Sao Loeum is a young female farmer married to a construction worker. The couple has a 9-month old son, Chan Rayuth. The family lives in a rural part of Cambodia’s Siem Reap province—a major tourist destination, best known as the gateway to the breathtaking Angkor ruins. Despite the province’s flourishing tourism industry, some of its villages are among the poorest in Cambodia with a poverty rate hovering above 30 percent.
For poor, rural families such as the Loeums, food insecurity, illness and limited economic opportunities are both causes and effects of the poverty that grips them. They struggle to afford nutritious food and have limited access to clean water and basic health services. The consequences for children are devastating: one in three children is stunted, and the prevalence of stunting is higher among low-income and rural children. Undernutrition also increases health expenditures and opportunity costs and reduces lifetime earnings, particularly for women, who are the primary caregivers of young children.
These consequences may be daunting, but with the right interventions, stunting is preventable during the first 1,000 days spanning pregnancy to the child’s second birthday. That’s where the Feed the Future NOURISH project comes in. The project is designed to accelerate stunting reduction in three provinces through activities in water, hygiene, sanitation (WASH) and agriculture focusing on the first 1,000 days, the first of its kind in Cambodia.
One project activity is the conditional cash transfer (CCT) program, which was introduced in June 2015 in two Siem Reap communes. It offers conditional cash payments to food-insecure families with pregnant women and children under two to incentivize the use of key health and nutrition services and practices. It also provides a social safety net during the critical first 1,000 days. Conditions for payments include prenatal care visits, childbirth at a health care facility, postnatal care, monthly growth monitoring and promotion visits, and routine use of a handwashing station.
Loeum is one of the first 800 mothers enrolled in the CCT program. As a CCT beneficiary, she committed to bring her son to the health center for growth monitoring and promotion and to set up a dedicated handwashing station in her home.
The project has also identified a local microfinance institution that helps CCT participants open bank accounts. Just like many others, Loeum has opened her very first savings account where she will receive the money if she meets her commitment to use the health and nutrition services. During the enrollment process, she and her husband also benefited from village fairs, where they learned about home gardens with nutrient-rich vegetables, cooking for growth, and handwashing with soap. “I have taken my son to get weighed at the health center every month to monitor his growth. I have already received 80,000 riels [$20] in my bank account and I have used some of the money to buy fish, vegetables and soap. I also kept some for my son’s health care so that he will grow up strong and smart,” she said. Loeum will continue to benefit from the CCT initiative until her son turns two, improving his chance to grow and develop to his full potential.
The CCT program just started, but health workers in Siem Reap are already seeing promising trends as more women are coming in for prenatal care and bringing in their children for growth monitoring. Health workers also use these visits as an opportunity to increase vaccination coverage to protect children from infectious diseases.