2016 Annual Report: ADRA Cambodia

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2016 Annual Report

The Adventist Development and Relief Agency Cambodia is registered with the Ministry of Foreign Affairs since 1991.

Contact Details: #4, Street 554 Khan Toul Kork Phnom Penh, Cambodia Tel: 023 880 693; Fax: 023 880 305 E-mail: info@adracambodia.org Website : www.adracambodia.org Facebook : www.facebook.com/ADRACambodia

2016 Annual Report

2016 in Review 2016 has been a blessing to our ADRA team as we have the privilege to work with all of our partners in local communities as well as around the world. We are grateful to hear about and see the positive changes in the lives of our beneficiaries and as well in ourselves as Agents of Change. In 2016 ADRA staff and partners worked with over 40,000 community members in Kompong Thom, Preah Vhear, Pursat, Siem Reap and Oddar Meanchey provinces through holistic empowerment programs. While most of these had a focus on improving maternal and child nutrition, we saw so many families make real changes in their broader family sanitation practices, nutritious food production and consumption, and overall care and concern for their children’s future. This year saw many of our donor development partners visiting projects from Australia, Canada, New Zealand, Czech Republic, Norway, Germany and South Korea to monitor progress. Funding support has continued and expanded from our ADRA office and government partners in Australia, Canada, New Zealand, Czech Republic, Norway, Germany, South Korea, USA and Cambodia. We hope this 2016 report reflects our commitment to positive changes taking place both externally as well as internally in fulfill our mission to bring about positive change through empowering partnerships. This past year our team is pleased to expand the partnership with ADRA Canada and Canadian Government through the EMBRACE maternal and child health program as well as reestablishing operations in partnership with ADRA Germany and the German government (BMZ) which included expansion of operations into Oddar Meanchey adjacent to prior operations. We also continued to raise awareness and long term sustainable changes in lifestyle behaviors that can bring about a healthier and happier life and restore hope for the future. As we are working to bring about even more positive changes, we are seeking more partners to participate in and support the process. We thank God for His many blessings in 2016 and continue to ask Him to guide ADRA Cambodia into the future.

Mark Schwisow Country Director May 29, 2017

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Table of Contents 2016 in Review ................................................ 1 Identity ............................................................ 2 Mission ............................................................ 2 Vision .............................................................. 2 Development Principles .................................. 2 Our Programs ................................................. 3 Human Development & Empowerment .......... 3 Health .............................................................. 4 Program Focus on Nutrition 2016………...…6 Rural Livelihoods ............................................ 7 Projects 2016 .................................................. 8 Health Projects ................................................ 8 WASH ............................................................. 8 Food Security Projects………………………..8 Education Projects……………………………8 Connections Groups…………………….……9 Achievement during 2016…………..……….10 Partnerships in 2016……………………..….10 Organogram 2016……………………..….....12 Members of the Governing Body 2016……...12 Finances 2016……………………………….13

Identity Mission ADRA Cambodia is a humanitarian and development organization of the Seventhday Adventist Church that works with people in poverty and distress to create positive change through empowering partnerships and responsible action. Vision ADRA Cambodia reflects God’s character of love for the poor and vulnerable through development and relief projects based on inclusive, trust-based community relationships that lead to improved quality of life. Development Principles ADRA Cambodia is an organization that…  Actively supports communities through a portfolio of development activities which are planned and implemented cooperatively  Provides assistance in situations of crisis or chronic distress, and works toward the development of long-term solutions with those affected  Works through equitable partnerships with those in need to achieve positive and sustainable change in communities  Builds networks that develop indigenous capacity, appropriate technology, and skills at all levels  Develops and maintains relationships with our partners and constituents that provide effective channels for mutual growth and action Promotes and expands the equitable and participatory involvement of women in the development process  Advocates for and assists in the increased use of communities’ capacities to care for and responsibly manage the natural resources of their environment.  Facilitates the right and ability of all children to attain their full potential, and assists in assuring the child’s survival to achieve that potential.

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2016 Annual Report

Our Programs ADRA Cambodia has been operating in Cambodia for 25 years. It has a diverse program across several sectors that focuses on sustainable community development and advocacy for strong community relationships and capacity. ADRA Cambodia currently works with communities in Oddar Meanchey, Siem Reap, Preah Vihear, Kompong Thom, and Pursat. The focus on the central and northern areas of the country will continue, based on the ongoing partnerships with communities, and development needs in that region. ADRA Cambodia has a diverse portfolio of projects across several sectors, with the following three priority sectors identified:  Human Development & Empowerment (REFLECT, Early Childhood Development)  Health - (Nutrition, Water Sanitation & Hygiene, Non-Communicable Diseases)  Rural Livelihoods - (Food Security) ADRA Cambodia has also identified Disaster Risk Reduction/Emergency Management as a sector to be mainstreamed throughout the entire community development program and has made a commitment to incorporate the community participation approach used in the REFLECT methodology wherever possible in ADRA Cambodia's community development program. ADRA Cambodia includes consideration of all cross-cutting issues in the implementation of projects, but special focus is being made on the cross-cutting issues of migration and gender-based violence. Human Development & Empowerment ADRA Cambodia has dedicated itself to developing projects that ensure that adults and young people have opportunity to gain skills that allow them to adapt as economic and social times change. Participatory methods such as REFLECT and Adventure Learning have been used to expand local community members' opportunities to learn and grow from one another based on local knowledge. Key areas of learning have included maternal and child health, nutrition, WASH, family communication and parenting, non communicable disease, how to increase family income, avoiding the dangers of human trafficking during migration. REFLECT Methodology REgenerated Freirean Literacy through Empowering Community Techniques (REFLECT) is a participatory approach to adult learning that combines the philosophy of Brazilian educator Paulo Freire with Participatory Rural Appraisal methods. It focuses on linking adult literacy with empowerment. REFLECT provides an ongoing democratic space for people to be supported by a local facilitator to meet and discuss issues relevant to them, according to their own priorities. Reflect Learning Units are developed by each project with facilitation guides and are trained to facilitators to use in facilitating Reflect Circle Meetings. May 2017


2016 Annual Report

Early Childhood Education has been integrated with adult learning using the REFLECT methodology. Child Reflect Circles aim to provide a rich learning environment for pre-school children. While parents meet in adult REFLECT Circles to learn key parenting skills, including child health and development, trained facilitators lead the children in a variety of activities, songs, games, stories and physical activities. Parents learn these activities and are encouraged to continue them at home. ADRA Cambodia is utilizing the skills developed in using this methodology across the community development program. Early Childhood Development/Learning through Play ADRA Cambodia's Early Childhood Education opportunities for children have been instrumental in giving children basic life skills, and ensure that families actively participate in their child’s early development and education. Additional positive impact has been seen in reduction of domestic violence, improved nutrition and income security. A key methodology in the Early Childhood Development (ECD) program is Learning through Play In My Own Way (LTP-IMOW). ADRA Cambodia is committed to strengthening internal linkages between projects to allow more communities access to the methodologies, seeking to formalize support for the curriculum with the Ministry of Education, improved social inclusion through targeting activities for children with disabilities, and strengthening the quality of the nutrition education provided through the program. Adventure Learning ADRA Cambodia’s Jombok Hoas Adventure Learning programs are designed to create positive and lasting changes. Thousands of youth and adults have participated in its programs focused on nurturing leadership and team building skills in addition to personal growth and self-confidence. http://adracambodia.org/our-programs/education/jombok-hoas/ Health ADRA Cambodia's health program has helped rebuild health clinics and train rural health providers. Projects have also trained community members in rural villages as primary health care promoters building the capacity of many to become Reflect facilitators. Special attention continues to be given to supporting Mother and Child health, including nutrition education and rehabilitation, and safe pregnancy and childbirth awareness. ADRA Cambodia employs a holistic approach to health issues, working with communities to discuss health from the perspective of nutrition, access to clean water, sanitation and hygiene practice, and health behavior that prevents problems by building awareness. One key area within a focus May 2017


2016 Annual Report


on lifestyle health includes raising awareness of the negative effects of tobacco and alcohol use. An area of key success for ADRA Cambodia is to use rural program results to advocate with key lawmakers to legislate tobacco control regulations to support those efforts. Nutrition Education ADRA’s integrated program on nutrition uses facilitation as a key for higher involvement and motivation. It involves parents, children, community leaders, health care providers and law makers for the greatest impact on nutrition. It includes prevention action on related disease and provides options for improved livelihoods that can help behavior change for nutrition to be more sustainable. The Royal Government of Cambodia has identified gaps in providing adequate nutrition for children. This is highlighted in the 2014 Fast Track Road Map for Improving Nutrition 20142020. ADRA has secured projects focused in nutrition increasing ADRA’s ability to respond to these gaps in harmony with Scaling Up Nutrition (SUN) Cambodia. ADRA’s priority areas in child nutrition include rehabilitation, food fortification and behavior change on child feeding practices. ADRA uses the internationally recognized Essential Nutrition Actions in promoting improved behaviors at the household level. Non Communicable Diseases Cambodia, like many developing countries, is facing the threat of emerging obesity and noncommunicable diseases (NCD) while still struggling with malnutrition, endemic and infectious diseases epidemic. The country has therefore to deal with this 'double burden' of diseases that has a long term economic risk for Cambodia. Although the prevalence of diabetes and hypertension are found to be relatively low in comparison with many countries in the region, the first large survey in 2010 revealed that major risk factors for noncommunicable diseases are relatively high including tobacco smoking, alcohol consumption, and increasing weight. This survey revealed that 8 in every 10 people (82.4% of the surveyed population) had one to two risk factors for developing non-communicable diseases. Currently Cambodians struggling with poverty spend a large part of their income on health costs. ADRA Cambodia has a long history of working with World Health Organisation, government departments and other organisations in tobacco control and health promotion. The promotion of a healthy lifestyle is also historical key focus for the Seventh-day Adventist Church, the parent organisation of ADRA Cambodia. ADRA Cambodia is committed to projects that promote protective health habits and practices.

Smoke Free Cambodia

Community Key Messages about 2nd hand smoke Community Smoke Free Night Shows National Smoke Free Area Advocacy

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Program Focus on Nutrition in 2016: PROVINCE/ PROGRAM GOAL


Preah Vihear & Kampong Thom/ Contributing to the reduction of maternal and child mortality in 168 targeted villages of Kampong Thom and Preah Vihear Provinces

Siem Reap/ Improved nutrition and food security, particularly WRA and children under-5

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Pursat/ To improve child nutrition and well-being through increased protective care and sustainable livelihoods in poor and vulnerable households

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 Kompong Thom/ Improved nutrition for 22,000 household members (11,000 females), particularly Women of Reproductive Age (WRA) and 4,000 boys and girls under-2 in the Baray-Santuk Operational District of Kompong Thom Province Oddar Meanchey/ Sustainable improvements in maternal and child nutritional health and family/community development in Cambodia.

U5 child mortality at 146 in Preah Vihear Province 94% of deliveries take place at home. High levels of anaemia caused by the effects of communicable diseases and poor dietary practices


INTERVENTIONS IN HEALTH & LIVELIHOODS  Health Systems  Learning sessions with families o Growth monitoring o NERP o Fortified foods  WASH  Agriculture  Learning sessions with families o Growth monitoring o Nutrition, education, rehabilitation program (NERP)  WASH  Agriculture  Learning sessions with families o Growth monitoring o NERP  Agriculture  Vocational skills  Livelihood skills  WASH

PART-NERSHIPS Madai Reakreah, Kone Reakreah, Hincks Dellcrest, *Ministry of Health (MOH)

Stunting rate 50% for Siem Reap Province and underweight children 35% High levels of anaemia (60% for children in the province) Limited dry season livelihood diversification leading to high rates of absentee migrant parents.


Child malnutrition rate is 44.8% in Pursat 29% of households live below or near the poverty line in Bakan district Over 75% of households in Bakan do not have sanitary latrines 50% of family members with no access to potable water 85% of rice farming totally dependent on natural rainfall with frequent floods and droughts causing significant damage Low average output of 1.7 tons of rice per hectare



 Health Systems  Learning sessions with families o Growth monitoring o NERP o Fortified foods  WASH  Agriculture

*Ministry of Health (MOH)

85% of households (HHs) now generate significant portions of their income from agrarian work. Stunting rates for children under 5 for Oddar Meanchey with recent surveys in nearby rural villages is around 40%. Very few households have an understanding of nutrition for themselves and their child.


 Health Systems  Learning sessions with families o Growth monitoring o NERP o Fortified foods  WASH  Agriculture

*Ministry of Health (MOH) *Ministry of Agriculture (MoAg)

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*MOH WatSan suppliers *Farmer Associations


2016 Annual Report Water, Sanitation and Hygiene (WASH) ADRA builds capacity of community partners in technical construction and hygiene promotion methods with a focus on sustainable change and investment. Technology and behavior change strategies have been improved through supporting households to install over 8400 open ring and bored wells, 6609 water collection tanks and pumps, and several community dams and ponds. Improved sanitation has resulted in the construction of over 8800 quality water sealed latrines, and has complimented families learning the importance of hygiene and being able to access clean water for drinking and washing including assisting over 12,000 families to obtain ceramic water filters. As a leader in the WASH sector in Cambodia, ADRA is committed to ongoing learning and development in this sector to further improve health habits and best practice.

Rural Livelihoods A primary focus over the years has been to ensure families have basic food security along with water, health and other basic needs. Starting with support for rice production and water supply, families are supported with access to high quality seeds and introduced to methods of farming that provide greater yields. Through these programs families learn to grow better vegetable gardens, make money from fruit trees, and fish farms, and learn how to raise livestock. ADRA programs acknowledge the need to address a broad range of key factors leading to families gaining sustainable ownership of their own food security. These include integration of adult literacy, technical agriculture skills, small business management, small loans, community cooperative groups, and access to resources such as water supplies. ADRA Cambodia has integrated livelihood training into programs for many years and is committed to improving the linkages between beneficiaries’ livelihood training and access to capital and credit, and on diversifying livelihood training provided through extended value chain analysis and identification of new opportunities.

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Projects 2016 Health Projects OPERATING DATES Name of Project Enhance Mother/Newborn/Child Health in Remote Areas Through Health Care and Community Engagement (EMBRACE) Project Baray-Santuk Nutrition for Under-2s and Mothers Project (BS-NUM)

Location Preah Vihear and Kampong Thom

Start 31/3/2016

End 31/3/2020

BUDGET US$ 2,532,700

Kampong Thom




"CHOICES" for Children: Child Health Outcomes Improved through Community Empowered Solutions Varin Integrated Nutrition for All Live More Cambodia (REFLECTing on CHIP in Cambodia)





Siem Reap




Phnom Penh & Pursat




Donor Global Affairs Canada, ADRA Canada

CFGB, the government of Czech Republic, ADRA Canada, and ADRA Czech Republic DFAT, ADRA Australia

CFGB, ADRA Canada ADRA Australia

WASH OPERATING DATES Name of Project Bakan WAter and Sanitation for Health (BWASH)

Location Pursat

Start 21/8/2013

BUDGET US$ 570,348

End 20/2/2017

Donor MFAT, ADRA New Zealand, ADRA Norway

Food Security Projects OPERATING DATES Name of Project Food Security and Nutrition for All Project (FSNFA)

Location Oddar Meanchey

Start 1/9/2016

End 30/4/2020

BUDGET US$ 900,716

Livelihoods for Life

Kompong Thom




Varin Food Security for All

Siem Reap




Donor BMZ-funding title for private German associations, Chapter 2303 Title 68776 and ADRA Germany MCIC, ADRA Canada CFGB, ADRA Canada

Education Projects Name of Project Adventure Training Program Jombok Hoas (JBH)

Location Preah Vihear

OPERATING DATES Start End 1/1/2006 31/12/2016

Pursat Child Sponsorship





Prasat Model Preschool

Kompong Thom Pursat







PAPSDA Tuol Thmea

BUDGET US$ 436,745

Donor User contributions, Avondale College, ADRA Australia, ADRA International ADRA Korea Kindercare, ADRA New Zealand PAPSDA, ADRA New Zealand

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2016 Annual Report

Achievements during 2016  Facilitated more than 1,600 Reflect Circles meeting in Kompong Thom, Preah Vihear, Pursat and Siem Reap provinces. Over 40,000 women, men and children have been learning about nutrition, parenting, gardening, health, water and sanitation topics.  Facilitated seven groups to complete the Complete Health Improvement Program (CHIP) and the contextualized Live More Cambodia (LMC) program to address noncommunicable diseases on the rise in Cambodia. Held a lessons learned and results dissemination workshop and laid plans for continued research and scale up.  Hosted the EMBRACE project Kick off workshop with ADRA Canada for the new EMBRACE project funded by ADRA Canada and the Canadian government in five countries including Cambodia, Canada, Myanmar, Philippines and Rwanda. In Cambodia EMBRACE is working in 168 villages in Preah Vihear and Kompong Thom provinces.  Entered the Oddar Meanchey province in 33 villages with the new FSNFA project funded by ADRA Germany with the German government  Completed 12 Reflect Learning Units with topics covering ADRA Cambodia’s development portfolio of health, nutrition, capacity building and livelihoods, with materials to support each. Arranged complementary video.  Conducted gender training was done for BSNUM, BWASH, CHOICES for Children and EMBRACE projects Actively participated in CCC, MEDiCAM, NEP, CCFIN – collaborative organizations for NGOs working in Cambodia including the sectors of health, education and micro-finance.  Hosted donors and volunteers group from different ADRA partner offices from Australia, Canada, New Zealand, Czech Republic, South Korea, Laos, United Kingdom and United States!

Partnerships in 2016 CCC * NEP * Vissot * Chab Dai * PAPSDA * Kindercare * Hincks Dellcrest * MRKR

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2016 Annual Report New Lifestyle Let’s hear a story from Ms. Thor Sovan, one of our Live More Cambodia participants. I heard about Complete Health Improvement Program (CHIP) through an announcement at church. This announcement was made by ADRA staff. As I remember, they announced it 3 or 4 times before the CHIP start date at Toul Kork Seventh-day Adventist church. I was very happy to hear about the CHIP program because they presented about the benefits of CHIP through videos and what I would learn if I attend CHIP program. The most significant change for me was in food consumption. My health was not good because I had high blood pressure. In fact, I spent much time for health checks every 6 months at private clinics to make sure that my blood pressure was stable. However, I still had not learned much or changed my practices as my doctors advised me because I was the only sick person in my family. I found it hard to talk to my family about my health problem and what the doctors recommended. Since then, I learned much from the CHIP program, and one of my CHIP Club meal at Thor Sovan’s house daughters also learned from it, then other members. They have started to realize what is good and to start on a health journey. CHIP taught me how to choose good food to eat in order to help low blood pressure, reduce bad LDL cholesterol, and Triglycerides. I remembered one of the sessions which talked about “eating a rainbow of foods”. It helped me to follow this principle. Right now, I eat more high fiber foods, drink lots of water every day, and spend time doing exercises every morning as I wake up at 4:00 am. I spend time cooking soy beans and add pumpkin every morning. In addition, I always prepare lots of vegetables with different colors and my family likes them. I believe it is very helpful and important that I can change my food habits as well as my family is understanding about my health. Since I changed and follow CHIP Lifestyle Health recommendations, my health has improved a lot. I was able to stop using medication for high blood pressure, it saves me some money and I even have better health!

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Organogram 2016

2016 Annual Report

Members of the Governing Body 2016 Lim Pheng-Chairman, Mark Schwisow-Secretary, Seak Chai Kaing, Hang Dara, Horng Sopheap, Sharyn Davis, Se Kim Seng, Tim Maddocks, Hang Sarim, Chun Savoeun, Ann Stickle (non-voting member). May 2017



2016 Annual Report

Finances 2016 WatSan 9%

Agriculture 4%

Education 8%

Health 39%

Nutrition 40%

2016 Expenses by Sector 1,400,000

2016 Expenses by Funding Country

1,236,000 1,200,000


2016 TOTAL: 2,265,000 USD 800,000

600,000 422,000 400,000 230,223 172,000











Canada Australia

New Cambodia Zealand

Thank You!


May 2017

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