The
maternal mortality rate has decreased from 472 per 100,000 live births in 2005
to 170 in 2014. Under-five mortality decreased from 83 per 1,000 live births in
2005 to 35 in 2014. The pre-school net enrolment rate for 3 to 5-year-old
children has increased from 18 to about 25 percent over the period 2005-2012,
with about 35 percent of five-year-olds enrolled.
The
education budget has increased year on year and reforms are changing the way
that children learn.
But
progress has been unequal, and these positive statistics mask great regional
disparities. In remote areas, less than 60 percent of children finish primary
school and the dropout rates among primary school children in remote areas are
higher than the national average.
Data from
the Cambodia Demographic Health Survey show that coverage of health services in
some provinces is less than half of the national average. A child in Kratie is
four times more likely to die before the age of five than a child in Phnom
Penh.
Access,
delivery and quality of health care and education are issues of major concern
for families living in remote areas of Cambodia. Coverage and quality of
services is not equitable and healthcare and education are still inaccessible
for many, particularly the rural poor.
Provinces
in the northeast of Cambodia, Preah Vihear, Koh Kong and provinces bordering
the Tonle Sap Lake, face issues of isolation due to geographic factors such as
lakes, rivers, tributaries, forests and mountains, combined with poor
infrastructure.
This limits
families’ ability to seek transportation for services any time of day or night
and adds an additional burden in terms of time and financial costs to seeking
services. Women in the northeast of Cambodia on average will spend nearly 70
percent of the time they allocate to seeking health services on travel.
Bopha,
13, is the top student in her class in remote Boeung Kachang village, located
in the islands and mangrove forests of Koh Kong province.
When she
grows up, she wants to be a doctor, because she has seen many women in labor
pains travelling long distances by boat due to the lack of medical services in
her village. She wants to give free medical care to all her villagers.
Bopha may
or may not be able to pursue her dream of becoming a doctor. Like so many other
students in her village, her father is unsure if he will be able to afford to
pay the extra costs for commuting to secondary school in Koh Kong city and the
costs of supplementary educational materials.
Bopha is
aware of all this and she knows that there is a huge difference in the dreams
of her future and the harsh reality of her present, but nevertheless she
continues to study hard and excel at her school, in the hope that something
will give, eventually, and one day she will become the first doctor in her
village.
It is to
reach children like Bopha – the most remote, the most vulnerable to shocks and
the poorest of the poor – that Save the Children is launching a new campaign,
Every Last Child, to advocate for the extension of healthcare and education
services to the most rural and remote areas.
Cambodia
has changed very rapidly in recent times and will continue to evolve along a
growth route that will involve transiting to middle income country status in
the near future. However, social equity will not be reached unless there is a
concerted effort to reach marginalized children in remote areas of Cambodia.
At Save
the Children we know that, like Bopha, we must continue to be passionate,
resilient and hopeful. The progress that has been made at a national level can
be extended to all provinces of Cambodia.
We must
work together, whether we are civil society, government or community members.
Together, we can reach every last child – but we must start now.
Elizabeth
Pearce
Elizabeth Pearce is Country Director for Save
the Children Cambodia Country Office.
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