KINGDOM OF CAMBODIA

Nation — Religion — King

National Population Policy

What does it mean for planning ?
PICTURES BY :
Frank Vink, Nhem Sothun, Mariolein Coren

DESIGN BY :
[email protected]
 KINGDOM OF CAMBODIA
Nation — Religion — King

National Population Policy

What does it mean for planning ?

PUBLISHED BY: SUPPORTED BY:

General Directorate of Planning Ministry of Planning

386, Preah Monivong Blvd. Phnom Penh, Cambodia
Telephone / fax : 023 - 218 895
Population and
sustainable development
concerns all of us
When preparing a development plan for men are and how you can ensure these
your community, commune, province, sector now and in the future. Involve the men,
or the country it is important to think women and youth in the decision making
about the people are you are planning for. process on what should be done so that
You need to determine what the needs the outcome of the development will be
and rights of the children, women and prosperous for all people.

Questions planners should ask

themselves are:
What livelihood assets or opportunities (natural, physical, financial, social)
do men and women have access to?
What percentages of the population are children, youth, men, women
and elderly? What resources are distributed to them?
What are the major obstacles to the participation of youth, women and
the poor in the social and economic development of your community?
What natural resources do we have, how are they being used and do we
know about the long term effect of this use?
How do the planned activities affect the allocation of the budget?

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What is the relationship
between population and
development?
Think of your home and family. What if your overuse of natural resources, such as trees
family continued to grow ? What things or fish, can result in a decrease in the overall
might change in the way you live? What supply and an increase in cost.
would you need in your home? For instance,
you might need more resources like food, When many families grow larger at the same
clothes and water, and you might need time, they need more houses, more land,
more space. In order to solve this problem, more food, more water, more schools, more
you might decide to build on to your house, health clinics, more jobs, etc. But resources
or move to a bigger house with more land are often limited, and economic and social
to grow rice, or move to a new location in development may not be able to grow as
order to get more income. If you had a quickly as the population. Therefore when
larger group of people in your household, a population grows we must take into
you might also organize cooking, cleaning account existing resources, the current
or farming tasks differently. If your neighbors environment, and current levels of economic
had a smaller household size, they might and social development.
organize their tasks differently.
When there is a rapid population growth
People depend on and use all kinds of it is more difficult to achieve sustainable
natural resources like water, trees, fish etc. development or raise the income per person
to improve their lives and develop eco- and reduce poverty, since every individual
nomically. However, using natural resources requires health care, education, employment
has an influence on the environment. More and equipment. Therefore population dyna-
people using more resources can result in mics, social development and poverty
an increase in the production of waste, reduction within the country are closely
such as garbage or dirty water. And, an linked.

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Population
development policies
The number of people, the speed of growth, Population development is not a one way
the quality of life, and the challenges to be process. People influence these conditions
faced are influenced by political, social, by the decisions they take.
economic and environmental conditions.

Population policies help individual countries, communities and

sectors to develop their own plans for sustainable and human rights
based development. Clear policies help make sure that everyone is
working towards the same goal. Population policies help planners
to provide evidence of which area to focus on.

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Cambodian National
Population Policy
In 2004 the Royal Government of Cambodia and traditional values and it fully respects
launched its first National Population International Human Rights principles and
Policy (NPP). The National Population policy conventions.
is formulated bearing in mind Khmer culture

The aim of this National Population Policy is to ensure sustainable

development, and to protect the environment and natural resources,
so that the people can live happy, healthy, productive lives, free
from poverty. The National Population Policy aligns with the long-
term Poverty Reduction goals of the Royal Cambodian Government,
and supports achievement of the Cambodian Millennium
Development Goals (CMDGs).

The National Population policy has the vision that all couples and
individuals should decide freely when they want to have children,
and how many children they want to have. The policy acknowledges
that people need access to adequate information and reproductive
health services in order to make informed choices. The National
Population Policy does not fix the total number of children that a
couple can have.

7
Who are the people that are poor
and why are they poor ?

Poverty
Cambodia is at a cross-roads between People who are poor often suffer
post conflict rehabilitation and long- from greater health problems, less
term economic and social develop- opportunities to receive education,
ment. Poverty remains very high, with develop themselves and therefore
36 percent of the population below often remain poor. Female headed
the poverty line. In Cambodia poverty households have a higher rate of child
is predominantly rural, associated labor than male-headed households
with landlessness, limited diversifi- and therefore their children espe-
cation of economic activity, limited cially girls, in these households are
access to social services and large particularly at risk of poverty.
household size.

The National Population Policy introduces seven key objectives and recommends a
number of related policy measures for implementation.

NPP objective

i n relation to data gatheri ng on population

dynamics

Integrate population variables into social and economic policies, plans and
programmes at all levels

8
Cambodia's Cambodia's age and sex
population dynamics population structure

Cambodia's population is still increasing, but the The age and sex composition of a country's
speed of growth is slowing down. Between the population is useful to know, especially for a
1962 census and the 1998 census the population government which needs to plan for develop-
grew from 5.7 million to 11.7 million people. ment of infrastructure and social services, like
roads, water supplies, schools, and health centers.
As of 2004, the population size was estimated
to be 13.1 million people with an annual growth The structure of a population is often shown as
rate of 1.8%. a population pyramid showing the numbers of
males and females in 5-year age groups. From
If Cambodia's population continues to grow in the shape of the `pyramid' we can see if most
this way, it is projected that in the year 2020 people are old or young, and we can get an
Cambodia will have a population of almost idea of our future infrastructure and social
18.4 million. service needs.

The population structure of Cambodia shows

Graph: Projected Population (in millions) of Cambodia,
that people are starting to live longer than
2001 - 2020 (based on the 1998 Census)
before, and that people are starting to have
fewer children. However, the majority of the
population growth population is still young, and the population
18.7 curve shows that almost 50 % of the population
20
16.9 was younger than 15 years of age as of 1998.
15.2
population (in million)

15 13.1
11.7
10
7
5.7
5

0
1962 1975 1998 2004 2010 2015 2020
year

9
 The age - sex pyramid shows the impact of the
Age group Population Pyramid, Cambodia 2004 Khmer rouge regime between 1975 and 1979.
75 + 0.5 0.7
During this period, a large number of people,
70 - 74 0.4 0.7 particularly men, died. This can be seen in the
65 - 69 0.7 0.9
60 - 64 0.9 1.2
pyramid by looking at all of the age groups
55 - 59 1.1 2.5 between 30 and 75+ and seeing fewer men
50 - 54 1.4 2.0
45 - 49 Male 1.7 2.5 Female than women. The number of children born
40 - 44 2.4 3.0 during this period also decreased. This can be
35 - 39 2.9 3.3
30 - 34 3.0 3.3 seen in the pyramid by looking at the age group
25 - 29
20 - 24
2.7 2.9
25 - 29 years of age, and seeing smaller numbers
4.9 5.2
15 - 19 5.9 5.8 of both males and females. After this period,
10 - 14 7.5 7.2
5-9 6.6 6.2
there was a large increase in the numbers of
0-4 5.7 5.4 babies born. This is called a post-war baby -
10 8 6 4 2 0 2 4 6 8 10
boom, and can be seen in the pyramid by
looking at the 10-14 year old age group.

NPP measures

what should we do?

Plan services bearing in mind the population variables including the increased
need for services targeting in and out of school youth, the increase in reproductive
health services, the need for employment, land, food, infrastructure and the
growing population of elderly
Promote the collection, analysis and dissemination of data and information on
population
Enhance the technical capacity of staff relevant in government institutions
regarding methods and approaches for integrated population development
and gender sensitive planning and programming

10
“Children and young people (0-24 years
of age) constitute more than 50% of the
population. Resource allocation should
reflect this fact”

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“When women have the number of
children they want and can negotiate
their reproductive health decisions
with men, they tend to have a larger
decision making role within families and
communities that benefits all ”

NPP objective

in relation to fertility
To support couples and individuals to decide freely and responsibly
on the number and spacing of their children, and to have access to
information, education, services and the means to do so

12
 education level. However, there is a trend to have
smaller families in both rural and urban areas.

Families with a large number of children need

more food, and more money for things like
school and health care. However, poor families
often have more children, because they fear that
some children will die at a young age, and the
need for increased labor and old age support.
However, earnings from child labor are usually
very small and it prevents children from going to
school. The lack of education of poor children, in
turn, helps to transfer poverty from one gene-
ration to the next.

Women who bear a lot of children often start

having children at a young age, have many
children close together and/or continue
Fertility having children when they are older. These are
factors which are harmful for the health of both
Fertility is used to describe the number of children women and their children. Although a decline
that a woman gives birth to during her life. in the fertility rate will decrease population
Cambodia's total fertility rate has declined from growth, the population in Cambodia is still
an estimated 7 births per women in 1962, to expected to increase, because there are many
around 4 children per women in 1998, and 3.3 young people that are now of child bearing
in 2004. The largest decline in the fertility rate age or will be in the near future. This feature is
is in the cities and among women with a higher known as "population momentum".

NPP measures

what should we do?

Improve the quality, accessibility and availability of primary health care
services including reproductive health services to the entire population
Establish adolescent-friendly reproductive health services
Promote male and female responsibility and partnership in reproductive
health at the household and community level
Target underserved areas and vulnerable groups including men, women
and youth
Encourage the provision of sexual health and reproductive health education
in school curricula, and through out of school programmes

13
NPP objective

in relation to gender equity and human

resource development
To promote gender equity and enhance human resource development

Gender equity

Gender relations in Cambodia are under- Underlining these gender inequalities are
going tremendous change. However, women cultural and traditional norms that consider
still do not enjoy equal access to the resources women to be of a lower status than men. This
and benefits of development. Women have gender discrimination is deeply embedded
less access to education, especially at the in, and reinforced by, social attitudes.
higher level of schooling, less access to paid
employment, again especially in the higher Gender issues are multi-sectoral and are an
categories of skilled and paid employment, integral part of population issues. Increasing
less access to landownership and other the status of women, their educational level,
property rights because of inheritance cus- their health status, their role in decision-
toms, fewer opportunities to ensure their making has proven to be an effective measure
views are included in the decision making in decreasing fertility rates, reducing pop-
process, and are more disadvantaged by ulation growth and promoting sustainable
the lack of quality health services, due to economic and social development of the
needs and risks associated with pregnancy entire population.
and child bearing.

14
 “Investing more in young people, espe-
cially girls and young women, has direct
benefits of improved health and edu-
cation outcomes in the household and
the longer term benefits of increased
economic growth”

Human resource development

Two of the key pillars for improved human elsewhere in the region, and this limits the
resource development, are better education country's economic productivity and the potential
and better training. Human resource develop- for rapid and sustainable development.
ment is important for the social and economic
development of Cambodia, and contributes However, the Cambodian government is prio-
towards improved standards of well-being of ritizing education and training in order to acce-
the people. Due to recent political instability, lerate poverty reduction, sustain economic
educational levels are lower in Cambodia than growth and institutionalize good governance.

NPP measures

what should we do?

Promote gender awareness and the importance of women's empowerment

among men and women
Promote and develop actions to achieve universal access to nine years
of education for boys and girls including the poor
Encourage positive gender attitudes within the household, schools,
work place and in the society

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“Reproductive a nd mate rna l hea lth
services promote health and economic
growth”

NPP objective

in relation to mortality and morbidity

To reduce infant, child and maternal morbidity and mortality rates

Mortality and morbidity

Maternal, infant and child mortality in mothers do not have the fundamental right
Cambodia are still high. Due to lack of ade- to a long and healthy life. Since high mor-
quate sanitation, poor nutrition, limited tality is especially prevalent among the
access to quality health care, and inappro- poor, rural groups, and those with fewer
priate health seeking behaviour there is a opportunities for education, it undermines
high level of mortality in infants, children the fundamental right for an equitable and
under five years of age and their mothers. just society for all Cambodians.
According to the Cambodian Demographic
and Health survey 2000, Cambodia's High mortality is directly related to high
health care indicators are among the lowest morbidity, or the high prevalence of illness
in the region. I.e.: infant mortality rate 95 and disease. High levels of morbidity
per 1000, under five mortality rate 125 per increases health costs for families and
1000 and maternal mortality 437 per means that people are less productive or are
100.000 live births. unable to work due to frequent illnesses.

A high mortality rate means that individu-

als, especially infants, young children and

16
NPP measures

what should we do?

Improve the quality and accessibility, and availability of primary health

care services to the population, especially targeting underserved areas
and vulnerable groups (women, children and elderly)
Increase the capacity for trained supervised deliveries and health
practices related to child bearing and mother and child nutrition
Promote appropriate health seeking behavior
Promotion of equitable access to priority services, especially by the poor
Support interventions to prevent the spread of HIV/AIDS among all target
groups
Support the development of social services for the HIV/AIDS affected,
people living with aids, orphaned children and the elderly
Support further condom programming

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NPP objective

in relation to HIV/AIDS

To further strengthen the reversal of the spread of HIV/AIDS

HIV/AIDS epidemic

Although the prevalence of HIV/AIDS the number of orphaned children, and an

declined from an estimated 3.3% in the increase in the number of grandparents who
general population in 1997, to 2.6% in 2002 need to take on the burden of caring and
and 1.9% in 2003, it still poses serious threats providing for their grandchildren. Another
for the development of the country. real challenge is the financial cost of the
epidemic, including reduced economic
Among the challenges caused by HIV/AIDS growth and increased costs for both
are the increase of families that have lost prevention and care activities.
their main source of income, an increase in

NPP measures

what should we do ?

Support interventions to prevent the spread of HIV/AIDS among

all target groups
Support the development of social services for the HIV/AIDS
affected, people living with aids, orphaned children and the elderly
Promote condom use and expand programmes

18
“Investing in sexual and reproductive
health helps curb the HIV/AIDS epidemic
and falling deeper into poverty ”

19
Are people mig rating from you r
community ?, Why ? What effect
does this have on the people
left behi nd ?
NPP objective

related to migration

To reduce the potential negative impact of rural-rural and rural-

urban migration

Migration

The term migration is used to describe not always turn out as the migrants or
people moving from one place to another. planners hope. Many migrants remain poor
Migration takes place at many levels, from because they are unable to find a job in
rural to urban areas, from rural to rural, and their new location and often no proper
from in-country migration to international place to live. Rural to urban migrants are
migration. often most at risk from poor sanitation,
contamination from industries, hazards such
There are a number of factors why people as flooding and fires, and labor or sexual
decide to move to another place. The factors exploitation. Migration may also act as a
in the decision are called PUSH or PULL bridge for the spread of HIV/AIDS from urban
factors. to rural areas.

Migration can have positive benefits as it Cambodia has experienced a great deal of
can provide necessary laborers to areas in internal and international migration since
need, and it can support economic growth 1970, largely as a result of war and political
and development. However, migration does instability. While migration remained high
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 PUSH FACTORS PULL FACTORS
Lack of land to farm Better chance of employment
Unemployment and under-employment in the region Prospect of higher living standards
Rural poverty and debt Better educational or medical facilities
Lack of educational and medical facilities Safe place
The prospect of a more prosperous, interesting
Environmental degradation caused by overpopulation
and challenging life.
Emergency or -natural- disaster situations
Dissatisfaction with traditional way of life

during the last decade, this was often due to social capital in the community. However, the
"pull factors" related to economic and educa- effects are often mixed, as migrants who receive
tional opportunities. The impact of young an income often send money back to their
people moving away from their villages can families in rural areas, and therefore contribute
also create issues, such as sex and age imba- towards the economic development of these
lances in rural areas; and a loss of human and communities.

“ Stimulate social and economic growth in

the local community to avoid too much
migration of young people out of the
community ”

NPP measures

what should we do ?

Improve the availability of data on migration, including magnitude and

composition of migrants
Support the economic and social development in the rural areas, including
education and health services and infrastructure
Reduce the obstacles in urban infrastructure and strengthen the infra-
structure and services

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Use natural resources wisely, so that they
can be replaced and do not cause dam-
age to the environment

NPP objective

in relation to population pressure on natural

resources and environment
To alleviate the impact of population pressure on the environment and
natural resources

Population pressure on natural local community is taken and used for large
resources and environment scale commercial projects, for example logging
or fishing concessions, or a plantation.
The overall population density in Cambodia is
not high by regional standards, but population Growing industrialization and the use of chem-
pressure is contributing to environmental icals for agricultural purposes can also lead to
degradation and undermining the local po- contamination of land, water and air, can destroy
pulation's means of livelihoods in certain areas. natural resources, and lead to increased health
This is especially the case where some of the hazards for the population and animals living
land -or water - traditionally controlled by the in that area.

NPP measures

what should we do ?
Improve the availability of data on the impact of population pressure on
the environment and natural resources
Ensure compatibility between population size and growth with access to
clean water and sanitation waste disposal systems
Encourage reforestation
Enforce legislation pertaining to common community property and right
to use open access resources

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To achieve sustainable development isn't just a matter
of numbers of people. In looking to protect the country's
natural beauty and keep natural resources for the
future, we must take care of our resources carefully
and be considerate of the needs of others. Resource
conservation means making thoughtful choices about
the way we use our land, use energy, eat, travel and
create waste. The decisions each person makes go a
long way to make our country a more happy and
healthy place to live.
PUBLISHED BY: SUPPORTED BY:
General Directorate of Planning
Ministry of Planning

386, Preah Monivong Blvd.

Phnom Penh, Cambodia
Telephone / fax : 023 - 218 895

MAY 2005