Child-Sensitivity of

Social Protection in
Cambodia
Policy Brief: June 2022

DEVELOPMENT

PATHWAYS
Child-sensitivity of social protection in Cambodia

Child-sensitivity of social protection in Cambodia

1 Introduction

This policy brief presents the headline findings of an assessment of the social protection sector in Cambodia
from a child-sensitive lens. The assessment was commissioned by Save the Children Cambodia and carried
out by Anh Tran from Development Pathways, with guidance provided by Gloria Doñate and Chanborith Ros
from Save the Children. Child-sensitive social protection is defined as ‘public policies, programmes and systems
that address the specific patterns of children’s poverty and vulnerability, are rights-based in approach, and
recognise the long-term developmental benefits of investing in children.’1

Investing in children is the most effective social protection investment to benefit human
capital. Child-sensitive social protection enhances children’s educational outcomes as well
as their opportunities in the labour market once they reach adulthood. In childhood, access
to education and health services are essential for future growth and development. However,
without sufficient income, families face significant constraints in investing adequately in
their children’s wellbeing: schools do little for educational achievements of children that
are unable to attend; health services are unlikely to contribute to overall health outcomes
when families cannot afford to travel or face other out-of-pocket costs for medication and
treatment; and inadequate nutrition during childhood can undermine both education and
health outcomes. The linkages between the core public policies and systems that underpin
children’s outcomes, is diagrammatically presented in Figure 1.

Figure 1: Investments in public policies and systems that enhance child outcomes

Source: Based on Kidd et al. (2021).

1
Save the Children (2020).
1
Child-sensitivity of social protection in Cambodia

In fact, undernutrition during early childhood is linked to lower income earning potential
later in life, underlining the importance of investing in child-sensitive social protection.
Figure 2 visualises the rate of return to human capital at different stages of the life course,
ranging from early preschool age to adulthood. Returns to investments in the youngest age
group is the highest when cognitive developments can be maximised, after which the rate
of return to investment in human capital declines.2 In fact, a lack of early childhood
interventions represents a forgone opportunity for skill formation.3 One global study finds
that stunting during early childhood is associated with an average 26 per cent reduction in
lifetime earnings due to the loss in education and work opportunities resulting from limited
child development. In certain contexts, this is linked to a loss in gross domestic product
that is twice as large as public expenditure on healthcare. 4

Figure 2: Rates of return to human capital investment

Source: Based on Carneiro et al. (2004).

2
Carneiro et al. (2004).
3
Cusick & Georgieff (2013).
4
Richter et al. (2017).
2
Child-sensitivity of social protection in Cambodia

2 Methodology and approach

This study comprised a literature review and a series of remote key informant interviews
carried out during June and July 2021 with key stakeholders, including donor agencies,
United Nations (UN) partners, non-governmental organisations (NGOs) and civil society
organisations (CSOs). The study was guided by the Core Diagnostic Instrument (CODI) which
has been adapted for the purpose of this study.5 Figure 3 provides an overview of the criteria
considered for this assessment.

Figure 3: Overview of the adapted CODI criteria for analysis of child-sensitivity

Source: Development Pathways’ interpretation of eight CODI criteria as provided in Archibald (2020).

Recognising the risks faced by women and girls related to gender norms, this study also
adopts a gender-sensitive lens. Well-designed social protection systems can enhance
outcomes for all genders. For example, by improving income security and access to personal
income for women, social protection provides a lifeline for women carers whose work and
contributions to child development are largely unpaid and go unrecognised.

5
CODI is an analytical tool designed as one of the Inter-Agency Social Protection Assessments (ISPA), by a multi-agency core
team comprised of experts from ILO, UNICEF, World Bank, GIZ and others. Reference has also been made to the framework
developed by UNICEF’s Regional Office for South Asia (ROSA) in 2014 to assess the child-sensitivity of social protection
systems. Source: ISPA (n.d.).
3
Child-sensitivity of social protection in Cambodia

3 Inclusiveness
The national social protection sector in Cambodia comprises a range of policies and
programmes that broadly address specific patterns of vulnerability across the lifecycle.
Figure 4 visualises Cambodia’s existing social protection schemes in line with the NSPPF.
The sector comprises two main components, as defined by the National Social Protection
Policy Framework (NSPPF) 2016-2025:

1. Social assistance comprises 1) emergency response6; 2) human capital

development; 3) vocational training; and 4) welfare for vulnerable people.

2. Social security comprises contributory social insurance schemes7 which provide

income security to citizens in both the formal and informal economy who can afford
to pay contributions.

Figure 4: The existing social protection system in Cambodia as defined by the NSPPF

Source: Kingdom of Cambodia (2017); Kingdom of Cambodia (2019); Bunthoun et al. (2019).

6
Emergency response includes food distribution programmes.
7
Social security is globally recognised to include all forms of income security schemes throughout the lifecycle (in the event
of old age, unemployment, sickness, invalidity, work injury, maternity, or loss of a breadwinner) regardless of whether schemes
are tax-financed or financed through payroll contributions (social insurance). In contrast, in Cambodia, social security refers
only to contributory schemes. Source: Social Security (Minimum Standards) Convention, 1952 (No. 102). Available at:
https://www.ilo.org/dyn/normlex/en/f?p=NORMLEXPUB:12100:0::NO::P12100_ILO_CODE:C102.
4
Child-sensitivity of social protection in Cambodia

Despite growing coverage of social protection schemes in Cambodia since the launch of the
NSPPF, most families with children do not benefit from existing social protection services.
Because the social protection sector in Cambodia comprises two distinct components –
social assistance and social security – which aim to cover different population groups, neither
addresses income protection for all citizens. Social security has a narrow definition in
Cambodia, comprising social insurance schemes that are financed through contributions
and cover income protection for those who have paid contributions during their
employment.8 Social assistance schemes that address the incomes of those who cannot
contribute, currently comprise ‘welfare for vulnerable people’, which only address the
incomes of the poorest and most vulnerable members of society. As a result, approximately
three quarters of the population belong to the ‘missing middle’, the proportion of society
that is estimated to be excluded from both contributory schemes and poverty-targeted
social assistance.

Approximately 6.6 per cent of children below the age of 18 years directly access some form
of social protection through the cash transfer (CT) for Pregnant Women and Children under
2 years and Scholarship Programme.9 In comparison, 16 per cent of children were living
below the national (monetary) poverty line in 2014.10 In reality, children in Cambodia face
a range of insecurities that are not measurable through income or consumption alone.
Forty-nine per cent of children are estimated to live in multidimensional poverty. 11
Furthermore, poverty lines give the impression that the welfare levels of children and their
families are static while, in reality, they are highly dynamic. People are constantly faced by
insecurities in life that can impact on their income and welfare at any point in time.

Low coverage of social protection schemes for children is explained by the gaps in coverage
of certain age groups as well as limited overall coverage of the existing schemes. The CT
for Pregnant Women and Children under two years was launched in 2019, and is set to
reach 200,000 recipients by 2022.12 As of 2021, it was reported 170,000 pregnant women
and children under the age of two years benefited from the scheme since its
implementation13, which would be equivalent to approximately a quarter of young infants
below two years.14 The Scholarship Programme reaches an estimated 122,000 children in

8
Kingdom of Cambodia (2019). Note: as will be discussed in Section 2.7, the RGC plans to expand coverage of social insurance
schemes for workers in the informal sector.
9
Based on the latest estimated number of children receiving the CT for Pregnant Women and Children under 2 years or
Scholarship and calculated as a proportion of the child population in Cambodia using UN Population projections.
10
Based on the Cambodia Socio-Economic Survey (CSES) 2014 in Karpati et al. (2018). This includes all children below the
age of 18 years. A new assessment of poverty has been conducted based on the CSES 2019 which has not yet been published.
11
Based on analysis of the Cambodia CSES 2014 and Cambodia Demographic Health Survey (DHS) 2014 in Karpati et al.,
(2018).
12
Joint SDG Fund (2020).
13
Samean (2021).
14
This provides a rough estimation of the proportion of young children that are covered by the scheme. The calculation does
not take into account pregnant women.
5
Child-sensitivity of social protection in Cambodia

years four to six of primary school, equivalent to around nine per cent of children in this
age category.15 Approximately 79,000 children, or five per cent of children, across grades
seven to 12 in secondary school receive a scholarship.16

Although estimates are unavailable, it is likely that only a limited proportion of children
indirectly benefit from other schemes across the lifecycle, including the Disability Pension,
and social security schemes through the National Social Security Fund (NSSF) and Civil
Service schemes. The Disability Pension reaches an estimated 180,000 people with
disabilities and older people, which covers only 3.5 per cent of the total number of persons
with moderate or severe disabilities.17 The Civil Service old age pension and disability
schemes reach an estimated seven per cent of the population above retirement age. Out of
a total workforce of 10 million, less than two million are members of the NSSF, mainly
comprising garment workers and civil servants.18 Due to low coverage of both social
assistance and social security, most households and individuals in Cambodia belong to the
‘missing middle’ who do not access any form of income security scheme and whose
vulnerabilities have exacerbated during the COVID-19 crisis.

4 Impact and adequacy

The Cash Transfer for Pregnant Women and Children under two years provides a transfer of
up to US$ 190 in total, on the condition that the woman attends appropriate health
examinations and vaccinations.19 The transfer is received in three stages. Pregnant women
who are eligible receive a transfer of US$10 (40,000 riel) up to four times when they attend
antenatal care appointments. After the birth of the child, an additional one-time payment
of US$50 (200,000 riel) is received. In the third and final stage, mothers receive US$10
(40,000 riel) up to ten times when they attend health examinations for themselves and their
children until they reach the age of two years. The scheme is designed to both provide
income support and encourage women to seek health services. However, the use of
conditions has drawbacks (see Box 1). When women are unable to attend all the health
examinations that are required, they automatically face a reduction in payments. This does

15
Communication with ILO.
16
MacAuslan et al. (2019). Note: According to the NSPPF, the total number of children in school accessing a Scholarship is
100,000, of which 75,000 are funded by the RGC and 25,000 are funded by the World Food Programme.
17
Development Pathways & ACCESS Cambodia (Forthcoming).
18
Communication with ILO.
19
This includes routine immunisation of children against diseases, not taking into account the COVID-19 vaccinations.
6
Child-sensitivity of social protection in Cambodia

not take into account the challenges Box 1: Gender-considerations for applying conditions to access

that women may experience in social protection

attending health appointments whilst Globally, conditional cash transfers (CCTs) are often designed for
balancing other care responsibilities women carers and children, making access to an income transfer
conditional on behaviour, such as attending health clinics.
or work. Therefore, while the use of
Conditions impose direct costs on recipients, in particular women,
conditions can have positive health who may find them too difficult to meet when they interfere with
and nutrition impacts for mothers and other care or work responsibilities, or public services are simply
unavailable. Therefore, CCTs have also been criticised for
children, they can be disempowering offloading the responsibilities of accessing services on to women.
for women by restricting their choices.
International reviews of CCTs find that there is no robust
evidence that the enforcement of conditions itself results in more
The CT for pregnant women and
positive impacts of the respective programmes. Rather, the
children is designed based on two combination of cash and provision of information/behavioural
pilot schemes, which both nudges appear to be the main determinants of better health, or
other desirable programme outcomes
demonstrated positive outcomes for
children. The NOURISH programme, Sources: Molyneux (2007); Baird et al. (2011); Benhassine et al.
(2013); Fiszbein & Schady (2009).
implemented by Save the Children
between 2014-2020, provided a CCT and voucher scheme, combined with social and
behaviour change communication (SBCC) and community-led sanitation practices, from
conception until a child’s second birthday.20 The programme achieved significant outcomes
among its recipients, including: prevalence of stunting declined by 19 per cent, prevalence
of underweight women decreased by 23 per cent; dietary diversity increased for both
women and children, and household sanitation practices improved.21 The 2013 CARD-
UNICEF pilot targeted children under the age of five years in Prasat Bakong district in Siem
Reap province. While the transfer amount was deemed insufficient by some recipients to
cover out-of-pocket health expenditures, the income transfer, to an extent, provided
recipients with more income security to attend health appointments, although this came at
a cost of losing a daily wage.22

The Scholarship Programme provides a transfer equivalent to US$5 per month to children
attending school. Students in primary and lower secondary school, identified from poor
households, may receive US$60 per year in total when they continue to attend school. The
transfer is paid in three instalments. Responses from school staff and parents, as part of an
evaluation of the programme, indicated a preference for higher transfers. Indeed, the level
of the transfer was found to cover between nine and 15 per cent of total direct and
opportunity costs of education. However, the evaluation did find that transfers enabled

20
The CCT and voucher schemes were implemented in combination with a range of complementary interventions. This
included social and behavioural change communication, community-led sanitation, and training component for community
agents and health staff, across health, nutrition, WASH and agricultural interventions. Parents and carers could receive up to
US$ 65, paid in six instalments, after attending specific health and nutrition services.
21
NOURISH (2020).
22
Mukherjee & Gupta (2018).
7
Child-sensitivity of social protection in Cambodia

most parents and caregivers to invest in education materials (93 per cent) or other school
expenses, such as uniforms (82 per cent) as well as purchasing food.23

The Scholarship Programme’s impact on school retention is undermined by lack of

monitoring procedures and high exclusion of children that are in need of financial support.
For example, scholarship students are often replaced (due to dropping out of school), yet
this is not monitored at the individual level. Therefore, it is likely that scholarship students
who have dropped out of school are no longer attending school, nor receiving scholarships.
In fact, most respondents in the evaluation of the Scholarship programme indicated that if
they had to choose, they would prefer to provide more scholarships, rather than increasing
the value of the scholarship for existing recipients. Large exclusion errors were a significant
concern for the programme’s adequacy to provide support to out-of-school children, since
too many children miss out.24

The social security programmes offer higher transfer values, yet they benefit a limited
proportion of the population who have paid contributions during their employment. The
amount received per person varies depending on length of service and salary, as the
transfers are financed from contributions. In 2019, the average value of the old age pension
received by recipients that did not have a disability was KHR 647,000 (US$ 160) per month
(115 per cent of GDP per capita), and this was KHR 434,600 (US$ 108) per month (78 per
cent of GDP per capita) for people with disabilities. 25 Families living on low incomes –
including working age carers – are less likely to benefit from social security due to being
in informal employment, or due to the welfare losses associated with the payment of
contributions into the ‘voluntary’ NSSF. While significant efforts are being made by the
Royal Government of Cambodia (RGC) and partners to expand coverage of the NSSF to
workers in the informal economy, the costs of contributions are still significant for
individuals and families living on low incomes. Further, workers in vulnerable sectors may
not feel empowered to claim their entitlements which requires employers to contribute on
behalf of the employees.

23
MacAuslan et al. (2019).
24
Ibid.
25
Development Pathways & ACCESS Cambodia (Forthcoming).
8
Child-sensitivity of social protection in Cambodia

5 Institutional and financing framework

The governance, systems management, and delivery of social assistance in Cambodia is
divided across several ministries. The Ministry of Social Affairs, Veterans and Youth Affairs
(MoSVY) administers social assistance schemes. However, several key components of
scheme delivery are managed by other line ministries. The ID Poor system for identification
of recipients is administered by the Ministry of Planning (MoP). This includes updating the
database and poverty-targeting mechanism (see Box 2).

MoSVY manages the social security schemes for civil servants and war veterans through the
Security Fund for Civil Servants (NSSF-C) and National Fund for Veterans (NFV). The Persons
with Disabilities Foundation (PWDF) is also governed by MoSVY, providing rehabilitative
services to people with disabilities.26

Social security schemes for workers outside of the public sector are administered by the
National Social Security Fund (NSSF). Due to the challenges with overlapping mandates
and systems of registration, the RGC plans to consolidate responsibilities for governing
‘social security’ under the NSSF.

Box 2: The ID Poor system

All social assistance schemes in Cambodia are poverty targeted based on the ID Poor system. It employs a proxy means
test, implemented through a survey questionnaire, in combination with community-based targeting to identify the poorest
and most vulnerable households within the community. Eligible households are provided with an Equity Card and are
allocated a score which determines their ‘poverty status’ and eligibility to be included in the ID Poor database. Based on
their score, households are identified as either Category 1 ‘very poor’ or Category 2 ‘poor’. In 2019, it was estimated that
approximately 470,000 households in Cambodia, including 1.8 million individuals, possessed an Equity Card, which is
equivalent to approximately 11 per cent of the national population.

However, significant concerns have been raised about the efficacy of the ID Poor targeting mechanisms, which is known
to result in exclusion of poor and vulnerable households. A recent assessment of the effectiveness of the ID Poor targeting
mechanism based on respondents in the 2019 Cambodia Socio-Economic Survey (CSES) who reported receiving an Equity
Card, finds that over 70 per cent of households who should have been eligible based on their characteristics, did not
receive an Equity Card. As the survey is conducted every three years, the ID Poor database does not capture the volatility
of household incomes and other socioeconomic changes as households’ welfare is likely to change significantly year-on-
year. Furthermore, qualitative findings revealed that households registered in the ID Poor database did not always receive
an Equity Card, indicating that there are operational challenges resulting in exclusion of households from the Equity Cards
system.

26
Bunthoun et al. (2019).
9
Child-sensitivity of social protection in Cambodia

There is no reliable estimate of the level of investment in social protection in Cambodia to

date,27 which comprises only a limited set of schemes that cover less than 80 per cent of
the population.28 Nonetheless, over the past decade, the RGC has significantly enhanced
both its governance and its financing of core systems underpinning the social protection
sector. For example, while initially financed by donors, the ID Poor database and targeting
mechanism has now transitioned entirely to domestic financing from general taxation, and
management by the Ministry of Planning in Cambodia.29

6 Shock-responsiveness of social protection for children

Shock-Responsive Social Protection incorporates disaster risk considerations in its design
so that it can respond flexibly in times of crisis. Social protection policies and programmes
address typical risks faced by individuals and households along their lifecycle, also known
as ‘idiosyncratic’ risks. ‘Shock responsive’ social protection aims to extend the types of risks
covered to include additional challenges which often impact a large proportion of the
population at the same time.30 When shocks are recurrent, protracted, or severe, they
destabilise household economies, making a return to normal life very challenging. Figure 5
visualises a typology of options devised by O’Brien et al. (2018) to adapt, or scale up, social
protection in order to respond to shocks.

Figure 5: Common measures used to for social protection systems to respond to shocks

Source: Based on O’Brien et al. (2018)

27
Bunthoun et al. (2019).
28
This estimate is based on the proportion of the population that was included in the ID Poor database in 2019, in addition
to the estimated number of individuals accessing a civil service pension.
29
Kaba et al. (2018).
30
UNICEF (2019).
10
Child-sensitivity of social protection in Cambodia

The existing social protection system in Cambodia is not well placed to maintain
households’ resilience in the face shocks or be adapted to respond to shocks. The vast
majority of the population was not covered by any form of social protection. Whereas
‘emergency assistance’ is a component of social assistance in Cambodia, this mainly
comprises food distribution schemes and no comprehensive income support mechanism.
Whereas the NSPPF has made significant progress in expanding coverage of social
assistance and social security, the two components are coordinated separately, both
institutionally and at an operational level. As a result, both components do not address
coverage of social protection in a coherent manner. Importantly, the missing middle –
among whom a limited proportion can afford contributions and the majority are excluded
from the ID poor system – remain unprotected by the system. Yet, this segment of the
population is highly susceptible to shocks and at risk of falling into poverty. Without a
strategic effort to address coverage of this group, there is a risk of leaving an increasing
number of people unprotected. Climate shocks are likely to increase in frequency and
duration, while Cambodia is also susceptible to other health and economic shocks, as the
COVID-19 crisis has demonstrated.

Emergency response efforts were largely coordinated by disaster relief agencies prior to
COVID-19, separate from the social protection sector, through the National Committee for
Disaster Management (NCDM). Overall, the government faces significant human and
financial resource constraints to ensure good coordination of preparedness, response and
recovery interventions. While a Disaster Management Law is in place, governments at
subnational levels lack the human and financial resources to ensure adequate preparedness
and operations of emergency support mechanisms. Financing of emergency support
currently relies mainly on external financing from donors. However, the COVID-19 has been
a catalyst for change in Cambodia. Since the onset of the crisis, the RGC has significantly
increased investment in social protection, enhancing the coverage of existing schemes
while the system is undergoing policy reforms, which includes a national framework for
shock-responsive social protection.

7 COVID-19: A catalyst for social protection reform

COVID-19 has emphasised the need to build a social protection system that is more able to
build the resilience of individuals and families and scale up support when a shock occurs.
The crisis has highlighted there is no simple dichotomy that delineates the ‘poor’ from ‘non-
poor’. The working class living on middle incomes who were formerly deemed to be ‘non-
poor’ are among those who were hardest hit by the health, and socio-economic crisis
resulting from COVID-19 and the measures to contain the virus. For example, many migrant
workers in urban areas have suffered significant income losses during the lockdown. Due
to the large-scale return migration to rural areas, this has not only increased infection rates

11
Child-sensitivity of social protection in Cambodia

across the country, but it has increased pressure on households to cover the basic needs of
a larger number of family members. In the meantime, many families lost income from
remittances and had no access to social protection.31 As highlighted by the Asian
Development Bank (2020), ‘COVID-19 has likely led to a reversal in the gains of poverty
reduction in Cambodia.’

COVID-19 emergency social protection support

In response to the crisis, the government allocated US$ 300 million to introduce an
emergency household benefit scheme in June 2020. During an initial phase, existing
households in the ID Poor database, under categories IDPoor 1 and IDPoor 2 were selected
to receive emergency transfers at the local community level. In a second phase, new
households were enrolled in the IDPoor system through ‘On-Demand IDPoor’, a mechanism
through which households were able to come forward themselves, or local community
leaders and NGOs were able to propose households for the ID Poor database. In total, the
COVID-19 social protection measure is estimated to cost around 1.3 per cent of GDP during
the first 12 months, making Cambodia’s response one of the largest across middle-income
countries. The transfer reached 674,146 households according to latest estimates and was
paid to the head of household.32 Each household was provided with a basic monthly benefit,
of around US$ 30 on average. Certain vulnerable members of the household including older
people, people with disabilities, people living with HIV/AIDS and children below the age of
5 years received an additional payment. Support to households affected by COVID-19 has
continued since. After a lockdown in 2021, an additional one-off emergency transfer
(ranging between US$ 39 and US$ 190) aimed at households affected by the virus and
garment sector workers in Phnom Penh, Takmao and Sihanoukville has been implemented
with the aim of covering the costs of food, water and electricity.

Social protection policy reforms

The COVID-19 pandemic has also been a catalyst for change to social protection policy
development in Cambodia. Ongoing developments within the social protection sector have
accelerated in Cambodia within the context of COVID-19 and the exposure of widespread
insecurities across the population. The NSPPF is undergoing a mid-term review, with the
aim of improving cross-coordination of the social protection sector and its components. The
NSPC plans to formulate a national framework for shock-responsive social protection, to
enable social assistance and social security to be better able to scale up during a response.

31
Asian Development Bank (2020).
32
Bailey (2021).
12
Child-sensitivity of social protection in Cambodia

A proposed framework has been presented to the Ministry of Finance to explore options to
horizontally expand programmes under the NSPPF.

The RGC is committed to expanding coverage of the social protection sector. Future social
assistance schemes will be provided across the lifecycle, building on the existing Cash
Transfer for Pregnant Women and Children Under Two. This will be based on the Family
Package, which includes the following schemes: 1) A child benefit for young children up
the age of six years, building on an expansion of the CCT for pregnant women and children;
2) Scholarship programme; 3) Disability allowance; and 4) Old Age Pension. Therefore, the
Family Package will significantly expand coverage of children. However, because all
schemes are proposed to remain poverty-targeted based on the ID Poor targeting database,
many vulnerable children are likely to remain excluded.33

The RGC also aims to extend coverage of social security schemes – alongside the
implementation of a health insurance scheme and maternity leave – to reach workers in
the informal economy. This includes voluntary schemes arrangements to incentivise
workers in vulnerable economic sectors, such as domestic workers, tuktuk drivers and
workers in the food service industry, to join the NSSF. Registration in the NSSF will also
provide access to the health insurance fund, which will cover care in both public hospital
and private hospitals, as well as maternity leave, sick leave and the cost of surgeries. If
implemented effectively, the extension of social security schemes will provide many more
workers, including many who are caring for children, with social protection entitlements.
The provision of maternity leave, in particular, is a significant milestone for women workers
who are faced with the challenge of childcare and are often forced to exit the workforce.
However, the NSSF does not currently provide any income security schemes for dependents
(i.e. a family benefit), while those in invisible forms of work such as domestic care work, or
self-employed workers, will be difficult to reach. Others in insecure forms of work will
continue to face challenges in accessing the scheme if their employers do not pay
contributions on their behalf. Importantly, the need to pay contributions can result in a
considerable reduction in welfare, creating significant challenges for families to enter the
NSSF.

33
EPRI (2020b, 2020a).
13
Child-sensitivity of social protection in Cambodia

8 Conclusion and recommendations

Significant efforts are ongoing to strengthen the NSPPF and the delivery of social protection
schemes, yet sustainable coverage of families remains a challenge. The COVID-19
emergency transfer has significantly expanded coverage of social assistance. However, the
continued reliance on the ID Poor system is likely to result in continued exclusion and
failure to address the ‘missing middle’ sustainably. Indeed, as discussed in Box 2, prior to
COVID-19, the system was found to result in significant exclusion of eligible households,
as 70 per cent of eligible households did not receive an Equity Card. While the social
assistance framework is planned to expand based on Cambodia’s ‘ID Poor’ targeting
database, at the same time, the RGC has an ambition to expand social security schemes
which will ‘continuously be increasingly financed by contributions and the investment return of
the accumulated fund’.34 Thus, significant expansion of the ID-Poor system has taken place
since the onset of the crisis to facilitate an increase in coverage of social assistance schemes
alongside expansion of the NSSF. However, the system does not take into account the
universal nature of crises and lifecycle risks, such as childbirth, disability and old age.
Without sustainably addressing the missing middle, many families in Cambodia remain
excluded from the social protection system.

The COVID-19 crisis has created a window of opportunity in Cambodia for social protection
to be enhanced and become more child-sensitive. Indeed, policy reforms are ongoing while
the NSPPF is undergoing a mid-term review and social protection schemes are gradually
being designed to address life cycle risks. It is an opportune time for Cambodia to enhance
child-sensitivity of the social protection system.

34
Kingdom of Cambodia (2017).
14
Child-sensitivity of social protection in Cambodia

This policy brief provides the following recommendations to enhance child-sensitivity of the
social protection system:

• Explore approaches to multi-tiered social protection in Cambodia with a focus on

families. There are ongoing developments to design a multi-tiered old age pension
system. Similar approaches can be achieved to sustainable enhance social assistance and
social security coverage for children and their families.35
• Implement alternative approaches to eligibility determination for life cycle social
protection schemes, including universal approaches. Reduce reliance on the ID Poor
system by simplifying eligibility criteria and registries for certain life cycle schemes based
on age and/or disability status. By linking eligibility for the CT for Pregnant Women and
Children under two years to childbirth and progressively growing its coverage to children
up to age six, child-focused social protection can be expanded in line with the CRC. A
child disability benefit with eligibility linked only to disability assessment can ensure
that all children with disabilities access income support.
• Conduct feasibility study of approaches to progressively realise a universal child benefit
(UCB) in Cambodia. In order to build on the achievements of the emergency cash transfer,
and promote sustainable coverage expansion along a lifecycle approach, practical
solutions are required that illustrate the costs and impacts of potential schemes in the
future and demonstrate their affordability.
• Strengthen case management and social care services. This should focus on
strengthening social services for children at risk of loss of family care, including: children
with disabilities, children at risk of family separation as well as children of skipped
generation families, in which older people are caring for children without the presence
of adult parents. The RGC could leverage partner support, including cash-plus
approaches, to strengthen linkages to community-based support services and existing
public health and support services (including assistive devices).
• Explore mechanisms to subsidise or provide compensation for the payment of
contributions to the NSSF to workers in the informal economy. This can facilitate the
expansion of coverage of the NSSF for many workers who are caring for dependent
children, but who face barriers to inclusion due to the welfare losses associated with
contribution payments.

35
See ILO (2020) and McClanahan et al. (2019) for an example of a multi-tiered approach in Viet Nam with a focus on families.
15
Child-sensitivity of social protection in Cambodia

References
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