is interrupted periodically by severe flooding
of the Mekong river basin and droughts in the north and
northwest.
Although the government has steadily increased spending
on social sectors, along with a decline in defense and
security outlay, Cambodia continues to depend heavily
on foreign assistance for its development. Government
revenues have improved because of VAT, but still fall
short of meeting current expenditures. The World Bank
estimates that Cambodia's per capita GDP is $273. External
debt in 2002 is estimated at 65.6% of GDP, with debt
servicing 3% of Exports and Imports. Price inflation
has been low since 1999, reflecting government avoidance
of banking financing. As a result, exchange rates have
been stable.
In recent years Cambodia's economy has become largely
dependent on only two sectors, garment manufacturing
and tourism. Garment manufacturing is the single largest
export item in Cambodian economy -- over 90% of all domestic
exports -- not to mention employment generated for Cambodians.
It is estimated that more than a million rural Cambodians
depend on the income sent home from garment workers in
the capital. For this reason, Cambodia has a large trade
surplus with the United States, much of it under quota.
US imports from Cambodia in 2002 were more than $1 billion
and US exports to Cambodia were $29 million. Many of
the garment worker jobs may be lost after the Multi-fiber
Agreement, and quotas, expire in 2005. Tourism is on
the increase, which could bring in foreign exchange,
expand investment, and generate jobs. The challenge is
to increase investment, both domestic and foreign, that
will absorb the more than 200,000 new labor force entrants
each year, and raise incomes in rural areas.
As a development partner, the government of Cambodia
has demonstrated commitment to make progress in education
and health, including HIV/AIDS, but the disbursement
rate of funds to provincial and district health centers
is so slow that it threatens progress in improving health
status. The legacy of authoritarian government, political
patronage and lack of human capacity has impeded donor
efforts to improve civil service administration and reform
the judiciary so that it can protect human and civil
rights. Accession to WTO signals commitment to open markets
and attracting investment. Reforms in rule of law and
governance required by WTO accession may bring about
the much-needed strengthened commitment to progress in
these areas.
U.S. interests and goals: Because Cambodia has the
potential to be a democratic and prosperous ally
in the region,
U.S. interests are firmly rooted in promoting democratic
practices and improving market-led growth and health
status, which includes reducing the spread of HIV/AIDS.
These goals are reflected in the strategic objectives
(SOs). USAID supports democratization by increasing
political competition, demand for reforms, professional
and focused
investigations of human rights abuses, and legal
action against trafficking in persons. USAID helps
trade unions
form and engage in non-violent dispute resolution.
Through its democracy SO, USAID also addresses market-led
growth
by increasing informed public debates on obstacles
to private sector growth, and by improving capacity
of small
and medium businesses to advocate for reforms. In
its education SO, USAID will help children stay in
school
and become productive future workers. In its health
SO, USAID encourages the poor to take preventive
and other
health care measures by bringing health services
to rural communities and improving the quality of
health care
provided in health centers and provincial hospitals.
USAID seeks to reduce the spread of HIV/AIDS and
related infectious diseases through home-based care
of patients,
training of health workers in treatment and prevention
of mother to child HIV transmission, community outreach
programs and care of children and orphans of HIV/AIDS.
Donor Relations
USAID is a member of donor technical working groups
in education, health, HIV/AIDS, legal and judicial
reform, forestry, fisheries and private sector development
and trade reform. The technical working groups meet
approximately once a month and are the platform for
identifying key issues with Cambodian government
counterparts, establishing action plans, and coordinating
funding
among donors on complementary activities. The most
successful groups have been in the education and
health sectors. The Health Sector Reform Program
came out
of a collaborative process, and the Education Sector
Strategy and Support Plan have been developed with
broad-based support. UNESCO and UNICEF provide support
for Cambodia's new education strategy which USAID
will support through curriculum reform and teacher
training.
Japan, United Kingdom, UNICEF and ADB are all partnering
with USAID on HIV/AIDS activities. Australia provides
support to the Ministry of Justice which complements
USAID efforts to increase prosecutions of human rights
offenders. Germany, the United Kingdom, Australia
and other bilateral donors provided funds to UNDP
for the
2003 national election, the National Election Council,
and media access, which complemented USAID support
for political party development and NGOs working
in other election related activities.
Challenges
Cambodia has made gains in the years since the Paris
Peace Accords of 1991 ended years of civil conflict,
but still faces formidable challenges. Foremost among
these is the high level of poverty that exists, with
some 36% of the Cambodian population living below
the poverty line of less than 50 cents per day according
to the 2002 National Poverty Reduction Strategy.
Poverty in Cambodia results from the high population
growth rate, inadequate opportunities, low literacy
levels and training, exclusion, and lack of security.
Due to lack of infrastructure and services, family
expenditures on health are a leading cause of indebtedness
and subsequent landlessness among the poor. Lack
of food, uncertainties about access to natural resources,
and powerlessness all keep the level of poverty high.
While the government of Cambodia has made commitments
to a broad governance action plan, actual progress
has been disappointing in most areas. The failure
to follow through on the reform agenda reflects not
only the lack of managerial capacity to implement
reforms but also, in some areas such as forestry,
continued resistance to reform from powerful vested
interests.
A vibrant civil society in Cambodia strengthens the
impact of USAID's program. Cambodia has more than 400
registered NGOs and many of these have extensive networks
throughout the country. A decade of USAID assistance
has contributed to the strength of NGOs. Now the leading
human rights organizations are prepared to challenge
abuses publicly, both in courts and in the media. Health
NGOs enable USAID to reach even the most remote rural
areas with programs to improve maternal and child health.
Key Achievements
FY 2003 was a year of substantial progress for the
USAID program in Cambodia. Significant gains were
made this year in creating opportunities for democratic
parties to gain access to the public at large and
compete on the basis of their platforms for the National
Assembly elections. Major legal victories also set
a new standard for prosecution of human rights offenders.
The challenge in future years will be to increase
government accountability to address the public's
demand for reform. Major gains were also made in
reducing HIV/AIDS infections and increasing prenatal
access to health care. The effectiveness of the health
program is due in part to close coordination with
and commitment of Cambodian government officials
to reform the health sector. The challenge will be
to extend results achieved in target areas to nationwide
coverage, which will require staff and resources.
1. Health Program: Health is an important USG priority
in Cambodia and USAID's investment under the health
portfolio continues to yield impressive results. The
program aims to promote effective HIV/AIDS prevention
and care activities and increase access to and quality
of Maternal Child, and Reproductive Health services.
HIV prevalence among sentinel populations continued
to decline and the overall adult prevalence has stabilized
at 2.6% - a notable decrease from 3.2% in 2001. USAID-funded
HIV/AIDS prevention programs have averted new cases
of HIV infection, especially among females and newborn
children. This slowing of the epidemic is positive,
but there are a number of reasons to regard this achievement
with caution. Underlying factors, such as increased
poverty, political will and financial disbursements,
and intravenous drug abuse, all have the potential
to compromise progress.
As a strategic imperative, both women and youth
are targets for interventions and as a result, health
protecting behaviors continue to increase. USAID
funded social marketing has made noteworthy progress.
Condoms sales exceeded the expected target by more
than 3.2 million condoms, or 18%. Nearly 100% contraceptive
availability level means more access to protection
for couples. A nationwide NGO network of community-based
social marketing and outreach in both the private
and public sectors has been established, thereby
ensuring coverage in the rural areas of Cambodia
where over 85% of the people live. The number of
orphaned and vulnerable children served reached 12,652,
more than twice the number served in 2002. The 129,731
individuals reached by community and home-based care
this year was a full 20 times more than in 2002.
FY 2003 was the first year USAID partners assisted
in offering Voluntary Counseling and Testing services,
with over 5,508 recipients receiving services.
The percent of women with at least two Antenatal
Care (ANC) visits in the USAID supported rural provinces
increased from a baseline of 28% to 40%, resulting
in a 75% increase in safe deliveries by trained midwives
in these areas. These improvements will continue
to be supported by persistent reproductive health
gains in contraceptive prevalence to at least 30%.
USAID's integrated objective continues to make gains
in Vitamin A distribution - with a national goal
of country-wide distribution and coverage by FY 2005.
2. Democracy and Governance Program: This SO actively
funds NGOs who challenge the political and judicial
system for equitable treatment of Cambodian citizens.
High profile land dispute, anti-trafficking, and labor
rights cases were successfully argued in court. By
increasing the capacity of legal and human rights professionals
and providing legal services or grants to pursue important
cases, USAID is increasing its pressure on the Cambodian
judiciary to conform to international norms.
USAID activities made substantial gains towards
achieving a level playing field for political parties
in the 2003 National Assembly elections. Major improvements
which allowed for more open and competitive elections
were made. Democratic opposition parties had increased
access to media outlets and were able to present
party platforms. For the first time, the share of
free broadcast airtime among the three major parties
was proportionate to their representation in the
National Assembly. Improvements of regulatory frameworks,
though still restrictive, enabled USAID funded NGOs
to broadcast their election programs on local television
and radio stations, notably the airing of public
candidate debates, held for the first time in a national
election in Cambodia. USAID activities through local
NGOs encouraged the high voter turnout, decreased
violence and intimidation, and an enhanced integrity
of the election process.
3. Basic Education: The USAID basic education program
in Cambodia is focused on improving the quality and
proficiency of the education system by increasing the
relevance of the basic education curriculum to everyday
life; building the capacity of the school system to
deliver competency-based education; and, training teachers
to utilize student-centered teaching methodologies.
Impact will be nationwide, with activities in all
22 provinces, 18 provincial Teacher Training Colleges,
and six Regional Training Colleges. The program addresses
key issues including increased attendance for females,
minorities, students with disabilities, and the poor.
The project is strong on reform and positive change
within the Ministry of Education and supports the
recruitment and training of teachers from minority
groups including Cambodia's Islamic Cham population.
The project is integrated into key government education
initiatives, including the Education Strategic Plan
(ESP) and the Education Sector Support Program (ESSP).
Gender
The USAID/Cambodia program emphasizes gender as
a cross-cutting issue in each of its strategic objectives.
During the period leading up to the July, 2003 National
Election, USAID/Cambodia supported the participation
of women by funding training for potential women
candidates. With USAID support, there was a 50% increase
(15 new legislators) in women elected to Parliament.
Training for women candidates included national and
regional conferences on women in politics and public
fora to develop their skills. USAID activities also
provided mechanisms for the relatively small but
growing group of female elected officials to develop
their own networks and agendas for action. In the
garment industry, where 95% of the labor force is
female, USAID supported training of more than 9,500
women garment workers and 1,500 women union leaders
in union organization and operations. Assistance
to the Ministry of Women's and Veteran's Affairs
focused on women's rights and anti-trafficking. USAID
also supported research that explored economic opportunities
for trafficked women in Siem Riep province. Another
USAID sub-grantee provided community-led conflict
resolution that resulted in supporting 107 victims
of domestic violence, and 14 victims of rape. USAID
also funded the investigation and intervention in
over 40 cases of trafficked women, with several court
victories over the perpetrators. The Basic Education
SO will improve the quality of education and increase
student enrollment, attendance and completion rates
in grades one to nine, with a particular emphasis
on female students. Program priorities include gender
balance in enrollment and ensuring continued attendance
of poor females, who drop out of school at a higher
rate than their male counterpart.
|
