Koh Kong

Introduction

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

Administrative Map of Koh Kong

This map shows the district and commune names and boundaries in Koh Kong, together with major roads and rivers, for your reference.

Map: Province Administrative map year 2000

(Download full size map: KKG_Map_Admin.pdf)

Geography of Koh Kong

Koh Kong is located in Southern Cambodia on the coast of the Gulf of Thailand. It borders Pursat to the North, Kampong Speu and Kampot to the East, Sihanoukville to the South, the Gulf of Thailand to the Southwest and Thailand to the West. The area of the province is 11160 square kilometers (MAFF www.maff.gov.kh). The topography of the province is variable, from the coastal region on the south and western borders, to extensive upland forested areas covering much of the province. Smaller areas of lowland paddy fields and areas of lowland/ upland mosaic are found between the coast and the mountains. Koh Kong is classified as a rural province.

Demography of Koh Kong

In 2004 the estimated population was 183 thousand persons and was 48% female. The population of children aged under 5 years was 24 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 74. 

The total number of households in 2004 was 36 thousand, giving an average household size of 5.0 persons (MAFF 2004). The people of Koh Kong live in 8 districts composed of 33 communes and 132 villages (CDB 2004).

The population density of the province is 16 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 09.1 below shows  estimates for the year 2000 of the rates and numbers of children who died prematurely in Koh Kong.

These mortality rates are medium. The estimate is that over 2,100  children aged under 5 years died prematurely in Koh Kong in the five years to 2000. Over 300 infants aged under 1 year had died in the preceding one year to the year 2000.

Table 09.1 Child Mortality in Koh Kong at Year 2000

Sources: Estimates calculated from CDHS 2000 & NIS 2004

Protein-Energy Malnutrition among Children

Table 09.2 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 Koh Kong.  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 high (a large decrease from year 2000) and over 9.000 children were Stunted (a decrease from year 2000). Underweight rates were very high (a decrease from year 2000) and over 9,000 children were Underweight (a limited decrease from year 2000). Wasting rates were medium (a decrease from year 2000) and over 1,800 children were Wasted (a large decrease from year 2000).

Table 09.2 Child Malnutrition in Koh Kong Years 2000 and 2005

Sources: CDHS 2000 & 2005

As shown in the table above the changes in number of children aged under 5 years affected by malnutrition is mainly due to lower malnutrition rates. The population  of children in 2005 is slightly larger than in 2000.

Rank Comparison of Malnutrition in Koh Kong with all 24 provinces in 2005

Table 09.3 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 about average. The actual numbers of children affected by malnutrition (considering differences in the child population of each province) was  relatively low.

Table 09.3 How Malnutrition in Koh Kong Ranks Compared to all 24 Provinces of Cambodia in 2005

Maps of the Distribution of Child Malnutrition in Koh Kong 2000

Below is a series of four maps showing the incidence of Stunting and Underweight by Commune in Koh Kong in 2000. The maps show both the rates and the numbers of children affected by commune. These estimates were 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 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 Koh Kong province year 2000

Map KKG 05.00 shows that the vast majority of communes in all districts of the province were estimated to have Extremely High rates of Stunting in 2000.

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

Map KKG 05.00: Children aged <5 years Stunted: Percent by Commune in Koh Kong province year 2000

(Download full size map: KKG_Map_0500.pdf)

Children aged <5 years Stunted: Number of Children by Commune in Koh Kong province year 2000

Map KKG 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. Communes with >=500 Stunted children each were most common in Sre Ambel district. They were also present in Kampong Seila, Botum Sakor, Mondul Siema and Smach Mean Chey districts.

Map KKG 06.00: Children aged <5 years Stunted: Number of Children by Commune in Koh Kong province year 2000

(Download full size map: KKG_Map_0600.pdf)

Children aged <5 years Underweight: Percent by Commune in Koh Kong province year 2000

Map KKG 07.00 shows that most communes in the province in almost all districts were estimated to have at least an Extremely High percentage of children Underweight, including five communes with Extremely High rates of underweight >=50%.

Note that these commune level percentages derived from the SME technique and therefore the WFP Nutrition Standard commune categories are the same as the direct CDHS estimates for the province level presented above.

Map KKG 07.00: Children aged <5 years Underweight: Percent by Commune in Koh Kong province year 2000

(Download full size map: KKG_Map_0700.pdf)

Children aged <5 years Underweight: Number of Children by Commune in Koh Kong province year 2000

Map KKG 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 Stunted children each were most common in Sre Ambel district. They were also present in Kampong Seila, Botum Sakor, Mondul Siema and Smach Mean Chey districts.

Map KKG 08.00: Children aged <5 years Underweight: Number of Children by Commune in Koh Kong province year 2000

(Download full size map: KKG_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 Koh Kong (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 Koh Kong from available information while these limitations do still exist in 2004.

Access to Agricultural Land in Koh Kong in 2004

Table 09.2.1 shows the percentage of rural households in Koh Kong by agricultural land holding size.

Rural households in Koh Kong 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, fully 52% of rural households in Koh Kong were landless and did not produce their own staple food crops.  A further 22% 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. These patterns reflect to some extent the role of alternative employment in coastal fisheries, however inland comunities within the province may still be facing land shortages.

Table 09.2.1 Agricultural Land Access in Koh Kong in 2004

Source: MAFF 2004

Percentage of Rural Households Producing Crops in 2004

Table 09.2.2 shows the percentage of rural households in Koh Kong 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.

Food crop production in Koh Kong is rain-fed and is confined to the wet season, with 32% of households producing a rice crop in that season and none growing a ric crop in the dry season.

Table 09.2.2 Percentage of Rural Households Producing Crops in Koh Kong in 2004

Source: MAFF 2004

Crop Production by Type and Season in 2004

Rice Production

Table 09.2.3 shows statistic about rice production in Koh Kong. 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 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. This limitation imposed through dependency on rain-fed crop cultivation is clearly contributing to shortages in food availability.

Table 09.2.3 Rice Crop Production by Season in Koh Kong in 2004

Source: MAFF 2004

Rice Food Balance 

Table 09.2.4 shows the balance between rice food availability from production and defined minimum white rice food needs of the population of Koh Kong. 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 falls way below the minimum rice food needs of the population. Among the communes of the province 27% of communes produce enough rice to meet minimum food needs while 73% 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 45% 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 09.2.1 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 09.2.4 Rice Food Balance in Koh Kong

Source: MAFF 2004

Other Non-Rice Annual & Perennial Crop Production in 2004

Table 09.2.5 shows some basic overall statistics to give an idea of the relative role of non-rice crops in agricultural cropping systems in Koh Kong.

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 only 3% of the total cultivated area for all crops which is lower than the national average.

Table 09.2.5 Non-Rice Annual & Perennial Crop Production Overview in Koh Kong in 2004

Source: MAFF 2004

Livestock production in Koh Kong in 2004

Table 09.2.5 shows some basic statistics on livestock production at the household level in Koh Kong 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.

Livestock holdings in general are much lower than the national average, particularly for cattle and pigs.

Table 09.2.5 Household Livestock Production Overview in Koh Kong in 2004

Source: MAFF 2004

Percentage of minimum rice needs produced  by Commune in Koh Kong in 2004

Map KKG.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 KKG.02.01 Percentage of per capita minimum rice food needs produced by Commune in Koh Kong in 2004

(Download full size map: KKG_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 Koh Kong 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 09.3.1 contains indicators of the prevalence of consumption poverty in Koh Kong in comparison to national rates. Results show that 28% of households are below the consumption poverty line and 32% 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 09.3.1 Indicators of Consumption Poverty in Koh Kong 2004

Source: CSES 2004 Knowles Analysis

Household Economic Asset Poverty in Koh Kong in 2004

Another important dimension of poverty is a lack of physical assets with which to generate household income.  Table 09.3.2 contains indicators of the prevalence of a lack of physical assets among households in Koh Kong 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 09.3.2 Indicators of Household Asset Poverty in Koh Kong 2004

Sources: MAFF 2004 & CDB 2004 aggregates from village data

Employment and Labor Force Characteristics in Koh Kong 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 "ïnformal 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 09.3.3 contains indicators of the characteristics of the labor force and employment in Koh Kong 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 09.3.3 Employment and Labor Force Indicators in Koh Kong 2004

Source: CSES 2004 Kanol Analysis (NIS)

Market Access in Koh Kong 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 09.3.4 contains indicators of access to markets and major transport systems serving them in Koh Kong in comparison to national statistics.

Table 09.3.4 Market Access Indicators in Koh Kong 2004

Source: CDB 2004 aggregates from village data

Percentage of the population below the consumption Poverty Line by Commune in Koh Kong in 1997

Map KKG.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 KKG.03.01 Percentage of the Population Below the Consumption Poverty Line by Commune in Koh Kong 1997

(Download full size map: KKG_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 Koh Kong

"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 09.04.1. Anemia (IDA) rates in Koh Kong were similar to 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 09.04.1Malnutrition rates among women in Koh Kong in 2005

Source: CDHS 2005

Maternal health care in Koh Kong

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

Table 09.04.2 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 lower percentage of pregnant women in this province did not have babies delivered with a health professional and a lower percentage did not deliver babies in a health facility.

Table 09.04.2 Maternal health care in Koh Kong Year 2005

Source: CDHS 2005

Mother-child care practices in Koh Kong

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 09.04.3 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 Koh Kong a similar 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 much higher percentage of children were not taken for medical treatment and a higher 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 higher percentage of children with ARI/Fever symptoms in this province were not taken to a health care provider for medical treatment.

Table 09.04.3 Mother-child care practices in Koh Kong

Source: CDHS 2005

Child health in Koh Kong

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 09.04.4 Child Illnesses and Treatment in Koh Kong in 2005

Source: CDHS 2005

Micro-nutrient malnutrition rates among children in Koh Kong

The percentages of children affected by these conditions, together with the outcomes of these forms of micro-nutrient malnutrition, is shown in Table 09.04.5. 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 higher than the national average in Koh Kong, 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 09.04.5 Micro-nutrient malnutrition rates among children in Koh Kong in 2005

Source: CDHS 2005

Access to sanitation and safe drinking water in Koh Kong

"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 09.04.6 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 very similar 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 much higher than the national average. Much more needs to be done to promote sanitation and 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 09.04.6 Access to sanitation and safe drinking water in Koh Kong 2004

Source: CDB 2004

Percentage of the population without access to safe drinking water  by Commune in Koh Kong in 2004

Map KKG.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 KKG.04.01 Percentage of the Population Without Access to Safe Drinking Water  by Commune in Koh Kong in 2004

(Download full size map: KKG_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 Koh Kong. 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 09.5.1. 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 Koh Kong.

In 2004 the wet season crop cultivated area was 100% of the total rice cultivated area for the year.  Of this wet season cultivated area, 5% was destroyed, mostly through drought damage. Dry season rice was not grown in this province in 2004.

Table 09.5.1 Percentage of rice cultivated area destroyed by season and cause in Koh Kong 2004

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.