Socio-Economic, Demographic and Service Accessibility Database Project in the Cambodia

Pilot Survey
Second Phase, (June 2002)
November 2001 to December 2002

Coordinated by
the Disability Action Council Secretariat
in collaboration with
the Ministry of Social Affairs, Labor, Vocational Training and Youth Rehabilitation

RATIONALE

Because disability is one of the major issue in Cambodia - a country of strong legacy of armed conflicts and violence that has been affecting people's lives for many decades and that will continue to traumatize the survived victims, their families, friends and communities - attention should be paid to address it based on reliable and exploitable data. Unfortunately those data still need to be generated and organized in a more scientific and comprehensive way. This gap is the main obstacle to any efficient and rational decision-making, strategic planning, monitoring and evaluation of the intervention to address the situation of the disabled persons, including resource allocation and services.

Although a number of surveys have been conducted by various agencies and organizations it is acknowledged that socio-economic and demographic data related to the disabled persons is far from being consistent and accurate. In addition, the categorization of disabilities varies from one institution to another, impeding any comparison, verification, analysis and interpretation of the information, very often fragmented and generated from diverse sources. Furthermore, the situation of the disabled persons is not wholistically addressed so far due to the lack of centralized, structured and accessible information related to the wide range of services provided by the stakeholders in Cambodia.

Indeed, significant efforts had been developed through a serial of socio-economic surveys conducted in 1996, 1997 and 1999 by the National Institute of Statistics in partnership with the Ministry of Planning but few data related to the disabled persons has been included in the survey and the categorization of the disabilities is not clearly defined. In addition to this, a survey supported by UNICEF and coordinated by the DAC Secretariat - called "the Socio-economic and Behavioral Pilot Survey on Disabled Persons" - was conducted in Kompong Speu and Banteay Meanchey within March and June 2000 among 243 disabled persons and their families. This pilot survey intended to designing, testing and developing appropriate tools and methodologies that help to ensure consistent, accurate and relevant data gathering and processing on persons with disabilities in the Cambodian context.

This previous pilot survey brought a significant progress by proposing a typology of disabilities that has been witnessed and acknowledged by the Department of Rehabilitation of the Ministry of Social Affairs, Labor, Vocational training and Youth rehabilitation (MOSALVY).

To deal with the issue of the provision and access to services, the National Center of Disabled Persons (NCDP) had developed a comprehensive database on "Services Available for Persons with Disabilities" so that access could be facilitated to the end-users and beneficiaries, including the service providers and disabled individuals. Given the importance of this existing service, American Red Cross continues to support this initiative in collaboration with the DAC Secretariat. To address the issue of disability in Cambodia MOSALVY, DDWG and supportive NGOs jointly supported the happening of the second pilot survey in Kompong Speu by improving the data collection method and tools that had been tested previously.

I. OBJECTIVES

The Pilot Disability Socio-economic/Demographic/Services Availability Data Base Project is aiming at - through on-going and systematic surveys - allowing coherent and interactive data gathering tools and methods, real possibility for analysis, interpretation, updating and dissemination to relevant stakeholders for planning, action, resources allocation, monitoring and evaluation of the impacts.

Specific objectives:

To finalize the standardization of the typology of disabilities, its definition and enforcement within the rehabilitation sectors in accordance to the international classification system and with the cooperation of the MOSALVY.
To develop an adequate and applicable data collection tools and methodologies for nation-wide data gathering, outcomes analysis, interpretation and dissemination.
To develop a sustainable and functional computerized data base system within provincial SALVY for a long run with high potential to enrich it with up to date and reliable data.
To build up and strengthen capacity of MOSALVY and NGOs' staff in the database management. 5/ To design and develop a long term planning in the establishment of long term, reliable and on-going data collection schedule, based on the outcomes of this pilot survey.

II. RESOURCES

II.1. Human resources:

The survey design and the project supervision and monitoring were made by an independent Senior Database Consultant. Another consultant worked in closed collaboration to deal with the technical aspects of the data entry, processing and analysis. The DAC Secretariat appointed a technical coordinator to coordinate this project.

It is important to note that DOSALVY of Kompong Speu appointed 24 surveyors to participate in the survey. The DAC Secretariat was represented by a coordinator and MOSALVY by two facilitation officers.

The DAC Secretariat and MOSALVY with the support of the American Red Cross (AmCross) and UNICEF constituted the core of this program.

NCDP/CBR provided 3 staff to work as surveyors, SSC and JSC appointed one staff each and MOSALVY appointed two staff. AmCross provided an advisor.

Field travels during the monitoring were made possible thanks to two drivers appointed by DAC Secretariat and AmCross.

II.2. The material resources:

A four-wheel drive car (DAC Sec./UNICEF)
A second four-wheel drive car (AmCross)
Two sets of computers (lent by CDPO)
One set of computer (lent by DAC Secretariat)
One set of computer (rent from a shop)
Two sets of computer plus one printer (purchased under the AmCross budget)
A white board
Two desks plus cheval
Kompong Speu's provincial/district color maps (purchased at the Department of Geography)
SSC kindly provided a room for the 3 days training of surveyors and one day evaluation workshop in Kompong Speu.
Data entry tasks were achieved at the DAC Secretariat Database Section in Phnom Penh.

II.3. Funding resources:

The project was possible with financial support received from UNICEF in the amount of USD 9,245 and USD 42,440 from AmCross, as well as the technical, moral and logistic support from these two potential donors and relevant DAC affiliated members.

III. METHODOLOGY

III.1. Scope and covering:

Coordinated by the DAC Secretariat with the collaboration of MOSALVY and affiliated members, the survey took place in eight districts of Kompong Speu Province on a household basis, using a nominative questionnaire as a tool of a structured interview in Khmer language. The eight survey sites encompassed the districts of Barset, Chbar Mon, Samrong Tong, Thpong, Oudong, Oral, Phnom Sruoch and Kong Pisey. A population of 1,260 disabled persons had been counted and among them, 1,055 (i.e. 84%) had been interviewed (table of statistic of disabled person interviewed during the pilot survey Kampong Speu province 03-29 June 2002 is available on request).

III.2. Organization of the survey:

The survey was designed and implemented by a consultant, two MOSALVY representatives and a DAC Secretariat Coordinator under the supervision of the DAC Disability Database Working Group (DDWG).

24 surveyors plus a MOSALVY' s senior team leader appointed by DOSALVY, MOSALVY and DAC member NGOs participated to the survey. In each district, the trained surveyors collected data under the close monitoring of a team leader. 21% of the surveyors were already involved in the 2000 previous survey in Kompong Speu. The most talented ones had been identified during this survey to follow further training so that they will be able to work as Trainer of Trainers (ToT) on a national basis.

Surveyors were provided with 3 days training prior the data collection task and one day workshop to evaluate the constraints of the data collection. The training contents comprised the understanding of the questionnaire, the survey procedure and methodology, the disability socio-cultural insights and basics on rural economics. Role plays were organized to get the surveyors familiar to the field work they had to achieve with maximum quality and reliability.

A screening form was developed and distributed to the village chief of the target villages through the DOSALVY' s staff so that the inventory could be done prior the interview phase (screening form used to inventory the disabled person in the target villages is available on request).

Efforts had been developed to communicate with the different levels of the local administration, including the provincial, the district, the commune and the village, despite the poor administrative linkage between the district, the commune and the village levels. Very often, the information reached the commune and the village heads through direct intervention of the surveyors themselves. However, despite some communication delay, the collaboration between the local administrative bodies was positively assessed by the participants during the closing meeting.

III.3. Sampling and identifying the survey population:

The size of the survey population in each district was determined by the consultant by taking into account the sample representation and the relevance of geographical coverage.

The selection criteria of the target villages are as follow:

Close to the national road
Accessible by secondary road
Service centers/provider
Mountainous areas/ war affected area
Population density
Province/District border.

The features of the selected villages were checked out with the field geographical insights of the surveyors during the 3 days training. Minor changes had been made and a final list of target villages was established (names and administrative location of the surveyed villages is available on request). Table 2 displays the number of target villages according to the criteria.

A total number of 1,055 disabled persons had been interviewed in the province of Kompong Speu where 5,385 disabled persons are living according to the provincial DOSALVY' s statistics (2000-2001 report). Prior to the survey, the respondents were screened by the key informants at the village level, e.g. the village leader, the elderly, the traditional birth attendants, the teachers, the mobile sellers, etc... Based on the screening list, the surveyors used a nominative questionnaire to interview every single disabled persons in the target villages. Each surveyor was able to interview 3-4 disabled person's household per day, under the close supervision of a field team leader. A surveillance officer (MOSALVY' s senior facilitator) also monitored the field team leaders and the surveyors to ensure that the survey procedure had been strictly followed and the data properly gathered, and to solve any administrative or logistical problem encountered with the support of the local authorities.

III.4. Data collection:

The data collection phase lasted 29 days included the service provider survey, involving 24 surveyors appointed by MOSALVY/OSALVY department, OSALVY office and DAC member NGOs.

The surveyors interviewed the disabled persons in the target villages in their respective district. Given the size of the districts - thus the number of target villages- the number of surveyors and monitors was not proportional to the huge task they had to achieve during the data collection phase. This problem occurred in Oral and Samrong Tong where the monitors spent quite a lot of time to ensure maximum accuracy and consistency to data collected.

Data gathered were checked, classified and centralized in Kompong Speu. Data entry and analysis were made possible at the DAC Secretariat database office in Phnom-Penh that had been equipped with computerized data entry tools and relevant facilities.

III.5. Data entry:

As soon as the data gathered are classified and centralized, 2 data entry clerks (DEC) were selected among the 24 surveyors (OSALVY) and 4 other clerks were recruited from both affiliated NGOs and MOSALVY, based on their skills in computer science and survey background to receive 3 days training prior the data entry work. The training was provided by a database design specialist, combining IMPS and SPSS software.

The data entry lasted 14 days. As expected, each DEC was able to enter an average of 10-15 questionnaires per day.

III.6. Data processing, analysis and interpretation:

This technical phase is a joint task involving the senior database consultant and the database design specialist.

Data were processed and analyzed according to the requirements of the DAC Database Working Group. Variables were analyzed separately (single variable analysis) or in correlation with other relevant variables (multi-variable analysis). Single variable analysis gives for instance the distribution of respondents by age group, gender, occupations, marital status, type of disability, educational level, etc...

Multi-variables analysis help to understand and verify some links between different aspects e.g. the relationship between the prevalence of disabilities and the occupations, the discrimination due to gender, the effect of parents' disability on children's schooling, etc..

Another category of data provide qualitative information on the access of disabled persons to services in terms of difficulties, mobility, discrimination, self-exclusion...

The disability service availability survey provides a mapping of the service providers in the survey area (see " the generated materials " in V.1.)

IV. MONITORING and EVALUATION

IV.1. Monitoring:

At the central level the DAC Data Base Working Group (DDWG) plays the role to monitor and evaluate the project in close consultation and cooperation with MOSALVY.

The progress had been steadily reported by the consultants to the DBWG and MOSALVY through informal and formal meetings, under the coordination of the DAC Secretariat.

At the field level DOSALVY was in charge to monitor the progress of the survey through its deputy director who actively traveled in the survey areas with the DAC Secretariat's coordinator, the MOSALVY coordinator and the consultant during the data collection phase.

IV.2. Evaluation:

A one-day workshop organized in SSC' s Kompong Speu office at the end of the survey phase allowed the participants to evaluate the difficulties and successfulness of their mission. Also meetings of DDWG to present preliminary key findings, draft report and final report to all DAC affiliated NGOs members and relevant ministries.

V. OUTCOMES

V.1. The generated materials:

(Key findings available on request)

V.1.1. The Socio-Economic and Demographic Database (SEDEDA):

A nominative database encompassing a population of 1,060 disabled persons of eight districts, of 36 communes and 81 villages of Kompong Speu province has been generated. This database provides key information about their socio-economic situations as well as their type(s) of disability.

Raw data had been registered into a software called IMPS (Integrated Micro-computer Processing System). Data Processing and analysis are made possible through a SPSS (Social Package of Statistical System) software so that cross-tabulation and correlation analysis could be done by advanced users. For common users, a set of pre-processed data is made available in a menu encompassing tables and charts to enable them to access to the key findings and/or to duplicate those materials according to the purposes.

V.1.2. The Service Availability Database (SADA):

This database contains practical and up to date information on the relevant service providers e.g. location, distance from the nearest commune administrative center, treatment fees, schedule, contact persons, accommodations facilities, referral system,...

The geographical location of the service providers is translated into a mapping included in the database. Eight maps of the eight districts surveyed are available in the database with a legend of formal and non-formal service providers ranging from health centers to traditional healers and traditional birth attendants (Maps of the eight districts with location of the service providers is available on request)

V.1.3. The Service Accessibility Database (SACCEDA):

This database intends mainly to provide information on possibilities and difficulties encountered by the disabled persons to access to services. It informs us for instance about:

Where the disabled persons receive treatment or service related to their disability,
How long did the treatment last,
The kinds of service received,
How much did they pay for the treatment,
What are their major problems to access to services
Wishes on how to improve accessibility to services...

V.1.4. A Resource Manual on Disability Issues (REMADIS):

The Resource Manual on Disability Issues was designed and is being developed as a complementary component to the Disability Data System. This computerized "encyclopedia" offers users of the socio-economic/Demographic and Services Availability Database a tool for a comprehensive and informed approach to research, problem solving and understanding the variable issues concerning persons with disabilities and disability issues.

Designed similar to a Web Site, users are able to accesses needed information on a wide range of topics concerning disabilities. The Resource manual is available on CD Rom, making accesses to needed information available without having to utilize the database program. It can actually be used as an integral part of the data system or as a stand-alone program. However, links are provided both programs assisting the ease of use.

Currently there is just a small amount of information ready to include into the manual. It is intended, however, that within the DAC Sec. a system will be developed to regularly update and add information. Through concerted and conscientious effort of the DAC Sec. and supportive agencies and organizations, the Resource Manual will develop into valuable and useful tools for users of the Disability Data System, members of the rehabilitation sector and those concerned with disability issues.

V.2. The qualitative outcomes:

V.2.1. Capacity building of DAC, MOSALVY, DOSALVY and OSALVY staff:

The project enables 26 persons to actively work on a survey in a methodic and scientific manner by achieving all the steps including training, data collection, monitoring/evaluation, data entry/processing/analysis. The project has developed a team spirit among all the participants in a strong willing to attain a common objective that is to build up a reliable, consistent and useful database on the disabled persons.

V.2.2. Toward more awareness and significant ownership:

Awareness and ownership are induced by improved understanding on the importance and the usefulness of this database to assess, plan and strategize any action for the benefit of the disabled persons.

By providing the MOSALVY and stakeholders with this valuable tool, the project was aiming at developing the sense of ownership of the national institutions so that the real beneficiaries are the disabled persons and the services provided are effective and appropriate because they actually address their needs and difficulties.

The DAC Secretariat has the role to continue to sensitize the government side to devote more energy, time and committed human resources to sustaining the database assets.

The Department of Rehabilitation of MOSALVY should make sure that appointed staff do have sufficient sense of ownership and genuine willing to acquire skills that allow them to maximize and develop these assets at the service of the stakeholders and the disabled persons.

VI. RECOMMENDATIONS

Linking MOSALVY and DOSALVY to the district, commune and village administration: The strategy would be to involve the commune leaders in the future surveys, very likely via SEILA program. This involvement would be relevant during the screening and monitoring phases because those steps require strong administrative support to ensure data consistency and reliability.
Enabling the project to select field staff according to capacity to fulfill survey duties. Staff appointment by the government institutions at all level should be limited and larger room should be made to identify the most talented ones to implement the survey and to train additional surveyors in other provinces.
Sensitizing the government institutions on the necessity to improve staff wage via various allowances (food, accommodations, transportation,...) with the participation of the project and to require full commitment and sense of ownership from the selected staff.
Lobbying in favor of gender equity in the staff recruitment by DOSALVY. Lack of female DOSALVY surveyors limits qualitative communication with female disabled persons and may lead to data bias.
Planning appropriate time and adequate transportation means. The field work should be planned during the dry season to access to remote areas.
Providing relevant training to build up capacity of the government institutions especially at the provincial and district levels. Training topics should include the following topics:
- Survey Tools Design and Development: 1 person as Trainer of Trainers (ToT)
- Data Collection and Monitoring Techniques: 4-5 persons as ToT
- Data Entry, Processing and Analysis: Number according to the needs
- Database Management and Development: 1 person from MOSALVY, 1 person from DOSALVY
- Budget Planning, Management and Reporting: 1 person
Recruiting qualified human resources at the provincial and district levels and providing them with above relevant skills. The most skillful surveyors at the district level who have been identified during the current pilot phase should be used as a pool of ToT so that further number of surveyors will be trained in other provinces.
Requiring strong support from affiliated NGOs and organizations to benefit from their insight and secondary data in the remote areas. Survey findings should be disseminated to the affiliated NGOs, organizations and relevant state institutions in order to promote the participatory process.

VII. PERSPECTIVES

To develop plan to further collect data on Service Providers in Phnom Penh and relevant data for the Resource Manual in or outside Cambodia.
Database Availability and Accessibility:
- The database should be installed in a stand by computer, which is located at the DAC-MOSALVY office in Phnom Penh and DOSALVY Kampong Speu province.
- A database program instructor should be made available to the users during working hours at the DAC Secretariat.
- CD Rom loaded with survey data must be available and find support for diffusion of CD-Roms to about 50 stakeholders.
- To propose fee for duplicating other 50 CD-Roms for sale to other interested users and use that income to buy new ones to fill the stock.
- To update and enrich the database with future findings e.g. tables requested by such and such user. It has to be proposed to the DAC DDWG who will assess the pertinence, accuracy and veracity of the findings.
To develop year 2003 plan to replicate the survey model to other provinces with the agreement of DDWG and financial support of various donors.
To develop plan for the capacity building to SALVY' s staff in computer science and tools/methodology of survey design and development.
Frequency of data updating: The project intends to update the data collected in Kampong Speu province every three years through additional surveys.
Confidentiality issue: The diffused CD-Roms of the database will not provide the name of respondents, which will remain confidential through a password system. Only a limited number of persons will be provided with the password to access to those names. The DDWG have the authority to decide who is eligible to be given the password.
Software requirement: To download or access to the CD-Roms of survey data, it is required to install SPSS and Microsoft Office program.

VIII. Funding Sources

ABBREVIATIONS

AmCross	American Red Cross
DAC	Disability Action Council
DOSALVY	Department of Social Affairs, Labour, Vocational Training and Youth Rehabilitation
DDWG	Disability Database Working Group
IMPS	Integrated Micro-Computer Processing System
JSC	Jesuit Service of Cambodia
MOSALVY	Ministry of Social Affairs, Labour, Vocational Training and Youth Rehabilitation
NCDP	National Center for Disabled Persons
OSALVY	Office of Social Affairs, Labour, Vocational Training and Youth Rehabilitation
SEILA	Socio-Economic Improvement in Local Areas
SPSS	Social Package of the Statistical System
SSC	Social Service of Cambodia