Cambodia’s Family Package: Baseline Findings on Poverty, Health and Resilience

The UNICEF-led baseline study reveals deep poverty, food insecurity, and limited financial access among Cambodia’s vulnerable households ahead of the Family Package Programme rollout. It establishes a solid foundation for future impact evaluation of this integrated social protection initiative.

In a pivotal moment for Cambodia’s social protection landscape, UNICEF Innocenti – Global Office of Research and Foresight, in collaboration with the General Secretariat of the National Social Protection Council (GS-NSPC) and the National Social Assistance Fund (NSAF), has released a sweeping baseline report for the Cambodia Family Package Programme. Designed to assess the conditions of poor and near-poor households prior to the programme’s implementation in 2024, the study provides critical insight into poverty, consumption, nutrition, economic activity, and household resilience. The Family Package aims to unify various cash transfer schemes, such as maternity support, scholarships for children, and allowances for the elderly and persons with disabilities, into a single delivery platform that uses mobile money systems for efficiency and scale. By integrating services and simplifying enrolment through the IDPoor system, the initiative seeks to bolster household resilience and build long-term human capital across Cambodia’s most vulnerable communities.

A Portrait of Households on the Margins

The baseline survey interviewed 2,404 households across Cambodia, split into treatment and comparison groups based on their IDPoor poverty scores. Households just below the poverty line were classified as treatment and eligible for the Family Package, while those just above the line served as comparisons. The survey found household heads to be, on average, 50 years old, with 38 percent of households headed by women. Educational attainment was low; 76 percent had attended school, but only 64 percent were literate, well below national averages. Household sizes averaged 4.2 members, with a significant proportion of members being school-aged children and elderly individuals. These figures speak to a demographic highly susceptible to economic shocks, health crises, and educational disruptions.

While household characteristics were broadly balanced between the treatment and comparison groups, key indicators revealed deep vulnerability. Only 15 percent of homes had piped water, and around 80 percent had access to basic sanitation. Electricity or solar energy was available in most households, but physical proximity to schools, markets, and healthcare facilities varied considerably. Mobile phone ownership was widespread (95 percent), yet access to formal banking or mobile money services remained low, with just 17 percent of households using them.

Poverty and Consumption Pressures

The average daily per capita consumption was reported at just KHR 11,100, far below national benchmarks. Over 58 percent of the sample lived below the national poverty line, and though poverty was more prevalent in the treatment group, the difference was not statistically significant. Health expenditures were higher in comparison to households, likely reflecting the lack of subsidies available to non-beneficiaries. Urban households reported slightly higher overall consumption than rural ones, but the difference was marginal and masked deeper vulnerabilities.

Food-related spending made up nearly half of total household expenditure. Households allocated modest amounts to housing, health, and transportation, while education and recreation expenditures were negligible. The poverty gap index, a measure of how far below the poverty line poor individuals fall, stood at 17 percent, or about KHR 1,777 per person per day, suggesting significant deprivation even among those already counted as poor.

Fragile Nutrition and Health Outcomes

Nutrition data painted a troubling picture. Only 35 percent of women met minimum dietary diversity requirements, and the average dietary diversity score for adults was just 4.06 out of 10, indicating monotonous diets heavily reliant on staples and lacking in protein, dairy, and micronutrient-rich foods. Among children under two years, exclusive breastfeeding was recorded at 47 percent, and only 28 percent of children aged 6–23 months received a minimum acceptable diet. Sweetened beverages and processed snacks were widely consumed, especially in urban areas, raising concerns about emerging non-communicable diseases in poor households.

Health outcomes reflected these nutritional deficits. Nearly half of all households reported a recent illness or injury. A large majority (85 percent) sought care from private providers, often at high out-of-pocket costs. Postnatal care and immunization rates were relatively high, especially among treatment households, but disparities persisted in breastfeeding practices and knowledge of diarrhoeal treatment. Elderly individuals and those with disabilities faced barriers in mobility and healthcare access, with the latter group reporting lower community participation and lower rates of health-seeking behavior.

Economic Activities and Coping with Crisis

The economic resilience of surveyed households was tenuous. Most relied on a mix of income sources: 54 percent on remittances or transfers, 50 percent on wage or salary employment, and 43 percent on agriculture. Non-farm enterprises were reported by just 24 percent of households, but women were responsible for running two-thirds of these businesses, underscoring their vital role in household economies. Land ownership was limited (average 0.75 hectare), and while 60 percent of households owned livestock, most holdings were small.

Households faced an average of 1.4 shocks in the past year, including drought, high food prices, and agricultural disease. To cope, 71 percent resorted to negative strategies, cutting meals, selling assets, pulling children from school, or taking on additional debt. One in three households did not use any strategy, possibly indicating an absence of options. Women were significantly more likely than men to reduce their own food intake to protect other family members, a stark example of gendered vulnerability within households.

Trust, Participation, and the Path Ahead

Despite these challenges, trust in the government was high. Respondents rated national government trustworthiness at 8.5 out of 10 and local government at 8.1. However, by October 2024, only 41 percent of eligible households had enrolled in the Family Package Programme. This suggests barriers in outreach, communication, or administrative procedures that must be urgently addressed.

Women’s empowerment indicators offered a glimmer of progress. About 92 percent of women reported involvement in decisions about their income, and joint decision-making was high across other household domains. Still, women in comparison to households reported slightly higher decision-making power overall.

Conditions in treatment and comparison groups are sufficiently balanced to support a rigorous impact evaluation moving forward. With fewer than 10 percent of over 360 balance tests showing significant differences, the study confirms that Cambodia is well-positioned to generate meaningful evidence about the programme’s effectiveness. As the Family Package scales up, continued investment in health services, nutrition awareness, financial inclusion, and gender equality will be essential to turning cash transfers into lasting transformations for Cambodia’s most vulnerable households.