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Kampong Thom

Introduction

Welcome to the Provincial Food Security Profile pages for Kampong Thom. This first section provides background information on this province including an administrative map and information on its geography, and population.

Administrative Map of Kampong Thom
This map shows the district and commune names and boundaries in Kampong Thom, together with major roads and rivers, for your reference.

Map: Province Administrative map year 2000

KTM_image_01.png

(Download full size map: KTM_Map_Admin.pdf)

 

Geography of Kampong Thom

Kampong Thom is located in the geographical center of Cambodia. It borders  Preah Vihear to the North, Kratie to the East,  Kampong Cham and Kampong Chnnang to the South and the Tonle Sap lake and Pursat to the West. The area of the province is 15060 square kilometers (MAFF www.maff.gov.kh). The topography is of the province is variable, from the Tonle Sap floodplains in the Southwest through lowland paddy fields, to lowland/ upland mosaic and upland forested areas in the Northeast. Kampong Thom is classified as a rural province.

Demography of Kampong Thom

In 2004 the estimated population was 669 thousand persons and was 52% female. The population of children aged under 5 years was 88 thousand which was 13% of the total province population (NIS 2004). The Dependency Ratio (numbers of persons <15 years and 65 or over years per 100 adults aged 15-64 years) was 80. 

The total number of households in 2004 was 132 thousand, giving an average household size of 5.1 persons (MAFF 2004). The people of Kampong Thom live in 8 districts composed of 80 communes and 737 villages (CDB 2004).

The population density of the province is 44 persons/km2 compared to an average population density for Cambodia of 75 persons/km2.

Malnutrition

Mortality among Children

Malnutrition is a common contributing cause of death among children. Table 06.1 below shows  estimates for the year 2000 (latest available) of the rates and numbers of children who died prematurely in Kampong Thom.

These mortality rates are medium. The estimate is that over 9,000 children aged under 5 years had died prematurely in Kampong Thom in the five years to 2000. Over 1,100 infants aged aged under 1 year had died in the preceding one year to the year 2000.

Table 06.1 Child Mortality in Kampong Thom at Year 2000

Mortality
Indicator
Rate
Percent
Rate
Prov.Rank
Number of
Children
Affected
Number
Prov.Rank
Infant Population
(aged < 1 year)
 -  - 17,361  10 
Infant Mortality
(aged < 1 year)
 6.45%  23  1,120  13
Child Population
(Aged 0-<5 years)
 -  91,523  10
Under 5 year Mortality
(aged 0-5 years)
9.88%   21  9,042  11

Source: Estimates calculated from CDHS 2000 & NIS 2004


Protein-Energy Malnutrition among Children

Table 06.2 below shows  estimates for the years 2000 and 2005  of the rates  and numbers of children aged under five years suffering from protein-energy malnutrition in Kampong Thom.  Three indicators are used: Stunting (height for age) Underweight (weight for age) and Wasting (weight for height). The  international WFP child nutrition standards categories for the rates are also included.

In 2005 Stunting rates were very high (a the same as year 2000) and over 37,000 children were Stunted (a decrease from year 2000). Underweight rates were very high (a decrease from year 2000) and over 33,000 children were Underweight (a large decrease from year 2000). Wasting rates were low ( a very large decrease from year 2000) and over 3,000 children were Wasted (a very large decrease from year 2000).

Table 06.2 Child Malnutrition in Kampong Thom Years 2000 and 2005

Malnutrition
Indicator
Rate
Percent
2000
WFP Rate
Category
2000
Number of
Children
Affected
2000
Rate
Percent
2005
WFP Rate
Category
2005
Number of
Children
Affected
2005
Population Children
Aged Under 5 years
100%  91,523  100%  90,101 
Stunted
(moderate &
severe <-2SD)
 47.2%  Very High
 43,199  41.1%  Very High
 37,032
Underweight
(moderate &
severe <-2SD)
 49.4%  Extremely
High
 45,212  37.4%  Very High
 33,698
Wasted
(moderate &
severe <-2SD)
24.5%  Extremely
High
22,423  3.4%  Low  3,063 

Source: CDHS 2000 & 2005

As shown in the table above the decline in number of children aged under 5 years affected by malnutrition is due to  lower malnutrition rates  as the population  of children has changed very little from 2000 to 2005. 

Rank Comparison of Malnutrition in Kampong Thom with all 24 provinces in 2005

Table 06.3 ranks the 2005 child under 5 year malnutrition outcomes  described above in comparison to all other provinces  in Cambodia. Comparing food security outcomes in this province to all other provinces of Cambodia:- The prevalence of Under 5 year mortality was relatively low. The prevalence of malnutrition among the child population was from low to very high varying by indicator. The actual numbers of children affected by malnutrition (considering differences in the child population of each province) was from relatively low to above average varying by indicator.

Table 06.3 How Malnutrition in Kampong Thom Ranks Compared to all 24 Provinces of Cambodia in 2005

Malnutrition Indicator Rank of This Province
Compared to all 24 Provinces:
1= the worst
24 = the best
 Population of Children Aged Under 5 years  10
 Number of Children Stunted  7
 Number of Children Underweight  7
 Number of Children Wasted  14
 Rate of Stunting  8
 Rate of Underweight  11
 Rate of Wasting  24

 

Maps of the Distribution of Child Malnutrition in Kampong Thom 2000

Below is a series of four maps showing the incidence of Stunting and Underweight by Commune in Kampong Thom in 2000. The maps show both the rates and the numbers of children affected by commune. These estimateswere made by WFP using small area estimation techniques. These maps now categorise communes by the new 2005 international WFP child nutrition standards

It is important to note that there are variations between the direct CHDHS 2000 province level estimates of Stunting and Wasting presented above (which are the best current estimates for the province level in 2000) and the WFP commune estimates for  the individual communes across the province presented in the following maps (percentage and number of children affected). This is a result of the the WFP commune estimates being based on a different methodology (small area estimation techniques-SME) and a different child Under 5 population estimate (1998 Census).

Despite these variations, these WFP commune level estimates or malnutrition are the only estimates of the geographical distribution of malnutrition within provinces for all communes in the country. They remain a useful tool to examine the relative incidence of child malnutrition by commune within provinces and give an initial estimate of proportions and numbers of children affected by commune in year 2000.

Children aged <5 years Stunted: Percent by Commune in Kampong Thom province year 2000

Map KTM 05.00 shows that most communes in the province were estimated to have at least a Very High percentage of children Stunted. Extremely High rates of Stunting were mostly concentrated among the communes in Stoung district on the northwest border, Kampong Svay and Steung Sen districts in central Kampong Thom, Sandan district in the remote northwest and Baray district in the south. In all these districts most, if not all, remaing communes in each district had a Very High percentage of children Stunted.

Note that these commune level percentages derived from the SME technique and therefore the WFP Nutrition Standard commune categories are slightly lower on average than the direct CDHS estimates for the province level presented above.

Map KTM 05.00: Children aged <5 years Stunted: Percent by Commune in Kampong Thom province year 2000

KTM_image_05.png

(Download full size map: KTM_Map_0500.pdf)

 

Children aged <5 years Stunted: Number of Children by Commune in Kampong Thom province year 2000

Map KTM 06.00 shows that the number of Stunted children varied substantially by commune within the province due to a combination of differences in commune child populations and Stunting rates at the commune level. These variations can also be seen between communes within districts. Commune with  with >=500 Stunted children per commune were particularly common in Stoung district on the northwest border, Kampong Svay and Steung Sen districts in central Kampong Thom, Prasat Balank and Prasat Sambour districts in the central north and Baray and Santul district in the south. 

The map also highlights some communes with large numbers of stunted children due to larger child populations, despite lower rates of Stunting, in Kampong Svay and Steung Sen districts close to the province centre.

Map KTM 06.00: Children aged <5 years Stunted: Number of Children by Commune in Kampong Thom province year 2000

KTM_image_06.png

(Download full size map: KTM_Map_0600.pdf)

 

Children aged <5 years Underweight: Percent by Commune in Kampong Thom province year 2000

Map KTM 07.00 shows that most communes in the province in almost all districts were estimated to have at least a Very High percentage of children Underweight.  Communes with Extremely High rates of underweight, including quite a number of communes with Extremely High rates of underweight >=50% are concentrated either along or near the northwest to south road corridor of Highway 6 (from Stoung to Baray), or along the Stung Sen river corridor running northeast from the province center to Sandan district.

Note that these commune level percentages derived from the SME technique and therefore the WFP Nutrition Standard commune categories are somewhat lower on average than the direct CDHS estimates for the province level presented above.

Map KTM 07.00: Children aged <5 years Underweight: Percent by Commune in Kampong Thom province year 2000

KTM_image_07.png

(Download full size map: KTM_Map_0700.pdf)


Children aged <5 years Underweight: Number of Children by Commune in Kampong Thom province year 2000

Map KTM 08.00 shows that the number of Underweight children varied substantially by commune within the province due to a combination of differences in commune child populations and Underweight rates at the commune level. These variations can also be seen between communes within districts. Communes with >=500 Underweight children were particularly common along or near the northwest to south road corridor of Highway 6 (from Stoung to Baray), and along the Stung Sen river corridor running northeast from the province center to Sandan district.

Map KTM 08.00: Children aged <5 years Underweight: Number of Children by Commune in Kampong Thom province year 2000

KTM_image_08.png

(Download full size map: KTM_Map_0800.pdf)

 

 

Food Availability

A lack of food availability can be an important cause of malnutrition and can contribute to premature mortality as well. Food availability is the ability of the people to directly produce the foods they need through their own activities in agriculture and livestock production,and through harvesting wild foods in  agricultural commons areas, forests and fisheries. 

This section examines evidence for a lack of food availability that might be contributing to child malnutrition and mortality levels found among the population of Kampong Thom (see Malnutrition and Food Utilization sections).

Information on food availability is limited in some areas, particularly in relation to wild foods from common property forest, agricultural and fisheries. However, we can still build an overall profile of food availability in Kampong Thom from available information while these limitations do still exist in 2004

Access to Agricultural Land in Kampong Thom in 2004

Table 06.2.1 shows the percentage of rural households in Kampong Thom by agricultural land holding size.

Rural households in Kampong Thom have limited access to agricultural land for crop production in general. Further, there are also large differences in the quantity of agricultural land available to individual rural households. Small land holdings and other factors limiting crop productivity limit food ability for many rural households.

In 2004, 7% of rural households in Kampong Thom were landless and did not produce their own staple food crops. This is a lower rate than at the national average. A further 44% possessed les than 1.0 hectares of land. These small hold farming households will typically only produce enough food from crop agriculture to meet a part of their staple food needs. 

Table 06.2.1 Agricultural Land Access in Kampong Thom in 2004

Agricultural land per rural household % of Rural HH
This Province
% of Rural HH
National
 No agricultural land (landless) 7%  15% 
 Less then 1.0 hectare (0.01- <1.0 ha)  44%  49%
 1.0- < 3.0 hectares  40%  30%
 >= 3.0 hectares  10%  6%

Source: MAFF 2004


Percentage of Rural Households Producing Crops in 2004

Table 06.2.2 shows the percentage of rural households in Kampong Thom engaged in crop production by season. Rural households are very commonly engaged in crop production, most typically rice production to grow their own food and for cash income at least for one season per year.

Most food crop production in Kampong Thom is rain-fed and is confined to the wet season. with 93% of households producing a rice crop in the wet season compared to only 6% of households in the dry season.  Further, most dry season cropping is restricted to only some communities within the province, those with access to groundwater or flood recession, or irrigation, surface water. This limitation imposed through dependency on rain-fed crop cultivation is clearly contributing to shortages in food availability.

Table 06.2.2 Percentage of Rural Households Producing Crops in Kampong Thom in 2004

Rural Households Producing Crops % of Rural HH
This Province
% of Rural HH
National
 Any Season-Any Crop 93%  85% 
 Wet Season-Rice Crop  95%  69%
 Dy Season-Rice Crop  6% 16% 

Source: MAFF 2004


Crop Production by Type and Season in 2004

Rice Production

Table 06.2.3 shows statistic about rice production in Kampong Thom. Rice is the staple cereal food crop of rural Cambodians. 

Comparing wet season rice production with national averages, the mean rice area cultivated per rural household was higher than the national level and the rice paddy yield per hectare was lower than the national level.

Comparing dry season rice production with national averages, the mean rice area cultivated per rural household was lower than the national level and the rice paddy yield per hectare was lower than the national level.

Rice production is limited to the wet season. Dry season rice production plays a very small role in this province.

Table 06.2.3 Rice Crop Production by Season in Kampong Thom in 2004

Rice Production
Indicator
this
Prov
Wet
Season
National
Wet
Season
This
Prov
Dry
Season
National
Dry
Season
 Area Cultivated- '000 ha. 170  2087  330 
 Area Harvested- '000 ha.  149  1851  3.5  318
 Paddy Production '000 MT  185  2918  7.8  973
 Yield-MT/ha  1.2  1.6  2.2  3.1
 Paddy % of total crop area cultivated  94%  81%  78%  84%
 Mean Area Cultivated/ Rural HH- ha. 1.4   0.9  >0.1  0.1

Source: MAFF 2004


Rice Food Balance   

Table 06.2.4 shows the balance between rice food availability from production and defined minimum white rice food needs of the population of Kampong Thom. Rice is the only food crop type for which such a direct measure of food availability compared to food needs can be made.

This overall rice balance at the province level is shown in the table. In addition, to illustrate how rice balances can vary between areas and between households within the province, two further rice balance indicators are included. One is the percentage of communes having >= 100% of minimum rice needs for the commune population. The second rice balance is for small-hold farmers (cropping 0.5 ha. of rice).

At the province level overall the rice balance exceeds the minimum rice food needs of the population. Among the communes of the province 66% of communes produce enough rice to meet minimum food needs while 34% produce less than minimum food needs.  Commune level rice balances are mapped at the bottom of this page.

For households that are small-hold farmers 48% of minimum rice needs are derived from the own production. This is indicative of the rice food balance in households farming 0.1- < 1.0 ha. of land shown in Table 06.2.1 above. Furthermore at the household level, it should be noted that the vast majority of the landless will produce no rice at all as very few rent  or share-crop rice land.

Table 06.2.4 Rice Food Balance in Kampong Thom

Rural Households Prdocing Crops This Province National
Total white rice available for food consumption
'000 MT
107  2166 
Minimum population white rice food
needs/ year '000 MT
 89  1713
Provincial Level: overall white rice food
balance as % of  minimum rice needs
 121%  126%
Commune Level: Percentage of Communes
with rice food balance >= 100%.
 66%  61%
Smallholders (cropping 0.5 ha.): white
rice food balance as % of  minimum rice needs.
 48%  66%

Source: MAFF 2004


Other Non-Rice Annual & Perennial Crop Production in 2004

Table 06.2.5 shows some basic overall statistics to give an idea of the relative role of non-rice crops in agricultural cropping systems in Kampong Thom.

A range of other annual field crops are typically grown in the provinces. These include food crops (such as maize, cassava, mung bean, vegetables) and non-food crops (such as jute, tobacco). In addition a range of perennial crops are grown including agricultural fruit trees and coffee. A food balance is not possible for non-rice food crops as there are no nutritional guidelines for these other food types. In addition, statistics do not indicate what proportion of these non-rice food crops are consumed versus being sold for cash income.

In available MAFF statistics, non-rice crops are only partially enumerated estimates (limited range of selected crops, one collective estimate for most vegetables, unclear whether home garden production is included) and are enumerated in less detail than for rice. There is also a limited data on agricultural tree and perennial crops (limited range of crops, trees estimated by area rather than number, no data on production). 

Considering these limitations, non-rice crop production accounts for 6% of the total cultivated area for all crops which is lower OR higher OR similar to than the national average. The heavy concentration on rice production within cropping systems will mean that the production of vegetables and fruit which are important for nutrition will be limited. OR This greater crop diversification will mean that cropping systems will have greater production of vegetables and fruit which are important for nutrition. A further limitation is that  non-rice crop  production on these small areas of land are mainly restricted to the wet season only. OR Non-rice crop production is undertaken in both the wet and dry seasons.

Table 06.2.5 Non-Rice Annual & Perennial Crop Production Overview in Kampong Thom in 2004

Non- Rice
Crop Indicato
Wet
Season
Dry
Season
Both
Seasons
% of total annual crop cultivated area
for non-rice field crops & vegetables
 6 24 
Mean ha./ rural household cultivated
for annual non-rice field crops & vegetables
 0.1  <0.1  0.1
Mean ha./ rural HH agricultural fruit tree
and other perennial crops
 - 0.1 

Source: MAFF 2004


Livestock production in Kampong Thom in 2004

Table 06.2.5 shows some basic statistics on livestock production at the household level in Kampong Thom. Livestock, if consumed, are an important source of protein and other important micro-nutrients such as Iron. A food balance is not possible from these livestock statistics as there are no nutritional guidelines for protein and nutrient supply by livestock type. Livestock statistics are only estimates and may be under-enumerated.

Poultry (second to fish) are typically consumed as a source of protein. Pigs are typically sold for cash and cattle and buffalo are retained for breeding, draught power and as a store of wealth and are therefore not consumed directly for food. However, examining statistics for these large livestock types does give and idea of local supply of pork and beef to markets, where they are bought in small amounts for consumption by rural households.

Table 06.2.5 Household Livestock Production Overview in Kampong Thom in 2004

Livestock Ownership among rural households This Province National
 Mean poultry per rural household (head) 5.6   6.5
 Mean pigs per rural household (head)  0.8  0.9
 Mean cattle per rural household (head)  1.6  1.2
 Mean water buffalo per rural household (head) 0.4   <0.1

Source: MAFF 2004


Percentage of minimum rice needs produced  by Commune in Kampong Thom in 2004

Map KTM.02.01 shows the percentage of per capita minimum rice food  needs produced for the population in each commune in 2004 according to MAFF statistics. This is an average figure for the commune level.

Map KTM.02.01 Percentage of per capita minimum rice food needs produced by Commune in Kampong Thom in 2004

KTM_image_15.png

(Download full size map: KTM_Map_0201.pdf)

 

Food Access

Problems with food access can be  an important cause of food insecurity and malnutrition. This section examines people's ability in the province to earn cash income with which to buy food that they need for an adequate diet but which they cannot produce themselves.

A written description and statistics are found here about food access the province level. There is also a map and description of poverty rates at the commune level in 1997.

Consumption Poverty in Kampong Thom in 2004

Consumption poverty refers to having insufficient cash income (or its equivalent in kind) to meet basic livelihood needs. This includes having insufficient cash income to buy foods that people need for an adequate diet as well as cash income to buy other basic needs such as shelter, clothing, health and education.

This lack of market purchasing power can be an important cause of food shortages and protein-energy and micro-nutrient malnutrition in the province population.

Table 06.3.1 contains indicators of the prevalence of consumption poverty in Kampong Thom in comparison to national rates. Results show that 48% of households are below the consumption poverty line and 52% of households in the province fall into the poorest two national quintiles of national consumption. These households will struggle to have enough cash available to buy food needs on the market and to meet other expenditure needs such as health services.

Table 06.3.1 Indicators of Consumption Poverty in Kampong Thom 2004

Consumption Poverty Indicator This
Province
National
Mean Total per capita HH daily per capita consumption
in riel
 2438 3247 
% of households in the lowest Q1 and Q2 (i.e. 40%)
of national consumption quintiles
 52  37
Consumption poverty line in riel  1785  1836
% of households below the  poverty line  48  32
The poverty line value as a percentage of total
consumption
73   49

Source: CSES 2004 Knowles Analysis


Household Economic Asset Poverty in Kampong Thom in 2004

Another important dimension of poverty is a lack of physical assets with which to generate household income.  Table 06.3.2 contains indicators of the prevalence of a lack of physical assets among households in Kampong Thom in comparison to national rates. Households lacking economic assets of their own will be more exclusively dependent upon wage labor or common property resources to generate cash income to buy food and other basic needs.

Table 06.3.2 Indicators of Household Asset Poverty in Kampong Thom 2004

Asset Poverty Indicator This
Province
National
 % rural households with no crop land-landless 0 ha. 15 
 Average crop land area cultivated for all annual crops ha./rural hh  1.5  1.2
 % households with thatched roof houses  45  34
 % HH not owning any cattle or buffalo  35  49
 % HH not owning any pigs-CDB 2004  48  54
 Mean no. of households per car  61  39
 Mean no. of households per motor  7.2  5.4
 Mean no. of households per oxcart 2.1  4.0 

Source: MAFF 2004 & CDB 2004 aggregates from village data


Employment and Labor Force Characteristics in Kampong Thom in 2004

Employment  either in the form of wage labor or operating a business enterprise  can be a very important source of cash income  to Cambodian households.  Unfortunately, we lack information on this important aspect of food security and poverty. This is because most Cambodians generate wage and business cash income outside the "formal sector" of the economy, in what is know as the "├»nformal sector". The limitation of most existing statistics is that they do not distinguish between formal sector (more regulated, more secure, and often higher income activities) and informal sector activities in statistics collection.

Wage labor in the informal sector is unregulated, casual and often low paid. A very typical example is agricultural casual wage labor. Businesses in the informal sector are commonly household based micro-enterprises, unregistered, unregulated and often with poor access to credit, business and legal services. These micro-enterprises are diverse including agro and natural resource processing, small scale industrial/ handicraft and service enterprises.

Table 06.3.3 contains indicators of the characteristics of the labor force and employment in Kampong Thom in comparison to national rates. Total and female adult literacy rates are a good proxy indicator for access to productive employment and higher incomes. The indicator on percentage of the labor force economically active <=10 days/ mth gives some indication of the problem of underemployment, a major limitation to income generation from wage labor in the informal sector.

Table 06.3.3 Employment and Labor Force Indicators in Kampong Thom 2004

Employment and Labor Force Indicator This
Province
National
 Literacy Rate > 15 years % total population 58  67 
 Literacy Rate > 15 years % females  53  60
 % of the labor force in the primary sector incl. Agriculture  62  60
 % of the labor force in the secondary sector/ Industry  13  13
 % of the labor force in the tertiary sector/ Services  24  25
 % of the labor force economically active <=10 days/ mth 34   29

Source: CSES 2004 Kanol Analysis (NIS)


Market Access in Kampong Thom in 2004

Characteristics of access to markets and major transport systems serving them are an important dimension of food access. Communities more isolated from markets will tend to suffer from lower prices for the products they sell and higher costs in buying food and other needs.

Table 06.3.4 contains indicators of access to markets and major transport systems serving them in Kampong Thom in comparison to national statistics.

Table 06.3.4 Market Access Indicators in Kampong Thom 2004

market access
Indicator
This
Province
National
 Average time (minutes) taken from village to the nearest market  45 45 
 Average farm gate price of paddy in Riel
(December)
 504  521
 Distance (Km) to nearest year-round road  9.0  3.8
 Average time (minutes) from village to nearest year-road 26  18 

Source: CDB 2004 aggregates from village data


Percentage of the population below the consumption Poverty Line by Commune in Kampong Thom in 1997

Map KTM.03.01 shows the WFP estimate of the percentage of the population below the consumption Poverty Line in the year 1997. These estimates were made by WFP using small area estimation techniques based on the CSES 1997. This remains the most recent source of poverty data  at the commune level. Note that some communes were not covered in  the CSES 1997 due to insecurity.

Map KTM.03.01 Percentage of the Population Below the Consumption Poverty Line by Commune in Kampong Thom 1997

KTM_image_20.png

(Download full size map: KTM_Map_0301.pdf)

 

Food Utilization

Problems with food use and utilization can be important causes of food insecurity and malnutrition. This section examines patterns of food use and utilization among mothers and children, which contributed to food insecurity in terms of increasing mortality, morbidity and malnutrition in the year 2005.

Included here are sections on malnutrition rates among women, maternal care, mother- child care practices, child illnesses, child micro-nutrient malnutrition and access to sanitation and safe drinking water.

Malnutrition rates among women in Kampong Thom

"A mother's well-being has a direct impact on her children's well-being. Similarly when one group fares poorly so does the other. For newborns, survival is directly linked to a mother's health during pregnancy" (CDHS 2000).

Results for 2005 are available for two important maternal micro-nutrient malnutrition indicators, Iron Deficiency Anemia (IDA) and Iodine Deficiency (IDD). Iodine Deficiency is avoided by the use of Iodized salt. The CDHS 2005 provides results for use rates of Iodized salt in households.

The percentages of women affected by these conditions, together with the outcomes of these forms of malnutrition, are shown in Table 06.04.1. Anemia (IDA) rates in Kampong Thom were higher than the rate at the national level. The percentage of households not using Iodized salt, an indicator for Iodine deficiency (IDD), was lower than the rate at the national level.

Table 06.04.1Malnutrition rates among women in Kampong Thom in 2005

Malnutrition Indicator for
Women aged 15-49 years
% of Women
This
Province
2005
% of Women
National
2005
Women with Iron Deficiency Anemia (IDA)
IDA Outcomes: "contributes to  low birth weight,
lower resistance to infection, poor cognitive development
and decreased work capacity."
57%  47% 
Iodine Deficiency (IDD) Household tested salt not Iodized.
IDD Outcomes: "increased rates of abortion, stillbirths,
congenital abnormalities, cretinism, psychomotor defects
and neonatal mortality."
20%  28% 

Source: CDHS 2005


Maternal health care in Kampong Thom

Access to maternal health care services is of great importance to support maternal and child health and nutrition during pregnancy and at birth.

Table 06.04.2 presents the percentages of pregnant women not having access to important maternal health care services in 2005. The lack of access to maternal health care services is a causal factor in the observed rates of child and maternal mortality and malnutrition in the province.

Compared to the national level, the percentage of pregnant women not having access to antenatal care services was generally higher than the national average. Compared to the national level, a much higher percentage of pregnant women in this province did not have babies delivered with a health professional and a similar percentage did not deliver babies in a health facility.

Table 06.04.2 Maternal health care in Kampong Thom Year 2005

Maternal Care Indicator for
Women during pregnancy who had a live birth in the previous five years
% of Women
This
Province
2005
% of Women
National
2005
 Pregnant women without antenatal care from a health professional 41%  31% 
 Pregnant women not receiving >=1 Tetanus toxoid injection  23%  23%
 Pregnant women not given iron tablets  43%  37%
 Women not having babies delivered with a health professional  75%  56%
 Women not having babies delivered in a health facility  81% 78% 

Source: CDHS 2005


Mother-child care practices in Kampong Thom

After birth, mother-child health and nutrition practices are extremely important for the healthy development and nutrition of a growing child. These practices are influenced by a mother's education and knowledge, and by physical, social and economic access to child health care services.

Table 06.04.3 presents the percentages of mothers not using appropriate mother-child health and nutrition practices. whether through a lack of knowledge or because of a lack of physical social or economic access to child health care services. The final indicator, women's illiteracy rate, is a more general indicator of mother's education and knowledge which has been shown to have a major affect on mother-child health and nutrition practices overall.

In Kampong Thom a substantially higher percentage of children had not received  their complete course of vaccinations compared to the national level.  Compared to the rates of diarrhea treatment practices at the national level, a higher  percentage of children were not taken for medical treatment and a similar percentage of children were not given any sort of Oral Rehydration treatment. Compared to the rates of ARI/Fever treatment practices at the national level, a lower percentage of children with ARI/Fever symptoms in this province were not taken to a health care provider for medical treatment.

Table 06.04.3 Mother-child care practices in Kampong Thom

Mother-Child Care Practices % of Children
This
Province
2005
% of Women
National
2005
Children aged 12-23 months not receiving all vaccinations (a) 45%  33% 
Children < 5 yrs with Diarrhea
not having medical treatment sought from health facility or provider
 58%  50%
Children < 5 yrs with Diarrhea
not given Oral Rehydration treatment of any sort
 39%  41%
Children < 5 yrs with Fever/ARI
not having medical treatment sought from health facility or provider (b)
 48% 57% 

Source: CDHS 2005


Child health in Kampong Thom

A combination of mother-child health care practices and external factors, particularly those related to water and sanitation, affect the prevalence rate of child infections. Diarrhea and Acute Respiratory Infections are common causes of morbidity and the most common final causes of death among children aged < 5 years. Diarrhea also directly reduces nutrition intake.

Table 06.04.4 Child Illnesses and Treatment in Kampong Thom in 2005

Children < 5 yrears illnesses % of Children
This
Province
2005
% of Children
National
2005
 Children < 5 yrs with Diarrhea within the preceding two weeks 25%  20% 
 Children < 5 yrs with symptoms of ARI within the preceding two weeks  18%  8.5%
 Children < 5 yrs with fever within the preceding two weeks  54% 35% 

Source: CDHS 2005


Micro-nutrient malnutrition rates among children in Kampong Thom

The percentages of children affected by these conditions, together with the outcomes of these forms of micro-nutrient malnutrition, is shown in Table 06.04.5. The percentage of children aged 6- 59 months suffering from both any level of IDA, and moderate levels of IDA, are shown. The CDHS 2005 results for use-rates of Iodized salt used in households is repeated here in this table, as an indicator of Iodine Deficiency (IDD) prevalence among children.

Rates for both any level, and moderate level, of Anemia (IDA) were much higher than the national average in Kampong Thom, meaning that a greater percentage of children were suffering the outcomes of Anemia described in the table.  The proportion of households not using Iodized salt was lower than the national average, with this percentage of children suffering the outcomes of Iodine deficiency (IDD) described in the table.

Table 06.04.5 Micro-nutrient malnutrition rates among children in Kampong Thom in 2005

Micronutrient Malnutrition
Indicator for Children
Children
This
Province
2005
% of Children
National
2005
% Children 6-59 months with any Iron Deficiency Anemia (IDA).
Outcomes: "impaired cognitive performance, motor development,
coordination, language development and scholastic achievement.
Increases morbidity from infectious diseases because it adversely affects immune mechanisms".
 75%  62%
% Children 6-59 months with moderate Iron Deficiency Anemia (IDA).
Outcomes: as above but more severe.
 47%  32%
Iodine Deficiency (IDD) Household tested salt not Iodized
Outcomes: "goiter, hypothyroidism, impaired mental functions,
retarded mental and physical development and diminished
school performance."
20%  28% 

Source: CDHS 2005


Access to sanitation and safe drinking water in Kampong Thom

"The type of water and sanitation facilities are important determinants of the health status of household members and particularly children. Proper hygienic and sanitation practices can reduce exposure to and the seriousness of major childhood diseases such as diarrhea". (CDHS 2000).

Table 06.04.6 shows the percentages of households not having access to sanitary toilets and not having access to safe drinking water in the year 2004. Among these households, members and particularly children are exposed to poor hygiene and sanitation conditions which will increase risks of infections including diarrhea, and which will in turn increase risks of child death, and levels of child malnutrition.

Compared to the national level, a higher percentage of households in this province did not have a sanitary toilet. The percentage of households not having access to safe drinking water in this province was lower than the national average. More needs to be done particularly to promote sanitation, and to further improve access to safe drinking water in this province, to reduce the risks of child death, and to reduce existing levels of child morbidity and malnutrition.

Table 06.04.6 Access to sanitation and safe drinking water in Kampong Thom 2004

Sanitation and Safe Drinking Water
Access Indicators
% of Households
This Province
% of Households
National
 Households not having a sanitary toilet  89%  81%
Households not having access to a safe source of drinking water at,
or within 150 meters, of their house
 27%  34%

Source: CDB 2004


Percentage of the population without access to safe drinking water  by Commune in Kampong Thom in 2004

Map KTM.04.01 shows the percentage of the population without access to a source of safe drinking water by commune according to the Commune Database 2004. This map can be compared with the maps in the malnutrition section. Children without access to safe water are more likely to suffer from Underweight, illnesses and mortality.

Map KTM.04.01 Percentage of the Population Without Access to Safe Drinking Water  by Commune in Kampong Thom in 2004

KTM_image_27.png

(Download full size map: KTM_Map_0401.pdf)

 

Food Vulnerability

A final set of causes of food insecurity are found in the vulnerability of Cambodian rural people to shocks and stresses that can reduce their food supply, or access or utilization of food to levels below minimum needs.

These issues have been shown to be an important dimension of food insecurity and poverty in Cambodia in a large number of studies. However, information about vulnerability covering all individual provinces is limited.

Below are a set of indicators of agro-ecological vulnerability at the province level for Kampong Thom. Some issues related to socio- economic vulnerability to food insecurity are also discussed and a cross reference is provided to the section of this profile that already includes relevant available indicators.

Agro-ecological Vulnerability

Agro-ecological vulnerabilities include risks of damage or destruction to crop production, livestock morbidity and morality and changes to common property fisheries and forest resources' productivity and access.

Indicators of such risks at the province level are limited to those about rice crop production, including flood, drought and pest damage. These results are presented in Table 06.5.1. They give an indication of vulnerability to food production loss for the staple crop rice, and other annual crops produced for food and income under mainly rain-fed cropping systems in Kampong Thom.

In 2004 the wet season crop cultivated area was 98% of the total rice cultivated area for the year.  Of this wet season cultivated area, 12% was destroyed, mostly through drought damage.

Table 06.5.1 Percentage of rice cultivated area destroyed by season and cause in Kampong Thom 2004

Indicator Wet Season Dry Season
% of total rice cultivated area for 2004
by season
98 
% Rice cultivated area destroyed by flood
by season
 2  0
% Rice cultivated area destroyed by drought
by season
 10  5
% Rice cultivated area destroyed by
insect/other by season
 0  2
% cultivated area destroyed-total
by season
12   7

Source: MAFF 2004


Socio-economic Vulnerability

There are a range of socio-economic vulnerabilities that can contribute to food insecurity. One such vulnerability is dependency on low, erratic, and insecure sources of cash income to buy household needs including food. Another characteristic vulnerability is illiteracy, which is associated with higher levels of poverty and low incomes, and higher rates of child malnutrition. A further set of vulnerabilities here relate to remoteness from markets, major transport networks and social services such as health and education.

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