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					Local Capacity Development
Investments for MDG Achievements in
Cambodia




                        Katarina Courtnadge-Kovačević
                                           Consultant
                               Phnom Penh, March 2009




                Draft
Contents


Abbreviations and Acronyms                                                      3
Introduction                                                                    5
       Background                                                               5
       Study Rationale and Objectives                                           6
       Research Methodology                                                     6
       Report structure                                                         7
1. National and sub-national framework for implementing the MDGs                8
       National and sub-national development planning                           8
       Progress towards the CMDGs                                               9
2. Capacity development and the CMDGs                                           11
       National Public Administration Reform (NPAR)                             11
       Decentralisation and Deconcentration (D&D)                               12
       Demand for Good Governance (DFGG)                                        15
       Public Financial Management Reform Programme (PFMRP)                     16
       Technical cooperation                                                    17
       Monitoring and Evaluation                                                17
       Capacity Development Providers                                           17
3. Role of aid & public expenditure in capacity development for localising CMDGs 19
4. Linking capacity with performance with the CMDGs                             21
       CMDG1: Eradicate extreme poverty and hunger                              21
       CMDG2: Achieve universal primary education                               22
       CMDG3: Promote gender equality and empower women                         23
       CMDG4: Reduce child mortality                                            24
       CMDG5: Improve maternal health                                           25
       CMDG6: Combat HIV/AIDS, malaria and other infectious diseases            26
       CMDG7: Ensure environmental sustainability                               28
       CMDG8: Develop a global partnership for development                      29
       CMDG9: De-mining, UXOs and victims assistance                            29
5. Critical factors in CMDG-related capacity development                        31
6. Conclusions                                                                  34
ANNEX 1 - Benchmarks, performance and target values for CMDG indicators         37
ANNEX 2 – Map of Cambodian province                                             42
ANNEX 3 – Public expenditure and aid for local level capacity development       43
CASE STUDY I: Health Sector Support Project (HSSP)                              48
CASE STUDY II: Project to Support Democratic Development (PSDD)                 50
CASE STUDY III: Female Commune Councillors Forum                                52
References                                                                      54
Abbreviations and Acronyms


ADB        Asian Development Bank
ADMAC      Agricultural Development in Mine-Affected Areas of Cambodia
ARDP       Administrative Reform and Decentralization Program
AWPB       Annual Work-Plan and Budget
BMC        Budget Management Centre
CAR        Council for Administrative Reform
C/S        Commune/Sangkat
CCDP       Commune Council Development Project
CD         Capacity Development
CDC        Committee for Development Cooperation
CDCs       Commune Development Councils
CIDA       Canadian International Development Agency
CIP        Commune Investment Project
CMDG       Cambodian Millennium Development Goals
CNM        Centre for Parasitology, Entomology and Malaria Control
D&D        Decentralization and Deconcentration
DANIDA     Danish International Development Agency
DDLG       Democratic Development and Local Governance
DFID       Department for International Development
DoLA       Department of Local Administration
DPs        Development Partners
EC         European Commission
ExCom      Executive Committee
GAPII      Governance Action Plan II
GMAG       Gender Mainstreaming Action Group
GMAP       Gender Mainstreaming Action Plan
GTZ        German Technical Cooperation Agency
HSP        Health Strategy Plan
HSSP       Health Sector Support Programme
IDLD       Innovations in Decentralization and Local Development
IFAD       International Fund for Agricultural Development
IPA        International Procurement Agency
IRI        International Republican Institute
ITA        International Technical Assistance
JDs        Job Descriptions
JICA       Japan International Cooperation Agency
M&E        Monitoring and Evaluation
MAFF       Ministry of Agriculture, Forestry and Fisheries
MBPI       Merit-Based Pay Initiative
MDG        Millennium Development Goals
MDLF       Multi-Donor Livelihood Facility
MDSP       Multi-Donor Support Project
MEF        Ministry of Economy and Finance
MoEYS      Ministry of Education, Youth and Sport
MoI        Ministry of Interior
MoWA       Ministry of Women’s Affairs
NCDD       National Committee for Management of D&D Reforms
NCDDS      NCDD Secretariat
NGO        Non-governmental Organisation
NMCP       National Malaria Control Programme
NP-SNDD    National Program Sub-National Democratic Development
NRM        Natural Resource Management
NRMLP      Natural Resource Management and Livelihoods Programme
NSDP       National Strategic Development Plan
NTA        National Technical Assistance
ODA        Official Development Assistance
OECD/DAC   Organisation for Economic Cooperation and Development / Development
           Assistance Committee
OWSO       One Window Service Office
PFM        Public Financial Management
PFMRP      Public Financial Management Reform Programme
PIF        Provincial Investment Fund
PILAC      Project on Improvement of Local Administration in Cambodia
PIUs       Project Implementation Units
PLG        Partnership for Local Governance
PMU        Project Management Unit
PRDC       Provincial Rural Development Committee
PSDD       Project in Support of Democratic Development through D&D
PST        Program Support Team
PT         Policy Team
PTTC       Provincial Teacher Training Centre
RGC        Royal Government of Cambodia
RILGP      Rural Investment and Local Governance
RPRP       Rural Poverty Reduction Project
RSA        Royal School of Administration
RTC        Regional Training Centre
RTTC       Regional Teacher Training Centre
RULIP      Rural Livelihoods Improvement Project
SIDA       Swedish International Development Agency
SPPA       Senior Provincial Program Adviser
STF        Seila Task Force
STFS       Seila Task-Force Secretariat
TA         Technical Assistance
TC         Technical Cooperation
TCP        Technical Cooperation Personnel
TORs       Terms of Reference
TSSL       Tonle Sap Sustainable Livelihoods Project
UHS        University of Health Sciences
UNCDF      United Nations Capital Development Fund
UNDP       United Nations Development Program
UNICEF     United Nations Children’s Fund
UNTAC      United Nations Transitional Authority in Cambodia
UXO        Unexploded Ordinances
WB         World Bank
WHO        United Nations World Health Organisaton




                                                                                 4
INTRODUCTION

Background
Cambodia is amongst the 189 countries that signed the Millennium Declaration in
2000 and has endorsed the associated set of eight Millennium Development Goals
(MDGs). The Royal Government of Cambodia (RGC) has furthermore recognised
that the MDGs cannot be achieved without national leadership and the development
of capacity to deliver services. It has also concluded that meeting the MDG targets
requires that they are widely understood, owned and applied at both national and
sub-national levels. Since 2003 the MDGs have therefore been fully incorporated into
national and sub-national policy-making and planning processes. This process of
'Cambodianisation' has also included the addition of a ninth Cambodia Millennium
Development Goal (CMDG) of ‘De-mining, clearing unexploded ordnance (UXO) and
providing victims assistance’.

Any study of Cambodia must pay close attention to the historical context. Beginning
in 1970, Cambodia experienced almost 30 years of insecurity and civil war, including
four devastating years under Khmer Rouge rule from 1975-1979; the country only
returned to complete peace as recently as 1998. Following the fall of the Khmer
Rouge regime in 1979 some efforts at institution-building took place under the
socialist-oriented People's Republic of Kampuchea and State of Cambodia
governments, and early efforts to establish and strengthen administration and service
delivery at sub-national level were initiated. The late 1980s was marked by market-
oriented economic reforms and the 1993 UNTAC-sponsored elections consolidated
the shift towards liberal democratic and economic policies that characterise the
RGC's current approach to national development. Capacity development, including at
the sub-national level, must therefore be understood in this broader national
development context in which human resources and institutions have been destroyed
and then, more gradually, rebuilt.

Since 1993, and with the onset of a full return to peace in 1998, Cambodia has made
significant progress in raising incomes and in reducing the headcount poverty ratio.
Economic growth averaged 7.7% in the period 1994-2004 (World Bank 2007:2) and
exceeded 10% per annum from 2005-2007. Poverty levels have been reduced from
nearly 50% in 1993 to just over 30% in 2007. In the period since 1998, average life
expectancy has also increased by approximately 5 years (World Bank 2007).
Significant inflows of development assistance (nearly USD 900 million in 2008) have
contributed to progress in other social and economic sectors, reducing the
prevalence of HIV/AIDS, promoting access to basic education and increasing the
stock of physical infrastructure. In other areas, however, progress has been uneven,
particularly in improving the quality of education; in reducing gender inequality; in
improving maternal health; and in managing environmental sustainability.

Despite overall progress and a growing sense of optimism – a 2008 survey by the
International Republican Institute1 reported that 82% of Cambodians believe that the
country is 'moving in the right direction' - formidable development challenges remain.
Perhaps the most acute problem relates to the development of capacity as Cambodia
emerges from its post-conflict stage seeking to strengthen and improve public service
delivery at all levels. The impact of capacity development initiatives on strengthening
local level services for achieving the MDGs depends on the design of local level
institutions and on the policies which influence that design. This study, therefore, is


1
  Survey of Cambodian Public Opinion, October 22- November 25 2008, International Republican
Institute
timely with respect to the current planning and evolution of Public Administration and
Decentralisation and Deconcentration (D&D) reforms in Cambodia.

Study Rationale and Objectives

This study of local capacity development investments for MDG localization in
Cambodia is part of a multi-country study being conducted by UNDP Regional Office
for Asia and the Pacific and SNV Netherlands Development Organization: ‘Advocacy
for Local Capacity Development for MDG Achievement in Asia’. The other countries
are Bhutan, Indonesia, Laos, Nepal, Pakistan, the Philippines and Vietnam.

The specific questions the study seeks to address are as follows:

       What are the prevailing and emerging perceptions of and approaches to
       capacity development, particularly at the local level?

       Who and/or which institutions have been the primary targets for local level
       capacity development initiatives? What have been the budgetary allocations
       targeted to local-level capacity development?

       What are the existing and emerging government and donor investment
       policies and practices in local-level capacity development?

       What are the emerging good practices of government and donor initiatives on
       successful investment in local capacity development that have the most
       potential for accelerating MDG progress?

       Are prevailing and emerging perceptions of and approaches to capacity
       development gender responsive at the local level?

Research Methodology
Research for this study comprised three stages: desk review of relevant
documentation, interviews with representatives of key institutions, and visits to case
study projects.

Key aspects of the methodology included:
•   Literature review of international practice and lessons relating to capacity
    development
•   Review of national policies and documents reflecting capacity development,
    including the Rectangular Strategy and the NSDP
•   Review of project documentation, reports and evaluations supporting capacity
    development
•   Semi-structured interviews with government officials, donors, technical
    cooperation personnel and consultants working on capacity development
•   Semi-structured interviews with Provincial authorities and Commune Councillors
    from the provinces of Takeo, Kep, Preah Vihear, Kampong Thom, Stung Treng,
    Kratie, Rattanakiri and Mondulkiri.
•   Interviews with foreign and local NGO representatives

Four provinces were selected for field visit: Takeo, Kep, Kratie and Phnom Penh.
Takeo province provided insight into the operation of the province with
decconcentrated responsibilities within Decentralisation and Deconcentration
context. Kep provides insight into the new ‘municipality’ arrangements. Phnom Penh
and the northeast provinces present a further contrast between rural and urban
provinces, each providing a different context and experience of capacity
                                                                                    6
development. The report includes three good practice case studies, including one
that focuses on gender equality issues.

Report structure
The research for this study revealed that it is not always valid to focus on task-
specific capacities for each of the respective MDGs. There is a strong correlation
between MDG-related achievement across Cambodia's provinces that suggests that
if capacity is defined as "the ability of people, organisations and society as a whole to
manage their affairs" (OECD 2006) then where these capacities exist at sub-national
level they have made an important contribution to progress against most, if not all, of
the MDG targets. Capacities are transferable and the research is therefore primarily
directed at an assessment of generic capacity development initiatives at the sub-
national level. This approach is also consistent with Baser and Morgan (2008) who
propose that "capacity is a potential state. It is elusive and transient. It is about latent
as opposed to kinetic energy. Performance, by comparison, is about execution and
implementation, or the application and use of capacity."

The report is therefore structured as follows:

   -   Section one discusses the framework for CMDG programming and
       implementation, including a brief overview of the progress in achieving
       CMDGs that can indicate where, and possibly why, capacities have been
       developed.

   -   Section two provides an overview of the mainstream approaches to capacity
       development in Cambodia.

   -   Section three discusses the role of aid and public expenditure in local level
       capacity development

   -   Section four reviews performance against selected CMDGs and discusses
       the role and impact of the capacity development initiatives described in
       section two.

   -   Section five then identifies critical factors determining effectiveness of
       capacity development efforts and highlights ‘good practices’.

   -   The report ends with a conclusion that directly addresses the research
       questions and provides recommendations for the future.




                                                                                          7
1. NATIONAL AND SUB-NATIONAL FRAMEWORK FOR IMPLEMENTING THE
   CAMBODIA MILLENNIUM DEVELOPMENT GOALS



National and sub-national development planning
Capacity development at a sub-national level can only be understood and analysed
effectively when it is located in an analytical framework that includes national and
sub-national planning and implementation arrangements. This section therefore
briefly describes national and sub-national arrangements before considering the
summary evidence on progress towards meeting the Cambodia Millenium
Development Goals (CMDG) targets.

The Royal Government of Cambodia has taken major steps in its effort to achieve the
Cambodia MDGs guided by key strategic policy documents. The Rectangular
Strategy for Growth, Employment, Equity and Efficiency – Phase II (2008) builds on
the first phase Strategy (2004-2008) to set the overall strategic priority goals of the
RGC. This makes specific reference to the nine CMDGs (Annex 1) which comprise
the 8 UN Millennium Development Goals with an additional goal of De-mining,
Clearing Unexploded Ordinances (UXO) and Providing Victims Assistance, which is
a priority for rural development. The Rectangular Strategy aims to ensure that social
progress and economic growth is equitable, and opportunities and benefits are
affordable and accessible to all, both geographically and between the rich and the
poor, all of which are seen as preconditions for achieving CMDGs.

The RGC priority development goals       Box 1: Capacity development policies at line
are then operationalised in the          ministry level
National Strategic Development
Plan (NSDP) 2006-2010. Two-thirds        The Education Strategic Plan (ESP) 2006-2010 is
of the NSDP’s indicators correspond      supported by donors through a SWAp approach
to the MDG indicators and each           and provides for universal basic education as well
                                         as focusing on other levels of education that will
CMDG has been disaggregated into         develop the human capital necessary to support
components with clear targets set        broader socio-economic advancement. The ESP
for 2005, 2010 and 2015. These           incorporates policies which are necessary to start
indicators are further reflected in      building a 'critical mass' of educated, skilled,
sectoral strategic plans. Key targets    talented, capable people that will underpin longer
– the Joint Monitoring Indicators        term growth and equity.
(JMIs) - related to the CMDG and         The Health Strategic Plan (HSP) 2008-2015 places
NSDP implementation are then             the focus on integrated health service delivery;
jointly identified by RGC and its        health financing, human resources and health
development partners and are             system governance while maintaining an emphasis
monitored through periodic high-         on the key priority health program areas of maternal
level meetings.                          and child health, communicable diseases and new
                                         emerging health challenges. HSP is being
Both the Rectangular Strategy and        implemented in close cooperation with all external
                                         development partners engaged in this sector,
the NSDP emphasize that improving        adopting a programme-based approach.
governance,             strengthening
institutions and improving capacity      From a capacity development perspective, the
for service delivery are immediate       Ministry of Health Workforce Strategic Plan 2006-
and necessary conditions for             2015 identifies major challenges to be met in terms
sustainable     development      and     of structure, size and composition of the future
                                         health workforce.
poverty       reduction.      Related
governance priorities are therefore
         articulated in the Governance Action Plan II (GAP II) 2005-20082 which promotes
         sector reforms and multi-sectoral and cross-sectoral governance actions.

         Sub-national service delivery, capacity development and associated reforms are
         defined in the Strategic Framework for Decentralisation and Deconcentration (D&D).
         This commits to ensuring that D&D reform will introduce systems and procedures
         and ensure that people, especially women, vulnerable groups and indigenous
         minorities can participate in decision-making at sub-national levels. It also
         operationalises the 2008 'Organic Law'3 by detailing arrangements for direct elections
         at commune level and for indirect elections at district and provincial levels. It notes
         that women representatives in the councils at these administrations must be ensured.

         Similar policy-making and planning processes that make direct reference to
         developing capacities for the CMDGs have been implemented at the sector and line
         ministry level (see Box 1).

         Progress towards the CMDGs
         In 2007, the Ministry of Planning reported to the United Nations ECOSOC as part of
         the global MDG monitoring process. Data was made available for each province
         (Table 1) and was indexed according to the progress made against each goal (with
         the exception of MDG8, which is a qualitative assessment). For reference, map of
         Cambodian provinces is provided in Annex 2.

         Table 1: Progress towards CMDGs by Province
                       Poverty
                                            Gender                Maternal                        Mine
Provinces              &          UPE                  C/IMR                 HIV/AIDS   Env                  Overall
                                            equality              health                          action
                       hunger
Phnom Penh             0.78       0.96      0.83       0.83       0.79       0.79       0.99      1.00       0.87
Kandal                 0.69       0.78      0.63       0.47       0.44       0.81       0.41      0.99       0.65
Svay Rieng             0.57       0.68      0.63       0.53       0.44       0.73       0.47      0.96       0.63
Sihanoukville          0.78       0.70      0.60       0.33       0.54       0.66       0.38      1.00       0.62
Kep                    0.75       0.66      0.71       0.33       0.54       0.59       0.35      1.00       0.62
Kampot                 0.79       0.77      0.72       0.33       0.54       0.60       0.23      0.92       0.61
Kratie                 0.60       0.64      0.74       0.44       0.31       0.61       0.37      0.97       0.59
Kampong Cham           0.64       0.72      0.56       0.39       0.33       0.74       0.34      0.90       0.58
Prey Veng              0.39       0.61      0.53       0.33       0.40       0.80       0.46      1.00       0.57
Takeo                  0.72       0.77      0.49       0.55       0.32       0.56       0.12      0.97       0.56
Kampong Thom           0.44       0.65      0.69       0.57       0.29       0.74       0.23      0.90       0.56
Kampong Chhnang        0.56       0.68      0.48       0.42       0.28       0.68       0.31      0.99       0.55
Banteay Meanchey       0.74       0.65      0.52       0.74       0.46       0.55       0.11      0.64       0.55
Kampong Speu           0.68       0.60      0.44       0.81       0.21       0.56       0.17      0.94       0.55
Koh Kong               0.69       0.41      0.31       0.55       0.55       0.68       0.35      0.87       0.55
Battambang             0.70       0.69      0.60       0.38       0.75       0.67       0.34      0.00       0.52
Pailin                 0.61       0.54      0.42       0.38       0.75       0.22       0.42      0.79       0.52
Preah Vihear           0.60       0.36      0.46       0.44       0.31       0.87       0.23      0.86       0.52
Stueng Treng           0.67       0.40      0.42       0.44       0.31       0.70       0.24      0.90       0.51
Pursat                 0.64       0.65      0.64       0.24       0.33       0.74       0.29      0.55       0.51
Siem Reap              0.53       0.60      0.49       0.39       0.19       0.50       0.17      0.55       0.43
Otdar Meanchey         0.60       0.33      0.19       0.39       0.19       0.94       0.00      0.64       0.41
Mondulkiri             0.36       0.15      0.30       0.25       0.10       0.82       0.25      0.99       0.40
Ratanakiri             0.31       0.15      0.31       0.25       0.10       0.57       0.12      0.96       0.35
         Source: Ministry of Planning, RGC, ECOSOC report, 2007




         2
           Accelerating State Reform : Strengthening Governance and Improving Public Service Delivery GAP II
         2005-2008, Supreme Council for State Reform/Council for Administrative Reform, Royal Government of
         Cambodia, 2005
         3
           Law on the Administrative Management of the Capital, Provinces, Municipalities, Districts and Khans
         (‘Organic Law’) adopted in May 2008
                                                                                                             9
For this study, which focuses on sub-national capacities for reaching the CMDG
targets, this data is revealing for the following reasons:
   a) There is a high degree of differentiation across the provinces. Those with
      large urban centres (Phnom Penh, Sihanoukville, Kampong Cham), or close
      to trading opportunities, either proximity to the sea/rivers (Kep, Kampot,
      Kratie) or on the main trading route with Vietnam (Svay Rieng, Prey Veng),
      appear to be making better progress towards the CMDGs.
   b) The five provinces that have made least progress are historically amongst the
      poorest areas of the country, isolated from the main trading routes and/or with
      land and other natural resources with more limited economic potential.
   c) Progress against each of the CMDG targets is highly correlated: if a province
      is doing well on one CMDG then there is a high probability that it is doing well
      on most others. (There is a correlation co-efficient between progress against
      the income/poverty target and overall progress of 0.61).

Higher-income level provinces appear to have made more progress on each of the
CMDG targets. Capacities therefore appear to be transferable – an ability to provide
services directed to one CMDG target appears likely to be associated with abilities to
support others equally well. These findings may allow some important hypotheses to
be made related to capacity development at the sub-national level for the MDGs:
   i)      Most of today's wealthier provinces have historically been the richer ones
           and they are amongst the 'better CMDG performers'. Despite decades of
           instability and upheaval they appear to have a faster 'recovery rate' that
           implies that some latent capacity has been robust enough to be sustained
           during the period of conflict and then gradually return to some form of
           'equilibrium'.
   ii)     An urban/rural divide is highlighted quite clearly in the data. The appeal of
           'urban life' appears to have a strong impact on CMDG progress, possibly
           because professionals remain clustered in the more affluent areas,
           creating a supply of and, importantly, a demand for higher-quality
           services.

For policy-makers seeking to develop capacity at sub-national level these factors are
likely to be important considerations. Economy, history and social preferences are
formidable forces to overcome: many of the more remote provinces have traditionally
received very limited public services, leading to a tradition of poor provider
performance and low user expectations.




                                                                                     10
2. CAPACITY DEVELOPMENT AND THE CMDGs

Success in achieving the CMDGs and sustainable development depends on the
capacity of public institutions to design and implement appropriate programmes and
projects. RGC recognised that, in conjunction with its reforms at central government
level, without early investments to support local institutional change little progress
could be reached in the implementation and monitoring of local plans. RGC has
therefore initiated reforms to strengthen local-level institutional capacity through
improving procedures and practices (for human resource and performance
management, budgeting and public expenditure procurement and internal controls) to
enhance the effectiveness, efficiency and accountability of local bodies to their local
clients.
The RGC has also recognised that provincial disparities in performance – and
underlying capacities – must be addressed through measures designed to improve
local service delivery as well as to stimulate 'effective demand' through the
democratisation reforms associated with the D&D programme. There has therefore
been a close relationship between reforms at the centre and those designed to
support service delivery at the sub-national level. There is also a high-degree of
complementarity between the political approach, which maintains power at the
centre, and the technical approach, with central government administering reform at
the sub-national level as an extension of central reform processes4.
Progress on governance and core reform priorities are therefore at the heart of both
national and sub-national efforts to develop the capacity required to implement
activities that will move the country toward the CMDG targets. This section
summarises the principal capacity development efforts that can account for much of
the progress made towards each of the respective CMDGs. It can be seen that
progress is being made in some areas, while in the others it is more mixed.

National Public Administration Reform
The reform of the Civil Service is perhaps the most critical of the core reforms that
will underpin other achievements in reaching the CMDGs. The National Public
Administration Reform Strategy (2009-2013) builds on previous reform programmes
by articulating a clear vision for the public service, setting performance standards,
establishing benchmarks and identifying a series of complementary programmes
designed to improve public service delivery and accountability.
The Council for Administrative Reform (CAR) leads this reform which is underpinned
by a vision of local ownership and ‘Cambodianisation’ of capacity development to be
achieved through four strategic objectives:
    (i) improving the delivery of public services;
    (ii) enhancing salaries and performance;
    (iii) developing the capacity of institutions; and,
    (iv) promoting the use of information and communication technology (ICT).

The approach is to anchor reforms in the national context while using best practices
and innovative tools such as Priority Mission Groups (PMGs), which are designed to
assemble and motivate teams dedicated to priority tasks, including those related to
the CMDGs and NSDP. A Merit-Based Pay Initiative (MBPI) scheme5 forms the basis
of the incentive structure at both national and sub-national levels, thus providing a
mechanism for officially establishing a consistent performance-based employment
4
  Hughes, C. (2006) The Politics of Gifts: Tradition and Regimentation in Contemporary Cambodia,
Journal of Southeast Asian Studies, 37 (3), pp.469-489 October 2006, The national University of
Singapore
5
  Government sub-decree No 29, April 2008
incentives program for RGC and development partners. The objective of the scheme
is to improve governance in priority ministries by improving performance in the key
policy and programme management areas thereby reducing the risk of corruption
through improved salary structures and meritocratic civil service management
principles.
Recognising disparities in the provision of services across the country – and the
adverse impact this has on the CMDGs and other national development objectives -
some ministries are attempting to develop additional incentive systems. The Ministry
of Health, for example, is developing an incentive for service in remote areas and the
Ministry of Education has a similar scheme in place for school teachers.
Decentralisation and Deconcentration (D&D)
D&D comprises the principal effort for
strengthening democracy at the grass roots              Box 2: Sub-national organisation
level through promoting participatory local
development and improving delivery of                   Cambodia currently consists of 24
public services at the commune level.                   Provinces (including 4 Municipalities),
                                                        185     Districts  1,621  Communes
Taking steps to “make decentralization and
                                                        (including “Sangkat” which are urban
deconcentration more effective” is portrayed            communes in Municipalities). The
in the NSDP as a prerequisite for poverty               average Commune population size is
reduction, and therefore for achieving the              7,600 inhabitants.
CMDGs.
                                                        The official decisions and Prakas
In 1996 RGC embarked upon a                             issued in January 2009 however
comprehensive process for strengthening                 established        new     administrative
commune          capacity      planning       and       territories in Cambodia with a different
implementation        through     the      ‘Seila’6     configuration: 1 Capital, 23 provinces,
programme. A complementary resource                     24 municipalities, 169 districts and 8
                                                        khans plus the reduction in communes
transfer arrangement was made via a
                                                        and an increase in sangkats. Reform
'Commune/Sangkat fund'. This facility,                  will     therefore   create   additional
which was continued by the National                     institutional demands on capacity
Committee        for    Decentralisation      and       development.
Deconcentration (NCDD) in 2007, has
                                                        The Law on Commune/Sangkat
significantly enhanced knowledge and skills
                                                        Administration provides the basic legal
and increased the credibility of the                    framework      and     assigned      to
commune councils through strengthening                  commune/Sangkat both administrative
skills in needs assessment and translating              and developmental responsibilities,
these into action (development) plans for               thus requiring them to have two-fold
implementation. Communes still however                  capacity:
require assistance despite the successes of             1) Capacity to deliver own functions
this facility in translating local priorities into         by    articulating  policies  and
funded programmes.                                         programs on behalf of a local
Currently, there is a structure and related                constituency and funding them
                                                           with own resources.
personnel at national and sub-national
levels (provincial, district and commune),    2) Capacity    to   deliver    agency
which reflect efforts at deconcentration         functions through implementing
within the overall responsibility of the         policies and programs defined and
Ministry of Interior that implements the D&D     funded by higher-level authorities.
reform programme in Cambodia. The
personnel attached to these structures have developed and adopted systems and
procedures particularly in planning, financial management, procurement,
implementation, and monitoring & evaluation to assist in the implementation of
service delivery at commune levels. Attempts have been made to establish a single
set of systems and procedures by these structures, in cooperation with development

6
  The name ‘Seila’ in Khmer means the foundation stone. Seila was the primary programme to provide
technical support, capacity development and investment funding for the communes (through the
Commune/Sagkat Investment Fund), district, provinces and line Ministries.
                                                                                                 12
partners. Line Ministries have their own sub-national offices and staff who carry out
their mandates including service delivery at commune levels.
With the passing of the Organic Law, however, there are significant changes to be
made to the sub-national structure, functions, and personnel through strengthening
the role of provinces and districts, and their connection with communes and
enhancing their services delivery responsibilities and capacities. Commune Councils
elections were held in April 2007. After the upcoming indirect Provincial and District
elections in May 2009 there will be 3,235 new councillors elected in the Districts and
Provinces (2,861 in Districts and 374 in Provinces) with their associated technical
committees and administrations. All councils will be resourced to prepare and
implement their own plans and budgets so as to improve infrastructure and services,
regulate natural assets, and create local employment opportunities. Decentralisation,
therefore, also represents risks for local level capacity development by creating
potential for duplication, confusion, and lack of clarity of mandate and mission at sub-
national level. Moreover, creating more layers of civil service may results in
increased rent-seeking opportunities and further strengthening of the patronage
systems at sub-national levels.

RGC understands that capacity development is paramount to the success of D&D
reform. Capacity development will have to be responsive to the new institutional
frameworks and associated mandates for sub-national governments and also include
institutional arrangements related to cooperative mechanisms with civil society and
the private sector as a means for effective public service delivery. This presents a
considerable challenge, particularly in addressing the continuous capacity
development needs. A chain of problems is shown in Chart 1 below, identifying
decentralisation challenges for local capacity development and highlighting factors
that contribute to developing local level capacity for CMDGs. Without addressing
these challenges that face local governments in Cambodia, achieving MDGs at the
local level will only be a ‘window shopping’ exercise of producing national MDG
Reports and will not enhance the improvement of standards of living at the local
level.

As discussed above, RGC has provided the necessary legal framework to support
political decentralisation, beyond mere administrative devolution, including defining
the roles of sub-national authorities with respect to local development initiative and
addressing CMDGs locally. However, achieving CMDGs locally requires also
providing space for empowerment and participation of local stakeholders in the local
development process. This includes removing all institutional barriers that prevent
local actors from participating in the development process, including putting in place
frameworks that encourage popular participation and promoting accountability.




                                                                                     13
Chart 1. Linking D&D Challenges to CD opportunities for CMDGs



                                   Principles of good sub-national governance with a direct bearing on the success of achieving MDGs:

                        Participation + Partnerships + Accountability + Local infrastructure and services


Decentralisation challenges for local capacity                   But how can decentralisation be                  The role of local government in              Resulting in the following
development include the following:                               an enabler for developing local                  fostering     local    capacity              decentralisation opportunities
                                                                 capacities?                                      development is then implied…                 for   local    level capacity
                                                                                                                                                               development:

• Uneven political commitment to reform                          • Having   the     necessary      legislative    • Strengthening information flows            • Local elections
                                                                   framework for decentralisation in place.
• New legislative environment, especially governing                                                               • Fostering trust and accountability         • Renewed       district   and    provincial
  decentralization and sub-national administration;              • Ensuring the decentralisation of financial                                                    legislation
                                                                   resources to the local level through fiscal    • Making use of local capacities
• Decentralization limited to devolution of some                   decentralisation reforms.                                                                   • Revised legal frameworks
  administrative and technical functions, particularly in line                                                    • Promoting participatory development
  ministries                                                     • Providing space for the empowerment                                                         • Local development initiatives
                                                                                                                  • Ensuring targeting of local poverty
                                                                   and participation of local stakeholders in       reduction interventions                    • Increased interest in localising the
• Limited or weak capacity of provincial, district and             the local development process.
  commune councils and other stakeholders;                                                                                                                       CMDGs
                                                                                                                  • Increasing        coordination        of
                                                                 • Enhancing the effectiveness, efficiency          development initiatives
• Limited accountability of local government to the local          and targeting of local public infrastructure
  constituency and its lack of representation;                     and services.
• Weak fiscal decentralization and the lack of financial         • Ensuring institutional strengthening for
  autonomy of local authorities;                                   availability of strong capacities at the
• Weak participatory culture and the lack of local democratic      local level.
  practices;
• Weak vertical and horisontal linkages;
• Lack of women’s access to and representation in decision-
  making structures and processes;
• Weak civil society structures and limited influence on local
  development processes;
• Weak local private sector, and weak public-private sector
  partnerships
Demand for Good Governance (DFGG)
Without good governance, efforts to sustain economic growth, reduce poverty and
attain the CMDGs will have reduced prospects for success. Similarly, for RGC
reforms to succeed there is a recognised need to stimulate 'demand' from citizens for
improved service delivery and for enhanced accountability. The Ministry of the
Interior has therefore collaborated with the World Bank to establish a Demand for
Good Governance (DFGG) project that seeks to strengthen the work of both state
and non-state institutions. The approach envisages four related themes (see chart
two, below) to: i) promote demand; ii) mediate that demand to ensure it can be
accommodated into realistic plans and budgets; iii) develop capacity and incentives
to deliver; and iv) monitor impact to ensure learning and adaptation.
Chart Two. Components of a DFGG Approach

                                             MONITOR
                                        -   Participatory
                                            monitoring


                RESPOND                                                     PROMOTE
            - Service delivery                  DFGG                      - Disclosure,
              innovations                                                   Demystification and
            - Performance rewards                                           Dissemination

                                              MEDIATE
                                             - Feedback
                                             - Consultation


      Source: World Bank, DFGG project documentation

Cambodian people have little trust in formal institutions and few expectations for
services to be delivered without informal fees being paid. Moreover, Cambodians are
reluctant to demand their rights and therefore they make use of ksae7 (informal
networks of contacts) in order to resolve disputes or to secure public services. This
behaviour reinforces patron-client systems at the expense of public sector reform.
The 2008 IRI survey found that position of village chief is the position that most
affects the daily lives of Cambodians with the role of the commune councillor – an
elected position – also of some importance. Being elected as a commune councillor
is therefore not solely dependent on one’s technical ability, but rather on their
popularity in the commune8 which is derived from the perception of their constituents
that the councillors may be able to ‘get things done’. Having a popular person in the
local government is predisposition for growing trust in the local government
institutions and in itself is an important part of the latent capacity that can be
mobilised, either through formal or informal means, to secure local government
performance.

There is however, evidence that new drivers of change are emerging slowly to
advocate for greater performance and accountability at the local level. For example,
work with the Commune/Sangkat Investment Fund (C/SIF) and Commune
Investment Projects (CIP) which are identified based on the consultation between
commune councils and population are starting to foster, although fledgling, roots of
downward accountability at the local level.
With CMDGs recognised as a central development challenge, complemented by
notions of good governance and accountability, civil society, often portrayed as the

7
  An interviewee suggested that ‘Depending on the ksae one has one can achieve things quickly and get
promoted quickly’.
8
  ‘When we talk about elections we talk about popularity, not about capacity, so capacity of the elected
councilor varies’, H.E. Hou Taing Eng, Secretary of State, Ministry of Planning statement at the Senate
– NLC/S Forum on ‘Decentralisation, Deconcentration in Cambodia and Representing
Commune/Sangkat Interests’ 17-18 March 2009.
champions of the poor, have assumed higher profile in the local service delivery in
Cambodia. For example, the Health Sector Support Programme (HSSP) aims at
addressing poor state of the health service delivery by having executive management
contracts with NGOs whereby NGOs are managing health facilities, training and
‘health equity funds’ (see more in the case study on HSSP). Typically this is
implemented by a Cambodian NGO operating with the support of an international
NGO, thus facilitating growth of local capacity.
Supporting the creation of a more enabling environment for capacity development by
strengthening rights-based approaches and demand-side pressures for improved
capacity and service delivery at the local level will therefore contribute to achieving
CMDGs. Hence, the DFGG approach promises to deliver significant capacity
development benefits at institutional, organisational and individual level, through an
overall positive impact on the enabling environment in which public services are
delivered.
Public Financial Management Reform Programme (PFMRP)

The decentralisation of responsibilities to sub-national level will not be sufficient to
develop local level capacity if it is not accompanied by appropriate fiscal
arrangements to enable sub-national authorities to pursue local strategies for
achieving CMDG goals locally. Hence, there needs to be a sufficient resource
transfer to the local level which will ensure that sub-national government has greater
responsibility for generating local revenue through the ability to make independent
fiscal decisions.
The RGC’s Public Financial Management Reform Program (PFMRP), launched by
the Prime Minister in December 2004 calls for improved programming, execution and
accountability in use of public funds. Ensuring improved financing of social services
will provide an important “enabling environment” factors for achieving CMDGs.
PFMRP is a 10-year reform program, based on a sequenced platform approach:

    •   Platform 1: Making the budget more credible in terms of timely and
        predictable delivery of funds;

    •   Platform 2: Implementing effective financial accountability;

    •   Platform 3: Achieving a fully affordable policy agenda through policy-budget
        linkage; and

    •   Platform 4: Achieving effective program performance accountability.

Platform 1, which was completed at the end of 2008, included laying groundwork for
improving fiscal decentralization in later platforms. Platform 2, launched in December
2008, aims at improving accountability for effective financial management, including
provision of systems-wide capacity development support to D&D stakeholders on
fiscal decentralization, including but not limited to the NCDD. Targeted capacity
development should continue to focus on the MEF Department of Local Finance; and
improving sub-national budgeting and financial management systems to improve the
accountability at the sub-national level.
Cambodia’s PFMRP faces many challenges9, however progress in PFM reform has
opened up possibilities for more effectively and efficiently directing public spending
towards achieving CMDGs.


9
  The quality of Cambodia’s public financial management systems was given a rating of only 2.5 under
the World Bank’s 2005 Country Policy and Institutional Assessment (CPIA), a score which was revised
upwards to 3.0 in 2006 and maintained at the same level in 2007. This is someway below the average of
3.2 for International Development Association (IDA) borrowers.

                                                                                                  16
Technical cooperation

The RGC’s 2007 Aid Effectiveness Report highlighted that technical cooperation (TC)
in Cambodia represents in excess of one third of aid. The report expressed concerns
regarding TC effectiveness in building capacity10. Focus placed on capacity
development by the Government, particularly by the Council for Administrative
Reform (CAR), compounded by concerns that significant technical cooperation over
many years did not appear to have had a substantial impact on national capacities
led the RGC to develop the “Guideline on the Provision and Management of
Technical Cooperation”11. It is intended that the Guideline be consolidated with the
Council for Administrative Reform work on capacity development and human
resource management, ensuring coordination and complementarity between RGC
and development partners’ activities at both central and sub-national levels.
For an example of a key donor-funded technical cooperation in support for D&D see
the case study on the ‘Project to Support Democratic Development through
Decentralization and Deconcentration’ (PSDD).

Monitoring and Evaluation (M&E)
Key data sources for monitoring CMDGs at sub-national level include:

     •   Administrative records- Health Information System (HIS), Education
         Management Information System (EMIS), and Commune Database System
         (CDBS).

     •   Population census 1998 and 2008

     •   National sample surveys, including Cambodia Socio-Economic Survey
         (CSES), Cambodia Demographic and Health Survey (CDHS), Cambodia
         Inter-Censal Population Survey (CIPS), and Labour Force Survey of
         Cambodia (LFS)

     •   Ad hoc surveys such as HIV Sentinel Surveillance (HSS), Behavioural
         Sentinel Surveillance (BSS), and STI Sentinel Surveillance (SSS)

The lack of data for most CMDG indicators at sub-national level is compounded by
the lack of capacity/statistical literacy at local level. Hence, the data are currently
primarily used for reporting and not for policy or decision-making. Moreover, only
limited data are used for informing resource allocation. Limitation of quality control of
data at sub-national level (data timeliness and data availability) raises serious issues
related to data quality and reliability.
Capacity development of the National Institute of Statistics and its representatives at
the local level in collecting disaggregated data, and in using interim proxy measures
is therefore essential for achieving MDGs.

Capacity Development providers

10
   Royal Government of Cambodia (RGC), (May, 2007), The Cambodia Aid Effectiveness Report, 2007,
Prepared by the Cambodian Rehabilitation and Development Board of the Council for the Development
of Cambodia for the First Cambodia Development Cooperation Forum on 19-20 June 2007.
11
   RGC (September 2008), A Guideline on the Provision and Management of Technical Cooperation,
Phnom Penh

                                                                                              17
In Cambodia there are several formal public sector capacity development providers.
Firstly, training institution specifically intended for the training of civil servants is the
Royal School of Administration. This school targets two groups of beneficiaries: a)
newly recruited civil servants in junior positions; and b) existing civil servants in so-
called ‘refresher’ or ‘continuous’ training. The Royal School of Administration course
contents tend to be invented ad hoc with no teaching curriculum as such. Instead, the
lecturing is based on a didactic teaching model and consists of the prominent and
high-level government officials delivering speeches to students12.
The Secretariat of State for Social Service is operating under CAR and is responsible
for management of civil servants. Its responsibilities include ensuring appropriate
human resources management and development which will provide efficient service
delivery at all levels of public service. The Secretariat has been providing some
trainings to build skills in development policy, governance, public finance and public
sector management both for managers (deputy directors and up), and all staff.
There are sector specific training institutions, such as the Central Pre-School
Teacher Training Centre, 6 Regional Teacher Training Centres (RTTC), and 18
Provincial Teacher Training Centres (PTTC). Significant improvement in the
education level of teaching staff has occurred in the recent years reflected in the
increase of the proportion of teachers who have at least lower secondary diplomas
from 26% in the 2000-2001 school year to 36% in the 2004-05 school year13. The
Department of Teacher Training is responsible for quality assurance and monitoring.
Health workers’ medical training takes place in the training institutions and pre-
service training programs in the Technical School of Medical Care, the Regional
Training Centres (RTCs), and the University of Health Sciences (UHS).
Despite the number of available training institutions, their capacity is insufficient to
provide the level and quality of training for civil service, education and health staff
that is required for meeting the CMDGs.




12
   Observation from a discussion with MoWA staff regarding attempt to integrate gender into curriculum
for new civil servants.
13
   Education Sector Strategic Plan 2006-2010, MoEYS, RGC, December 2005, p.4

                                                                                                    18
3. ROLE OF AID AND PUBLIC EXPENDITURE IN CAPACITY DEVELOPMENT
   FOR LOCALISING CMDGs
Achieving the CMDGs requires sustained public sector funding and Cambodian
public expenditure has continued to rise (see Table 3.1. Annex 3). In 2008 US$ 265m
was allocated for priority sectors (health, education, agriculture, and rural
development). Of the 2008 national budget 2.7 percent was allocated specifically to
the Commune/Sangkat Investment Fund.
The allocation for priority sectors in national budget has been increasing. Moreover,
priority sectors’ allocation is growing faster than the public expenditure is increasing.
This reflects RGC commitment to addressing CMDG challenges. In addition,
allocation for wages has been increasing, further highlighting RGC’s intention to
strengthen incentives for public service delivery.
The costing of the NSDP 2006-2010 (Table 3.2. in Annex 3) estimated that US$
4.2bn was needed for NSDP implementation. Comparing Cambodia’s central
government expenditure and donor commitments (Table 3.1. and 3.5. in Annex 3), it
appears that there is sufficient funding available for implementing NSDP and
therefore for making progress towards achieving CMDGs.
Cambodia is highly aid-dependent country, with Official Development Assistance
(ODA) accounting for between 87% and 88% of total capital expenditure in the period
2005 to 200814. ODA disbursements have grown from $555 million in 2004 to an
estimated $888 million in 2008. Of the 2008 ODA disbursements USD 531m was
distributed through the sub-national authorities, which represents nearly 60 percent
of the total ODA. Within this allocation direct ODA contributions to NCDD for sub-
national capacity development are valued at over USD 70 million annually of which
investments into the Commune/Sangkat (C/S) Funds are valued at around USD 20
million annually. The C/S Fund allocations have been used by the
Commune/Sangkat councils to directly meet their communities’ needs through
planning and managing participatory projects. Detailed information on donor and civil
society disbursements and commitments per province for the period 2006-2010 is
provided in Table 3.6. in Annex 3.
By examining the aid investments in provinces in 2007 (Table 2) it can be concluded
that, in general, the profile of aid disbursements is consistent with supporting those
provinces that have the poorest performance on CMDG attainment (Stung Treng,
Mondul Kiri, Pailin, Siem Reap, Otdar Meanchey). The relationship (graphed
overleaf) is not statistically strong, however, and Sihanoukville is a clear exception,
perhaps due to the significant infrastructure projects taking place in this major sea
port. Mondul Kiri receives the second largest aid per capita which is a result of its
small population numbers. Rattanakiri is Cambodia’s poorest performing province,
however it is receiving relatively small amount of aid per capita which can be
explained by the difficult access to the province and its remoteness. There is also a
skewed distribution of aid to the provinces as the ten largest beneficiary provinces in
2007 received USD 329 million, which is three times higher than the USD 110 million
received by the other fourteen provinces combined (RGC 2008b).
Table 2: Donor and civil society disbursements and CMDG progress per
province
               Province                2007 population   2007 aid per capita   CMDG indices
 Sihanoukville                                 199,902                  221            0.62
 Mondul Kiri                                    60,811                  140              0.4
 Stung Treng                                   111,734                   63            0.51
 Otdar Meanchey                                185,443                   61            0.41
 Nationwide                                 13,388,910                   59
 Kratie                                        318,523                   56             0.59
 Kep                                            35,753                   54             0.62


14
     Council for Development of Cambodia Database
                Province                   2007 population      2007 aid per capita CMDG indices
 Phnom Penh                                        1,325,681                    53          0.87
 Siem Reap                                           896,309                    49          0.43
 Kandal                                            1,265,085                    43          0.65
 Pailin                                               70,482                    42          0.52
 Koh Kong                                            139,722                    32          0.55
 Rattanak Kiri                                       149,997                    31          0.35
 Preah Vihear                                        170,852                    30          0.52
 Kampong Thom                                        630,803                    28          0.56
 Banteay Meanchey                                    678,033                    25          0.55
 Kampot                                              585,110                    24          0.61
 Battambang                                        1,024,663                    22          0.52
 Pursat                                              397,107                    20          0.51
 Kampong Chnnag                                      471,616                    18          0.55
 Prey Veng                                           947,357                    18          0.57
 Svay Rieng                                          482,785                    17          0.63
 Kampong Speu                                        716,517                    15          0.55
 Kampong Cham                                      1,680,694                    14          0.58
 Takeo                                               843,931                    11          0.56
Source: The Cambodia Aid Effectiveness Report 2008, CRDB/CDC; and MoP ECOSOC Report 2007,
National Institute of Statistics (2008 provisional census data)



                          ODA expenditure and CMDG attainment
                                   2007 aid pc        CMDG indices
            250                                                                       0.9

            200                                                                       0.8




                                                                                            CMDG index
                                                                                      0.7
   USD pc




            150
                                                                                      0.6
            100
                                                                                      0.5
             50                                                                       0.4

             0                                                                        0.3




NGOs represent an important source of assistance to provinces; although their total
support represents only 10% of total aid, the NGO share channelled to provinces is
approximately 18%. The 2008 Aid Effectiveness Report also reports that in some
provinces (Siem Reap, Takeo and Koh Kong) the NGOs deliver in excess of one-
third of total aid to those provinces. Moreover, social sectors continue to be major
areas of NGO involvement with increased involvement in agriculture and rural
development. In 2006 and 2007 approximately two-thirds of NGOs' own resources
were directed to health and education, with community welfare and rural
development comprising the other main activities (RGC, 2008b). This highlights the
importance of NGOs in supporting local level progress towards CMDGs.




                                                                                                         20
4. LINKING CAPACITY WITH PERFORMANCE WITH THE CMDGs

Having identified the principal approaches to national and sub-national planning and
capacity development it is possible to consider the extent to which progress against
each of the CMDGs can be associated with the development of capacity at sub-
national level. Cambodia is on track to achieve at least 23 of 59 CMDG targets for
which information is available (Annex 1) but it is important to emphasise that because
of the large amount of generic capacity development support and core reform
programmes asserting direct attribution between capacity-related investments and
the progress recorded against each of the CMDGs is not a feasible proposition. The
data presented in section one, however, combined with the discussion in section two,
makes it possible to make some association between sub-national capacity and
performance in meeting the CMDG targets. Discussion in this section uses examples
from innovative flagship programmes for local capacity development as they apply to
each of the CMDGS. Annex 1 provides summary of performance against CMDGs.
However, where possible, discussion in this section uses updated information on
CMDG performance15.
CMDG1: Eradicate extreme poverty and hunger
Cambodia has seen significant and steady macro-economic growth, spurred by
private sector investments and assistance from external development partners.
However, Cambodia remains a least developed, low income food deficit country.
Economic growth has been heavily reliant on garment manufacturing, tourism and
construction, all of which are concentrated in urban areas, in particular in Phnom
Penh, Siem Reap town and Sihanoukville.
Progress has been achieved in reducing poverty and hunger. The percentage of the
population below the national poverty line is on target. The poverty rate has declined
from 47 percent in 1994 to 30 percent in 2007. The decline in child malnutrition is
also on target.
Whilst there has been a marked poverty reduction in urban centres such as Phnom
Penh or Sihanoukville, it is interesting to note that this was not the case for Siem
Reap. Although Siem Reap town is the centre of multi-million dollar tourism industry,
the rest of the province remains extremely poor. This highlights the potential for (in
this case extreme) variations in poverty reduction within the same province.
Government with donor support has taken measures to create an enabling
environment for the private sector to develop under the leadership of the Steering
Committee on Private Sector Development. Risk management arrangements are
currently being put into place to move forward trade reforms. The main focus next is
on a "Trade SWAP" and strengthening the legal framework to improve the
environment for the private sector to grow with support from development partners in
a harmonised way and private sector participation. To this end UNDP supports RGC
in trade and private sector development through its project with the Ministry of
Commerce. The TRADE project focuses on enhancing the national capacity to
promote trade and investment by integrating pro-poor trade policies in NSDP and
developing capacity to negotiate, interpret, and implement trade agreements. The
entrepreneurship component of this project seeks to contribute to rural poverty
reduction. UNDP will further build on the opportunity for UN agency collaboration
through joint programs with ILO and UNIDO on employment and SME support
focusing on youth and women - in particular by promoting public and private
partnership initiatives.

15
  Collated from the World Development Indicators Database, CamInfo, NSDP statistics, Cambodian
Education Management Information System, and Health Management Information System.
CMDG2: Achieve universal primary education
As a basic right, education is an intrinsic good in itself, leading to broadened
individual capacities and freedoms. Education is also associated with a number of
positive development outcomes, thus contributing to the achievement of a number of
related MDGs. Improved access to education for girls in particular is one dimension
of capacity development which helps break the inter-generational transmission of
poverty and serves as a catalyst for human development overall.
Progress was achieved in increasing net primary school enrolment (Grades 1-6) from
78 percent in 1997 to 92 percent in 2004. Although net enrolment declined slightly in
2005 it subsequently recovered and has since increased to 93 percent in 2007.
However, it remains below the 2005 target of 95 percent. The net enrolment rate of
females increased from 91.0% in school year 2006-2007 to 93.3% in 2007-2008 at
national level while the rate for boys remained unchanged at 93.2%.
The survival rate from Grade 1 to Grade 6 at the national level also increased from.
The Survival rate for female students increased more sharply from 48.9% to 55.4%
while that for boys slightly increased from 49.6% to 50%. However, little progress has
been made in primary school survival rates which stand at 53 percent in 2007, far
below the 73 percent target set for 2005.
In recent years, the education sector has become a strong focus of reform, with the
Ministry of Education Youth and Sport (MoEYS) launching a major overhaul of the
sector. The SWAp approach was adopted as the main framework for supporting the
Education Strategic Plan (ESP). The capacity development features of the donor
support include support for expanding access to a 9 year basic education cycle,
quality improvement, enabling pro-poor access to education through a scholarship
programme, teacher pay reform, and increased government expenditure and donor
contribution to the sector. However, whilst reforms of the education system to date
represent significant achievement, the knowledge and skills of the graduates coming
out of the present system is inadequate to meet the needs of the modern civil
service. Ensuring capacity development for CMDGs at the local level, therefore
requires that attention be paid to promoting other levels of education, including
vocational training and higher education in rural areas, to start building a 'critical
mass' of educated people to serve the development needs. Moreover, overcoming
inequalities in deployment, particularly the rural/urban divide, necessitates promoting
institutional incentives that will encourage more equitable recruitment and
deployment of teachers, including recruitment of teachers from minority groups.
EC has been providing Education Sector Budget Support since 200316. The principal
lessons learned from the EC past support to the education sector underscore the
importance of (1) ensuring a close alignment with government policy; (2) nation-wide
support, covering reforms and capacity building, and (3) dispersing support in a
manner that strengthens provinces, districts and communes as well as the central
level. While combining budgetary support with the necessary capacity building has
proved challenging, the results of the current EC sectoral budget support programme
have so far been positive. By providing funding through the budget, the EC has been
able to support institutional change and strengthening the internal procedures of the
MoEYS.


16
   The current programme covers the period 2008-2010 with investment of € 10m. Programme objective
is to support the MoEYS to achieve its Education for All targets through sector budget support to basic
education. A second component focuses on continued development and strengthening of the
institutional and human resource capacity of the sector to deliver effective and efficient basic education
from central to school levels, and thus strengthening the pro-poor policy basis in MoEYS’ education
policy development. This allows for a more holistic approach to education sector reform, with the EC
contribution going to the General Education Programme.

                                                                                                       22
CMDG3: Promote gender equality and empower women
Cambodia expanded the Goal 3 indicators and targets to include gender parity in
literacy for adults 25-44 years of age; disaggregation of waged employment into
agriculture, industry and services; a broader range of indicators for women in
decision making, and indicators related to violence against women.
Gender parity in education has increased at all levels of education, however the
improvements have fallen short of targets at all levels except upper secondary
school. Only modest gains have been achieved towards gender parity in literacy
amongst young people (15-24) and adults (25-44). However, as relatively little
attention is being paid to non-formal education, hence there are few opportunities for
achieving literacy for those who never enrolled in school or were unable to attend
school long enough to attain literacy.
The global MDG indicator related to gender parity in non-agricultural waged
employment was disaggregated to cover all three sectors of the economy separately:
agriculture, industry and services. Cambodia has exceeded its 2005 target for gender
parity in waged employment in industry, however this was primarily due to the
predominance of women employed in the garment industry, Cambodia’s primary
source of export earnings. The target for waged employment in the agriculture sector
has also been exceeded. However, the female share of waged employment in
services fell short of the 2005 target of 30 percent. A substantial proportion of
employment in the service sector is in public services which has traditionally been a
male-dominated domain. Achieving gender parity targets in the service sector will
therefore require improving gender equity in government employment. However, as
there are relatively few women with the levels of education required for white-collar
occupations, achievement of gender parity targets in waged employment in services
will also require achieving increased gender equity at higher levels of education.
In line with D&D reforms, the Seila and NCDD programmes have had significant
gender-related components. Moreover, support from UNDP-funded Partnership for
Gender Equality (PGE) project17 and support from other donors for gender-
responsive service delivery at the sub national level has therefore resulted in an
increased understanding of the links between gender and development, the adoption
and integration of gender mainstreaming concepts and tools in local governance
processes, and an increased number of women participating in service delivery. For
example 18:
•    Enabling framework- Ministry of Women’s Affairs (MoWA) was able to lead in
     establishing Gender Mainstreaming Action Groups (GMAGs) and Gender
     Mainstreaming Action Plans (GMAPs) in line ministries to provide a mechanism
     for implementation and monitoring of gender equality policy at national, provincial
     and district levels. All donor programmes supporting capacity development
     through the line ministries are subject to GMAP provisions.



17
   UNDP funded Partnership for Gender Equity (PGE) Project works to strengthen the capacity of the
Ministry of Women's Affairs and selected line ministries for gender mainstreaming; leadership and
management skills; for effectively advocating for change in traditional perceptions of women's status in
the family, community and society at large; and for promoting improved skills training and business
development services for women-entrepreneurs. The PGE project also supports aid effectiveness and
coordination for gender equality through its support to the Chair and Secretariat of the Technical
Working Group on Gender (TWG-G).
18
   Based on findings of Brereton, H. (2006) Gender Mainstreaming and Decentralisation: An
Assessment of the Process with Recommendations, Report prepared for Partnership for Local
Governance, Phnom Penh, 2006

                                                                                                       23
•   Capacity development - gender mainstreaming sensitisation training at the
    Ministry of Interior and provincial, district and commune levels has resulted in
    familiarisation and recognition of gender concepts and the mainstreaming
    process.
•   Budget allocation – funds were earmarked for targeting women’s and children’s
    issues through setting gender-specific criteria in identifying Provincial Investment
    Funds (PIF) and Commune Investment Plans (CIP)
•   Policy development - gender is one of the criteria/topics considered in planning
    and budgeting processes, resulting in increased attention and recognition to
    issues relevant to women such as domestic violence and access to social
    services
•   Service delivery systems - tools and processes, such as gender sensitive M&E
    approaches are developed, which help measure changes at local level and
    improve service delivery and gender mainstreaming process.
•   Representation - a quota for women’s participation has been set at village and
    commune level, whilst at the commune level additional measures such as the
    introduction of women’s and children’s’ focal points and committees have been
    put in place to ensure women’s participation where there is no elected female
    councillor. With the passing of the Organic Laws in April 2008, similar measures
    are now also being put in place at the district and provincial level by establishing
    Women and Children Consultative Committees, resulting in increased attention to
    participation by women at local level.
Current capacity development at sub-national level is focusing on Provincial and
District Departments of Women’s Affairs; Gender Focal Points that have been
designated in Provincial line departments; Commune Council Women and Children
Focal Points (WCFPs); and Commune Council Women and Children Committees
that have been formed. Moreover, preparations are underway to support legal
framework for establishing Women and Children Consultative Committees (WCCC)
which are to be formed within the Provincial and District Councils following the
elections in May 2009.
Key elements of gender responsive budgeting have been incorporated into the PFM
reform program and MOWA's Ministerial Action Plan for implementing the PFM
reform incorporates the support mechanisms for reviewing the gender implications
statements prescribed for the line ministry budget submissions to MEF. The purpose
of the gender implications statement is to ensure that proposals include an
assessment of the impact of proposed and existing policies and programmes on
women and men, and whether they advantage or disadvantage women and men.
Although a comprehensive system is in place for gender mainstreaming on sub-
national level, it is important that this is brought forward to inform the reform and new
institutions. The decentralization reform is progressing and concerted effort and
further support is therefore essential to ensure that gender equality considerations
are included in all stages and at all levels of the reform.
CMDG4: Reduce child mortality
Progress has been achieved in reducing both under-five and infant mortality. The
under-five mortality rate declined from 124 per 1000 live births in 1998 to 83 in 2005,
greatly below the target of 105 set for that year. Similarly, the infant mortality rate
declined from 95 per 1000 live births in 1998 to 66 in 2005. Although the national
targets adopted were somewhat modest in comparison with the global MDGs,
Cambodia appears to be on track towards achieving the global MDG target to reduce
child mortality by two-thirds by 2015. However, Cambodia’s child mortality rates
remain among the highest in the region.

                                                                                      24
Donor and NGO investment in capacity development for health-related CMDGs is
discussed in the section on CMDG5 below.
CMDG5 5: Improve maternal health
There has been no statistically significant change in Cambodia’s maternal mortality
rate which is still estimated to be at 472 per 100,000 live births. Progress is being
achieved in increasing the proportion of births attended by skilled health personnel,
however improvements have been slow and the current target is to reach the 2005
CMDG target of 60 percent by the end of 2009.
There is broad agreement that a significant number of maternal deaths could be
averted by preventing unwanted pregnancies and eliminating unsafe abortion.
Progress is being achieved in increased use of modern birth spacing methods, but
this is still below the MDG target in 2005.
There are considerable financial barriers to accessing essential services, in particular
for the poor (an estimated 70 percent of total per capita health expenditure of US$36
is funded out-of-pocket). There are concerns about quality of care and effectiveness
of public sector (only 17 percent of the people who fall ill and use health services rely
on Government systems). Moreover, there are new public health challenges
emerging e.g. new communicable diseases (Avian Flu, sudden acute respiratory
syndrome) in addition to an increasing burden of non-communicable diseases, and
injuries.
Some key health achievements in the past should be attributed to strong vertical
public health programs such as those addressing HIV/AIDS, TB and malaria.
However progress in other areas is dependent on the health sector capacity to
provide effective primary health care and related referral services, particularly at the
local level and in remote areas. Health sector analyses in Cambodia point towards
the need for improved financing of front line health facilities, and policies to recruit
and retain key health staff19.
Physical access to health facilities able to provide the full complement of health
centre care and referral hospital care is improving. Utilisation of essential health
services, such as for immunisation or pregnancy, is on the increase. Donor support
through the Equity Funds (see HSSP case study) provided effective health coverage
for about 1 million poor people through helping to pay user fees and cover other
health care related costs. Out-of-pocket costs per disease episode have fallen in
rural areas by 30% and health cost related borrowing and asset sales have been
falling.
Capacity development imperatives in remote areas – and in the context of proposed
decentralisation –remain to improve the quality of training and competencies of staff,
protect the poor from the impact of significant health care related costs, and for the
Government to provide stronger leadership and stewardship of the health sector, in
particular as this relates to the fairly large private sector. In that respect, Cambodia is
well known for its policy innovations in health systems strengthening (contracting for
service delivery, equity funds for protection of poor) that have successfully addressed
some of the challenges such as unresponsive and poorly managed health facilities,
poor demand articulation, mismatches between health needs and service delivery,
and inadequately trained and supervised staff.




19
   Health Sector Strategy Review 2003-2007 (2007); Public Expenditure Tracking Survey Report in the
Health Sector (2007); Contracting Review (2007); Midwifery Review (2007); Poverty Assessment
(2006); and, Equity Report (2007).
19
   Health Strategic Plan 2008-2015 “Accountability, Efficiency, Quality, Equity”, Department of Planning
& Health Information, Ministry of Health, 31 December 2007

                                                                                                      25
These mainly donor-funded20 arrangements of HSSP were shown to improve poor
people’s access to utilisation of and their satisfaction with the health facilities by
reducing out-of-pocket health costs, particularly in areas in Preah Vihear, Mondul Kiri
and Rattanak Kiri which are all amongst the poorest provinces. However, the effects
on local level capacity development are anecdotal since initial design of the
programmes intentionally bypassed local level service providers, thus these
innovations had little alignment with, and impact on, the capacity development of the
health service providers, primary accountability between citizens and elected leaders,
the sub-national accountability, and unified administrative arrangements that are
being established under the current D&D reforms. As a consequence, MoH engaged
on pilot-based deconcentration reforms with aim to transfer and strengthen specific
functional assignments from central ministry to its sub-national offices.
NGOs have also attempted to build capacity for service demand through community-
based arrangements. They have enabled relations with voluntary village health
workers, and have encouraged Health Care Management Committees (HCMCs) to
take an active interest in the management of the Health Centres. Unfortunately, there
has been limited cooperation between health professionals who seemed reluctant to
‘take direction’ from elected leaders, thus limiting capacity development impact.
The shortage and inefficient geographical deployment of qualified health
professionals remain critical constraints to achieving the health-related MDGs,
particularly in rural areas. Migration of staff from rural to urban areas has caused an
imbalance in deployment, with some overstaffing in urban areas and severe
understaffing in remote rural areas, thus depleting local level capacity. This is
particularly the case for severe shortage of midwives and to a less extent nurses in
rural areas, thus representing a contributing factor to continuously high maternal
mortality rates in Cambodia.
However, challenges of achieving MDGs in local level service delivery often
overshadow efforts to strengthen workforce in its entirety. For example, in recent
years, health human resources development with donors support has been
strategically focussed on increasing the numbers of midwives21. A salary incentive for
midwives based on the number of deliveries was adopted22 and the adapted midwife
salary scales and compensation payments for professional related health risks as
proposed by MoH are soon to be endorsed. However, placing primary midwives in
rural areas has failed to address broader health needs, in particular those of children,
because rural areas need a more multi-skilled staff cadre.
CMDG6: Combat HIV/AIDS, malaria and other infectious diseases
Substantial progress has been achieved in reducing HIV prevalence in both the
general adult population and amongst pregnant women. HIV/AIDS prevalence in
2006 was 0.9 percent among the adult population compared with 3 percent in 1997.
However, in 2006 52% of people living with HIV/AIDS were female which represents
an increase from 38% in 1997 whilst incidence has decreased among men over the
same period23. Moreover, there is an ongoing concentrated epidemic among men-
who-have-sex-with men (MSM), injecting drug users (IDU), and sex workers. The

20
   Since 2003 a number of donors supported HSSP including ADB, AFD, AusAID, BTC, DFID, UNFPA,
World Bank. Since 2008 there have been joint financing arrangement put in place. Other donors, such
as GTZ and Swiss Red Cross, are aligning their assistance under common management arrangements.
For more information see HSSP case study at the end of this report.
21
   188 primary midwives and 40 secondary midwives were recruited in 2007 and have been allocated to
166 health centers, of which 66 had never had one in 2006. This continued in 2008, with a total 181
midwives recruited and deployed to hospitals and health centers across the country. Health Strategic
Plan 2008-2015 “Accountability, Efficiency, Quality, Equity”, Department of Planning & Health
Information, Ministry of Health, 31 December 2007
22
   Inter-Ministerial Prakas of the Minirty of Economy and Finance and the Ministry of Health No 268,
April 2 2007
23
   Brief on Gender Mainstreaming in Cambodia, MoWA, RGC, March 2009

                                                                                                 26
coverage rate for antiretroviral combination therapy in 2005 at 45 percent was nearly
double the target of 25 percent.
The rapid decline in prevalence of HIV/AIDS was brought about by a combination of
RGC commitment and substantial donor support. RGC's highly focused commitment
and excellent collaboration with and among external development partners.
Recognising the importance of a multi-sectoral response to the HIV epidemic, RGC
established the National Aids Authority (NAA), to lead, coordinate and monitor the
national response across ministries and all provinces.
UN agencies are jointly supporting RGC efforts to reduce HIV/AIDS through a UN
Joint Support Program which has developed inter alia an initiative for ‘The
Governance of the HIV/AIDS Response’ which pursues an integrated approach to
supporting the establishment of mechanisms of good governance, enabling state
institutions and empowering civil society to engage collectively in the national
HIV/AIDS response at central and local levels.
In line with D&D reforms, the national HIV/AIDS response encouraged responsibility
for coordination and implementation, including funding, to be delegated to
implementing organisations at provincial, operational and commune level. During
NSP124 provincial level coordination forums have been developed, such as the
Provincial AIDS Committees (PAC), Secretariats (PAS), networks (PAN), and offices
(PAO), with slightly differing mandates. There are also provincial outreach teams
(POT), in support of the 100% Condom Use Programme. Provincial stakeholders
were encouraged to decided what worked best for them and technical assistance and
funding from donors was mobilised to support efforts emanating from provincial,
district and commune levels. In the given context of strong and well-performing
vertical national programme, donors’ capacity development support was focused on
strengthening and supporting organisation and structure at the national level.
Cambodia’s National Malaria Control programme (NMCP) is a dynamic and
innovative malaria control programme which was set up by the Cambodia National
Centre for Parasitology, Entomology and Malaria Control (CNM) as a response to the
baseline study conducted in 1998/99 which discovered that around 90% of malaria
cases were treated outside of the public sector, with largely inappropriate drugs.
Supported by the European Union and the World Health Organization (WHO), the
CNM developed a pilot program to distribute anti-malarial medicine which contributed
to significant reduction in incidence of malaria.
Whilst the NMCP programme was recognised as success, there are some critical
gaps in its capacity to deliver an efficient malaria control programme, particularly at
the sub-national level. At the height of the NMCP repute, it was receiving full-time
technical support from three donor-funded senior advisers (this support was in
addition to that provided by the CNM’s existing in-house WHO team). Whilst this level
of support was at times excessive and problematic, its complete withdrawal over a
relatively short period of time resulted in CNM’s outputs slipping. Although technical
capacity at CNM has grown dramatically (as a result of an active capacity
development programme involving a combination of overseas and on-the-job training
and mentoring) this institute has not developed capacity sufficiently to become self
reliant. CNM still require support for capacity development at Provincial and District
levels to develop and implement plans for effective malaria control. However, until
the planned reform of public sector salaries and incentives has been extended to
provinces, the capacity development efforts will have a limited impact.25.


24
  National Strategic Plan for Comprehensive and Multisectoral Response to HIV/AIDS (NSP1 2001-
2005; and NSP2 2006-2010)
25
  An Assessment of the Technical Assistance needs of Cambodia’s National Malaria Control
Programme, Sean Hewitt PhD, VBDC Consulting Ltd., July 2006 funded by DFID Cambodia for the
Ministry of Health (Health Sector Support Project) and the National Malaria Control Programme

                                                                                                 27
With private sector capacity for engagement in the HIV/AIDS response becoming the
key in expanding the HIV/AIDS prevention and response, sustainability of the funding
continues to be one of the important factors for the success. Moreover, the private
sector in Cambodia is vast and unregulated. Nevertheless, approximately eighty
percent of people in Cambodia choose private-sector health providers as their first
port of call in the event of developing a fever. The CNM has therefore adopted a
policy of engaging with private-sector health care providers in an effort to improve
their performance, including training regarding the dangers of counterfeit drugs and
in the diagnosis and treatment of malaria.
CMDG7: Ensure environmental sustainability
Regarding natural resource management (NRM) the pace of forest depletion has not
been reduced as planned. Moreover, fuel wood dependency remains high at 84
percent of households in 2005, well above the target of 70 percent. Good progress
has been achieved in the establishment of community-based fisheries, providing
more secure access to this common property resource.
Cambodia is ahead of targets for safe water in both rural and urban areas, however
the targets set were rather modest. Moreover, progress in safe sanitation in rural
areas is ahead of target at 16.7 percent, however safe sanitation in urban areas was
slightly below the 2005 target.
Environment and conservation in rural areas of Cambodia are substantially worse off
than urban areas, with rural households comprising about 90% of the poor
population. This disparity is further magnified in the non-rice-cultivating rural areas.
These often remote areas (covering 14 out of 24 provinces, two-thirds of the total
land area, and 20 percent of the total population) receive less government and donor
support than the more densely populated rice-growing areas and are characterized
by dependence on finite natural resources, such as aquaculture and forestry. While
rich in natural resources, the poor populations in these areas are particularly
vulnerable to chronic poverty because the resources do not lend themselves easily to
diversification and intensification efforts, and there are few alternative livelihood
options.
The challenges to effective NRM in Cambodia can be found at both the local and
national levels. Many of the problems are specific to the local environment, such as
limited local capacity and lack of participation in local decision-making on natural
resources. Others are stemming from weak governance, and greatly worsening NRM
management, resulting in growing incidence of illegal and corrupt practices, such as
land-grabbing, by powerful vested interests26. The poorest are the most
disadvantaged and especially vulnerable to such abuses.
Natural resource management in Cambodia, therefore, is a complex field with reform
and progress urgently needed on many fronts, from broadening participation in local
decision-making, to improving national policy governing user rights, enforcement,
and implementation of policy.
A flagship innovative approach to local level capacity development for natural
resources management is represented by joint DFID and DANIDA comprehensive
multi-faceted approach through Natural Resource Management and Livelihood
Programme (NRMLP) which is being implemented by the Multi-Donor Livelihoods
Facility (MDLF). The NRMLP strengthens the capacities of local governance
structures at commune, district, and province level to facilitate the sustainable
management of natural resources, and to provide services that lead to tangible

26
   Cambodian record of resource management practices was a subject of significant criticism from
international NGOs such as the Global witness who have alleged wide-spread illegal practices and
corruption taking place. For more information see Global Witness Reports ‘Cambodia’s Family Trees’
and ‘Country for Sale’ at www.globalwitness.org

                                                                                                     28
improvements in rural livelihoods. This will be of critical importance in the future as
natural resources come to play an increasingly important role in the generation of
local revenue, thus impacting on poverty reduction and other CMDGs. Moreover,
combination of legal and regulatory framework established under the NRM Sector
and Policy Development Component; the local governance capacity development
and mechanisms institutionalised under the D&D component; and the empowerment
of citizens under the Civil Society and Pro-Poor Market Opportunities (CSPPM)
component have set the stage for sustainable capacity development for pro-poor
natural resource management in Cambodia and therefore for accelerating progress
towards reaching CMDG 7.
CMDG8: Develop a global partnership for development
Both Paris Declaration and Accra Agenda for Action reflect the international
commitment to strengthening and using country systems to accelerate an effective
use of development assistance and help ensure the achievement of the MDGs by
2015.
The Multi-Donor Support Program for Aid Coordination (MDSP) is an innovative
capacity development initiative funded through partnership between UNDP, Australia,
Canada, UK/DFID and New Zealand which supports the Cambodian Rehabilitation
and Development Board at the Council for the Development of Cambodia
(CRDB/CDC). This programme directly contributes to capacity development for
CMDGs by supporting CDC/CRDB to mobilize and coordinate development aid, thus
strengthening Government ownership of the aid coordination process. MDSP
provides policy advice and logistical support to the CRDB to support aid coordination
processes at national and sub-national level through Technical Working Groups. It
also contributes to strengthened partnerships between the public sector, NGOs and
civil society at the national and sub-national levels. MDSP raises awareness on
harmonisation, alignment, and managing for results issues in RGC and among
donors and NGOs. It develops capacity for coordination and improving the aid
management information in all ministries and agencies. MDSP contributes to
strengthening government leadership and capacity to monitoring investments and
progress towards all CMDGs.
CMDG9: De-mining, UXOs and victims assistance
Given the importance of mine clearance to expanding the availability of land for
productive uses, and the health and well-being of people living in mine-affected
areas, Cambodia added a 9th goal to the MDGs. The 2005 target for clearance of
suspected contaminated areas was nearly achieved at 50 percent compared to a
baseline of 10 percent in 1995. Reducing the number of civilian casualties is proving
to be more difficult to achieve (Target 9.1) and may be because human habitats are
approaching the remaining more densely contaminated areas and due to dismantling
of UXOs for scrap metal by scavengers.
Jointly-funded programme (between UNDP, CIDA, AusAID, Sweden, Spain: Euros
800,000, and Adopt a Minefield) is a multi-donor funding facility for mine action,
which has been designed to build capacity of Cambodian Mine Action Authority
(CMAA) to address efficiency and transparency issues, support a systematic
integration of mine clearance with national and provincial development plans and
programmes, and build national capacities to provide independent quality assurance
and defining clearance standards. The programme helped clear nearly 15 million
square metres of priority land to be used for agriculture, resettlement, rural roads,
school and irrigation, thus contributing towards progress against most of the CMDGs.
Complementary local-level capacity development was provided by AusAID funding to
NGOs such as CARE, World Vision and AUSTCARE to implemented integrated mine
action programs such as the recently completed CARE Integrated Demining and
Development Project (IDDP) which worked with villagers on agricultural programs,

                                                                                    29
water and sanitation projects, community and institutional capacity building,
infrastructure, village mapping, and land tenure.
Table three, below, summarises overall progress towards the CMDGs.
Table Three: Achievements and gaps in realising CMDGs
      Achievements                                   Shortfalls
 1    Significant improvements in poverty rates      High rural poverty rates.
      in urban and more accessible rural areas.
 2    Expansion of primary education to more         Failure to increase net enrolments at
      children.                                      higher levels and achieve high survival
                                                     rates at all levels of education.
 3    Significant reduction in mortality rates for   Limited progress in achieving the goals
      both infants and undr-5 year olds.             of universal nine-year basic education
                                                     particularly those beyond primary
                                                     education.
 4    Improved immunization against         major    Gender disparity in secondary and
      childhood diseases.                            tertiary education.
 5    Improved breastfeeding rates                   Persistent high levels of domestic
                                                     violence.
 6    Reduction of gender disparity in most areas    Access to quality health services
      especially in primary education, adult         especially in case of women and
      literacy, and wage employment in               maternal health.
      agriculture and industry.
 7    Noteworthy reduction of communicable           Environmental degradation, especially
      diseases, especially HIV/AIDS.                 forest depletion and water resources.
 8    Improved urban access to safe water and        Natural resource management in rural
      rural access to improved sanitation.           areas constrained
 9    Reduced rates of civilian casualties from      Reducing casualties will become
      landmines and UXOs, clearing of                increasingly difficult as human habitats
      priority land to be used for agriculture,      are    approaching       more   densely
      resettlement, rural roads, school and          contaminated areas.
      irrigation




                                                                                           30
5.   CRITICAL FACTORS IN CMDG-RELATED CAPACITY DEVELOPMENT



Based on the analysis in the preceding sections it is possible to identify a number of
emerging issues and themes that appear to be particularly pertinent to capacity
development at the local level:
There is not yet a coherent approach to capacity development.
Every sector and central agency has its own capacity development needs, with a
narrow focus on sector needs rather than thinking in terms of integrated approach.
Hence, donor support risks creating overlapping and multiple capacity development
interventions. Innovative existing programmes, such as NRML, and new capacity
development approaches, such as NCDD, promote integrated approach to managing
and designing local level capacity development interventions, therefore mitigating this
risk. Moreover, there has been a continuing debate around managing the tension
between product and process, which has intensified with the recent emphasis on
results-based management.
Capacity and service delivery is strongly linked to economic growth.
This is necessary for achieving CMDGs and with 85 percent of Cambodian
population residing in rural areas, the greatest challenge for Cambodia lies in
alleviating rural poverty and avoiding inequality.
Commitment and incentives matter.                   Box 3: Incentives & commitment
Cambodian government's budget expenditure,
                                                    Teacher salaries are typically
including for service delivery, has seen            between USD 25-60 per month,
considerable increase, however much more            well below the minimum required
needs to be done not only in increasing             to secure a decent living. At the
allocations but also in ensuring that incentives    2009 Education Summit held in
are provided (see Box 3).                           Phnom Penh on 18 March 2009,
                                                    Prime Minister Hun Sen was
Formal capacity development is dependent            reported as saying that although
on aid-financing.                                   he really wanted to raise teachers’
As aid continues to fund the majority of CMDG-      salaries, he could not do so due to
related     investments,       enhancing      aid   budget constraints.
effectiveness will ensure that these services are
                                                    The 2009 budget, however, has
delivered in a coordinated manner and with a        accommodated            significant
longer-term view to capacity development and        increases in defence expenditure
achieving CMDGs.                                    and the Cabinet has been
There is a strong complementarity between           enlarged to 255 members – the
                                                    largest in the world – to create
public sector administrative reform and             posts for opposition defectors
decentralisation.                                   during the 2008 elections. Rongh
Current administrative reforms need to pay          Chun, President of Cambodian
more attention to this issue of complementarity.    Independent             Teachers’
Achieving CMDGs at local level requires sub-        Association, in response to the
national authorities and communes to have           Prime Minister's remarks also
financial and administrative decision-making        observed that members of the
power. Specific structure, functions, lines of      delegation that accompanies the
authority and responsibility, budgets and staff of  Prime Minister to events such as
different levels of government and different        the Education Summit receive
                                                    approximately     US$400         in
institutions have to be clearly specified. This will
                                                    expenses.
be provided within the 10-years National
                                                     Source: Phnom Penh Post, 20/3/2009
Programme for Sub-National Democratic
Development (NP-SNDD) which is currently
being developed and should be a key aspect of strengthening local capacity to
achieve CMDGs.
Public service pay is too low.
Current public sector salaries are not sufficient to ensure a living wage. This results
in lack of motivation and spurring public servants, teachers and health workers alike
to absenteeism from work and rent-seeking behaviour27. Incentives and rewards to
encourage retention and motivation of staff are lacking, which results in under-
utilisation of existing capacities or capacity attrition. The approach to providing
financial incentives, however, remains largely fragmented through the provision of
uncoordinated salary supplements by donors, thus creating complex challenges for
capacity development. Moreover, this also presents challenges for the transition
towards unitary sub-national management proposed under D&D reforms28.There is
consensus among development partners that this approach is inefficient and
therefore steps have been taken towards aligning around and harmonising with the
Government’s MBPI scheme under the guidance and leadership from the Council for
Administrative Reform.
Incentives are skewed.
Public sector in Cambodia is characterised by the dichotomy between the ‘formal’
and ‘informal’. Encouraging senior managers in the public service to improve
performance or support effective capacity development requires incentives which are
lacking. Moreover, most of officials working in local government are accountable to
their party, rather than to their senior management or elected representatives.
Hence, public service administration is highly politicised and opaque. The shift from
the current state to a public sector that is more formal, merit-based and performance-
oriented will likely take a very long time. In response to this, the NP-SNDD that is
currently being developed includes careful consideration of how to incorporate
efficient and effective merit-based performance management systems for sub-
national level accountability.
There is still a need for more trained and experienced staff.
The middle and lower level of public service is in particular need for trained and
experienced staff that would fill the policy implementation gap that currently exists
between central and local levels. This is an urgent need in the light of upcoming
District and Provincial elections in May 2009 which will see further increase in the
numbers of staff at sub-national level.
There is a lack of capacity to manage change.
Sector ministries need capacity development to enable them to adapt to new context
of decentralisation, to effectively interface with sub-national authorities, and in
particular to strengthen capacity for policy coordination and dialogue, programme
monitoring, financial control and technical mentoring. However, due to the lack of
local level capacity development plans, donors appear to focus too much attention on
supplying capacity development to the local level and too little time on developing
local level capacity to manage the process and implementation of change. With
introduction of capacity development strategy within the National Programme for
D&D, donor efforts may adopt a more ‘active learning’ approach.
Effective engagement in dialogue will have a positive capacity impact.

27
   Maream Dam, a 14-year-old eighth-grader at Chaktomuk Secondary School estimated in a recent
interview that she pays between 30,000 and 40,000 riel (roughly US$7.25 and $9.75) each month in
"informal fees" collected by teachers for supplies - such as lesson paper and pens - that are supposed
to be free. "If I don't buy them, I will get a low score or I will not pass the exam, even though I am an
outstanding student" she said. (Source: Dropout rates mar Cambodia's MDG quest for 'education for all',
Robbie Corey-Boulet and Mom Kunthear, The Phnom Penh Post, Friday, 20 February 2009)
28
   Ad hoc salary supplementation by projects and programs is pervasive. For example, a midwife
working in a health centre or Operational District (OD) hospital potentially receives payments from 4 or
more vertical programs, in addition to payments from several OD and facility revenue sources
(government budget, user fees, Community Based Health Initiatives, contracting NGOs).

                                                                                                      32
Cambodian NGOs are increasingly involved in capacity development for local service
delivery and aside from being a legitimate actor in local governance, they are taking
on new role in a decentralising context. This includes a role in local policy process for
creating space and opportunity for local-level dialogue on matters such as localising
MDGs and strengthening local accountability. Moreover, civil society is also taking on
new role in preparing community leaders and political representatives for increased
local level service delivery and health and education system management and
oversight. NGOs have a role to play in developing communities’ awareness of users’
rights as well as establishing mechanisms to improve interaction between local level
service providers and users at operational level. This implies that in the
decentralisation context, NGOs will themselves require capacity development for
effective engagement and dialogue.
Community participation in local service delivery promotes awareness and
demand.
With increasing strengthening of local level service providers, the NGO role will need
to evolve towards developing local capacity for demanding services, for active
participation in education and health service planning, policy development, service
delivery and ongoing evaluation of services.
Capacity development as a complex process – how do we learn and apply
lessons?
Performance monitoring of capacity development interventions is undertaken by most
donors on a regular basis through a project-specific system. However, local level
capacity development interventions are often output-based, putting emphasis on
delivery of products instead of focusing on the capacity development as a process.
Therefore, monitoring and evaluation frameworks for capacity building interventions
at local level require indicators that will focus on process, allowing time for effective
capacity to be developed.




                                                                                      33
6. CONCLUSIONS

A review of the data and accompanying literature on progress towards the CMDGs
shows that much has been achieved to enable local capacity development for CMDG
localisation. The foundations laid at national and sub-national level are now relatively
well established and the D&D reforms, under the 2008 Organic Law provide an
opportunity for accelerating capacity or improved service delivery at sub-national
level. Monitoring and evaluation systems are also beginning to emerge to motivate
performance and to enable learning. But despite this progress much more needs to
be done. Capacity development will be the key determinant of securing Cambodia's
further progress towards the CMDGs.
To conclude, it is helpful to return to the questions that guided this research:
What are the prevailing and emerging perceptions of and approaches to
capacity development, particularly at the local level?
       The decentralisation and deconcentration reforms provide the framework for
       local level capacity development. They are expected to delegate significant
       government responsibilities to provincial, district and commune levels. In this
       context, the line ministries will need to move from an integrated model of
       service delivery management and financing to an approach that places
       greater emphasis on its regulatory and enforcement role, that develops ways
       of exercising leadership, and that engages with lower levels of Government
       on national CMDG priorities. The decentralisation policy therefore increases
       the scale and need for capacity building at lower levels of Government.

       The Public Administration Reform is perhaps the most critical of the core
       reforms that will underpin other achievements in reaching CMDGs through
       the impact of new policies on public service delivery advocating greater
       autonomy for service delivery units, and the adoption of civil servant incentive
       reforms.

       Similarly, the Cambodia Public Finance Management Reform Programme
       depends on developing local level capacity through strengthening the
       financial management systems at sub-national level, including budgeting and
       expenditure management systems.

       The increased level of downward accountability, envisioned in the D&D
       reforms, requires greater consultation with citizens, access to information and
       transparency in general. However, developing supply side of accountability is
       not enough. Developing capacities to demand accountability from the state
       therefore represents and important requirement for achieving CMDGs.

What are the institutions that have been the primary targets for local level
capacity development initiatives? What budgetary allocations have been
targeted for local-level capacity development?
Commune and Sangkat Councils have been the primary targets for local capacity
development initiatives to date. With the new 10-years’ National Programme for Sub-
National Democratic Development capacity development demands will also be
placed on the provinces and districts/municipalities.
The national budget included estimated US$ 265m for priority sectors (health,
education, agriculture, and rural development) in 2008. Of the 2008 national budget
2.7 percent was allocated specifically to the Commune/Sangkat Council Fund.
Development partners’ investment in Cambodia in 2008 amounted to nearly USD
890m, of which USD 531m was targeting the sub-national authorities. Within this
allocation direct contributions to NCDD for sub-national capacity development are
valued at over USD 70 million annually of which             investments into the
Commune/Sangkat (C/S) Funds are valued at around USD 20 million annually. This
fund allocations have been used by the Commune/Sangkat councils to directly meet
their communities’ needs through planning and managing participatory projects.
What are the existing and emerging government and donor investment policies
and practices in local-level capacity development?

Existing and emerging government and donor investment policies and practices in
local capacity development include Seila/Project to Support Democratic Development
(PSDD) which was continued by the National Committee for Decentralisation and
Deconcentration (NCDD) in 2007. These policies have significantly enhanced
knowledge and skills and increased the credibility of the commune councils through
strengthening skills in needs assessment and translating these into action
(development) plans for implementation.
Complementary emerging government and donor practices in capacity development
include strengthening demand for good governance and sector programmes, such as
CNM and NCHADS.

What are the emerging good practices of government and donor initiatives on
successful investment in local capacity development that have the most
potential for accelerating MDG progress?

NCDD is the emerging good practice of successful investment in local capacity
development. Complementary example is NRML project which uses NCDD for
channelling support to commune council’s capacity development initiatives for natural
resource management. In addition, the key to ensuring prioritised and predictable
resourcing for informed planning is achieved through coherent sector programmes
supported by PFM.

Are prevailing and emerging perceptions of and approaches to capacity
development gender responsive at the local level?

The prevailing and emerging perceptions of and approaches to capacity development
are in principle gender responsive at the local level. In practice, however existing
traditional and cultural barriers need to be broken down for formal policies to be
effective.
                                  -----------------------

Investments in local government capacity development for MDG localisation in
Cambodia need to be viewed as a change management process intended to
transform local level service delivery agencies so that they can achieve their
development vision and play their part in meeting the CMDG targets and other
national priorities. Managing this process successfully will require local governments
to work towards developing the following capacities:
 •   Ability to look beyond capability to deliver core functions and technical
     services. Whilst this is necessary, it is not sufficient. Cambodian local
     government is geared towards administrative processes for routine operations of
     implementing ‘higher level goals’ which is no longer sufficient. Sub-national
     authorities and commune councils will need to improve their working practices to
     strengthen service delivery and demonstrate what results are being achieved.
     Local government will need to introduce new ways of working and equip staff
     with the appropriate capacity (tools and skills) to do their jobs better, thus

                                                                                   35
    enabling commune councillors to effectively respond to change and challenges
    of improved service delivery. RGC will therefore need to re-think and enhance
    core management skills as well as processes in sub-national and local
    authorities.
•   Capability to manage change and adapt. This is fundamental to long-term
    institutional and organisational sustainability. Sub-national authorities and
    commune councils will face continuous challenge to become more responsive,
    flexible and more efficient. As they strive to become more effective, to grow and
    to establish their role as service providers, they must change the old values and
    perceptions, particularly the patronage system related values and behaviours.
    Adapting to change, however, is not the only thing the sub-national authorities
    will have to do. Besides changing, the sub-national authorities and local service
    providers must learnt to provide services to Cambodians in a satisfactory way
    and continue to do so while improving the governance systems, thus demanding
    a two-fold approach to capacity development.
•   Capability to dialogue, maintain and manage multiple relationships.
    Provincial, district and commune councils are a part of complex network of
    relationships upward, downwards and horisontal which include all stakeholders
    in local development: sub-national authorities, sector Ministry staff, local
    population, NGOs, development partners. These relationships will result in
    different lines of accountability which have to be managed.
•   Capability to motivate, inspire and earn legitimacy. Local level capacity
    development offers opportunities to enhance the capabilities and accountability
    of province, districts and commune councils, which is essential for achieving the
    CMDGs and other development objectives. However, it requires balancing
    political and administrative dimensions, and creating local level legitimacy.
    Capacity development initiatives that are poorly designed and implemented will
    not contribute to sustainable development of CMDGs and, in a worse case
    scenario may result in inertia in the effort to attain the MDG targets.
•   Capability to monitor capacity development. There is much written about
    monitoring and evaluation for upward accountability and, more recently, for
    downward and horisontal accountability too. However, monitoring and
    evaluation should be used as learning tools, rather that just to ‘tick boxes’.
    Efficient monitoring and evaluation for capacity development requires combining
    learning and accountability i.e. having qualitative & quantitative, multiple
    perspectives. In addition, indicators for monitoring and evaluation can also be
    used as incentives, for example to increase performance towards attaining
    CMDGs.




                                                                                  36
ANNEX 1 - Benchmarks, performance and target values for CMDG indicators

Note:
1. List of CMDGs, base year and targets for 2005, 2010 and 2015, are from CMDG
Report, 2003.
2. Achievements as in 2005 are compiled from CMDG Update (MOP, October 2005),
MDG report (MoP, 2007), MDG World Development Indicators Database; and United
Nations Statistics Database (UNSD)

CMDG 1: Eradicate extreme poverty and hunger

Indicator                                     Benchmarks     2005             Target
                                              Value          Target   Value   2010 2015
1.1 Proportion of people whose income is      39      1993   31       34.7    25     19.5
less than the national poverty line (%)
1.2 Share of poorest quintile in national     7.4    1993    9                10     11
consumption (%)
1.3 Proportion of working children aged 5-    16.5   1999    13       22.3    10.6   8
17 years old (%)
1.4 Prevalence of underweight (weight for     45.2   2000    36       n.a.    29     22.6
age <2SD ) children under five years of
age (%)
1.5 Proportion of population below the food   20     1993    16       19.7    13     10
poverty line (%)
1.6 Prevalence of stunted (height for age     44.6   2000    35       n.a.    28     22
<2SD) children under five years of age (%)
1.7 Prevalence of wasted (weight for height   15     2000    13       n.a.    10     9
<2SD) children under five year of age (%)
1.8 Proportion of households using iodized    14     2000    80       31.5    90     90
salt (%)

CMDG 2: Achieve universal primary education

Indicator                                     Benchmarks     2005             Target
                                              Value          Target   Value   2010 2015
2.1 Net admission rate (%)                    81      2001   95       81.0    100    100
2.2 Net enrolment ration in primary           87      2001   95       89.9    100    100
education (%)
Male                                          90     2001    96               100    100
Female                                        84     2001    94               100    100
2.3 Net enrolment ration in lower             19     2001    50       26.1    75     100
secondary education (%)
Male                                          21     2001    51               75     100
Female                                        16     2001    49               75     100
2.4 Proportion of 6-14 years old out of       35     1999    22       18.7    11     0
school (%)
2.5 Survival rate from grade 1 to 5 (%)       58     2001    77       59.2    100    100
2.6 Survival rate from grade 1 to 6 (last     51     2001    73       53.1    100    100
grade of primary cycle) (%)
2.7 Survival rate from grad 1 to 9 (last      33     2001    52       30.18   76     100
grade of basic cycle) (%)
2.8 Literacy rate of 15-24 years old (%)      82     1999    90       83.4    95     100
2.9 Ratio of girls to boys in primary         87     2001    98       89.5    100    100
education (%)
2.10 Ratio of girls to boys in lower          63     2001    96       77.0    100    100
secondary education (%)
CMDG 3: Promote gender equality and empower women

Indicator                                       Benchmarks     2005             Target
                                                Value          Target   Value   2010 2015
3.1Rtion of girls to boys in upper secondary    48      2001   59       59.9    80     100
education (%)
3.2 Ratio of females to males in tertiary       38     2001    50       45.6    70    85
education (%)
3.3 Ratio of literate females to mates 15-24    87     1998    95       90.0    100   100
years old (%)
3.4 Ratio of literate females to males 25-44    78     1998    85       80.0    100   100
years old (%)
3.5 Female share in wage employment in          35     1998    50       52.5    50    50
agriculture (%)
3.6 Female share in wage employment in          44     1998    50       53.5    50    50
industry (%)
3.7 Female share in wage employment in          21     1998    30       37      37    50
service (%)
3.8 Proportion of seats held by women in        12     2003    17       24      24    30
national assembly (%)
3.9 Proportion of seats held by women in        13     2003    17       14      24    30
Senate (%)
3.10 Proportion of female Minister (%)          8      2003    9        12      12    15
3.11 Proportion of female Secretaries of        6      2003    8        15      15    18
State (%)
3.12    Proportion      of   female    Under    5      2003    8        17      17    20
Secretaries of State (%)
3.13 Proportion of female provincial            0      2003    3        6       6     10
governors (%)
3.14 Proportion of female deputy provincial     1      2003    4        8       8     15
governors (%)
3.15 Proportion of seats held by women in       8      2003    8        14.6    15    25
commune councils (%)
3.16 Population percentage aware that           n.a    n.a     25       50      50    100
violence against women is wrongful
behaviour and a criminal act (%)
3.17 Proportion of cases of domestic            n.a    n.a     20       50      50    100
violence counselled by qualified personnel
(%)
3.18 Laws against all forms of violence
against women and children are developed
and implemented according to international
requirements and standards
3.19 Statistics to monitor violence against
women collected annually
3.20 A prevention plan developed and
implemented

CMDG 4: Reduce child mortality

Indicator                                       Benchmarks     2005             Target
                                                Value          Target   Value   2010 2015
4.1 Under-five mortality rate (per 1,000 live   124     1998   105      82      85     65
births)
4.2 Infant mortality rate (per 1,000 live       95     1998    75       66      60    50
births)
4.3 Proportion of children under 1 year         41.4   2000    80       80      85    90
immunized against measles (%)
4.4 Proportion of children aged 6-59            28     2000    70       n.a.    80    90
months receiving Vitamin A capsules (%)

                                                                                      38
4.5 Proportion of children under 1 year          43     2000    80       83      85    90
immunized against DPT3 (%)
4.6 Proportion of infants exclusively            11.4   2000    20       n.a.    34    49
breastfed up to 6 months of age (%)
4.7 Proportion of mothers who start breast-      11     2000    28       29.3    45    62
feeding newborn child within 1 hour of birth
(%)

CMDG 5: Improve maternal health

Indicator                                        Benchmarks     2005             Target
                                                 Value          Target   Value   2010 2015
5.1 Maternal mortality ratio (per 100,000        437     1997   343      n.a.    243    140
live births)
5.2 Total fertility rate                         4      1998    3.8      3.3     3.4   3.0
5.3 Proportion of births attended by skilled     32     2000    60       n.a.    70    80
health personnel (%)
5.4 Proportion of married women using            18.5   2000    30       40      44    60
modern birth spacing methods (%)
5.5 Percentage of pregnant women with 2          30.5   2000    60       69      75    90
or more ANC consultation from skilled
health personnel (%)
5.6 Proportion of pregnant women with Iron       66     2000    50       n.a.    39    33
Deficiency Anemia (%)
5.7 Proportion of women aged 15-49 with          21     2000    17       n.a.    12    8
BMI<18.5Sq.meter (%)
5.8 Proportion of women aged 15-49 with          58     2000    45       n.a.    32    19
Iron Deficiency Anemia (%)
5.9 Proportion of pregnant women who             0.8    2000    2        0.8     3     4
delivered by Caesarean Section (%)

CMDG 6: Combat HIV/AIDS, malaria and other diseases

Indicator                                        Benchmarks     2005             Target
                                                 Value          Target   Value   2010 2015
6.1 HIV prevalence rate among adults             3.0     1997   2.3      1.9     2.0    1.8
aged 15-49 (%)
6.2 HIV prevalence rate among pregnant           2.5    1998    2.4      2.1     2.0   1.5
women aged 15-24 visiting ANC (%)
6.3 Condom use rate among commercial             91     2002    98       96.7    98    98
sex workers during last commercial sexual
intercourse (%)
6.4 Percentage of young people aged 15-          82     2002    85       n.a.    90    95
24 reporting the use of a condom during
sexual intercourse with a non-regular
sexual partner (%)
6.5 Proportion of condom use reported by         1      2000    2        n.a.    5     10
marred women who identified themselves
at risk (%)
6.6 Percentage of HIV infected pregnant          2.7    2002    10       3.8     35    50
women attending ANC receiving a
complete      course     of     antiretroviral
prophylaxis to reduce the risk of MTCT (%)
6.7 Percentage of people with advanced           3      2002    25       45      60    75
HIV infection receiving antiretroviral
combination therapy (%)
6.8 Malaria case fatality rate reported by       0.4    2000    0.3      0.36    0.2   0.1
public health sector (%)
6.9 Proportion of population at high risk        24     1998    80       49      95    98
who slept under insecticide-treated bed

                                                                                       39
nets during the previous night (%)
6.10 Number of malaria cases treated in       11.4    2000   9        7.3     7      4
the public health sector per 1 000
population
6.11 Proportion of public health facilities   60      2002   70       n.a.    80     95
ale to confirm malaria diagnosis according
to national guidelines with 95% accuracy
(%)
6.12 Number of dengue cases treated in        1       2001   0.8      0.84    0.6    0.4
the public health sector per 1 000
population
6.13 Dengue case fatality rate reported by    1.5     2003   1        0.74    0.5    0.3
public health facilities (%)
6.14 Prevalence of smear-positive TB per      428     1997   321      n.a.    214    135
100 000 population
6.15 TB deaths rate per 100 000               90      1997   68       n.a.    45     32
population
6.16 Proportion of all estimated new          57      2002   70       61      >70    >70
smear-positive TB cases detected under
DOTS (%)
6.17 Proportion of registered smear-          89      2002   >85      n.a.    >85    >85
positive TB cases successfully treated
under DOTS (%)

CMDG 7: Ensure environmental sustainability

Indicator                                     Benchmarks     2005             Target
                                              Value          Target   Value   2010 2015
7.1 Forest coverage as a percentage of        60      (a)    60       58      60     60
total area (%)
7.2 Surface of 23 protected areas (million    3.3     1993   3.3      n.a.    3.3    3.3
hectares)
7.3 Surface of 6 new forest-protected areas   1.35    1996   1.35     n.a.    1.35   1.35
(million hectares)
7.4 Number of rangers in protected areas      600     2001   772      n.a.    987    1,200
7.5 Number of rangers in forest protected     500     2001   500      n.a.    500    500
areas
7.6 Proportion of fishing lots allocated to   56      1998   58       56.46   60     60
total communities (%)
7.7 Number of community-based fisheries       264     2000   364      375     464    589
7.8 Surface of fish sanctuary (thousand ha)   264     2000   581      n.a.    581    581
7.9 Fuel wood dependency (% of                92      1993   70       83.9    61     52
household)
7.10 Proportion of rural population with      24      1998   39       41.6    40     50
access to safe water source (%)
7.11 Proportion of urban population with      60      1998   68       75.8    74     80
access to safe water source (%)
7.12 Proportion of rural population with      8.6     1998   12       16.4    20     30
access to improved sanitation (%)
7.13 Proportion of urban population with      49      1998   59       55      67     74
access to improved sanitation (%)
7.14 Percentage of land parcels having        15      2000   16       16      32     65
titles in both urban and rural areas (%)
(a) The benchmark is the average forest coverage in the last decade (1992-2002)

CMDG 8: Develop a global partnership for development

Indicator                                     Benchmarks     2005             Target
                                              Value          Target   Value   2010 2015
Aid (% of GNI)                                15      1995            10

                                                                                     40
Exports of goods and services (% of GDP)         31         1995                55
Debt service (PPG and IMF only, % of             1.5        2000                1.0
exports of goods and services, excl.
workers' remittances)
Internet users (per 100 people)                  n.a.                           0.5
Fixed lines and mobile telephones (per           7          1995                54
1000 people)
Note: No clear targets set by RGC for CMDG 8 since it requires a qualitative assessment, hence the
data in the table above is based on 2007 indicators used in the World Development Indicators Database
instead.

CMDG 9: De-mining, UXO and assistance

Indicator                                        Benchmarks          2005                Target
                                                 Value               Target     Value    2010 2015
9.1 Annual numbers of civilian casualties        1691    1993        500        797      200    0
recorded
9.2 Percentage of severe/high/medium/low         10         1995     51         50.3     77      100
suspected contaminated areas cleared (%)
9.3 A comprehensive victim assistance
framework developed and implemented
9.4 Numbers of landmine/UXO victims              n.a.       n.a      To    be   To be    To      To
receiving an assistance package and                                  set        set      be      be
integrated into the society.                                                             set     set
Note: The comprehensive victim assistance framework was developed in 2007




                                                                                                  41
ANNEX II: MAP OF CAMBODIAN PROVINCES
ANNEX III: PUBLIC EXPENDITURE AND AID FOR LOCAL LEVEL
CAPACITY DEVELOPMENT


Table 3.1.: Cambodia’s Central Government Expenditure ($ millions)
Source: Cambodia Economic Watch, Economic Institute of Cambodia, October 2008.

                                  2005           2006         2007             2008                2009
                                                              (provisional)    (provisional)       (provisional)
Total Expenditure                 777.61         1,002.19     1,242.85         1,612.25            1,828.50
Current Expenditure               480.69         631.73       762.08           1049.25             1251.75
Civil Administration              370.48         505.00       594.18           794.75              959.50
 Priority Sector                  157.38         192.79       195.02           265.00              320.50
(Health, Education, Agriculture
and Rural Development)
 Other Civil Ministries           213.10         312.21       399.16           529.50              639.25
Defence & Security                110.22         126.74       167.90           254.50              292.25
 Defence                          70.63          83.84        124.51           190.75              215.25
 Security                         39.59          42.90        43.39            63.75               76.75
Capital Expenditure               296.92         370.46       480.77           563.00              576.75
 Through             National     76.98          92.37        108.48           179.50              167.00
 Treasury
 Direct External Financed         219.94         278.09       372.29           383.50              409.75
 Memorandum Items
 Wages                            156.40         173.29       202.66           405.25              485.25
 Non-Wages        Operating       276.15         306.12       436.39           644.00              766.50
Costs


Table 3.2.: NSDP Allocations 2006 – 2010 (USD million)
                                                                       2008                          2006   -
                                           2006           2006     %                  2008     %
Sector                                                                 MTR                           2008 %
                                           NSDP           allocation                  allocation
                                                                       revision                      change
Social Sectors
Education (basic = 60%)                    550            15.71%       670            15.95%         22%
Health                                     600            17.14%       720            17.14%         20%
  Sub-Total                                1150           32.85%       1,390          33.10%         21%
Economic Sectors
Agriculture & Land Mgmt: other
than crops                                 150            4.29%        200            4.76%          33%
  Seasonal crops: rice etc                 200            5.71%        370            8.81%          85%
Rural Development                          350            10.00%       420            10.00%         20%
Manufacturing, Mining & Trade              80             2.29%        100            2.38%          25%
  Sub-Total                                780            22.29%       1,090          25.95%         40%
Infrastructure
Transportation       (Primary &
Secondary Roads)                           550            15.71%       690            16.43%         25%
Water and Sanitation (excluding
rural)                                     150            4.29%        180            4.29%          20%
Power & Electricity                        120            3.43%        160            3.81%          33%
Post & Telecommunications                  60             1.71%        75             1.79%          25%
  Sub-Total                                880            25.14%       1,105          26.31%         26%
Services & Cross Sectoral
Programmes
Gender Mainstreaming                       30             0.86%        40             0.95%          33%
Tourism                                    30             0.86%        45             1.07%          50%
Environment and Conservation               100            2.86%        120            2.86%          20%
Community and Social Services               80            2.29%          100           2.38%         25%
Culture & Arts                              30            0.86%          40            0.95%         33%
Governance & Administration                 220           6.29%          270           6.43%         23%
 Sub-Total                                  490           14.00%         615           14.64%        26%
Unallocated                                 200           5.71%
Grand Total:                                3,500         100%           4,200         100%          20%
Source: CDC/CRDB: RGC 2008b, MoP: NSDP 2006 Table 5.2 and MoP: NSDP MTR 2008 Table 4.3
Note. In 2006 the sum estimated to secure full resourcing of the NSDP was $3.5 billion over 5 years. This was
increased to $4.2 billion in 2008 after the mid-term review.

Table 3.3.: Development Partner Disbursements ($ million) 2004–200829
Source: CDC/CRDB, Cambodia ODA Database.

                                                             2007
Development                                                                           2008 (estimated)
                        2004        2005         2006        (provisional)
Partner
                                                             $m        %              $m          %
Japan                   101.8       111.7        103.7       122.1     15.4           144.6       16.3
China                   32.5        46.6         53.2        92.4      11.7           127.9       14.4
ADB                     76.7        89.4         67.5        69.4      8.8            114.0       12.8
UN (core)               36.3        41.1         54          52.4      6.6            94.1        10.6
World Bank              49.5        37.8         24.5        47.6      6.0            57.1        6.4
USA                     40.6        43.3         51          58.1      7.4            54.9        6.2
EC                      15          23.7         46.5        44.9      5.7            52.1        5.9
UK                      17          20.6         20.7        23.7      3.0            37.8        4.3
France                  23          24.4         21.8        21.8      2.8            33.3        3.8
Germany                 14.1        27.3         32.4        36.5      4.6            33.0        3.7
Global Fund              –-         18.8         21.9        21.1      2.7            32.3        3.6
Australia               24.3        16.8         22.5        29.6      3.7            23.0        2.6
Canada                  1.5         9.1          7.9         8.7       1.1            19.2        2.2
Sweden                  22.0        13.6         16          17.3      2.2            17.9        2.0
Republic of Korea       24.1        14.9         13.3        31.4      4.0            12.1        1.4
Denmark                 5.8         4.8          4.1         9.8       1.2            10.1        1.1
Spain                                            2.8         4.1       0.5            7.4         0.8
Finland                 3.3         3.3          4.5         5.2       0.7            6.8         0.8
Switzerland             3.2         2.8          2.4         3.6       0.5            3.8         0.4
Belgium                 5.2         11.7         7.3         8         1.0            3.3         0.4
New Zealand             2.4         2.1          1.7         3.8       0.5            3.3         0.4
IMF                     2.4         0.3          83.5        0.9       0.1             –-          –-
Netherlands             1.6         1.1          0.1         0.1       0.0             –-          –-
Norway                  3.4                                                            –-          –-
NGO (core)              49.4        44.7         50.2        77.7         9.8          –-          –-
TOTAL                   555.1       609.9        713.5       790.2        100.0       888         100.0
Annual          %
increase                            9.8          16.9        10.8                     12.3




29
  The development assistance data here and in Tables 3.4. and 3.5. below is taken from the Council for
Development in Cambodia’s database, which is used by Cambodia government and all development
partners and provides accurate information, including data for countries not included in the OECD/DAC
database which is used as the source for most Country Programme Evaluations. The data is consistent
with the DAC source and so comparisons with other evaluations are possible.

                                                                                                          44
Table 3.4.: Donor Disbursement by Sector 1998–2007
Source: CDC/CRDB Cambodia ODA database
                                                                                         Total
                                                                                         Disbursements
SECTOR              2003           2004         2005           2006           2007
                                                                                         2003–2007
                                                                                         US%’000 %
Health              83,097         95,867       110,299        109,024        111,159    509,446   15.9%
Education           75,023         73,421       69,278         79,725         88,160     385,607   12.0%
Agriculture         37,790         45,261       33,819         123,499        43,281     283,650   8.8%
Manufacturing,
Mining Trade        1,732          6,953        9,966          24,184         15,662     58,497      1.8%
Rural
Development         35,878         60,484       50,005         49,852         70,976     267,195     8.3%
Banking and
Business
Services                                        12,720         9,736          15,571     38,027      1.2%
Urban Planning
& Management                                    3,926          935            1,956      6,817       0.2%
Information &
Communications      1,172          1,207        857            9,914          31,300     44,450      1.4%
Energy, Power
& Electricity       20,270         12,871       15,632         13,736         12,610     75,119      2.3%
Transportation      65,607         81,959       73,855         54,828         99,175     375,424     11.7%
Water and
Sanitation          22,906         4,882        24,494         18,237         17,420     87,939      2.7%
Community and
Social Welfare      81,024         43,748       35,324         38,531         52,179     250,806     7.8%
Culture & Arts      15,937         18,425       4,795          14,114         7,171      60,442      1.9%
Environment &
Conservation        18,181         19,586       12,308         14,587         8,925      73,587      2.3%
Gender                                          2,591          3,850          6,406      12,847      0.4%
HIV/AIDS                                        25,358         35,381         40,974     101,713     3.2%
Governance &
Administration      58,441         46,838       67,347         96,827         109,899    379,352     11.8%
Tourism                                         1,242          2,505          3,043      6,790       0.2%
Budget &
Budget Support                                  11,097                        29,131     40,228      1.3%
Emergency &
Food Aid                                        3,038          383            2,068      5,489       0.2%
Other               22,450         43,889       42,002         13,395         23,311     145,047     4.5%
Total
Disbursements       539,507        555,392      609,953        713,241        790,377    3,208,470   100.0%


Table 3.5.: Donor and NGO aid disbursement and commitments for provinces
2006-2010 (US$ thousands)
Source: The Cambodia Aid Effectiveness Report, CRCB/CDC, 2008

 Province        Group                                2006           2007       2008       2009      2010
 Banteay         United Nations Agencies              1,941          1,729      1,393      1,438     1,448
 Meanchey        IFIs                                 5,469          6,998      12,037     7,971     2,900
                 European Union                       2,094          3,628      4,523      4,427     2,592
                 Bilateral                            4,840          2,580      2,224      1,700     1,034
                 NGO                                  858            1,730
                 TOTAL                                15,203         16,665     20,177     15,536    7,975
 Battambang      United Nations Agencies              1,758          1,640      1,054      991       823
                 Int'l Financial Institutions         5,688          4,475      7,318      3,171     3,570
                 European Union                       3,789          5,002      6,524      5,229     2,592
                 Bilateral                            7,038          7,601      12,179     8,201     7,101
                 NGO                                  3,408          3,516
                 TOTAL                                21,682         22,235     27,074     17,592    14,086
 Kampong Cham    United Nations Agencies              2,060          1,472      2,831      2,900     2,920
                 Int'l Financial Institutions         1,271          963        1,695      488

                                                                                                              45
Province       Group                          2006     2007     2008     2009     2010
               European Union                 4,848    7,171    5,018    3,897    2,881
               Bilateral                      4,880    9,971    18,485   7,409    4,435
               NGO                            2,919    4,571
               TOTAL                          15,978   24,148   28,029   14,693   10,236
Kampong        United Nations Agencies        1,343    1,396    2,251    2,285    2,293
Chhnang        Int'l Financial Institutions   2,475    1,904    3,800    2,131    1,870
               European Union                 826      1,928    2,009    1,112    252
               Bilateral                      377      1,627    6,643    16,306   6,255
               NGO                            1,177    1,843
               TOTAL                          6,198    8,699    14,702   21,835   10,670
Kampong Speu   United Nations Agencies        2,946    2,753    2,990    3,143    2,587
               Int'l Financial Institutions   1,217    927      2,700    908      350
               European Union                 2,247    4,296    3,767    2,909    2,615
               Bilateral                      2,053    1,194    727      941      22
               NGO                            1,110    1,652
               TOTAL                          9,572    10,822   10,183   7,901    5,574
Kampong Thom   United Nations Agencies        3,593    2,933    3,985    3,447    2,899
               Int'l Financial Institutions   6,418    4,823    7,829    3,424    1,870
               European Union                 5,382    5,936    5,033    5,202    6,278
               Bilateral                      1,055    2,115    7,072    10,193   12,194
               NGO                            940      1,754
               TOTAL                          17,387   17,562   23,919   22,265   23,241
Kampot         United Nations Agencies        1,265    974      1,019    421      273
               Int'l Financial Institutions   2,012    2,448    6,624    6,297    8,130
               European Union                 1,874    2,215    4,951    17,888   4,168
               Bilateral                      4,852    7,847    1,194    1,997    4,056
               NGO                            789      517
               TOTAL                          10,792   14,001   13,787   26,603   16,627
Kandal         United Nations Agencies        739      542      740      748      753
               Int'l Financial Institutions   276      1,279    5,331    3,988    3,010
               European Union                 216      705      857      516      233
               Bilateral                      24,101   48,605   70,935   27,183   10,856
               NGO                            1,332    2,666
               TOTAL                          26,664   53,796   77,864   32,435   14,853
Koh Kong       United Nations Agencies        154      124      98       127      129
               Int'l Financial Institutions   83       136      153      169      600
               European Union                 587      1,517    1,370    1,442    1,174
               Bilateral                      368      1,050    429      294      114
               NGO                            956      1,576
               TOTAL                          2,148    4,403    2,049    2,031    2,017
Kracheh        United Nations Agencies        155      447      518      815      817
               Int'l Financial Institutions   372      498      1,341
               European Union                 699      2,685    3,278    2,351    1,329
               Bilateral                      8,410    13,450   26,842   11,850   5,304
               NGO                            373      908
               TOTAL                          10,009   17,987   31,979   15,016   7,451
Mondul Kiri    United Nations Agencies        112      127      105      137      131
               Int'l Financial Institutions   83       136      113      69
               European Union                 418      1,303    1,804    2,047    2,701
               Bilateral                      4,393    6,537    9,360    8,737    114
               NGO                            271      433
               TOTAL                          5,277    8,537    11,381   10,990   2,947
Phnom Penh     United Nations Agencies        3,914    4,556    9,147    2,963    1,435
               Int'l Financial Institutions   1,463    1,671    2,995    2,273    350
               European Union                 5,227    6,925    11,722   6,037    10,156
               Bilateral                      42,395   35,199   25,860   15,329   7,391
               NGO                            15,163   22,339
               TOTAL                          68,162   70,690   49,723   26,602   19,332
Preah Vihear   United Nations Agencies        203      460      1,116    1,444    1,381
               Int'l Financial Institutions   619      890      2,453    1,138
               European Union                 1,700    1,257    1,646    1,417    1,094
               Bilateral                      1,057    1,641    6,692    8,037    7,842
               NGO                            348      880
               TOTAL                          3,928    5,128    11,908   12,036   10,318
Prey Veng      United Nations Agencies        4,378    4,476    5,876    5,503    5,046
               Int'l Financial Institutions   1,603    605      1,635    488
               European Union                 1,543    2,435    2,208    1,401    847
               Bilateral                      1,530    8,142    17,903   8,845    3,683
               NGO                            692      1,707
               TOTAL                          9,747    17,365   27,623   16,236   9,575
Pursat         United Nations Agencies        379      405      1,910    1,847    1,846
               Int'l Financial Institutions   3,230    2,599    5,520    3,081    3,195
               European Union                 2,452    2,916    2,256    2,732    1,569

                                                                                           46
Province         Group                          2006      2007      2008      2009      2010
                 Bilateral                      625       928       1,225     647       647
                 NGO                            518       1,173
                 TOTAL                          7,204     8,021     10,911    8,307     7,257
Ratanak Kiri     United Nations Agencies        72        382       439       734       736
                 Int'l Financial Institutions   1,463     933       1,113     1,119
                 European Union                 308       2,183     2,663     2,884     1,379
                 Bilateral                      475       760       781       294       114
                 NGO                            312       404
                 TOTAL                          2,630     4,662     4,996     5,032     2,229
Siem Reap        United Nations Agencies        3,687     2,607     5,908     5,294     5,202
                 Int'l Financial Institutions   5,579     6,119     8,954     7,144     2,170
                 European Union                 7,264     10,897    11,503    12,344    9,152
                 Bilateral                      6,361     4,268     4,970     4,226     970
                 NGO                            14,339    20,187
                 TOTAL                          37,230    44,078    31,335    29,008    17,494
Krong    Preah   United Nations Agencies        146       69        170       173       174
Sihanouk         Int'l Financial Institutions   930       845       2,878     3,128     6,550
                 European Union                 1,329     1,779     1,789     1,307     1,299
                 Bilateral                      25,069    39,432    27,075    21,857    18,018
                 NGO                            306       2,061
                 TOTAL                          27,779    44,186    31,911    26,464    26,042
Stung Treng      United Nations Agencies        622       614       1,214     1,314     975
                 Int'l Financial Institutions   1,753     1,297     2,345     1,050
                 European Union                 2,498     2,639     3,290     2,471     1,725
                 Bilateral                      5,466     1,874     429       294       114
                 NGO                            493       598
                 TOTAL                          10,831    7,021     7,278     5,129     2,814
Svay Rieng       United Nations Agencies        2,866     3,912     3,206     2,863     2,335
                 Int'l Financial Institutions   2,079     819       1,147
                 European Union                 1,017     1,348     1,070     741       497
                 Bilateral                      897       1,253     1,188     1,762
                 NGO                            502       921
                 TOTAL                          7,361     8,253     6,612     5,366     2,832
Takeo            United Nations Agencies        802       639       1,154     1,000     935
                 Int'l Financial Institutions   1,543     2,147     7,199     4,130     2,310
                 European Union                 1,873     1,605     997       4,076     2,227
                 Bilateral                      1,497     1,673     1,745     2,096     4,048
                 NGO                            1,925     3,435
                 TOTAL                          7,640     9,498     11,096    11,303    9,520
Otdar            United Nations Agencies        867       783       1,044     1,122     925
Meanchey         Int'l Financial Institutions   3,702     4,737     5,678     4,300     175
                 European Union                 3,210     4,347     2,943     3,040     1,223
                 Bilateral                      358       886       316       180
                 NGO                            383       651
                 TOTAL                          8,519     11,404    9,981     8,642     2,323
Krong Kep        United Nations Agencies        6         4         10        10        10
                 Int'l Financial Institutions   298       342       1,147
                 European Union                 457       950       823       1,039     1,091
                 Bilateral                      6         285
                 NGO                            124       356
                 TOTAL                          892       1,937     1,980     1,049     1,101
Krong Pailin     United Nations Agencies        727       726       140       169       172
                 Int'l Financial Institutions   713       851       2,519
                 European Union                 297       52        361       360       93
                 Bilateral                      1,380     1,208     6,031     6,932     6,282
                 NGO                            905       134
                 TOTAL                          4,021     2,971     9,051     7,462     6,547
Natiowide        United Nations Agencies        19,226    18,674    42,433    17,488    3,927
                 Int'l Financial Institutions   125,083   68,997    65,960    45,645    22,446
                 European Union                 102,903   95,354    118,557   100,035   63,038
                 Bilateral                      106,206   149,716   137,911   67,395    5,835
                 NGO                            22        1,724
                 Others                         21,854    21,067    32,290    17,419
                 TOTAL                          375,294   355,532   397,152   247,982   95,246
                 United Nations Agencies        53,959    52,444    94,065    58,377    40,175
                 Int'l Financial Institutions   175,429   117,930   171,092   127,110   98,696
                 European Union                 156,149   171,357   201,682   191,488   126,338
Totals           Bilateral                      255,688   349,843   388,812   233,399   106,428
                 NGO                            50,162    77,736
                 Others                         21,854    21,067    32,290    17,419
                 TOTAL                          713,241   790,377   887,941   627,793   371,637




                                                                                                 47
CASE STUDY I: Health Sector Support Project

In a Nutshell

Under the first Health Sector Support Programme (HSSP1) 2003-2007 consisted of
investments for Health Equity Funds (HEFs) and for contracting-out service delivery
in selected provinces. HSSP1 (HEFs) contributed significantly to expanding access
to services for the poorest and therefore to progress on CMDGs. The local level
capacity development legacy of the contracting component, however, was limited.
This was mainly due to lack of consideration for capacity development needs at the
design stages of HSSP1 and absence of requirement for integrated capacity
development in programme activities. Development partners' prerogative to deliver
on services has overshadowed the capacity development aspect of the intervention.
This, however, is being addressed in the subsequent HSSP2 (2008-2013)

The Story
The Health Sector Support Program (HSSP) is an effort to directly address chronic
problems of health service delivery in Cambodia: unresponsive and poorly managed
health facilities, poor demand articulation, mis-matches between health needs and
service delivery, and inadequately trained and supervised staff which, often, results
in abuse of basic rights. To do this, HSSP adopted the ‘direct route’, that is,
administrative arrangements were made to effectively by-pass sub-national
administrations (province and district) and elected commune leaders to impact on
service delivery directly through executive management contracts with NGOs – for
managing health facilities, training and ‘health equity funds’.
Using a mixture of external funding consisting of loans and grants, and internal RGC
budgetary allocations, 5 international non-governmental organisations (INGOs) are
contracted to manage service delivery within 11 Operational District (ODs). As
Contractors, these INGOs in turn contract with Ministry of Health (MOH) managers
and service delivery facilities to make performance related incentive payments as
salary supplements to MOH staff at the facilities. In addition, Equity Funds are
operational in 28 ODs, mostly administered by Local NGOs. At the same time other
contracting experiments are underway and planned by many vertical programmes
and other NGOs.

Table 1: Contracted ODs and Commencement Dates
Contractors            Province              Operational          Commencement
                                             District             Date
Save The Children      Kampong Cham          Mehmut               January 1999
Australia
Save The Children      Kampong Cham          Ponhea Krek          April 2004
Australia
Health Net             Prey Veng             Pearaing             April 1999
International
Health Net             Prey Veng             Preah Sedach         April 2004
International
Health Net             Mondulkiri            Sen Monorem          April 2004
International
Swiss Red Cross        Takeo                 Ang Roka             January 1999
Swiss Red Cross        Takeo                 Kirivong             January 1999
Health Net             Ratanakiri            Ban Lung             October 2004
International
CARE                   Koh Kong              Sre Ambel            January 2004
CARE                   Koh Kong              Smach Meanchey       January 2004
Health Unlimited       Preah Vihear          Tbeng Meanchey       May 2005
The HSSP has many innovative features. Firstly, it represents efforts by donors to
align with government policy around a sector-wide approach (or the SWiM- sector
wide management). Secondly, HSSP provides a platform for common donor-national
government accountability on health policy, financing and outcomes, thus
contributing to MDG localisation. HSSP is supported by development banks,
multilateral and bilateral agencies and a range of NGOs who act as advocates and
contractors to the program. However, the experience with the contracting component
of the HSSP arrangements illustrate the kinds of ‘alignment’ challenges that will need
to be addressed to achieve consistency with the provisions of the Organic Law and
required roles of sub-national administration intended to be set up under D&D
reforms.
Developing management capacity at OD level and sense of ownership primarily
depended on the length of contracting, hence ODs that were contracted earlier had
achieved better capacity transfer. However, INGOs were not formally required to
work as single teams with their counterparts at the District Health Management Team
(DHMT). Hence, depending on INGOs approach to capacity development (some
worked as single merged teams with their counterparts and others in parallel) the
capacity for learning, monitoring and supervision has developed to a varying extent.
Whilst the single-team approach was implemented more consistently in the newly
contracted ODs, no DHMTs have a clear individual ownership of the capacity
development process.
The planning and management capacity of the DHMTs have improved, however the
related capacity development initiatives were mainly limited to managing
interventions related to contracting alone and not to comprehensive health system
management. Moreover, supervision and monitoring are still not integrated in most
ODs resulting in different teams supervising different vertical health programmes.
Many different checklists were elaborated by MOH and the INGOs to facilitate
monitoring, thus putting further focus on results, without much regard for the capacity
development process this entails. Likewise, monitoring of staff performance is done
jointly by OD, Referral Hospital (RH) Director and INGOs, following very complex and
time consuming tools.
Only one INGO has planned and started implementing an exit strategy, including
progressive decrease in incentives and more prominent role given to the DHMT for
monitoring and supervision and for managing sub contracts with the Regional
Hospital (RH)/Health Centre (HC). In most ODs there has been little or no attention
given to exit and handover strategies, particularly with respect to local level capacity
development that will be required to enable handover to take place without significant
disruption to the services.
Cambodia's policies for D&D suggest that at the sub-national level there are only two
options for administering contracts- at the OD level or at the PHD level. Whilst HSSP
activities were focussing on OD level, the requirement for the INGOs to have direct
control and accountability for the programme implementation resulted in giving little
attention the role of the PHD in contracting. This has significantly weakened
accountability lines between ODs and PHDs, thus negatively impacting on the future
development of sub-national administration and related capacity for accountability.
The second phase of HSSP intends to learn from the previous experience and
recognises that NGOs currently involved in contracting have a wealth of experience
that should be used to assist with expansion of contracting to new ODs. Hence, in
the context of Public Service Reform and D&D Reforms, the new arrangements are
made to enable a process that will specifically require INGOs to build the capacity for
handing over contracting functions to the Ministry of Health, whether at the OD or
PHD level, within a specified period of time.




                                                                                     49
CASE STUDY II: Project to Support Democratic Development through
Decentralisation and Deconcentration (PSDD)


In a Nutshell

PSDD provides core technical advisory support to 24 provinces and their related
districts to improve capacity for governance, service delivery and programming for
the Commune/Sangat Fund investments at the local level. The projects main
component consists of a substantial network of advisors 70 percent of who are
working alongside provincial and district governments to build their capacity.

The Story


Jointly funded by Sida, DFID, and UNDP, the ‘Project to Support Democratic
Development through Decentralization and Deconcentration’ (PSDD) is a flagship
donor-funded technical cooperation in support for D&D. PSDD has been designed to
assist the Royal Government of Cambodia (RGC) to meet D&D reform challenges
through improvement of governance, service delivery and development programming
for the rural poor.
The main component of PSDD is to provide core advisory support for the NCDD
structures, systems and procedures allowing other donors to leverage these costs
and channel more funds into investment. PSDD therefore has a substantial network
of approximately 170 advisers. This includes 6 international and around 160
Cambodian advisers, of whom 145 are based at sub-national level. PSDD advisers
work with sub-national counterparts on a day-to-day basis over an extended period of
time and in the framework of an established multi-year project.
Review of PSDD adviser’s functions, raises several issues. For example, PSDD
personnel at the provincial level are referred to using the generic term of ‘adviser’.
However, the functions of an adviser may be divided into four categories: capacity
building; transparency and accountability; monitoring and evaluation; and partnership
development. As such it is difficult to tell what balance of an ‘adviser’s’ time is
allocated to addressing capacity needs as compared to their accountability role with
respect to different DP projects.
In the context of D&D, PSDD approach and identification of areas of advisory support
was underpinned by a participatory capacity assessment conducted in 2005 at
provincial level in relation to 13 different functional areas. This assessment continues
to inform the mobilisation of PSDD advisors today. This appears to be the most
comprehensive capacity assessment that has been undertaken by development
partners in programme preparation. Moreover, the Government has taken on a more
active ownership of capacity development initiatives, thus resulting in PSDD having
government participation in recruitment processes of advisors.
The primary focus of PSDD is capacity development at sub-national level, however
the advisers frequently, provide capacity substitution instead. Whilst this is not
uncommon in capacity development interventions, it highlights the ongoing need for
capacity development substitution which should be incorporated in programmes
supporting local level capacity development in context of D&D reforms.
The advisers encountered in Takeo, Kep and Kratie provinces were highly competent
and therefore their support was appreciated by their local government counterparts.
However, when considering the substantial difference in salary between advisers and
their counterparts inevitably raises issues of motivation and disincentives.
The approach adopted by the PSDD is an innovative and comprehensive effort to
harmonise across different projects and to minimise the capacity drain associated
with receiving assistance from a range of different development partners through
project modalities. Firstly, PSDD and its predecessors PLG and Seila invested in the
development of common systems in areas such as financing, planning,
programming, budgeting, contracting and implementation which enabled other
development partners to harmonise around those systems. This has resulted in
reducing the potential for capacity fragmentation at local level.
There is strong recognition among DPs and government that PSDD have managed
to facilitate investment funds reaching the local level and has achieved significant
capacity development at the sub-national level. However, PSDD’s coverage and high
profile may be providing the ‘adverse role model’ raising expectations among
government staff that all technical cooperation would be provided in similar fashion.




                                                                                  51
CASE STUDY III: Female Commune Councillors Forum


In a Nutshell

In order to assist the Cambodian women councillors to deal with the specific
challenges they face development partners engaged in a co-operation with a local
NGO – Women for Prosperity (WfP) – to pilot an alternative capacity building
approach: Female Councillor Forums (FCF).

The programme contributed to increased confidence of the female councillors to
perform their roles and responsibilities and to assert themselves in Commune
Council proceedings. Relations with the male councillors improved and female
councillors’ opinions are more valued. The female councillors are in a better position
to deal with general commune problems as well as with specific difficulties arising out
of their role as women in public office. Solidarity and the provision of mutual support
improved beyond party lines. In addition to the above, the capacity of WfP to facilitate
the forums in a manner responsive to the overall objectives and in line with the
methodology set out in the concept was increased.


The Story
Despite government efforts to promote women in politics, only a small percentage of
female candidates were actually elected in the first Commune/Sangkats election in
2002: 16% of the candidates and only 8.5% of the elected councillors were women.
In addition to low representation, the female councillors faced their limited capacities
in participation in day-to-day work of the commune councils as well as traditional
discrimination which perceives women as not qualified or skilful enough to participate
in decision-making on an equal level with men.
With the aim to improve the Female Councillor’s situation, the “German Technical
Cooperation Program “Support to Administrative Reform and Decentralization
Program” (ARDP) implemented by GTZ created the Female Councillors Forum
(Forum) concept in 2003. The focus of this project was to form a network of mutual
support and sharing experiences in order to strengthen cooperation among the
female councillors; to enhance their capabilities to deal with challenges they face,
especially    discrimination; to develop strategies for issues in their communes they
regard as urgent; and to increasing their visibility in their respective communes.
Starting in late 2003 the Female Councillor Forums were piloted in 7 (out of 24)
provinces. Since 2006 the programme has been expanded to cover 9 provinces.
Each of the Forums brings together approximately 30 – 40 participants from
neighbouring communes. In three provinces all female councillors participate in the
Forums, in six provinces the Forums include approximately 50% of the female
councillors. Selection of participants proportionately reflects political party affiliation
within each province. In order to promote a sense of ownership the principles of self-
learning, self-directed learning, and self-organization were interwoven in the overall
structure of the implementation process.
The Forums are highly appreciated by representatives of the Ministry of Interior and
perceived as a contribution towards both CMDGs and implementing MoI Gender
Mainstreaming Action Plan through improvement in women’s performance
representation in the Commune Councils. Moreover, the Government has
encouraged ownership of the Forums by Ministry of Interior participating in
monitoring the Forums and providing the Female Councillors with technical support.
The Provincial Local Administration Units (PLAUs) provided a place for the Forums to
take place and assisted with secretarial arrangements. Moreover, representatives of
the PLAUs and Provincial Department of the Ministry of Women’s Affairs attend the
Forums as guest speakers and chairpersons.
The concept of Female Councillor Forums has been very much in line with the
interest of the female councillors in terms of providing an opportunity for sharing
experiences, building solidarity, increasing confidence and leadership skills and
improving capacities to solve common problems. Moreover, the programme resulted
in increased confidence of the female councillors to perform their roles and
responsibilities and in their increased ability assert their views in predominantly male
Commune Council proceedings. The female councillors were also in a better position
to deal with general problems in the commune as well as with specific difficulties
arising out of their role as women in public office.
The Female Councillor Forums are widely known in the provinces. Commune
Councils as well as officials of the provincial administrations see them as an effective
instrument towards capacity building and promoting the equal participation of women
in commune affairs and decision-making. A noticeable progress has also been
achieved regarding the capacity of WfP to facilitate the forums in a manner
responsive to the needs of the female councillors.
In 2006, with the goal of becoming sustainable, the WfP started to implement the
three-year Exit Strategy to enhance the Female Councillors' capacities with regard to
their facilitation and organizational skills and supporting the councillors in attracting
future support. Within three years and after nine Forum sessions, there was a
gradual step by step transfer of skills from the WfP facilitators to the 4 Female
Councillor Facilitators (FCFs) selected in each of the nine provinces. However, the
capacity of the female councillors to identify responses to the priority CMDG-related
issues raised by commune’s populations is still limited, hence strengthening
downward accountability is an area to be considered, particularly in the context of
decentralisation reforms.
The FCF are recognised among development partners and NGOs in Cambodia as a
successful model for individual capacity development. The Forums are supported by
a range of partners, including GTZ, Novib, The Asia Foundation, Oxfam GB, Pact
and ForumSyd. Based on its success and experiences, the Forums have been
replicated with support from the ADB in 5 provinces and adapted to project priorities
by UNICEF in 6 provinces.
The Ministry of Interior expressed an interest in providing financial support to the
Forums in the future and has engaged in discussing the Forums’ sustainability with
the National League of Communes and Sangkats. If the National League becomes a
focal point for supporting the Forums this would make it easy not only to open
Forums for all female councillors in the provinces but also to open Forums in the
fifteen other provinces. It seems recommendable that those women who are focal
points in charge of women and children’s affairs in their communes without being a
councillor take part in the Forums as well. However, the expansion if the Forum
project should only be addressed once the sustainability of the current Forums is
guaranteed when they can fully begin to function as a good practice model.




                                                                                      53
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