Estimating the size of the homeless adolescent population across seven cities in Cambodia.

BACKGROUND: The Government of Cambodia has committed to supporting family care for vulnerable children, including homeless populations. Collecting baseline data on the numbers and characteristics of homeless adolescents was prioritized to illuminate the scope of the issue, mobilize resources and direct the response. METHODS: Administrative zones across seven cities were purposively selected to cover the main urban areas known to have homeless populations in Cambodia. A complete enumeration of homeless individuals between the ages of 13 and 17 was attempted in the selected areas. In addition, a second independent count was conducted to enable a statistical estimation of completeness based on overlap across counts. This technique is known as capture-recapture. Adolescents were also interviewed about their schooling, health and other circumstances. RESULTS: After adjustment by the capture-recapture corrective multipliers (range: 3.53 -27.08), the study yielded an estimate of 2,697 13-17 year old homeless adolescents across all seven cities. The total number of homeless boys counted was significantly greater than homeless girls, especially in older ages. CONCLUSIONS: To the authors' knowledge, this is the first time capture-recapture methods have been applied to a homeless estimation of this scale in a resource-limited setting. Findings suggest the number of homeless adolescents in Cambodia is much greater than one would expect if relying on single count data alone and that this population faces many hardships.

National estimation of children in residential care institutions in Cambodia: a modelling study.

OBJECTIVES: The primary objective of this study was to collect baseline data on the number of children living in residential care institutions in Cambodia. The secondary objective was to describe the characteristics of the children (eg, age, sex, duration of stay, education and health). The data were intended to guide recent efforts by the Government of Cambodia to reduce the number of children living in residential care institutions and increase the number of children growing up in supportive family environments. SETTING: Data were collected in Cambodia across 24 sites at the commune level. Communes-administrative divisions roughly equivalent to counties-were selected by the National Institute of Statistics using a two-stage sampling method. DESIGN: Government lists and key informant interviews were used to construct a complete roster of institutions across the 24 communes. All identified institutions were visited to count the number of children and gather data on their basic characteristics. The rate of children in residential care in the selected communes was calculated as a percentage of total population using a Poisson model. This rate was applied to all districts in Cambodia with at least one reported residential care institution. PARTICIPANTS: A total of 3588 children were counted across 122 institutions. A child living in a residential care institution was defined as anyone under the age of 18 years who was sleeping in the institution for at least four nights per week during the data collection period. RESULTS: There are an estimated 48 775 children living in residential care institutions in Cambodia. The vast majority of children have a living parent and are school-aged. More than half are between 13 and 17 years of age. CONCLUSIONS: Nearly 1 of every 100 children in Cambodia is living in residential care. This raises substantial concerns for child health, protection and national development.

The economic consequences of malnutrition in Cambodia, more than 400 million US dollar lost annually.

BACKGROUND: Cambodia is among the 28 worst countries globally with the highest rates of childhood malnutrition. The aim of the assessment was to apply published evidence associating malnutrition and a variety of functional consequences to project economic implications of this high rate of childhood malnutrition. Such information is vital to advocate for appropriate programs and action plan to reduce malnutrition (from severe stunting to micronutrient deficiencies). METHODS: This exercise used a "consequence model" to apply these "coefficients of loss" established in the global scientific literature to Cambodia health, demographic and economic data to develop a national estimation of the economic losses link to malnutrition. RESULTS: The impact of the indicators of malnutrition analysed represent a burden to the national economy of Cambodia estimated at more than $400 million annually -2.5% of GDP. Micronutrient deficiencies suggest deficits in the quality of the diet - representing a national burden of more than $200 million annually while breastfeeding behaviours account for 6% of the burden. 57% of the losses emerge from indicators measured in children, while 43% of losses are from indicators independent of childhood measurements - indicators of maternal behaviour along with maternal and adult nutrition. CONCLUSIONS: Given the low cost of interventions and the high baseline losses, investment in nutrition programs in Cambodia is likely to offer high returns and attractive benefit cost ratios. Since nearly half the losses are determined prior to the birth of the child, this has implications for targeting and timing of programs.