1 The Socioeconomic Impacts of COVID-19 on Households in Cambodia Results from a High-Frequency Phone Survey of Households Round 3 14 October–6 November 2020 (LSMS+ and IDPoor sample) 17 February, 2021 2 High-Frequency Phone Survey of Households in Cambodia Round 1 Round 2 Round 3 11–26 May 2020 (LSMS+) Survey period 17 August–7 September 2020 14 October–6 November 2020 11–28 June 2020 (IDPoor) 1,684 respondents 1,667 respondents 1,665 respondents Sample size • 700 (LSMS+) • 612 (LSMS+) • 481 (LSMS+) • 984 (IDPoor) • 1,055 (IDPoor) • 1,184 (IDPoor) LSMS+: National, Urban and Rural LSMS+: National, Urban and Rural LSMS+: National, Urban and Rural Coverage IDPoor: National IDPoor: National IDPoor: National Partnerships World Bank; World Bank; World Bank; Ministry of Planning (MoP, the National MoP, NIS; MoSVY; National Social MoP, NIS; MoSVY; NSPC Institute of Statistic (NIS)); Protection Council (NSPC) Ministry of Social Affairs, Veterans and Youth Rehabilitation (MoSVY). Coordinated with other Development Partners (DPs), shared instruments and received feedback 3 Key Findings (I) COVID-19 Testing and Vaccination • Cambodians demonstrate a high willingness to get tested for and vaccinated against COVID-19 when it is at no cost. • More than 8 in 10 respondents are willing to get tested for free. • Around 9 in 10 are willing to receive an approved vaccine for free. • Fewer are willing to get vaccinated at a cost (around 6 in 10 respondents). Access to Food Staples, Health & Education Services • Close to 100 percent of households can access food staples as markets continue to function well. • Close to 100 percent of households can access medicine and health services when needed. • As schools reopened, children’s engagement in education has returned to pre-pandemic levels. • Around 92 percent of households with school-age children (6–17 years) reported their children are engaged in education or learning activities. • Learning continued to shift from remote towards face-to-face activities. 4 Key Findings (II) Employment and Income • After an initial shock due to COVID-19, employment remained relatively stable, but has yet to return to pre-pandemic levels when 82 percent of respondents were working. • About 65 percent of the respondents were working in October. Nearly all remained in the same jobs since the last round. • The negative impact of the pandemic on non-farm family businesses remains substantial but is diminishing. Weak consumer demand continues to constrain business revenues. • In October, 54 percent of households engaged in a non-farm family business reported having made “less” or “no revenues” relative to the previous month, compared to 64 percent in August and 81 percent in May. About 84 percent of family businesses with reduced or no sales mention having fewer or no customers relative to the previous month. • Fewer households report a decline in household income, but substantial income losses remain. • In October, 51 percent of households reported a decline in household income relative to the previous round, compared to 63 percent in August and 83 percent in May. • Households reported an average reduction in total household income of around 40 percent in October and in August. • Not all households experiencing income losses due to the COVID-19 pandemic are currently covered under the IDPoor program, which can result in increased poverty. 5 Key Findings (III) Social Assistance • Marked increase in the proportion of poor and vulnerable households receiving social assistance (SA) from the government since the launch of the COVID-19 relief cash transfer program in June 2020. • By October, 92 percent of surveyed IDPoor households had received SA and 92 percent the relief cash transfers. • Only 8 percent of IDPoor households had yet to receive these relief transfers, but registration —required to receive the transfers—had been increasing. • Amount and frequency of cash transfers provided to households are as expected: Most beneficiaries have received 4 to 5 installments of the cash transfers, averaging a total of US$182 since the program launch in June 2020. Food Security • Food security improved between August and October. • Among the LSMS+ households, the prevalence of moderate-or-severe food insecurity in October was 17 percent, down from 48 percent in August. • Among IDPoor households, the prevalence declined from 67 percent in August to 38 percent in October. Payment Methods • Cash is still the predominant payment method in Cambodia, and many are not interested in any other payment devices. 6 Cambodians demonstrate a high willingness to get tested for COVID-19 at no cost If you could get tested for free for COVID-19, would you get tested? 100 5 4 4 4 9 6 11 10 11 8 10 15 80 60 % 84 86 85 84 87 40 75 20 0 Cambodia Urban Rural Top 60 Bottom 40 LSMS+ IDPoor Yes No Not sure 7 Cambodians also show a high willingness to receive an approved vaccine against COVID-19 If an approved vaccine to prevent COVID-19 was If an approved vaccine to prevent COVID-19 was available at no cost, would you agree to be available at cost, would you agree to be vaccinated? vaccinated? 100 3 5 100 5 7 5 7 10 7 9 7 5 10 12 11 6 6 6 6 80 80 23 24 23 24 23 31 60 60 % % 89 86 89 88 90 90 40 40 67 70 66 68 65 59 20 20 0 0 Cambodia Urban Rural Top 60 Bottom 40 Cambodia Urban Rural Top 60 Bottom 40 LSMS+ IDPoor LSMS+ IDPoor Yes No Not sure Yes No Not sure 8 Vaccine side effects and safety, and low perceived risk of COVID-19 infection are reasons respondents are hesitant about COVID-19 vaccine Reasons for being against or unsure about COVID-19 vaccination 37 I am worried about the side effects 34 27 I am not enough at risk of contracting COVID-19 26 20 I don't think it will be safe 29 6 I don't think it will work 6 2 I am against vaccines in general 0 8 Other 6 0 10 20 30 40 % LSMS+ IDPoor Sample of respondents who are not willing or are unsure about receiving a COVID-19 vaccination at no cost. 9 Access to food staples remained robust as markets continued to function well since the onset of the COVID-19 pandemic In the last 7 days, was your household able to buy… 100 IDPoor 100 100 Rice 98 LSMS+ 100 100 100 Fish or meat IDPoor 100 100 99 LSMS+ 100 100 Vegetable or fruit 100 IDPoor 100 100 99 LSMS+ 100 99 0 20 40 60 80 100 % Round 1 Round 2 Round 3 10 Nearly all households have been able to access medicine and health services when needed throughout the pandemic, even as demand rose In the last 7 days, was your household able to buy Since the last interview, did you or any household medicine? member ...? 100 100 2 2 30 28 80 39 34 34 33 45 44 80 60 57 55 73 60 % 60 98 100 100 100 98 100 40 % 61 66 40 55 56 69 72 20 39 66 67 26 20 42 45 0 R1 R2 R3 R1 R2 R3 R1 R2 R3 R1 R2 R3 LSMS+ IDPoor LSMS+ IDPoor 0 Need medical treatment Access medical treatment R1 R2 R3 R1 R2 R3 (for those who needed LSMS+ IDPoor treatment) Yes No Not tried Yes No Phase III: School closures Phase I: Partial Phase II: Partial Reopening of nationwide reopening of schools reopening of schools schools nationwide Mar. 2020 May 2020 Aug. 2020 Aug.–Sep. 2020 Sep. 2020 Oct.–Nov. 2020 Nov. 2020 HFPS Round 1 HFPS Round 2 HFPS Round 3 Children engaged in Children engaged in Children engaged in education/learning education/learning education/learning activities activities activities (% households with (% households with (% households with school-age children) school-age children) school-age children) No 8% No No 25% 38% Yes 62% Yes Yes 75% 92% Source: LSMS+ sample. “In the last 7 days” is the reference period. 12 As schools reopened, children's engagement in education/learning activities returned to their pre-pandemic levels and transitioned to face-to-face learning In the last 7 days, have the children engaged in Types of education or learning activities in the last 7 days education or learning activities? 100 100 95 86 92 92 92 78 89 80 90 86 66 80 58 80 60 75 76 47 45 % 69 70 36 70 68 40 66 29 29 % 63 64 28 62 62 24 59 20 60 20 10 3 3 0 2 3 2 0 50 0 Cambodia Urban Rural Bottom 40 Top 60 LSMS+ IDPoor LSMS+ IDPoor Round 1 Round 2 Round 3 Round 1 Round 2 Round 3 Note: Schools were closed in mid-March and partially reopened in August 2020 and on 7 September 2020. On November 2, 2020, all schools reopened. 13 Education/learning activities shifted from remote learning activities to in- person meetings with teachers across the country and population groups Types of education or learning activities in last 7 days Types of education or learning activities in last 7 days by urban and rural by top 60 and bottom 40 60 60 51 48 45 41 40 40 31 18 21 18 20 20 9 8 10 10 2 4 0 % 0 % 0 -1 -1 -1 -2 -1 -1 -1 -5 -7 -5 -7 -20 -14 -11 -20 -15 -16 -20 -24 -28 -26 -28-25 -40 -32 -40 -33 -33 -36 -60 -60 Urban Rural Urban Rural Urban Rural Urban Rural Urban Rural Top 60 Bottom Top 60 Bottom Top 60 Bottom Top 60 Bottom Top 60 Bottom 40 40 40 40 40 Met with Completed Listened to Watched TV Mobile apps teacher assignment radio learning Met with Completed Listened to Watched TV Mobile apps teacher assignment radio learning (Round 2 - Round 1) (Round 3 - Round 2) (Round 2 - Round 1) (Round 3 - Round 2) Source: LSMS+ sample. Changes in the proportion between rounds. Note: Schools were closed in mid-March and partially reopened in August 2020 and on 7 September 2020. On November 2, 2020, all schools reopened. 14 Employment has mostly remained steady since May 2020, but has yet to return to pre-pandemic levels when 8 in 10 respondents were working In the last 7 days, did you do any work? Why did you stop working? 100 40 7 Business/office closed due to Covid-19 13 18 20 16 1 21 10 19 Furlough (temporarily laid off) 3 80 11 5 2 11 10 9 13 Seasonal worker 32 6 5 8 19 1 8 60 Not farming season 5 24 5 Ill/quarantined 21 % 9 6 40 78 Other 2 35 65 65 64 65 3 Need to care for ill relative 3 20 3 Business/office closed due to other reasons 9 4 2 Not able to farm due to lack of inputs 3 0 2 Round 1 Round 2 Round 3 Round 2 Round 3 Vacation 6 2 2 Retired LSMS+ IDPoor 2 1 Not able to go to farm due to movement… 1 Out of work since last round Maternity leave 5 Stopped working since last round Currently working (changed job since last round) 0 5 10 15 20 25 30 35 40 45 % Currently working (same job) Round 1 Round 2 Round 3 “Before the COVID-19 outbreak” is the reference period in round 1. Source: LSMS+ sample. “Other” reasons in round 3 mostly are related to flooding. 15 The negative impact of the pandemic on non-farm family businesses remains substantial but is diminishing. Weak consumer demand continues to drive revenue losses. Compared to last month, revenue from business Reasons for having less or no revenue? sales ...? 100 5 5 5 100 5 8 12 16 14 15 21 30 80 31 80 40 44 42 60 60 % % 73 88 84 86 40 40 79 61 70 52 48 48 20 20 8 3 2 0 3 4 0 Round 1 Round 2 Round 3 Round 2 Round 3 Round 1 Round 2 Round 3 Round 2 Round 3 LSMS+ IDPoor LSMS+ IDPoor No revenue Less The same Higher No customers/few customers Other reason 16 Fewer households reported a decline in household income, but substantial income losses remain Changes in total household income How much was total household income reduced since the last interview (in %) since the last interview? R1 83 16 1 LSMS+ R2 63 29 8 -41 LSMS+ -39 R3 51 42 7 R1 88 11 1 IDPoor -44 R2 57 32 12 IDPoor -41 R3 44 46 9 0 20 40 60 80 100 -50 -40 -30 -20 -10 0 % % Reduced Stayed the same Increased Round 2 Round 3 “Before the COVID-19 outbreak” is the reference period for R1. Average % reduction in total household income for sample of households reporting a reduction in total household income since the last round. 17 Losses in income slowed across population groups and area of residence in Cambodia, but many families still suffered losses Changes in total household income How much was total household income reduced since the last interview (in %) since the last interview? R1 85 15 0 Round 2 Round 3 Urban R2 61 33 6 Bottom Bottom R3 51 44 5 Urban Rural 40 Top 60 Urban Rural 40 Top 60 R1 0 83 16 1 Rural R2 63 29 8 R3 51 41 8 -10 Bottom 40 R1 84 15 1 R2 64 27 9 -20 R3 48 42 10 % R1 83 16 1 -30 Top 60 R2 61 31 7 R3 53 41 5 -40 -38 -39 -39 -41 -40 0 20 40 60 80 100 -42 -42 -42 % -50 Reduced Stayed the same Increased Source: LSMS+ sample. Average % reduction in total household income for sample of households reporting a reduction in total household income since the last round. 18 Households perceive their well-being and economic status to have deteriorated since the previous year How has your household wellbeing and economic How has your household wellbeing and economic status changed? status changed? LSMS+ IDPoor 100 3 100 6 8 8 80 32 80 48 33 53 60 60 % % 40 44 40 41 40 30 20 20 18 17 9 9 0 0 Compared to September 2019 Compared to June 2020 Compared to September 2019 Compared to June 2020 Increased by a lot Increased by a lot Increased by a little bit Increased by a little bit Stayed about the same Stayed about the same Reduced by a little bit Reduced by a little bit Reduced by a lot Reduced by a lot 19 High coverage of social assistance (SA) among IDPoor: 9 in 10 IDPoor households receive some form of SA, mostly via cash transfers from the government Share of social assistance Main source of social assistance Types of social assistance beneficiaries since last interview 3% 2% 2% 1% 8% 8% 94% 90% 92% Social assistance Government Food No social assistance NGO Direct cash transfers Religious body Other Other in-kind transfers (excluding food) Source: IDPoor sample. Round 3. Source: IDPoor sample. Round 3. Source: IDPoor sample. Round 3. 20 Coverage of social assistance among IDPoor increased since June 2020 following the launch of the government's relief cash transfer program Share of social assistance Main source of social Types of social assistance beneficiaries since last assistance interview 100 3 11 2 100 3 2 100 2 1 12 90 91 92 8 8 89 12 29 80 80 80 60 60 20 60 50 % % % 97 94 90 91 40 83 40 40 30 52 20 20 20 0 0 0 LSMS+ IDPoor Round 1 Round 2 Round 3 Round 1 Round 2 Round 3 Other Other in-kind transfers (excluding food) Religious body Food Round 1 Round 2 Round 3 NGO Direct cash transfers Government Source: Eligible sample (IDPoor households with Source: IDPoor sample. Source: IDPoor sample. registered equity card). 21 Relief cash transfers have reached many IDPoor households. A small proportion remains uncovered, but registration has increased among those who did not receive these transfers. Have you ever received the relief Did you register with the village Why did you not register? cash transfer program from govt chief/commune council to receive since June 2020? the transfer? 100 100 10 10 8 14 5% 80 80 60 60 74 60 36% % % 90 90 92 86 40 40 59% 20 20 40 26 0 0 Round 2 Round 3 Round 2 Round 3 Round 2 Round 3 Unaware of the program LSMS+ IDPoor Didn’t know the transfer is for them Yes No Yes No Other Source: Eligible sample (IDPoor households with Source: IDPoor sample that have not yet Source: IDPoor sample. Round 3. registered equity card). received relief transfers. 22 Take-up is high among IDPoor households that registered for the relief cash transfer program 100 97 97 95 98 97 96 96 99 98 97 96 97 96 95 97 94 97 98 99 99 96 96 95 95 93 94 80 60 % 40 20 0 All Male Female Phnom Plain Tonle Sap Coastal Plateau 1 (Poorest) 2 3 4 5 (Average Penh and and or higher) urban Mountain areas All Gender Region Social economic status Round 2 Round 3 Source: IDPoor sample. 23 Over 9 in 10 IDPoor households perceive the registration and payment process for the relief transfers as easy How easy did you find the registration How easy did you find the process for process for the relief transfer program? receiving payments from the relief transfer program? 1% 2% 7% 16% 19% 76% 79% Very easy Easy Difficult Very difficult Very easy Easy Difficult Very difficult Source: IDPoor sample. Round 3. Source: IDPoor sample. Round 3. 24 Frequency and amounts of cash transfers are as expected: Most beneficiaries have received 4 to 5 cash payments, averaging US$182 in total How many times have you received the transfer How much did you receive in total? so far? 50 48 250 227 40 200 181 182 31 30 150 USD 136 % 100 20 100 16 10 50 41 4 2 0 0 Once Twice Three times Four times Five times Once Twice Three Four Five times Total times times Round 3 Source: IDPoor sample. 25 Most households spent their cash transfers on food, a significant portion also spend it on essential items What did you do with the money that you received? 98 Food 100 43 Other essential items 54 6 Paid back loan 8 9 Other 5 0 10 20 30 40 50 60 70 80 90 100 % LSMS+ IDPoor Data from round 3 only. 26 Food insecurity improved between August and October 100 “In the last 30 days” is the reference period. 80 People experiencing moderate levels of 67 food insecurity will typically eat low quality diets and might have been 60 forced, at times during the year, to also % 48 reduce the quantity of food they would 39 normally eat, while those experiencing 40 severe levels would have gone for entire days without eating, due to lack 20 17 of money or other resources to obtain food. 5 1 4 3 0 Prevalence of food insecurity, based on R2 R3 R2 R3 the Food Insecurity Experience Scale LSMS+ IDPoor (FIES), was estimated by the Food and Agriculture Organization of the United Total population Nations. Moderate-or-severe food insecurity Severe food insecurity 27 Relief cash transfers are important for IDPoor households and are perceived to have had a positive impact on household economic well-being How important was the relief transfer for your How much of a difference did the relief transfer household's (economic) well-being? make to your household's (economic) wellbeing? 0% 0% 2% 11% 19% 46% 45% 44% 33% Extremely important 1 - no difference Very important 2 3 Moderately important 4 Not important at all 5 - a lot of a difference Source: IDPoor sample. Round 3. Source: IDPoor sample. Round 3. 28 Many Cambodians are still unbanked and prefer to make payments in cash instead of using other payment devices Do you have a payment account? Do you use anything other than cash to make 100 payments? 80 74 80 71 60 60 75 86 % % 40 40 20 17 16 20 19 8 7 3 5 1 1 3 9 5 0 0 LSMS+ IDPoor Yes, Yes, mobile Yes, other No, but No, and not payment phone interested interested No card Yes, another type of account Yes, e-money/mobile money account LSMS+ IDPoor Yes, bank account 29 Difficulty of use is the main reason for using cash only, while convenience is the primary reason for using payment methods other than cash Reason for not using other payment devices Reasons for using payment device of choice 79 85 Too difficult to use 74 More convenient 93 11 Other 14 41 6 Safer Too expensive 34 9 Don't trust the 4 2 technology 1 Other reason 2 Don't trust the 0 institutions 0 1 0 Cheaper Concern for privacy 0 2 0 20 40 60 80 100 0 20 40 60 80 100 % % LSMS+ IDPoor LSMS+ IDPoor Sample of respondents using payment methods other than cash and Sample of respondents only using cash to make payments who are not respondents who are using cash but would be interested in other devices. interested in other payment devices. 30 Concluding remarks • The Cambodian economy continues to suffer from the impacts of COVID-19 pandemic, although there are signs that economic activity is picking up. • The pandemic has had negative impacts on jobs and incomes; these impacts appear to be less severe compared to the onset of the pandemic, but a substantial share of households continues to face challenges. • Prolonged economic hardships linked to the lingering global pandemic however risk increasing poverty. • The government has temporarily expanded the existing social assistance program to provide cash transfers to impoverished families during the COVID-19 pandemic and has provided unemployment benefits for suspended workers in tourism and garment workers for a brief period. • Cambodia had very low levels of social assistance spending pre-COVID. • Relief cash transfer program has drastically increased social assistance to the poor and vulnerable in Cambodia in a short timeframe. • This has provided much-needed support during difficult times. • While the relief transfers have high demand and some positive impact, not all households that have been adversely impacted by the pandemic are covered under the government’s assistance program. • Only around 15 to 20 percent of the HHs covered (much less than those negatively affected by the COVID-19 crisis: newly poor, the vulnerable). • The evolving COVID-19 pandemic implies that the full impact of the crisis on households is yet to be known. To mitigate the social and economic impacts, instituting broad-based social assistance and boosting pro-poor and growth enhancing public investments can help. 31 Implementation plan Follow-up (Round 3) Baseline (Round 1) October–November 2020 May–June 2020 Knowledge, Access, Knowledge, Behavior, Employment, Income Access, Employment, Loss, Food Insecurity, Income Loss, Food Safety Net, Vaccination, Insecurity, Coping Socioeconomic Status, Mechanism, Safety Net Payment Methods Follow-up (Round 2) Follow-up (Round 4) August–September 2020 December 2020–January 2021 Access, Employment, Knowledge, Access, Income Loss, Food Employment, Income Loss, Insecurity, Safety Net, Food Insecurity, Coping Migration Mechanism, Safety Net, Socioeconomic Status, Payment Methods 32 Annex: Types of social assistance programs Eligibility criteria Transfer amount COVID-19 related Social Assistance Programs Relief cash transfer program for poor IDPoor households (See next slide) and vulnerable households Unemployment benefits for Garment and tourism workers in the US$70 per month for two months suspended workers in garment and formal sector (US$40 paid by the government, and tourism sector US$30 paid by the factory) Non-COVID-19 related Social Assistance Programs Conditional cash transfer for pregnant IDPoor households US$190 for 1000 days women and child under 2 Home grown school feeding program All household with children in the targeted schools Scholarship program Performance based (school) IDPoor households (government) 33 Annex: Relief cash transfer program for poor and vulnerable households during COVID-19 Phnom Penh Other urban Other rural IDPoor 1 IDPoor 2 IDPoor 1 IDPoor 2 IDPoor 1 IDPoor 2 Household $30 $30 $30 $30 $20 $20 Each member $13 $9 $10 $7 $6 $4 Vulnerable member Child aged 0-5 $10 $7 $10 $7 $6 $4 Disability $10 $7 $10 $7 $6 $4 Adult aged 60+ $10 $7 $10 $7 $6 $4 HIV/AIDS $10 $7 $10 $7 $6 $4 IDPoor1 households (very poor) are estimated to receive on average $67 per month, while IDPoor2 (poor) are estimated to receive $52 34 Thank you Wendy Karamba and Kimsun Tong led the Cambodia High-Frequency Phone Survey (HFPS) team that comprised of Maheshwor Shrestha, Sokbunthoeun So and Isabelle Salcher. Nuppun Research Consulting implemented the survey with technical and financial support from the World Bank. Additional financial contributions for the HFPS were received from the Public Financial Management and Service Delivery Trust Fund contributed by Australia and the European Union. The team is grateful to the National Institute of Statistics of the Ministry of Planning and the Ministry of Social Affairs, Veterans and Youth Rehabilitation for their collaboration, as well as the Food and Agriculture Organization for their analytical support on the Food Insecurity Experience Scale (FIES). Website: Monitoring the Impact of COVID-19 on Households in Cambodia Contact: Wendy Karamba Kimsun Tong