ADRA Cambodia 2018 Annual Report

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2018 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 E-mail: info@ADRAcambodia.org Website : www.ADRAcambodia.org Facebook : /ADRACambodia ADRA IS A SMOKE FREE ORGANIZATION


2018 Annual Report

2018 in Review Once again 2018 has given our team so many opportunities to see that God has blessed ADRA Cambodia in fulfilling our vision to reflect God's character of love for the poor and vulnerable. It was our privilege this year to work with so many local partners and see many the lives of so many family members improved. In 2018 ADRA staff and partners worked with over 40,000 community members in Kompong Thom, Preah Vhear, Pursat, and Oddar Meanchey provinces through holistic interventions that are adding real value to people’s lives. Programing continued with the focus on improving maternal and child nutrition and through this 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 our team began a journey to dig even deeper into sustainable behavior change by looking at motivations driven by core universal values. We are so thankful to our ongoing partner donor teams and government partners who supported us this past year including those in Australia, Canada, New Zealand, Norway, Germany, South Korea, USA, United Kingdom and Cambodia. We were also pleased to secure a project agreement with ADRA New Zealand/NZ Government this year for Agro Business programing over the next five years starting in January of 2019. We trust that this 2018 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. In 2018 ADRA Cambodia invested in time for longer term strategic planning. A broad range of stakeholders chose to continue programmatic focus areas in primary health, rural livelihoods, and human development & education. As well the Non-Communicable Disease and Environmental Health sectors were emerging areas of strategic focus that were chosen for expansion in 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 2018 and continue to ask Him to guide ADRA Cambodia into the future.

Mark Schwisow Country Director

June 2019

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2018 Annual Report

Table of Contents 2018 in Review ................................................. 1 Our Identity ..................................................... 2 Our Purpose ..................................................... 2 Our Vision ....................................................... 2 Our Mission ..................................................... 2 Our New Strategic Program Priorities ............ 3 Human Development & Empowerment ........... 3 Health ............................................................... 5 Program Focus on Human Development & Empowerment 2018…………...……....…...…8 Rural Livelihoods ............................................. 9 Projects 2018 ................................................. 10 Health Projects ............................................... 10 Nutrition Projects………..…………….…....10 Education Projects………………………..…10 Connections Groups…………………….…...11 Achievement during 2018…………..……….12 Partnerships in 2018……………………..….12 Organogram 2018……………………..….....13 Members of the Governing Body 2018……...13 Finances 2018……………………………….14

Our Identity The Adventist Development and Relief Agency is a global humanitarian organization that demonstrates God’s love and compassion.

Our Purpose To serve humanity so all may live as God intended.

Our Motto Justice. Compassion. Love.

Our Vision A just and sustainable world where people can attain well-being and live life to the full, physically, psychologically and spiritually.

Our Mission ADRA acts a catalyst for change, inspiring, engaging and empowering people to strive together to overcome poverty and injustice, and managing the risks and impacts of disasters.

What We Do We are the global humanitarian arm of the Seventh-day Adventist Church—part of the 20-million strong Adventist community, with hundreds of thousands of churches globally and the world’s largest integrated healthcare and education network. We deliver relief and development assistance to individuals in more than 130 countries— regardless of their ethnicity, political affiliation, gender, or religious association. By partnering with local communities, organizations, and governments, we are able to deliver culturally relevant programs and build local capability for sustainable change. June 2019

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2018 Annual Report

Our New Strategic Program Priorities ADRA Cambodia has been operating in Cambodia for 27 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, 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, the strategic planning sessions identified three priority sectors from the previous strategy which will be continued. In addition ADRA Cambodia will expand its program focus into two new sectors that build on ADRA Cambodia’s programming strengths and capacity to effectively address the changing future of development challenges in Cambodia. Carrying forward from previous strategy:  Human Development & Empowerment - (REFLECT1, Early Childhood Development)  Health - (Nutrition, Water Sanitation & Hygiene, MCH)  Rural Livelihoods - (Food Security) New strategic growth priorities:  Non-Communicable Disease (NCD – alcohol, tobacco, lifestyle and diet)  Environmental Health (waste management, recycling) 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 are being used to expand local community members' opportunities to learn and grow from one

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REFLECT is an innovative approach to adult learning and social change, which fuses the theories of Brazilian educator Paulo Freire with participatory methodologies. Key to the Reflect approach is creating a space where people feel comfortable to meet and discuss issues relevant to them and their lives. Reflect aims to improve the meaningful participation of people in decisions that affect their lives, through strengthening their ability to communicate. It was developed in the 1990s through pilot projects in Bangladesh, Uganda and El Salvador and is now used by over 500 organisations in over 70 countries worldwide. Read more at http://rhizome.coop/reflect-action-org/

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2018 Annual Report 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), a participatory approach to adult learning and social change, is founded on 10 key principles that 1) strengthen people’s power to communicate, 2) achieve social change and greater social justice, 3) create a safe space where everyone’s voice is given equal weight, 4) are intensive and extensive, 5) are grounded in existing knowledge, 6) include reflection, action and are followed again by reflection, 7) use participatory tools, 8) analyzing power in relationships, 9) selfmanagement and 10) using these principles systematically. ADRA works to set up groups of community members in Reflect Circles and train local facilitators. These facilitators support Reflect Circle members in identifying and prioritizing issues to analyze, discuss and take action on over an ongoing basis. REFLECT provides an ongoing democratic space for the meetings. ADRA trains facilitators in leadership and facilitation skills to use in facilitating Reflect Circle Meetings. Staff and facilitators develop Reflect Learning Units2 from 4 to 10 key topics to guide facilitators during those Reflect Circle meetings. 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

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See Reflect Learning Unit topics and sample guides here: http://www.adracambodia.org/resources/reflect-learning-units/

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2018 Annual Report methodology in the Early Childhood Development (ECD) program is Learning through Play In My Own Way (LTP-IMOW)3. The Learning through Play materials introduce new and enjoyable ways for parents to play with and nurture their children at each stage of development. Each time parents play, talk, touch and respond to their children in a loving manner, they make a significant difference and help their children learn. They promote physical growth, relationship building and understanding of the world, communication and sense of self. Additional topics covered include brain development, attachment, guiding behavior and addressing malnutrition. 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 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.

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See LTP-IMOW resources information here: http://www.sickkidscmh.ca/Home/Resources-AndPublications/Learning-through-Play/List-of-Learning-Through-Play-Resources.aspx

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2018 Annual Report 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 2016 STEPS survey revealed that major risk factors for non-communicable diseases are relatively high including tobacco smoking, alcohol consumption, and increasing weight. This survey revealed that 8 in every 10 people (80.7% of the surveyed population) had one to two risk factors for developing non-communicable diseases and 11.6% have three to five risk factors. 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 Organization, government departments, the Seventh-day Adventist Church and other organizations in tobacco control and health promotion and is committed to projects that promote protective health habits and practices.

Environmental Health With our new strategic program priorities, ADRA Cambodia is expanding our program focus in the Environmental Health sector. This is in response to the changing development challenges of progress which are negatively impacting climate change in Cambodia. ADRA Cambodia is committed to engaging experts for consultation who will be engaged to support the process. An internal Environmental Health Technical Working Group (TWG) within ADRA Cambodia is established and will meet periodically to discuss and share practical applications within projects as well as the progress towards key targets. In addition, ADRA Cambodia will integrate the environmental health June 2019

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2018 Annual Report promotion into the new projects including household and community waste management, promotion of recycling, and reducing the usage of unrecyclable materials such as plastics.

“Positive Deviant Program helped improve my child’s health!”

I have joined in the Reflect Circle discussion group a few years ago. Before that, I rarely washed my hands, covered food and let my kid eat the poor nutritional food such as white rice porridge with salt, and packaged snack foods. When I got pregnant, I wanted to smoke and I smoked a lot even thought my husband told me not to. I didn’t care about cleaning house and other materials. Because of these unhealthy behaviors, my first and second kid got sick quite often. When I started to join the Reflect Circle learning meetings, I was pregnant for my third child. At the time when I joined the activities was a great chance for me to learn a number of topics for well development of my baby. I learned and practiced learning through play, nutrition and child health caring. I have practiced new behaviors including starting to care for my baby while I was pregnant for better growth of his brain. Now my son is growing bigger than my other children and I taught him to speak politely, wash his hands with soap, and give him safe water from our water filter. However, even though I got to practice some good habits, my child was identified as one of malnourish children. It was good that ADRA led community to organize the Positive Deviant (PD) Hearth rehabilitation program, so that my child had a chance to join to improve his health. After joining in the PD Hearth program, I received more knowledge on how to cook the healthy food for my kid. Since that time, my kid started to grow better and healthier. Both my husband and I are very happy with this PD hearth program as we can see our kid are active and gain weight. Besides providing him with the main meals, I give other supplementary nutritious foods such as bananas, fruit, potatoes etc. Moreover, I regularly clean food storage utensils and wash my hands. I was then also able to quit smoking successfully with the encouragement and the support from the group members, facilitator and ADRA staff who have been working together to deliver these important health messages!

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2018 Annual Report

Program Focus on Human Development & Empowerment in 2018: PROVINCE/ PROGRAM GOAL

CONTEXT

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

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

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 High levels of anaemia caused by the effects of communicable diseases and poor dietary practices

TARGET BENEFICIARIES 39,120

INTERVENTIONS IN HEALTH & LIVELIHOODS  Learning sessions with families o Growth monitoring o NERP o Fortified foods  Health Systems  WASH  Agriculture  Learning sessions with families o Growth monitoring o NERP  Agriculture  Vocational skills  Livelihood skills  WASH

PARTNERSHIPS Madai Reakreah, Kone Reakreah, Racha, Sick Kids, *Ministry of Health (MOH)

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

12,400

MOH MOAg

13,050

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

12,300

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

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

June 2019


2018 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 above 8,400 open ring and bored wells, 6,600 water collection tanks and pumps, 1,978 family ponds and 15 community dams and ponds. Improved sanitation has resulted in the construction of over 10,000 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 17,000 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 using permaculture principles. 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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2018 Annual Report

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Projects 2018 Education Projects Name of Project Adventure Training Program Jombok Hoas (JBH)

Location Preah Vihear

OPERATING DATES Start End 1/1/2018 31/12/2018

Pursat Child Sponsorship

Pursat

1/7/2015

1/10/2018

144,633

Prasat Model Preschool

Kompong Thom Pursat

1/8/2013

30/4/2018

181,947

1/9/2014

1/8/2018

130,058

PAPSDA Model Village

BUDGET US$ 70,553

Donor User contributions, Avondale College, ADRA Australia, ADRA International ADRA Korea Kindercare, ADRA New Zealand ADRA New Zealand Volunteer Group (PAPSDA)

Health Projects OPERATING DATES Name of Project Enhance Mother/Newborn/Child Health in Remote Areas through Health Care and Community Engagement (EMBRACE) Project Live More Asia (REFLECTing on CHIP in Cambodia)

BUDGET

Location Preah Vihear and Kampong Thom

Start 31/3/2016

End 31/3/2020

US$ 5,041,110

Pursat

1/10/2017

30/9/2018

60,510

Donor Global Affairs Canada, ADRA Canada

ADRA International and ADRA Australia

Nutrition Projects OPERATING DATES

BUDGET

Name of Project Baray-Santuk Nutrition for Under-2s and Mothers Project (BSNUM)

Location Kampong Thom

Start 1/3/2015

End 30/4/2019

US$ 1,201,982

"CHOICES" for Children: Child Health Outcomes Improved through Community Empowered Solutions Food Security and Nutrition for All Project (FSNFA) Sustainable Produce to Market (Pro-Market) Value Chain Enhancement Project

Pursat

1/7/2014

30/6/2019

2,324,545

Oddar Meanchey

1/9/2016

30/4/2020

900,716

Pursat

1/1/2019

31/7/203

1,958,759

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

BMZ and ADRA Germany MFAT, ADRA New Zealand

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2018 Annual Report

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Connections Groups 2018 Connections group trips are arranged with partner ADRA offices as small projects that support the goals and objectives of larger sustainable projects, filling gaps that the current project does not meet. Every trip has lots of opportunities for interaction between the community members and volunteers, resulting in an appreciation for each other, good memories and sometimes lasting friendships. Each group does that fundraising for their own projects. Activities that the groups have participated in during 2018 include:      

Learning through play building child shelters, latrines, water tanks and playgrounds, well, Preschool Teacher trainings, supporting schools and preschools Environment campaign Home gardening Conducting kid’s clubs, and cooking demonstrations Sewing training

A big thank you to Individuals group, Sanitarium SOSA group from Australia, Kindercare, PAPSDA, Farm Cove Intermediate Help and Manurewa Schools from New Zealand, and Honam group from Korea! ADRA UK, ARDR Norway! You bring positive change, hope and joy!!

June 2019


2018 Annual Report

Achievements during 2018  Facilitated more than 3,000 Reflect Circles meeting in Kompong Thom, Preah Vihear, Pursat and Oddar Meanchey provinces. Over 52,000 women, men and children have been learning about nutrition, parenting, gardening, health, water and sanitation topics.  Hosted a fruitful round table workshop to share community based intervention, best practices, lesson learned, and program progress from the EMBRACE project to advocate for effective scaling up nutrition methods.  Hosted a team coming from Canada, Rwanda, Philippines, Myanmar, and Cambodia who are implementers of this multicountry Enhancing Mother/newBorn/child health in Remote Areas through health Care & Community Engagement (EMBRACE) project in Kampong Thom province to analyze results, and plan for strategic actions to improve impact, reach, and sustainability of the project as it reached the half way mark.  On October 3, 2018, two standalone labour and delivery room buildings and a health center with a labour/delivery room suite were officially opened. The buildings were constructed by ADRA Cambodia through the Enhancing Mother/newBorn/child health in Remote Areas through health Care & Community Engagement (EMBRACE) and HELP Health Center Construction projects of HELP International. For that occasion, we also had such an honor to have Ms. Allison Stewart, Chargé d'affaires, Cambodia Office of the Embassy of Canada, our donor representatives, present for the opening and visited some of the project activities in Sandan district.  November 29, 2018 was another very exciting day for the community members in Choam Ksant Commune in Preah Vihear province as a new Health Center Chheu Teal Kong with a delivery and waiting room was officially opened after the completion of its construction. We were also privileged to welcome our donors representatives from HELP International and the Columbia Union of the Seventh-Day Adventist church from the States that joined with us in the Opening ceremony!  Our Pro-Market Agriculture Business was approved funded by the New Zealand government through ADRA New Zealand  Hosted donors, visitors and volunteers group from different ADRA partner offices from Australia, Canada, New Zealand, Germany, South Korea, United Kingdom, Norway and United States!

Partnerships in 2018 CCC * CCF * Chab Dai * Cambodian Midwives Association * Danish Care Foods Co., Ltd * Eco Soap Bank * Freedom Collaborative * HRF * HACC * Kindercare * Labor Forum * MRKR * NEP * NECCD * PAPSDA * RACHA * SickKids Centre * SUN CSA * Vissot *

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2018 Annual Report

Organogram 2018

Members of the Governing Body 2018 Lim Pheng-Chairman, Hang Dara-Vice Chairman, Mark Schwisow-Secretary, Sharyn Davis, Tim Maddocks, Hang Sarim, Se Kimseng, Chin Bopha, Sieng Socheata, Abigail Koo, Ann Stickle (non-voting member). June 2019

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2018 Annual Report

Finances 2018 2018 Expenses by Sector WatSan 1% Education 6%

Nutrition 32%

Health 56%

2018 Funding by Donor Country 1,800,000

1,678,000

TOTAL: 2,769,723 USD

1,600,000 1,400,000 1,200,000 1,000,000 800,000 600,000 400,000 200,000

415,000 207,000 204,000

137,000

-

THANK YOU!

73,000

49,000

19,000

10,723

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