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Preah Vihear

Introduction

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

Administrative Map of Preah Vihear

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

Map: Province Administrative map year 2000

PVR_image_01.png

(Download full size map: PVR_Map_Admin.pdf)


Geography of Preah Vihear

Preah Vihear is located in the North of Cambodia. It borders Thailand and Laos to the North, Stung Treng to the East,  Kampong Thom and Siem Reap to the South and Oddar Meanchey to the West. The area of the province is 15000 square kilometers (MAFF www.maff.gov.kh). The topography is undulating forested uplands and lowlands for much of its area, with the Dangrek Mountains to the North along the Thai Border. Preah Vihear is classified as a rural province.

Demography of Preah Vihear

In 2004 the estimated population was 148 thousand persons and was 50% female. The population of children aged under 5 years was 20 thousand which was 14% 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 87. 

The total number of households in 2004 was 31 thousand, giving an average household size of 4.9 persons (MAFF 2004). The people of Preah Vihear live in 7 districts composed of 48 communes and 208 villages (CDB 2004).

The population density of the province is 10 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 13.1 below shows  estimates for the year 2000 of the rates and numbers of children who died prematurely in Preah Vihear.

These mortality rates are medium. The estimate is that over 2,700 children aged under 5 years died prematurely in Preah Vihear in the five years to 2000. Over 270 infants aged under 1 year had died in the preceding one year to the year 2000.

Table 13.1 Child Mortality in Preah Vihear at Year 2000

Mortality
Indicator
Rate
Percent
Rate
Prov.Rank
Number of
Children
Affected
Number
Prov.Rank
Infant Population
(aged < 1 year)
3,872   19
Infant Mortality
(aged < 1 year)
 7.1%  19  276  19
Child Population
(Aged 0-<5 years)
 -  -  22,722  18
Under 5 year Mortality
(aged 0-5 years)
 12.0%  16 2,715  18 

Sources: Estimates calculated from CDHS 2000 & NIS 2004


Protein-Energy Malnutrition among Children

Table 13.2 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 Preah Vihear.  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 decrease from year 2000) and over 8,600 children were Stunted (a decrease from year 2000). Underweight rates were extremely high (the same as in year 2000) and over 9,800 children were Underweight (a small decrease from year 2000). Wasting rates were medium (a decrease from year 2000) and over 1,900 children were Wasted (a decrease from year 2000).

Table 13.2 Child Malnutrition in Preah Vihear 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%  22,722  100%  20,568 
Stunted
(moderate &
severe <-2SD)
 51.0%  Extremely
High
 11,588  42.0%  Very High
 8,639
Underweight
(moderate &
severe <-2SD)
 47.0%  Extremely
High
 10,679  48.1%  Extremely
High
 9,893
Wasted
(moderate &
severe <-2SD)
 10.9% High  2,477  9.7%  Medium   1,995

Sources: CDHS 2000 & 2005

As shown in the table above the limited decline in number of children aged under 5 years affected by malnutrition is partly due to changes in malnutrition rates  and is also partly due to the smaller population  of children in 2005. The smaller population of  children in 2005 is the combined result of mothers giving birth to fewer children by 2005 and the premature death of children aged under 5 years over the period 2000-2005.

Rank Comparison of Malnutrition in Preah Vihear with all 24 provinces in 2005

Table 13.3 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 average. The prevalence of malnutrition among the child population was relatively very high. The actual numbers of children affected by malnutrition (considering differences in the child population of each province) was  relatively low given the small child population in Preah Vihear.

Table 13.3 How Malnutrition in Preah Vihear 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 18 
Number of Children Stunted  19
Number of Children Underweight  17
Number of Children Wasted  15
Rate of Stunting  6.5
Rate of Underweight  4.5
Rate of Wasting 5.5 

 

Maps of the Distribution of Child Malnutrition in Preah Vihear 2000

Below is a series of four maps showing the incidence of   Stunting and Underweight by Commune in Preah Vihear 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 Preah Vihear province year 2000

Map PVR 05.00 shows that the vast majority of communes in the province had at least a Very High percentage of children Stunted. Communes with Extremely High rates of Stunting in 2000 were also common in most districts.

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

Map PVR 05.00: Children aged <5 years Stunted: Percent by Commune in Preah Vihear province year 2000

PVR_image_05.png

 

 

 

 

 

 

 

 

 

 

(Download full size map: PVR_Map_0500.pdf) 


Children aged <5 years Stunted: Number of Children by Commune in Preah Vihear province year 2000

Map PVR 06.00 shows that the number of Stunted children by commune. Given the small child populations of communes in this province most communes have <349 Stunted children each. It is useful here to also refer to the scale of the map. These communes with small affected child populations are often large in area, and relatively remote from the province centre. Further, they are commonly communes in upland areas with poor road access infrastructure. Three communes located in Tbeng Mean Chey (province centre) and Sangkom Thmei had 350- <750 Stunted children per commune.

Map PVR 06.00: Children aged <5 years Stunted: Number of Children by Commune in Preah Vihear province year 2000

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(Download full size map: PVR_Map_0600.pdf) 


Children aged <5 years Underweight: Percent by Commune in Preah Vihear province year 2000

Map PVR 07.00 strikingly shows that almost all communes in the province in all districts had at least an Extremely High percentage of children Underweight, including a large proportion of 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 on average similar to the direct CDHS estimates for the province level presented above.

Map PVR 07.00: Children aged <5 years Underweight: Percent by Commune in Preah Vihear province year 2000

PVR_image_07.png

 

 

 

 

 

 

 

 

 

 

(Download full size map: PVR_Map_0700.pdf)


Children aged <5 years Underweight: Number of Children by Commune in Preah Vihear province year 2000

Map PVR 08.00 shows that the number of the number of Underweight children by commune. Given the small child populations of communes in this province most communes have <349 Underweight children each. It is useful here to also refer to the scale of the map. These communes with small affected child populations are often large in area, and relatively remote from the province centre. Further, they are commonly communes in upland areas with poor road access infrastructure. Four communes located in Tbeng Mean Chey (province centre) Chey Sen and Sangkom Thmei had 350- <750 Stunted children per commune.

Map PVR 08.00: Children aged <5 years Underweight: Number of Children by Commune in Preah Vihear province year 2000

PVR_image_08.png

 

 

 

 

 

 

 

 

 

 

(Download full size map: PVR_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 Preah Vihear (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 Preah Vihear from available information while these limitations do still exist in 2004.

Access to Agricultural Land in Preah Vihear in 2004

Table 13.2.1 shows the percentage of rural households in Preah Vihear by agricultural land holding size.

Rural households in Preah Vihear 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, 9% of rural households in Preah Vihear were landless and did not produce their own staple food crops.  A further 29% 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 13.2.1 Agricultural Land Access in Preah Vihear in 2004

Agricultural land per rural household % of Rural HH
This Province
% of Rural HH
National
No agricultural land (landless) 9%  15% 
Less then 1.0 hectare (0.01- <1.0 ha)  29%  49%
1.0- < 3.0 hectares  51%  30%
>= 3.0 hectares  9% 6% 

Source: MAFF 2004


Percentage of Rural Households Producing Crops in 2004

Table 13.2.2 shows the percentage of rural households in Preah Vihear 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 Preah Vihear is rain-fed and is confined to the wet season. with 84% of households producing crop in the wet season compared to only <1% of 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 13.2.2 Percentage of Rural Households Producing Crops in Preah Vihear in 2004

Rural Households Producing Crops % of Rural HH
This Province
% of Rural HH
National
 Any Season-Any Crop 88%  85% 
 Wet Season-Rice Crop  84%  69%
 Dy Season-Rice Crop <1%  16% 

Source: MAFF 2004


Crop Production by Type and Season in 2004

Rice Production

Table 13.2.3 shows statistic about rice production in Preah Vihear. 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 similar to 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 higher than the national level.

Rice production is limited mainly to the wet season. Dry season rice production is undertaken in a limited area but produces higher yields. Dry season rice areas are restricted within the province to only some communities, those with access to groundwater or dry season surface water resources (flood recession, or irrigation). This limitation imposed through dependency on rain-fed crop cultivation is clearly contributing to shortages in food availability.

Table 13.2.3 Rice Crop Production by Season in Preah Vihear in 2004

Rice Production
Indicator
This
Prov
Wet
Season
National
Wet
Season
This
Prov
Dry
Season
National
Dry
Season
 Area Cultivated- '000 ha. 33  2087  <0.1  330 
 Area Harvested- '000 ha.  29  1851  <0.1  318
 Paddy Production '000 MT  43  2918  53  973
 Yield-MT/ha.  1.5  1.6  4.8  3.1
 Paddy % of total crop area cultivated  61  81%  14%  84%
 Mean Area Cultivated/ Rural HH- ha.  1.2  0.9 <0.1  0.1 

Source: MAFF 2004


Rice Food Balance 

Table 13.2.4 shows the balance between rice food availability from production and defined minimum white rice food needs of the population of Preah Vihear. 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 69% of communes produce enough rice to meet minimum food needs while 31% 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 58% 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 13.2.1 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 13.2.4 Rice Food Balance in Preah Vihear

Rural Households Prdocing Crops This Province National
Total white rice available for food consumption
'000 MT
24  2166 
Minimum population white rice food needs/ year '000 MT  19  1713
Provincial Level: overall white rice food balance
as % of  minimum rice needs
 122%  126%
Commune Level: Percentage of Communes with rice
food balance >= 100%.
 69% 61% 
Smallholders (cropping 0.5 ha.): white rice food balance
as % of  minimum rice needs.
 58%  66%

Source: MAFF 2004


Other Non-Rice Annual & Perennial Crop Production in 2004

Table 13.2.5 shows some basic overall statistics to give an idea of the relative role of non-rice crops in agricultural cropping systems in Preah Vihear. 

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 40% of the total cultivated area for all crops which is considerably higher than the national average. This greater crop diversification will mean that cropping systems will have greater production of vegetables and fruit which are important for nutrition. A limitation is that  non-rice crop production is mainly restricted to the wet season only.

Table 13.2.5 Non-Rice Annual & Perennial Crop Production Overview in Preah Vihear in 2004

Non- Rice
Crop Indicator
Wet
Season
Dry
Season
Both
Seasons
% of total annual crop cultivated area
for non-rice field crops & vegetables
39  111  40 

Mean ha./ rural household cultivated
for annual non-rice field crops & vegetables

 0.8  <0.1  0.8
Mean ha./ rural HH agricultural fruit tree
and other perennial crops
 - <0.1 

Source: MAFF 2004


Livestock production in Preah Vihear in 2004

Table 13.2.5 shows some basic statistics on livestock production at the household level in Preah Vihear. 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, see below) 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 13.2.5 Household Livestock Production Overview in Preah Vihear in 2004

Livestock Ownership among rural households This Province National
Mean poultry per rural household (head)  14.7 6.5 
Mean pigs per rural household (head)  2.7  0.9
Mean cattle per rural household (head)  1.9  1.2
Mean water buffalo per rural household (head)  0.8 0.2 

Source: MAFF 2004


Percentage of minimum rice needs produced  by Commune in Preah Vihear in 2004

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

Map PVR.02.01 Percentage of per capita minimum roce food needs produced by Commune in Preah Vihear in 2004

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(Download full size map: PVR_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 Preah Vihear 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 13.3.1 contains indicators of the prevalence of consumption poverty in Preah Vihear in comparison to national rates. Results show that 54% of households are below the consumption poverty line and 60% 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 13.3.1 Indicators of Consumption Poverty in Preah Vihear 2004

 Consumption Poverty Indicator This
Province
National
Mean Total per capita HH daily per capita consumption
in riel
2104  3247 
% of households in the lowest Q1 and Q2 (i.e. 40%)
of national consumption quintiles
 60  37
Consumption poverty line in riel  1810  1836
% of households below the  poverty line  54  32
The poverty line value as a percentage of
total consumption
 86 49 

Source: CSES 2004 Knowles Analysis


Household Economic Asset Poverty in Preah Vihear in 2004

Another important dimension of poverty is a lack of physical assets with which to generate household income.  Table 13.3.2 contains indicators of the prevalence of a lack of physical assets among households in Preah Vihear 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.
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Table 13.3.2 Indicators of Household Asset Poverty in Preah Vihear 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  2.0  1.2
% households with thatched roof houses  52  34
% HH not owning any cattle or buffalo  33  49
% HH not owning any pigs-CDB 2004  36  54
Mean no. of households per car  28  39
Mean no. of households per motor  8.8  5.4
Mean no. of households per oxcart 3.2   4.0

Sources: MAFF 2004 & CDB 2004 aggregates from village data


Employment and Labor Force Characteristics in Preah Vihear 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 13.3.3 contains indicators of the characteristics of the labor force and employment in Preah Vihear 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 13.3.3 Employment and Labor Force Indicators in Preah Vihear 2004

Employment and Labor Force Indicator

This
Province

National
Literacy Rate > 15 years % total population 53  67 
Literacy Rate > 15 years % females  47  60
% of the labor force in the primary sector incl. Agriculture  70  60
% of the labor force in the secondary sector/ Industry  6  13
% of the labor force in the tertiary sector/ Services  18  25
% of the labor force economically active <=10 days/ mth 27   29

Source: CSES 2004 Kanol Analysis (NIS)


Market Access in Preah Vihear 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 13.3.4 contains indicators of access to markets and major transport systems serving them in Preah Vihear in comparison to national statistics.

Table 13.3.4 Market Access Indicators in Preah Vihear 2004

Indicator This
Province
National
Average time (minutes) taken from village to
the nearest market
166  45 
Average farm gate price of paddy in Riel
(December)
 514  521
Distance (Km) to nearest year-round road  25.3  3.8
Average time (minutes) from village to
nearest year-road
117  18 

Source: CDB 2004 aggregates from village data


Percentage of the population below the consumption Poverty Line by Commune in Preah Vihear in 1997

Map PVR.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 PVR.03.01 Percentage of the Population Below the Consumption Poverty Line by Commune in Preah Vihear 1997

PVR_image_20.png



 

 

 

 

 

 

 

 

 

(Download full size map: PVR_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 Preah Vihear

"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 13.04.1. Anemia (IDA) rates in Preah Vihear 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 13.04.1Malnutrition rates among women in Preah Vihear 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."
62%  47% 
Iodine Deficiency (IDD) Household tested salt not Iodized.
IDD Outcomes: "increased rates of abortion, stillbirths,
congenital abnormalities, cretinism, psychomotor defects
and neonatal mortality."
 16% 28% 

Source: CDHS 2005


Maternal health care in Preah Vihear

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

Table 13.04.2 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 percentages of pregnant women not having access to antenatal care services was generally much 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 higher percentage did not deliver babies in a health facility.  

Table 13.04.2 Maternal health care in Preah Vihear 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
62%  31% 
Pregnant women not receiving >=1 Tetanus
toxoid injection
 37%  23%
Pregnant women not given iron tablets  64%  37%
Women not having babies delivered with a
health professional
 87%  56%
Women not having babies delivered in a
health facility
 94%  78%

Source: CDHS 2005


Mother-child care practices in Preah Vihear

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 13.04.3 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 Preah Vihear a much 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 lower percentage of children were not given any sort of Oral Re-hydration 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 13.04.3 Mother-child care practices in Preah Vihear

Mother-Child Care Practices % of Children
This
Province
2005
% of Women
National
2005
Children aged 12-23 months not receiving
all vaccinations (a)
54%  33% 
Children < 5 yrs with Diarrhea
not having medical treatment sought from
health facility or provider
 71%  50%
Children < 5 yrs with Diarrhea
not given Oral Rehydration treatment of any sort
 29%  41%
Children < 5 yrs with Fever/ARI
not having medical treatment sought from
health facility or provider (b)
73%  57% 

Source: CDHS 2005


Child health in Preah Vihear

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 13.04.4 Child Illnesses and Treatment in Preah Vihear 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 28%  20% 
Children < 5 yrs with symptoms of ARI within the preceding two weeks  19%  8.5%
Children < 5 yrs with fever within the preceding two weeks  53% 35% 

Source: CDHS 2005


Micro-nutrient malnutrition rates among children in Preah Vihear

The percentages of children affected by these conditions, together with the outcomes of these forms of micro-nutrient malnutrition, are shown in Table 13.04.5. 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 slightly higher  than the national average in Preah Vihear, meaning that asimilar percentage of children were suffering the outcomes of Anemia described in the table.  The proportion of households not using Iodized salt was much lower than the national average, with this percentage of children suffering the outcomes of Iodine deficiency (IDD) described in the table.

Table 13.04.5 Micro-nutrient malnutrition rates among children in Preah Vihear in 2005

Micronutrient Malnutrition
Indicator for Children
% of 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".
67%  62% 
% Children 6-59 months with moderate Iron Deficiency Anemia (IDA).
Outcomes: as above but more severe.
 35% 32% 
Iodine Deficiency (IDD) Household tested salt not Iodized
Outcomes: "goiter, hypothyroidism, impaired mental functions,
retarded mental and physical development and diminished
school performance."
 16% 28% 

Source: CDHS 2005


Access to sanitation and safe drinking water in Preah Vihear

"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 13.04.6 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 slightly 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 13.04.6 Access to sanitation and safe drinking water in Preah Vihear 2004

Sanitation and Safe Drinking Water
Access Indicators
% of Households
This Province
% of Households
National
Households not having a sanitary toilet 96%  81% 
Households not having access to a safe source of
drinking water at, or within 150 meters, of their house
39%  34% 

Source: CDB 2004


Percentage of the population without access to safe drinking water  by Commune in Preah Vihear in 2004

Map PVR.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 PVR.04.01 Percentage of the Population Without Access to Safe Drinking Water  by Commune in Preah Vihear in 2004

PVR_image_27.png




 

 

 

 

 

 

 

 

(Download full size map: PVR_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 Preah Vihear. 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 13.5.1. 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 Preah Vihear.

In 2004 the wet season crop cultivated area was 99% of the total rice cultivated area for the year.  Of this wet season cultivated area, 12% was destroyed, mostly through drought damage.

Table 13.5.1 Percentage of rice cultivated area destroyed by season and cause in Preah Vihear 2004

indicator
Wet Season
Dry season
% of total rice cultivated area for 2004 by season 99 0
% Rice cultivated area destroyed by flood by season 0 0
% Rice cultivated area destroyed by drought by season 12
0
% Rice cultivated area destroyed by insect/other by season 0 0
% cultivated area destroyed-total by season 0 0

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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