PCR: CAM 27411

ASIAN DEVELOPMENT BANK

PROJECT COMPLETION REPORT

ON THE

BASIC SKILLS PROJECT

(Loan 1368-CAM[SF])

IN CAMBODIA

July 2003
 CURRENCY EQUIVALENTS

Currency Unit – riel (KR)

At Appraisal At Project Completion
(July 1995) (February 2003)
KR1.00 = $0.0004 $0.00026
$1.00 = KR2300 KR3835

ABBREVIATIONS
ADB – Asian Development Bank
AusAid – Australian Agency for International Development
BME – benefit monitoring and evaluation
CES – Continuing Education System
CNHE – National Center for Hygiene and Epidemiology (now known as NIPH)
CPA – complementary package of activities (at referral hospitals)
DTVET – Department of Technical and Vocational Education and Training
ECSS – Ecole des Cadres Sanitaires Secondairies
(Central Health Workers' School, now known as TSMC)
HPT – health personnel training
HRD – Human Resources Development of MOH
HRMIS – human resources management information system
IACT – Industrial Advisory Training Committee
ILO – International Labor Organization
ISIAF – Innovative Skills Investment Assistance Fund
MOEYS – Ministry of Education, Youth, and Sport
MOH – Ministry of Health
MPA – minimum package of activities
MTR – midterm review
NGO – nongovernment organization
NIB – National Institute of Business (formerly known as Secondary School
of Business and School of Commerce)
NIPH – National Institute of Public Health
NTB – National Training Board
NTF – National Training Fund
NTTI – National Technical Training Institute
NVTC – National Vocational Training Center
PAC – Project Advisory Committee
PHC – primary health care
PHD – provincial health department
PIU – project implementation unit
PTC – provincial training center
RTC – regional training center
SEGF – Self-Employment Generation Fund
TENA – training evaluation needs assessment
TGF – Training Grant Fund
TSMC – Technical School of Medical Care
TVET – technical and vocational education and training
WHO – World Health Organization
WID – women-in-development
NOTE
(i) The fiscal year (FY) of Government of Cambodia ends on 31 December.

(ii) In this report, "$" refers to US dollars.

 CONTENTS
Page

BASIC DATA i
MAP v
EXECUTIVE SUMMARY vi
I. PROJECT DESCRIPTION 1
II. EVALUAT ION OF DESIGN AND IMPLEMENTATION 2
A. Relevance of Design and Formulation 2
B. Project Outputs 2
C. Project Costs 6
D. Disbursements 6
E. Project Schedule 7
F. Implementation Arrangements 7
G. Conditions and Covenants 7
H. Related Technical Assistance 7
I. Consultant Recruitment and Procurement 8
J. Performance of Consultants, Contractors, and Suppliers 9
K. Performance of the Borrower and the Executing Agency 9
L. Performance of ADB 9
III. EVALUATION OF PERFORMANCE 10
A. Relevance 10
B. Efficacy in Achievement of Purpose 10
C. Efficiency in Achievement of Outputs and Purpose 10
D. Preliminary Assessment of Sustainability 11
E. Environmental, Sociocultural, and Other Impacts 11
IV. OVERALL ASSESSMENT AND RECOMMENDATIONS 12
A. Overall Assessment 12
B. Lessons Learned 12
C. Recommendations 13
APPENDIXES
1. Project Framework 14
2. Comparison of Planned and Actual Key Project Outputs by Component 17
3. Establishment of the National Training Board (NTB) and National Training Fund (NTF) 23
4. Organization Chart of the Ministry of Education, Youth, and Sport (MOEYS) 33
(Before and After the Project)
5. Enrollment at Technical and Vocational Education and Training (TVET) Institutions 35
6. International Fellowships and In-Country Training & Staff Development 36
7. Minimum Package of Activities (MPA) Training Modules 37
8. Project Cost and Financing Plan 39
9. Disbursement Summary 40
10. Implementation Schedule 41
11. Compliance with Major Loan Covenants 43
12. Capacity Building for Technical and Vocational Education and Training (TVET) 51
13. Consultancy Services 53
14. Health Cadre Before and After the Project 54
15. Assessment of Overall Performance of the Project 56
16. Benefit Monitoring and Evaluation 57
 BASIC DATA

A. Loan Identification

1. Country Cambodia
2. Loan Number 1368-CAM(SF)
3. Project Title Basic Skills Project
4. Borrower Kingdom of Cambodia
5. Executing Agency Part A: Ministry of Education, Youth, and Sport
Part B: Ministry of Health
6. Amount of Loan SDR12.749 million
7. Project Completion Report Number PCR: CAM 747

B. Loan Data
1. Appraisal
– Date Started 16 Mar 1995
– Date Completed 5 Apr 1995

2. Loan Negotiations
– Date Started 12 Jul 1995
– Date Completed 13 Jul 1995

3. Date of Board Approval 30 Aug 1995

4. Date of Loan Agreement 2 Nov 1995

5. Date of Loan Effectiveness

– In Loan Agreement 2 Feb 1996
– Actual 20 Nov 1995
– Number of Extensions 0

6. Closing Date
– In Loan Agreement 31 May 2001
– Actual 14 Feb 2003
– Number of Extensions 2

7. Terms of Loan
– Interest Rate 1% per annum
– Maturity 40 years
– Grace Period 10 years

8. Disbursements
a. Dates
Initial Disbursement Final Disbursement Time Interval

2 Apr 1996 14 Feb 2003 6 years and 9.5 months

Effective Date Original Closing Date Time Interval

20 Nov 1995 31 May 2001 6 years and 6.5 months

 ii
b. Amount ($'000)
Last Net
Original Amount Amount Undisbursed
Category or Subloan Revised Amount
Allocation Cancelled Disbursed Balance
Allocation Available
1. Civil Works
a. Part A 864 1,225 11 1,214 1,214 0
b. Part B 705 616 0 616 616 0
2. Equipment and Furniture
a. Part A 2,996 3,572 166 3,406 3,406 0
b. Part B 774 1,184 -28 1,212 1,212 0
3. Training and Fellowships
a. Part A 5,847 4,704 89 4,615 4,615 0
b. Part B 1,525 1,993 50 1,943 1,943 0
4. Consulting Services
a. Part A 1,857 1,433 51 1,382 1,382 0
b. Part B 853 676 -10 686 686 0
5. Operation and Maintenance
a. Part A 360 73 11 62 62 0
b. Part B 128 107 26 81 81 0
6. Project Implementation Unit
a. Part A 355 408 -17 425 425 0
b. Part B 257 215 -4 219 219 0
7.Service Charge 398 333 0 333 333 0
8. Unallocated 2,963 18 18 18 18 0
9. Imprest Fund
a. Part A -35 -35 0 0 0
b. Part B -1 -1 0 0 0

Total 19,882a 16,521b 327 c 16,194 16,194 0

a
Equivalent of SDR12,749,000 at appraisal.
b
The exchange rate depreciated during implementation from SDR1=$0.641216 at appraisal to SDR1=$1.37654 at loan
closing.
c
Cancelled at loan closing.

9. Local Costs (ADB -Financed)

– Amount $4.6 million
C. Project Data

1. Project Cost ($ million)

Cost Appraisal Estimate Actual

Foreign Exchange Cost 15.40 16.20

Local Currency Cost 9.60 3.10
Total 25.00 19.30

2. Financing Plan ($ million)

Cost Appraisal Estimate Actual Total

Total
Foreign Local Foreign Local
Implementation Costs
Borrower-Financed 0.00 5.00 5.00 0.00 3.10 3.10
ADB-Financed 15.00 4.60 19.60 15.90 0.00 15.90
Subtotal 15.00 9.60 24.60 15.90 3.10 19.00
IDC Costs
Borrower-Financed 0.00 0.00 0.00 0.00 0.00 0.00
ADB-Financed 0.40 0.00 0.40 0.30 0.00 0.30
Subtotal 0.40 0.00 0.40 0.30 0.00 0.30
Total 15.40 9.60 25.00 16.20 3.10 19.30
ADB = Asian Development Bank, IDC = interest during construction.
 iii

3. Cost Breakdown by Project Component ($ million)

Component Appraisal Estimate Actual

1. Civil Works
c.Part A 1,500 2,093
d.Part B 1,220 1,061
2. Equipment and Furniture
c.Part A 3,150 3,457
d.Part B 900 1,214
3. Training and Fellowships
c.Part A 7,710 6,057
d.Part B 1,730 2,084
4. Consulting Services
c.Part A 2,060 1,431
d.Part B 980 687
5. Operation and Maintenance
c.Part A 530 72
d.Part B 160 82
6. Project Implementation Unit
c.Part A 380 440
d.Part B 280 251
7. Physical Contingencies 1,800 0
8. Price Contingencies 2,200 0
9. Service Charges 400 333
Total 25,000 19,262

4. Project Schedule
Item Appraisal Estimate Actual
Date of Contract with Consultants Mar 1996 Sep 1996
Completion of Engineering Designs Jun 1996 Dec 1996
Civil Works Contract
Date of Award Sep 1996 Nov 1996
Completion of Work Nov 2000 Jul 2001
Equipment and Supplies
Dates
First Procurement Sep 1997 Oct 1997
Last Procurement Nov 1999 Aug 2002
Completion of Equipment Installation Dec 1999 May 1999
Start of Operations

5. Project Performance Report Ratings

Ratings
Development Implementation
Implementation Period Objectives Progress
20 Nov 1995 to 19 Nov 1996 - Partly Satisfactory
20 Nov 1996 to 19 Nov 1997 - Partly Satisfactory
20 Nov 1997 to 19 Nov 1998 Satisfactory Satisfactory
20 Nov 1998 to 19 Nov 1999 Satisfactory Satisfactory
20 Nov 1999 to 19 Nov 2000 Satisfactory Highly Satisfactory
20 Nov 2000 to 19 Nov 2001 Satisfactory Highly Satisfactory
20 Nov 2001 to 31 May 2002 Satisfactory Highly Satisfactory
iv

D. Data on Asian Development Bank Missions

Persons Person-Days Specialization
a
Name of Mission Date of Members
(no.) (no.)

Fact-Finding 12-30 Sep 94 5 90 d, a, a, e, g

Appraisal 16 Mar–5 Apr 95 6 100 d, a, a, d, c, e
Inception Review 29 Jan–8 Feb 96 2 22 a, a
Review 1 5–15 Jul 96 1 11 a
Review 2 5–13 Mar 97 1 9 a
Review 3 22–27 Jan 98 2 12 a, a
Review 4 15–25 Mar 99 2 22 a, h
Review 5 (Special Loan Admin.) 22–26 Mar 99 1 5 a
Review 6 25–29 Oct 99 1 5 a
Review 7 15–19 May 00 1 5 a
Review 8 11–20 Jul 01 2 20 a, h
Review 9 22–30 Nov 01 1 9 a
b
Project Completion Review 10–21 Feb 03 2 24 a, e
a
a = health/project specialist, b = financial analyst, c = counsel, d = economist, e = consultant, f = control officer,
g = programs officer, h = assistant/senior assistant.
b
The mission comprised Mr. Wan Azmin, health specialist/mission leader, and Mr. Harry Abrillo, consultant.
v
vi

EXECUTIVE SUMMARY

The social-political conflicts before the 1990s devastated Cambodia’s predominantly

agrarian economy. Cambodia is one of the least-developed countries in Asia, with a gross
domestic product of $259 per capita, a human index of 0.54, a human poverty index of 45% in
2001, and 36% poverty incidence in 1997. Life expectancy at birth was 56.4 years in 1999, child
malnutrition was 52% and infant mortality rate was 95 per 1,000 live births. From 80 to 90% of
Cambodia's population lives in rural areas. The Royal Government of Cambodia began
implementation of its development programs with international assistance in the early 1990s.
Cambodia is still recovering; its average annual economic growth rate was about 7% from 1999
through 2001.

The Government placed high priority on a substantial investment in physical

infrastructure requiring a large number of skilled workers. The Government decided to increase
basic skills training to meet the increasing demand for skilled labor and labor productivity, and to
increase the income earning capacity of the workforce, particularly rural workers. The
Government also planned to upgrade basic skills and increase the knowledge of primary health
workers in peripheral areas so it strongly supported investments in general education, technical
and vocational training, and primary health care. The Government’s development policy
emphasized human development, sustained economic growth, and management of natural
resources. Within the education sector, technical and vocational education and training (TVET)
was selected for immediate attention because increasing physical infrastructure investments in
Cambodia had caused an urgent demand for skilled workers. Health personnel training (HPT)
was emphasized to improve the welfare of the poor rural population, particularly women and
children.

The Project's main objectives were to help the Government (i) to develop training in
basic skills needed for the development of physical infrastructure, the growing service industry,
and the delivery of basic health services; (ii) give basic income-generating skills to
disadvantaged and displaced people; and (iii) develop planning and management capacities in
health care training.

Project activities facilitated the development of the infra-structural and industrial sectors
expected in the medium term, with foreign investment at the national, central, and southern
provinces. In the first half of the Project period, implementation focused on capacity building for
the Department of Technical and Vocational Education and Training (DTVET) of the Ministry of
Education, Youth, and Sport, and Human Resource Department of the Ministry of Health
(MOH), and with rehabilitating the TVET training system and providing priority training programs
to meet immediate needs. The remaining Project period was devoted to consolidation of
capacity building and support for the expansion of the TVET training delivery system in the light
of labor market signals.

The Project TVET was completed satisfactorily as planned at appraisal. The DTVET
building was completed, and DTVET's organizational, planning, and management capacities
were strengthened. DTVET presently continues to plan and manage the TVET system in
Cambodia, and to coordinate the operations of the National Training Board and the National
Training Fund. The TVET system has become a major player in Cambodia's development
strategy, and extended from seven to nine other provinces. Improvement of the quality and
relevance of TVET training continues, including improvement of TVET's four training institutes,
and its outreach programs. A significant number of rural populations, including disadvantaged
 vii

groups, demobilized soldiers, displaced women, and the poor have benefited from micro-credit
schemes implemented through NTF.

The HPT component has completed its planned achievements satisfactorily, as

expected at appraisal. The Project supported capacity building of HRD for the management of
health personnel by strengthening its training in health personnel and development. HRD has
played a key role in reform of the health sector, and in formulation of the Health Strategic Plan
(2003-2007), Implementation Framework for the Health Strategic Plan (2003–2007), and in the
perspective plan for the Health Workforce Development Plan (2004–2013). A database for
human resources management information system has been developed in HRD.

The National Institute of Public Health (NIPH) and the Technical School of Medical Care
(TSMC) in Phnom Penh have been upgraded and strengthened. Within MOH, NIPH
collaborates closely with both HRD and the Planning and Health Information System. TSMC,
through the University of Health Science of Cambodia, now leads pre-service and basic 3-year
training courses to become nurses, physiotherapist, and laboratory technician. Through
continuing education programs, TSMC provides post-basic nursing training, including training in
midwifery and to be a laboratory technician. The health personnel training network was
strengthened among the upgraded the four regional training centers (RTCs) at Battambang,
Kampot, Kampong Cham and Stung Treng.

In its efforts to improve health care services countrywide, particularly primary health
care, HRD continues to strengthen coordination for continuing education with the MOH’s
training institutions, particularly NIPH and TSMC in Phnom Penh, the four RTCs, and the
provincial health departments. HRD will assist MOH in the development of a perspective health
workforce plan under the new Health Sector Support Project, jointly funded by the Asian
Development Bank, the World Bank, and the Department for International Development.
 I. PROJECT DESCRIPTION

1. After the emergency loan in 1993 1 for rebuilding basic physical infrastructures, the Basic
Skills Project aimed at providing longer and sustainable development in institutional capacity
and basic social services (Appendix 1). The Project was to support the provision of urgently
needed training of the technical workforce through the International Labor Organization (ILO);
and long-term institutional development, and policy planning and implementation, for health with
assistance from the World Health Organization (WHO). The Project has two major components:

Part A: Technical and Vocational Education and Training (T VET). This component includes

(i) Building of TVET planning and management capacity, which includes

(a) establishment of the National Training Board;

(b) establishment of the National Training Fund;
(c) strengthening of the Office of Technical and Vocational Education and
Training;

(ii) Improvement in quality and relevance of training, which includes

(a) rehabilitation of training institutions;

(b) establishment of the National Vocational Training Center;

(iii) Expansion of outreach programs, which includes

(a) Provincial Training Centers;

(b) Women’s Centers;
(c) Mobile and Outreach Training.

(iv) Staff training and development.

Part B: Training Health Personnel (HPT). This component includes

(i) Building of planning and management capacity in the Ministry of Health (MOH),
which includes

(a) strengthening of Human Resource Department (HRD);

(b) strengthening of health training institutions.

(ii) Improvements in quality and relevance of training, which includes

(a) in-service training;

(b) training of trainers and professional development.

(iii) Expansion in outreach training, which includes

(a) regional training centers;

(b) demonstration and training centers at the district level.

1
ADB. 1992. Report and Recommendation of the President to the Board of Directors on a Proposed Loan to
Cambodia for Special Rehabilitation Assistance Project. Manila.
2

(iv) Staff training and development.

Project implementation comprised two phases. The first phase included capacity building in the
Ministry of Education, Youth, and Sport (MOEYS) and MOH, including rehabilitation of training
system. The second phase included the consolidation of capacity building and expansion of the
training delivery system. In addition to the Project loan, an advisory technical assistance (TA) 2
was approved for assistance in Project implementation in the establishment of the national
training board under technical and vocational education and training (TVET) and MOEYS.

II. EVALUATION OF DESIGN AND IMPLEMENTATION

A. Relevance of Design and Formulation

2. In the early 1990s, Cambodia started a massive, countrywide reconstruction and

rehabilitation of its physical infrastructure. The strengthening of TVET delivery system is
consistent with the country strategy and program of the Asian Development Bank (ADB), and
particularly with the country’s objectives. ADB supported the Government’s high priority and
commitment to the development of its human resources that aimed to (i) improve training
programs for skilled workers by developing planning and management capacity, and by
providing better delivery of training services; and (ii) rationalize the training system by
establishing demand-driven training programs in support of small-scale enterprises and self-
employment through formal and non-formal training targeted to disadvantaged groups,
especially women and the poor.

3. The Project design,3 which comprised two main components of unrelated activities, was
sound, and the formulation process4 was adequate. It aimed at increasing the capacity building
of executing agencies, MOEYS, and MOH, and streamlining the delivery of training to meet
labor market needs and quality of care. Improvements have just started at the key institutions,
whose participation and level of ownership are high. The activities, which originally focused on
the national level and on central and southern Cambodia, spreads to the four northern provinces
after the midterm review in March 1999. The Project's relevance was high at appraisal, and
continued to be high at Project completion. 5 The Project is in accordance with the ADB
operational strategy on human resources development, including poverty reduction 6 and
improving the health status of Cambodia's rural poor.

B. Project Outputs

4. The evaluation of implementation is based on (i) indicators set at appraisal, (ii) midterm
review in March 1999, (iii) completion reports prepared by MOEYS and MOH, (iv) benefit
monitoring and evaluation (BME) data on TVET and the health sectors, and (v) comparison of
planned and actual key Project outputs by component (Appendix 2).

2
ADB. 1996. Technical Assistance to Cambodia for Capacity Building for TVET. Manila.
3
ADB. 1994. Technical Assistance to Cambodia for Skills Development. Manila.
4
The Fact-finding Mission was completed on September 1994; appraisal was conducted from 16 Mar to 1 Apr 1995.
5
ADB. 2001. Report and Recommendation of the President to the Board of Directors on a Proposed Loan to
Cambodia for Education Sector Development Project. Manila: ADB 2002. Report and Recommendation of the
President to the Board of Directors on a Proposed Loan to Cambodia for Health Sector Support Project. Manila.
6
Particularly poverty reduction that is specifically designed for displaced workers, and contributions to sustainable
employment for poor women.
 3

1. Part A: Technical and Vocation Education and Training

a. Building of TVET Planning and Management Capacity

5. National Training Board. The National Training Board (NTB), established 7 on 28
November 1996, strengthened TVET policy and the planning mechanisms by (i) developing an
organizational culture that increases accessibility to training programs for quality skills, (ii)
initiating reforms for advancement of TVET institutions, and (iii) partnership programs of the
public and private sectors to deliver demand-driven TVET programs. The NTB is fully
operational and functions effectively, as envisaged at appraisal. Its Executive Committee serves
as the management committee of the NTF, which reviews policy documents for submission to
NTB. Its Industrial Advisory Training Committee (IATC) comprises representatives from major
industries will ensure that training is responsive to labor market needs. The DTVET serves as
the secretariat for the National Training Fund (NTF) (Appendix 3). The NTB met 21 times and
made decisions on the NTF training grants, comprising the first to the eighth phases, a
proposed scheme for the National Occupational Skills Standards, Testing, Accreditation and
Certification System; and the 5-year TVET Strategic Plan. 8 The strategy paper focused on the
TVET system development framework within the overall educational system. A task force was
created for the introduction of a levy grant scheme on industry. Its legal implications, including
the Cambodian tax structure, are currently being addressed.

6. National Training Fund. NTB established the NTF on 26 December 1997, about 7
months later9 than the date set at appraisal. The NTF was initially managed by the NTB, and
was a demand-driven program for skills training through a system of output-based contracts
with public and private training providers. NTF was funded through Government and external
contributions and, eventually, revenue from a levy on industry. The financing of the NTF would
be cost sharing, and incentives would be provided to enterprises to conduct in-house trainings.
The NTF started implementing three programs in April 1999, disbursing a total of $3.13 million:
(i) $1.92 million for Training Grant Fund (TGF), (ii) $0.30 million through the Innovative Skills
Investment Assistance Fund (ISIAF), and (iii) $1.36 million through Self-Employment Generation
Fund (SEFG). The NTF's achievements have been encouraging, but additional support is
needed to eventually make it self-sustaining (Appendix 3).

7. Department of Technical Vocational Education and Training. The management

capacity of the Office of TVET was strengthened and upgraded into the Department of
Technical Vocational Education and Training (DTVET). Its organizational structure was
redesigned, and new functions were added, including planning, training in benefit monitoring
and evaluation (BME) and management information systems (MIS); assessment of employment
needs, encouraging gender equal opportunities, standards, and accreditation; and industry
liaison (Appendix 4). DTVET’s physical facilities were upgraded, and assistance for staff
development and consulting services was provided.

b. Improvement in Quality and Relevance of Training

8. Rehabilitation of Formal Training Institutions. The increased enrollment for TVET
was well coordinated, and TVET institutions complemented one another. The Preah

7
Formally constituted through a sub-decree on 11 Mar 1998 as the apex inter-ministerial, and the main policy and
planning body for the country's TVET sub-sector.
8
Approved by NTB on 28 Dec 2002 and submitted to the Council of Ministers for appropriate action.
9
The delay was mainly due to late fielding of the NTF specialist and enterprise-based training specialist who
designed the programs, organizational structure, guidelines and procedures, and staff training.
4

Kommossak Polytechnical Institute (PKPI) would offer civil, electrical, and electronics courses at
the diploma level and related courses at the certificate level. The Russey Keo Institute of
Technical College (RKITC) would offer mechanical, automotive, and refrigeration, and air-
conditioning courses at the diploma level and related courses at the certificate level. The new
curricula developed for the 2-year diploma and 3-year certificate courses were implemented as
follows: (i) the first-year curricula for certificate and diploma courses in 1999, (ii) the second-
year curricula in 2000, and (iii) the third-year curricula in certificate courses in 2001. To ensure
that courses are relevant to industry's needs, the curricula required 1 to 3 months of industry
attachment. An Industry Liaison Unit was established, and an Industry Advisory Committee is
being established at each institution. TVET's enrollment has increased significantly since 1999,
after implementation of the new curricula and upgrading of the physical facilities (Appendix 5).
Improvements to the TVET system include upgrading of physical facilities, training of its
management and staff, upgrading of its training programs, allocation of facilities and equipment,
and internal organization of the four formal public TVET institutions 10 in Phnom Penh. To
encourage sustainability, TVET institutions were allowed to generate income by offering higher
courses and independently operating higher courses. The institutions were authorized to
manage incomes they received. The TVET institutions, particularly the National Institute of
Business (NIB),11 are performing well. NIB has the highest increase in enrollment, including in
fee-charging courses, which has enabled it to cover maintenance and other operating
expenses. But the training workshop at RKITC remains underutilized.

9. Establishment of the National Vocational Training Center. The Project established

the National Vocational Training Center (NVTC)12 within the PKPI at Tuk Thla 1. The earlier
achievements made by ILO and Vocational Training for the Alleviation of Poverty (VTAP) were
consolidated under the National Technical Training Institute (NTTI). The NTTI participated
actively in the development of the new TVET curricula and preparation of specifications for new
TVET equipment. The NTTI is envisaged as a center for excellence and a resource center for
teacher training, curriculum development, and materials development. It now has a significant
number highly qualified staff. The NTTI was further empowered through a sub-decree on 24
October 2001 allowing it to offer higher-level technical and technological courses; NTTI now
offers courses in Civil, Electrical, and Electronics Engineering. NTTI's income is adequate to
cover operating expenses and some capital expenditures.

c. Expansion in Outreach Programs, Provincial Training Centers

(PTCs), Women's (WID) Centers, and Mobile Training
10. The TVET rural outreach programs13 for employment generation were strengthened,
particularly for women and other disadvantaged groups through programs targeted at
employment, self-employment, small business opportunities, and micro-credit. As planned at
appraisal, seven provincial training centers (PTCs)14 were upgraded through rehabilitation of
existing or construction of new buildings, providing basic workshop and office equipment,
providing training materials, and staff training. During the Mid-Term Review (MTR), another nine

10
Refers to the National Technical Training Institute (NTTI), the Preah Kommossak Polytechnical Institute (PKPI), the
Russey Keo Institute of Technical College (RKITC), and the National Institute of Business (NIB).
11
Formerly known as the School of Commerce, later renamed the Secondary School of Business, and subsequently
upgraded to NIB through a sub-decree on 24 Oct 2001.
12
NVTC was converted into the National Technical Training Institute (NTTI) through a sub-decree on 29 Dec 1999.
13
Implemented in close association with ILO, nongovernment organizations (NGOs), and the Women's Centers of
the Ministry of Women's Affairs and Veterans.
14
Earlier established under ILO before the Project, including at Banteay Meachey, Battambang, Kampot, Kampong
Cham, Pursat, Sihanoukville, and Takeo.
 5

PTCs15 were added to expand the TVET system. A national network for skills testing and
certification was established. The 12 new civil work packages, and the supply of equipment for
the multipurpose workshops, were completed satisfactorily. A micro-credit scheme was provided
for graduates of the Skills Training Program; it was implemented in close coordination with ILO
and nongovernment organizations (NGOs). The Project also expanded TVET opportunities for
women through women in development (WID) Centers beyond the plan at appraisal. An
additional five WID 16 Centers were provided office equipment, classroom furniture and fixtures,
and some basic equipment for workshops. Through mobile on-site training, beneficiaries in
targeted communities who could not attend training at PTCs were provided skills training in
livelihood areas such as duck raising, fish farming, onion growing, motorbike repair, masonry,
silk weaving (Appendix 6).

d. Training and Staff Development Programs

11. Eighteen staff participated in the overseas fellowship program, which had been planned
for 14 staff (Appendix 6). All 18 staff are currently working in MOH and central MOH institutions.
The Continuing Education System (CES) was established in 1998 to assist the training
programs of all vertical national health programs at the provincial level. The Technical School
for Medical Care (TSMC) and NIPH provided in-country training for services management in
primary health care (PHC), with emphasis on health education and adult consultation for health
center staff. About 100 trainers for RTCs have undertaken training of trainers during the five 6-
weeks training courses conducted by the master trainers trained by the World Health
Organization (WHO) and the Australian Agency for International Development (AusAID). At
Project completion, about 212 trainers had received training in PHC. Through Project training
programs at four RTCs, 4,652 staff were trained in PHC. Training included immunization, control
of diarrheal diseases, a safe rural water supply, and sanitation.

2. Part B: Health Personnel Training

a. Building Ministry of Health Planning and Management Capacity by

Strengthening of the Human Resource Department and Health Care
Training Institutions
12. The Project constructed the annex building at MOH that accommodates its Human
Resource Development (HRD) and personnel departments, and externally funded projects
including the ADB-assisted Basic Skills (Part B: Health Personnel Training), Basic Health
Services, Emergency Flood Rehabilitation, and Health Sector Support projects. The HRD
Department established a computer-based system of cadre registration and certification 17
through its health personnel management program. About 20,000 MOH staff are now registered
on the database. The system was customized from the general human resource information
system format that the Government uses. The information system is now being used in the
development of a 10-year Plan Work Force (which is revised every 5 years), health care
delivery services,18 and allocation of resources through the Priority Action Program to province
and district-level institutions. The benefit monitoring and evaluation was conducted after the
Project midterm review to identify problems and issues during Project implementation, and to
15
Including Kandal, Kampong Chhnang, Kampong Speu, Kampong Thom, Kratie, Prey Veng, Siem Reap, Stung
Treng, and Svay Rieng.
16
There are nine WID centers at Kampot, Preah Vihear, Ratanak Kiri, Mondul Kiri, Koh Kong and Kandal, Kam pong
Cham, Kampong Chhnang, and Kampot Speu.
17
A medical council was established through royal decree on 1 February 2000. A committee was established to
evaluate health workers who had completed various sources of training.
18
PHC services in Cambodia are provided complementary package of activities through Health Coverage Plan.
6

determine activities that would be possible and appropriate to assure satisfactory progress. The
Project upgraded NIPH, 19 improved its main building, and constructed a new hostel for
managers who attend training courses. The NIPH plays the main role in public health services
for Cambodia. The Project also upgraded the Technical School of Medical Care (TSMC) 20 by
providing a building for continuing education and an auditorium for conferences, seminars, and
workshops. All completed Project facilities are fully operational.

b. Improvements in Quality and Relevance of Training

13. The provincial CES was established through the in-service training program in 1998 to
facilitate and coordinate province-level training for all national health programs. The provincial
CES coordinates with master trainers at TSMC and the RTCs. Five core trainers have been
trained for continuing training in each province. The RTCs have conducted minimum packages
of activities (MPA) for curriculum development and training, based on 13 modules developed
through the Project. About 4,800 copies of each module have been printed in Khmer and
distributed to health center (HC) staff across the country. About 4,652 HC staff have been
trained through MPA module I (Health Management at the Grass Roots Level). Training was
conducted for HC staff in 17 selected provinces through MPA module II (Patient Assessment)
and module VII (Primary Health Care and Health Education). The same HC staff were trained
through MPA module VI (Basic Infection Control) and module XIII (Emergency Treatment and
Minor Surgery) (Appendix 7).

c. Expansion in Outreach of Training

14. To improve outreach training in rural areas, the Project upgraded and fully equipped four
RTCs: Battambang, Kampot, Stung Treng, and Kampong Cham. A training and demonstration
center in Prey Veng was proposed, but MTR dropped it because MOH wanted to concentrate
only through TSMC, and on the four RTCs.

C. Project Costs

15. At appraisal the total Project cost was estimated at $25 million: $20 million to be
financed by ADB, and $5 million by the Government. The foreign exchange component was
estimated at $15.4 million, fully financed by ADB. The local component was $9.6 million: $4.6
million funded by ADB and $5 million by the Cambodian Government. Of the total Project cost,
the total TVET allocation was $18.5 million and the HPT allocation, $6.5 million. The
Government’s contribution was $3.71 million for the TVET and $1.29 million for the HPT
component. At Project closing, the actual base cost was $20.31 million equivalent compared
with the original allocation of $20.60 million equivalent (Appendix 8). There were two loan re-
allocations (on 24 October 2000 and 31 August 2001) of loan proceeds that ADB approved to
overcome shortfalls in civil works, equipment, furniture, and consulting services caused by the
depreciation of the SDR vs. the US dollar. Also covered were the costs of civil works,
equipment, and furniture for the additional nine PTCs and four WID Centers. Reallocated funds
were from staff development and operation and maintenance.

D. Disbursements

16. The amount of loan proceeds disbursed was $16.19 million equivalent (98%), mainly
through the imprest account and direct payment in accordance with financial regulations of the

19
Formerly known as National Center for Hygiene and Epidemiology.
20
Formerly known as Ecole des Cadres Sanitaires Secondairies (ECSS) or the "Center Health Workers' School".
 7

Ministry of Economy and Finance and the ADB Guidelines on Imprest Fund and Statement of
Expenditures Procedures (Appendix 9). Because so many small contract payments were
involved, the statement of expenditures procedure was allowed. For the HPT component, the
initial advance to the imprest account was $0.15 million. By August 2002, $1.28 million had
been disbursed through the imprest account; $0.25 million from counterpart funds, and $7,800
from Insftitute International Pour la Formation d' Anesthsie et Reamination de Medecine d'
Urgence (IIFARMU). The nondisbursed loan amount? $0.33 million equivalent? was cancelled
at loan closing on 14 February 2003.

E. Project Schedule

17. The Project was planned for 5.5 years, from 20 November 1995 to 31 May 2001, for
capacity building of MOEYS and MOH to meet TVET and health care reforms. Project
implementation was slow in the first 2 years, but progressed well by MTR (Appendix 10). New
target completion dates were set during the MTR. After 1998, Project implementation proceeded
smoothly, with no major deviations from the revised completion targets Two consecutive 6-
month extensions were approved to finalize the medical equipment needed for demonstration at
the RTCs. There was no cost overrun. The Project loan account was closed on 14 February
2003 because of a delay in submission of final disbursement, and several adjustments of the
SDR imprest account.

F. Implementation Arrangements

18. The implementation arrangements were in accordance with the design at appraisal.
MOEYS was the Executing Agency (EA) for the TVET component. A Project Implementation
Unit (PIU) was established at the DTVET (before OTVET), headed by a Project director.
Progress was slow during the first 2 years of implementation, lagging behind targets. This was
because of the staff's lack of experience, and some problems with the team leader of the
consulting group. But the pace of implementation picked up, catching up with the backlog from
the initial years, as the staff gained experience and with a new team leader. MOH was the EA
for the HPT component. A PIU was established in the MOH Human Resources Department,
headed by the Project director and assisted by a full-time Project manager. A Project Advisory
Committee (PAC) was established for coordination within MOH, and met quarterly. The PIUs at
MOEYS and MOH were responsible for day-to-day operations, including coordination with
various agencies, procurement, financial management, consultant recruitment, fellowship
awards, preparation of reports for ADB, and monitoring of the progress of Project
implementation. The Project provided adequate funds, office equipment, furniture, and service
vehicles for operation of the PIUs.

G. Conditions and Covenants

19. MOEYS and MOH generally complied with the major loan covenants stipulated in the
Loan Agreement (Appendix 11). No covenant was modified, suspended, or waived. MTR
resolved the initial delays in Project implementation, including establishment of NTF and
engagement of consultant team.

H. Related Technical Assistance

20. Appendix 12 summarizes findings of the advisory TA on institutional strengthening of

TVET training. The main objectives were to assist in (i) the development of a policy framework
for TVET, (ii) the introduction of demand-based training programs, and (iii) the linking of TVET
8

institutions with the private sector. Four consultants were recruited, following ADB’s Guidelines
on the Use of Consulting Services: (i) a policy and organizational development specialist for
12.5 person-months, (ii) an institutional and staff development specialist for 6 person-months,
(iii) a strategic planner for 6 person-months, and (iv) a program coordination specialist for 6
person-months. DTVET provided adequate support for the successful implementation of the TA
by organizing the Project Steering Committee, appointing competent counterpart staff, and
providing adequate office space and equipment. The TA consultants submitted the inception,
interim, draft final, and final reports as scheduled. ADB supervision of the TA was adequate and
timely. The TA fully met its objectives and scope, particularly in establishment of NTF, the staff
development plan and benefit monitoring and evaluation.

I. Consultant Recruitment and Procurement

1. Engagement of Consultants
21. A lack of familiarity with ADB procedures for consultant recruitment caused initial delays
in engagement of consultants for TVET and HPT. There were some interruptions in the fielding
of international consultants for TVET, including the enterprise-based training specialist who
terminated his assignment and was replaced after about a year. Three international consultants
were recruited for 2 months each through a contract variation for the development of a national
system for testing and certification of skills standards in mechanical, electrical/electronics, and
civil trades. This problem, and lower-than-expected cost for domestic consultants, resulted in
lower costs for consulting services. There were no major problems in the recruitment and
fielding of domestic consultants. MOH had minor problems with the five international consultants
recruited through HPT; they spent most of their time developing the MPA modules. There were
no major problems in recruiting and fielding of domestic consultants through HPT.

2. Civil Works
22. Civil works consisted of renovation or construction of new buildings for DTVET and 4
TVET institutions in Phnom Penh, 16 PTCs, and 5 WID centers; construction of annex buildings
at MOH, NIPH, TSMC; and minor work at four RTCs. A total of 16 major and 12 small packages
of civil works through TVET, and 6 packages through HPT, were awarded following ADB’s
Guidelines for Procurement. Despite initial delays caused by a lack of familiarity with ADB
procedures, all contracts were completed as scheduled, based on revised target dates agreed
at MTR. A problem with illegal occupants in NIB has been resolved by the Government’s
decision to relocate NIB. The Government has agreed to hand over the current NIB site to the
French School, and the government of France will fund construction of a new NIB building.
Local authorities and security forces helped resolve a problem with construction of a boundary
wall on the NTTI campus. But these problems caused some delay in the completion of civil
works.

3. Equipment, Furniture, and Materials

23. Equipment, vehicles, furniture, and learning materials for TVET and HPT were procured
with ADB’s Guidelines for Procurement. For TVET, all 15 lots of procurement items were
delivered, except for some textbooks. The procured items were delivered to the DTVET, 4 TVET
institutions in Phnom Penh, 16 PTCs, and 9 WID Centers. For HPT, initial delays in
procurement procedures delayed the distribution training and demonstration equipment for the
four RTCs, and laboratory equipment for NIPH. Despite the initial delays caused by
nonfamiliarity with ADB procedures, all contracts were completed as scheduled, based on
revised target dates agreed at MTR.
 9

J. Performance of Consultants, Contractors, and Suppliers

24. For TVET, some problems encountered with performance during the early years of
implementation. The training fund specialists, enterprise-based training specialist, and project
implementation specialist terminated their services early because of disputes with the consulting
firm. The infrastructure and construction training consultant, initially assigned as acting team
leader, became the new team leader until Project completion The overall performance of the
consultants, including domestic consultants, was considered satisfactory (Appendix 13). The
civil works contractors was generally considered satisfactory with acceptable quality. There
were no major delays for new construction and renovation of existing buildings. The suppliers of
equipment and furniture also performed satisfactorily. The suppliers of high-tech equipment
provided inadequate after-sales training, although the items delivered were according to
specifications and were in good condition. The textbook supplier failed to deliver several
textbooks packages.

25. Under HPT, the overall performance of consulting services was considered satisfactory.
The consultants assisted the PIU in project management, with assistance of domestic
consultants. The civil works, particularly at MOH, NIPH, and TSMC, were considered
satisfactory despite difficulties during construction and renovation because of nonfamiliarity with
civil works procedures. Despite some delays in construction, the quality of work was
satisfactory. The initial delays in procurement were resolved by Project completion. Overall,
performance was satisfactory for the civil works contractors, suppliers of training demonstration
equipment, and providers of MPA curriculum and training.

K. Performance of the Borrower and the Executing Agency

26. There was strong ownership by the Government ownership, particularly for TVET and
the health sector reforms. The Borrower provided adequate counterpart funds, even during the
economic downturn. Cooperation between Government and ADB review missions was
professional, and performance by both EAs, as well as MOEYS and MOH, is considered
satisfactory. Documentation of Project implementation aspects such as procurement,
consulting, staff development, monitoring, and disbursements was satisfactory and made
available to ADB. The PIU prepared progress reports, and submitted them to ADB, regularly.
Coordination with international development partners, particularly the ILO, was satisfactory. The
PIU staff's initial inexperience in project management and implementation, and nonfamiliarity
with ADB procedures, were offset by willingness to learn through hands-on experience at
seminars, workshops, and counterpart training with international consultants. Nonfamiliarity with
project management concepts and procedures for contracting services caused considerable
delay at initial Project implementation. These bottlenecks were overcome by year three, and
development of eight of the MPA modules was successfully contracted to a local firm.

L. Performance of ADB

27. The performance of ADB, comprising eight missions including the MTR, was considered
satisfactory. The Project benefited from ADB field visits to the Project sites; agreed actions
facilitated project implementation. The processing of withdrawal applications was generally
satisfactory. Relationships among MOEYS, MOH, and ADB strengthened as Project
implementation progress, and resulted in successful working relationships in a number of follow-
up projects. The ADB Cambodian Resident Mission in Phnom Penh provided considerable
support, particularly during later Project implementation.
10

III. EVALUATION OF PERFORMANCE

A. Relevance

28. The Project's objective and scope continue to be fully aligned with, and supportive of,
Cambodia's development agenda and its capacity building for TVET, MOEYS, and HRD, and
other relevant institutions. The Project’s components continue to contribute to the strategic
thrusts of TVET and health care reforms. Major policy documents emphasize the importance of
human resources development,21 particularly for the society's disadvantaged, poor, and
marginalized sections. Project implementation was gaining momentum at MTR and focused on
policy-related and quality aspects of NTB and NTF, new curricula technologies, in-country TVET
training programs, establishment of the HRD Department and CES, and in-country training for
nurses and paramedics. The original scope developed at appraisal was highly relevant, with no
change in scope, and still highly relevant 22 at Project completion.

B. Efficacy in Achievement of Purpose

29. With the major thrust on HRD, the Project has significantly to TVET reforms, led by
NVTC (NTTI), elevated its importance in skills development for the development of
socioeconomic infrastructure, and generating income for the disadvantaged. All 28 civil works
packages for 16 PTCs and 9 WID Centers, were contracted and completed satisfactorily.
Fifteen packages of equipment, vehicles, and furniture strengthened DTVET and improved
TVET institutions. Public-private partnerships were established among the private sector, local
business, and industry that now provide priority occupational employment. The TVET
management system was strengthened and a significant number of TVET staff was trained, as
the TVET training institutions were reorganized. The TVET outreach programs were also
strengthened to generate employment for the rural poor. Thus, both components of the Project
are considered efficacious.

C. Efficiency in Achievement of Outputs and Purpose

30. Project implementation23 was efficient, with no major problems. The implementation
arrangements and management structures and procedures were in accordance with those
agreed upon in the loan agreements and at appraisal. The loan proceeds, with adequate
counterpart funds, were used efficiently to pay for procurement of civil works, equipment,
vehicles, and teaching materials. The Project used loan resources efficiently, and achieved its
anticipated outputs. The annual turnover ratio 24 improved over time from 0.11 in 1996, to 0.26 in
1997, to 1.43 in 1998 and 1999, and 2.04 2000. The audited financial statements were
submitted to ADB on timely basis, with no financial problems. The organization, management,

21
ADB. 1996. Education Sector Study. Manila: ADB. 2002. Technical Assistance to Cambodia for Health Sector
Support. Manila: MOEYS. 1996. First Socio-Economic Development Plan, 1996–2000. Cambodia: Ministry of
Economy and Finance (MEF). 1995. Socio-Economic Development Plan, 1996–2000, Cambodia: Ministry of
Health (MOH). 2002. Health Strategic Plan, 2003–2007. Cambodia: Under the Health Sector Support Project, MOH
will formulate the perspective Health Workforce Development Plan (2004–2013).
22
Particularly in terms of poverty alleviation, as ADB's main goal.
23
Economic analysis using: ADB. 1999. Economic Analysis of Health Sector Projects: A Review of Issues, Methods
and Approaches. Manila: ADB. 2000. Handbook for the Economic Analysis of Health Sector Projects. Manila. –was
not possible because of a lack of reliable baseline data. The economic internal rate of return (EIRR) and financial
internal rate of return (FIRR) could not be estimated because they were not computed at appraisal. But some
financial assessment was made, based on tracer studies, as in Appendix 3.
24
Turnover ratio = liquidation: average fund balance.
 11

and performance of DTVET, MOEYS, and MOH were satisfactory. Project management and
consultants recruitment were effective.

31. The formal TVET institutions are now updated and fully operational, with marked
improvement in internal efficiency and increased enrollment. The student-teacher ratio, and
efficiency of use of buildings and equipment, were improved (Appendix 5). The quality of
instruction also improved with a redesigned curriculum that includes industry involvement, more
trained teachers, and better laboratory and workshop facilities. Implementation of the outreach
program was efficient and highly satisfactory. The NTF programs were successfully
implemented, with the following results: (i) A grant for graduate training in basic skills was
contracted for 13,084 students through public and private trainers. The 1- to 6-month training
courses costs about $147 per trainee; (ii) An NTF loan to private schools and training centers
resulted in 11,595 graduates; and (iii) the Self-Employment Generating Fund (SEGF) 25
disbursed $1.36 million (including re-lending) through provincial PTCs to 1,754 groups with
5,653 members. The average income ranged from $32 to $73 per month,26 a significant
contribution rural family incomes. The average repayment rate remained high, at 92.9%
(Appendix 3).

D. Preliminary Assessment of Sustainability

32. Income-generating activities conducted by the formal TVET institutions, through evening
teaching programs, are financially sustainable. Enrollment of paying students is increasing, and
funds generated have been managed with some degree of autonomy. But, financial
sustainability has improved mainly at the more established original seven PTCs, which have
organized better SEGF micro-credit schemes through NTF, have trained more eligible
borrowers, and thus, disbursed more loans. The SEGFs of the smaller PTCs would require a far
higher volume of lending to be self-sustaining. That would require more budgetary support from
the Government. The MOH HRD Department maintains sustainability in the training
institutions? NIPH, TSMC, and the RTCs? in terms of services benefits, particularly among the
rural poor, and will continue to play the key role in development for the health sector. Support is
adequate from key stakeholders, development partners, international NGOs, the local,
provincial, and central government, and local communities. Thus, both the TVET and HPT
components will probably be sustainable.

E. Environmental, Sociocultural, and Other Impacts

33. The TVET system will continue to be strengthened through strengthening of DTVET and
establishment of NTB and NTF. NTB will continue to establish the policy framework for
coordination of externally funded TVET activities with nationally funded programs. NTF has
established the Industrial Advisory Training Committee (IATC) to ensure strong linkages with
major private sector. NTF supports training programs to meet employment needs, in
accordance with NTB's training policies and priorities. NTF has trained 24,488 beneficiaries
through its nine phases and schemes.

34. The MOH HRD Department has played a key role in health sector reforms, formulation,
and implementation framework for the Health Strategic Plan (2003–2007), and the perspective
for the Health Workforce Development Plan (2004–2013). The HRD Department has developed

25
The Self-Employment Generation Fund (SEGF) under NTF comprises rural enterprises such as duck raising,
electrical and automotive repair, fish farming, food processing, sewing, hairdressing, silk weaving, and welding.
26
Government doctors in Cambodia receive a monthly salary of only $20.00.
12

a database for human resource information management (Appendix 14). HRD will continue to
strengthen coordination with MOH’s training institutions, particularly TSMC and the RTCs, and
the provincial health departments for the continuing education system. HRD will help MOH
develop a perspective workforce plan through the new Health Sector Support Project. NIPH
plans to develop a critical mass of health specialists for Cambodia. Currently TSMC, through the
University of Health Science of Cambodia, leads the pre-service and basic 3-year training
courses for nursing, physiotherapy and laboratory technician courses. Through continuing
education programs, TSMC provides post-basic training for nurses, midwives, and laboratory
technicians. The upgraded RTCs have strengthened the primary health care training network.

35. The Project has contributed to environmental awareness through skills training and
health education. Building construction was in accordance with Government regulations.
Building designs considered environmental factors such as natural lighting and adequate
ventilation. There were no adverse environmental impacts. The Project has contributed to the
well being of rural communities, particularly of women and the rural poor, through TVET
programs and improved performance of health staff. Job opportunities increased for women
trained as nurses and midwives, providing primary health care at health centers and referral
hospitals. The rating on the institutional, environmental, social, and other impacts is considered
substantial.

IV. OVERALL ASSESSMENT AND RECOMMENDATIONS

A. Overall Assessment

36. The Project achieved the development targets set at appraisal, and is considered
successful (Appendix 15). Through its planning, management, and capacity-building activities,
the Project has established a pragmatic development framework for TVET. The Project has
articulated its vision and mission, formulated its strategy and programs, established a structure
and system for governance, upgraded its facilities, revised its curricula, trained adequate staff,
and streamlined the organization structure of the formal TVET institutions as substantiated in
Appendixes 3, 5, and 16. The quality of instruction has improved with increasing enrollment, and
has enhanced the institutions’ sustainability (Appendix 5). The Project has also addressed the
problem of poverty alleviation, particularly for the rural poor. Its outreach component has
provided basic employment skills to disadvantaged groups, particularly women and the rural
poor. The NTF micro-credit scheme has established and expanded rural enterprises (Appendix
3). A solid foundation for long-term development for TVET has been established. There was a
positive change in the attitude of Government officials and industry leaders about TVET, and the
Project has contributed to the emergence of a TVET culture. In the health sector, the Project
brought about capacity building of MOH training institutions for human resources development
and better health care delivery systems (Appendixes 14 and 16). High priority was given to the
health sector, as indicated in the Government Policy and Strategy for Health. Project
implementation was generally efficient, with no major problems. Most outputs were completed
on schedule. The implementation arrangements, management structures, and procedures were
in accordance with the loan agreements. The organization and management of the EAs,
MOEYS, and MOH, were satisfactory. The Government's commitment and ownership were
high.

B. Lessons Learned

37. Under HPT, a national policy on human resource development was timely to deploy
qualified staff to health institutions, because reform of the health care system was in early
 13

implementation. Much of the Project’s success can be attributed to good leadership at various
levels of the organization: DTVET, formal TVET institutions, PTCs, HRD, MOH, NIPH, TSMC,
RTCs, and PIUs. Differences in physical appearances of the institutions, enthusiasm, and
quantity and quality of outputs can be traced to the effectiveness of leadership. Some notable
traits of effective leadership are: (i) a clear vision of TVET subsectors, manifested by
development of long-term plans, (ii) openness to new ideas, (iii) willingness to take risks,
perseverance in going around bureaucratic rules in order to get achieve results, (iv) concern
and care for the staff, providing the training and logistical support to enable to perform better,
and (v) giving constant recognition for good performer through verbal appreciation or financial
incentives. Delays at start-up activities are common with project implementation, and actions
should be taken to minimize this.

C. Recommendations

1. Project-Related

38. Future Monitoring. Benefit and evaluation activities should begin with project
implementation. The project performance management system should be integrated with the
management information system.
39. Covenants. The existing covenants in the loan and project agreements should be
maintained.
40. Further Action or Follow-Up: National Training Board and National Training Fund.
Committees should be established by January 2004 to examine and advise on key functions of
National Training Board (NTB), including skills standards, testing and certification, financial
management, curricula, staff development, and industry linkages. For National Training Fund
(NTF), a trust fund, or training grant fund (TGF) should be established by June 2004 to ensure
sustainability, provide capital for institutionalization of SEGF, and establish a critical mass of
lending through SEGF to provincial PTCs.
2. Formal TVET Institutions
41. Recommendations for follow-up actions for the formal TVET institutions, which should be
implemented by June 2004, include (i) establishment of an industry advisory committee to
ensure alignment of their thrusts and programs with industry's needs, (ii) integration of an
entrepreneurship module in TVET curricula to help graduates prepare for self-employment, (iii)
formulation of guidelines to ensure that TVET scholarships will be awarded to the poor with
potential for development, and (iv) formulation of guidelines for the use of funds that TVET
institutions have generated as a step towards reaching economic sustainability while assuring
transparency.
42. Timing of PPAR Preparation. A Project performance audit is proposed during, or after,
mid–2005 to help ensure Project facilities are fully operational, and to measure Project impacts.
3. General
43. The momentum gained by the Project’s successful implementation for TVET
development should be maintained. The nine new PTCs planned at MTR require staff training
and development. Other new PTCs will be established in seven provinces that now do not have
them. Quality will be assured through a system of registration and accreditation, skills
standardization, testing and certification, training of trainers, and curricula and training materials
development.
 14 Appendix 1

PROJECT FRAMEWORK
Monitoring Assumptions
Design Summary Performance Targets
Mechanisms and Risks
1. Goal
Develop institutional Increase in number of Socioeconomic reports Current annual economic
capacity and basic skilled workers for Population censuses growth rate is maintained
social services infrastructural projects, Household surveys throughout Project period.
and maintaining the Political and civil stability
population's basic maintained
health.

2. Purpose
1. Developing basic Adequate skilled Human Resources Department of Technical
skills training needed workers in the market, Department (HRD) and and Vocational Education
for physical meeting requirements personnel database and Training (DTVET)
infrastructure for economic growth, statistics strengthened and able to
development, growing and adequate trained manage development in
services industry, and health workers in Quarterly progress technical and vocational
delivery of basic health care institutions, reports education and training
health services particularly health (TVET)
centers and referral Baseline and evaluation
hospitals surveys Demand for large number
of skilled workers
Baseline and final continues
assessments

2. Equipping groups of Displaced and HRD and personnel Assistance to

disadvantaged and disadvantaged people database statistics disadvantaged and
displaced people with develop basic income- displaced is well
basic income- generating skills Quarterly progress organized.
generating skills reports
3. Establish planning Effective system for HRD and personnel Ministry of Education,
and management coordination of inputs database statistics Youth, and Sport
capacities in technical into TVET and human (MOEYS) and Ministry of
and health training resources for health is Quarterly progress Health (MOH) have
established reports capacity to absorb
increased external inputs
Political and civil stability
maintained

3. Output
3.1. Component A: Technical and Vocational Education and Training
Subcomponent A.1 Building of TVET planning and management capacity
A.1.1
Establishment of TVET DTVET is Socio-economic reports MOEYS has capacity to
planning and management strengthened and absorb increased external
capacity capable of planning a Labor Market Information inputs
skilled workforce to System
meet growing services
industry Project progress reports
A.1.2
Establishment of the National Training Quarterly progress Political and civil stability
National Training Fund Board and NTF are reports maintained.
(NTF) established and Willingness of private
functioning. sector to participate in
NTB/NTF activities.
 Appendix 1 15

Design Summary
A.1.3
Strengthening of the Office
of Technical and Vocational
Education and Training
Monitoring Assumptions
Performance Targets
Mechanisms and Risks
DTVET in MOEYS is Socio-economic report Demand for large number
strengthened. of skilled workers for the
Inter-ministerial policy Labor Market Information growing services industry
framework to support System continues
national TVET system
is established Quarterly progress
reports

Subcomponent A.2 Improvement in Quality and Relevance of Training (Quarterly progress reports)
A.2.1
Rehabilitation of training Training institutions Project progress reports Continued demand for
institutions upgraded skilled workers in services
Training records and industry
Curricula are assessment reports
developed for
competency-based Tracer studies
skills standards and
skill testing
certification.
A.2.2
Establishment of National NVTC established and Project progress reports Continued demand for
Vocational Training Center operational skilled workers in services
(NVTC) industry

Subcomponent A.3 Expansion in Outreach Programs

A.3.1

Provincial Training Centers Basic skill training and Project progress reports Continued demand for
(PTCs) employment for skilled workers in services
women, youth, Training records and industry
displaced and assessment reports
disadvantaged people
are enhanced Tracer studies
A.3.2
Women's Centers Basic skill training and Project progress reports Continued demand for
employment for skilled workers in services
women are enhanced Training records and industry
assessment reports

Tracer studies
A.3.3
Mobile and Outreach Basic skill training and Project progress reports Continued demand for
Training employment for skilled workers in services
women, youth, and Training records and industry
displaced and assessment reports
disadvantaged people
are enhanced Tracer studies
3.2 Component B: Training of Health Personnel
Subcomponent B.1 Building MOH Planning and Management Capacity
B.1.1
Strengthening of HRD Health cadres are re- National Health Statistics Political and civil stability
categorized and Reports maintained
registered.
Vertical program reports
 16 Appendix 1

Monitoring Assumptions
Design Summary Performance Targets
Mechanisms and Risks
Human Resources MOH has capacity to
Information System absorb increased external
(HRIS) established. inputs
HRD Unit of MOH
strengthened.
B.1.2
Health Care Training Training institutions Vertical health programs MOH has capacity to
Institutions upgraded to meet reports absorb increased external
requirements of inputs
training programs and Training records and
continuing education assessment reports

Subcomponent B.2 Improvements in Quality and Relevance of Training

B.2.1
In-Service Training Staff at national, Staff training and National, PHD, and OD
provincial health assessment reports staff are available to
department (PHD) and participate in training
Operational District
(OD), health centers
(HCs), and referral
hospitals (RHs) are
adequately trained.
B.2.2
Training of trainers (TOT) Adequate trainers at TOT training reports Health Coverage Plan
and professional health training (HCP) accurately reflects
development institutions Consultants reports health coverage needs

Quarterly progress
reports
Subcomponent B.3 Expansion in Outreach of Training
B.3.1
Regional training centers Adequate trained staff Project progress reports Health center staff are
in HCs and RHs Delivery notes available to participate in
training
B.3.2
Demonstration and training Adequate trained staff minimum package of HC staff and health
Center at the district level in HCs and health activities (MPA) training volunteers are available to
volunteers in the and follow-up reports participate in training
community
4. Inputs by Subcomponent
Civil works Asian Development Contract awards Availability of counterpart
Bank (ADB) funds
$2.72 million
Equipment and furniture ADB $4.05 million Withdrawal applications
Consulting services ADB $3.04 million Quarterly progress reports
Staff Development ADB $9.44 million Loan Review
Operation and maintenance ADB $0.69 million Missions
Project implementation unit ADB $0.66 million
Physical contingencies ADB $1.80 million
Price contingencies ADB $2.20 million
Service charges ADB $0.40 million
Total Project Value ADB $20.00 million
Royal Government of Cambodia $5.0 million

COMPARISON OF PLANNED AND ACTUAL KEY PROJECT OUTPUT S BY COMPONENT
Component/Activity
Part A: Technical and Vocational Education Training (TVET)
I. Building of TVET Planning and Management Capacity
A. Establishment of TVET planning and management capacity
1. Establishment of the
National Training Board
(NTB)
2. Establishment of the
National Training Fund
(NTF)
3. Strengthening of the Office of Technical and Vocational Education and Training (OTVET)
Focusing on OTVET, the
Project will upgrade the
TVET management
capacity of the Ministry of
Education, Youth, and
Sport (MOEYS)
Appraisal
NTB, as the lead TVET agency and
main inter-ministerial policy and
planning body, including private
sector, will provide direction for
TVET development, coordinate
TVET activities. In line with
development needs, and advise on
overall resource allocations for TVET
and TVET training.
NTF would promote a demand-
driven basic skills training under the
public-private partnership TVET
programs, in accordance with NTB’s
training policies and priorities.
New responsibilities, tasks, and work
programs will be assigned to
OTVET. Specifically, the Project will
(i) introduce new operating systems
and procedures for planning and
budgeting for TVET; (ii) establish
and operate a monitoring,
evaluation, and quality assurance
system; and (iii) establish a TVET
management information system.
Appendix 2 17
Actual
NTB, established on 28 November
1996, is fully operational and
functioning as planned. The
organization for the TVET system has
improved through strengthening of
the policy and planning mechanisms,
increased accessibility to quality skills
training programs, reforms for
advancement in formal TVET
institutions, and coordinating public-
private partnership TVET programs. A
5-year TVET Strategic Plan on the
TVET system development
framework has been developed within
the overall educational system. The
Project has provided in-service
training for staff, fellowships, office
equipment, and consulting services to
help set up and operate NTB and its
secretariat.
NTF, established on 26 December
1997 and managed by NTB, was
funded initially through Government
and external contributions and, in the
long-term, through revenue based on
a levy on industry. The NTF has
disbursed $3.13 million: (i) $1.92
million through the Training Grant
Fund (TGF), (ii) $0.30 million through
the Innovative Skills Investment
Assistance Fund (ISIAF), and (iii)
$1.36 million through the Self-
Employment Generation Fund
(SEFG). The Project has provided
consultant services to help set up and
operate the NTF, including its
organization, operating procedures,
criteria for evaluating proposals for
funding, and the contracting scheme.
The Project has also supported NTF
staff training.
The OTVET management capacity
was upgraded into Department of
Technical and Vocational Education
Training (DTVET) on 23 March 1998.
Its organizational structure was
redesigned accordingly and
reassigned new functions and
reforms for the TVET system,
including benefit monitoring and
evaluation, a management
information system, training
18 Appendix 2

Component/Activity Appraisal Actual

employment needs assessment,
gender equal opportunities, standards
and accreditation, and industry liaison
were added (Appendix 3). DTVET
has the capacity to analyze labor
market information and signals and to
respond by selecting appropriate
programs for provinces and local
administration. It will monitor
nationally and externally funded
training programs in the light of
economic requirements to ensure that
the combined thrust of these activities
is in accordance with national
priorities. The Project has upgraded
DTVET’s physical facilities and
provided assistance for staff
development, and consulting services
as planned. Works were completed
by 22 March 1999.

B. Improvement in Quality and Relevance of Training

1. Rehabilitation of Training Institutions
2. Establishment of National Vocational Training Center (NVTC)
To improve the quality and
relevance of skills training,
the Project will establish
NVTC at the Preah
Kossomak Technical and
Vocational Training Center
in Phnom Penh.
NVTC will (i) develop improved
curricula and training materials; (ii)
design skills training, standards, and
tests based on national standards
and guidelines adopted by NTB; and
(iii) provide TVET management
training.
The NVTC was converted to the
National Technical Training Institute
(NTTI) on 29 December 1999. The
NTTI played a key role in
development of the new TVET
curricula and preparation of
specifications for new TVET
equipment. The NTTI is envisaged as
a center for excellence and a
resource center for teacher training,
curricula development, and materials
development. It offers higher-level
technical courses in civil and
electrical/electronics engineering.
Consultant services provided have
helped NTTI design and develop
curricula and materials, and provide
instructor and management training.
Consultant services will be provided
to develop NVTC, including
assistance in designing and
implementing the programs of
curricula and materials development,
and instructor and management
training.

C. Expansion in Outreach Programs

1. Provincial Training Outreach TVET programs will be
Centers identified within the TVET training
framework based on the demand for
skills in provinces. Special attention
will be paid to training programs
The Project upgraded and expanded
the TVET outreach training programs
targeted at employment, self-
employment, small business
opportunities and micro-credit, and

Component/Activity Appraisal
relevant to the self-employed and to
part-time workers.
2. Women in Development Existing courses in the WID Center
Center (WID) related to sewing, typing, catering,
hospitality, hairdressing, and
handicrafts will be updated. New
courses will be introduced in office
administration, textile design, and
handicrafts.
3. Mobile and Outreach Training
Mobile training facilities will be
provided to disadvantaged target
groups through the provincial training
centers.
Appendix 2 19
Actual
for disadvantaged groups. As
planned, seven provincial training
centers (PTCs) at Banteay Meachey,
Battambang, Kampot, Kampong
Cham, Pursat, Sihanoukville, and
Takeo were upgraded through
rehabilitation of existing buildings or
construction of new buildings,
provision of basic workshop and
office equipment, provision of training
materials, and staff training. During
midterm review, an additional nine
PTCs were added to expand the
TVET system and to establish a
national network for skills testing and
certification. Those nine PTCs were
at Kandal, Kampong Chhnang,
Kampong Speu, Kampong Thom,
Kratie, Prey Veng, Siem Reap, Stung
Treng, and Svay Rieng. The 12 new
civil work packages and supply of
equipment for the multipurpose
workshops were completed
satisfactorily on 30 September 2001.
A micro-credit scheme was provided
for graduates of the Skills Training
Program. It was implemented in close
coordination with the International
Labor Organization and
nongovernment organizations.
The Project expanded TVET
opportunities for WID Center at
Kampot, including office equipment,
furniture and fixtures for classrooms,
and basic workshop equipment by 23
February 1999. After midterm review
mission, similar provisions to WID
Centers at Preah Vihear, Ratanak
Kiri, Mondul Kiri, Koh Kong, and
Kandal by 18 May 2001. Related
curricular material and instructor
training, were provided to WID
Centers at Preah Vihear, Ratanak
Kiri, Mondul Kiri, Koh Kong and
Kandal by 18 May 2001. Related
curricula material, instructor training,
and training equipment were also
provided.
The Project has provided capacity
building for mobile training systems
through related staff training, and
advisory and technical services. This
was completed by 30 September
2001. Beneficiaries in targeted
communities who could not attend
training at PTCs received income-
generating skills training in livelihood
projects such as duck raising, fish
20 Appendix 2

Component/Activity Appraisal Actual

farming, onion growing, motorbike
repair, masonry, and silk weaving.
D. Training and Staff Development Programs
One hundred and forty-eight fellows
from DTVET, TVET institutions, and
PTCs completed the overseas/regional
fellowship programs (see Appendix 3).
In-country workshops on key TVET
fields were organized for 500
counterpart staff by the international
and domestic consultants. In-country
training programs were provided,
including in the English language and
computer skills. In-country training for
DTVET staff and trainers from TVET
institutions and PTCs has been
completed through contractual
arrangements. In-country fellowship
programs for DTVET staff and TVET
institutions were also undertaken to
upgrade trainers’ qualifications and
improve teaching. On-the-job
counterpart training for TVET staff was
provided through consultants
throughout the Project implementation
period.

Part B: Health Personnel Training (HPT)

A. Building Ministry of Health Planning and Management Capacity
1. Strengthening of Human Resource Department
The Project will improve The HRMIS will feed into the HPT. Construction of the annex building at
the capacity for Development plans will enable MOH was completed on 21 June
management of health continuous professional education 2001. The building now
personnel of the Human and training, facilitate deployment of accommodates the MOH HRD and
Resources Department health professionals, and assist in Personnel departments, and
(HRD) of the Ministry of the development of detailed externally-funded projects including
Health (MOH) by procedures for health personnel for the new Health Sector Support
developing programs from delivery of primary health care. It will projects. The HRD Department has
computer databases, or be coordinated with the MOH established a computer-based system
the human resources budgeting system. of cadre registration and certification
management information through HRMIS. It is presently used in
system (HRMIS) and the development of a 10-year Plan
baseline studies. Work Force (2004–2013), a Health
Strategic Plan (2003–2007), and
allocation of resources through the
Priority Action Program. The Project
provided consultant services and staff
development, and strengthened
information systems by providing
equipment, including computers, and
by upgrading facilities.
2. Health Care Training Institutions
The Project will strengthen A continuing health education The Project completed upgrading of
the training capacity of the system will be established for the the NIPH on 27 May 2001. The main
key professional national health programs. NIPH building was improved. A new
institutions of MOH. A public health laboratory will also be hostel for managers attending training
established at NIPH to strengthen courses was built. The Project
the epidemiological surveillance supplied office and medical
system. Similarly, assistance will be equipment, and supported the
provided for in-service training establishment of a public health

Component/Activity Appraisal
programs for nurses, midwives,
laboratory technicians, x-ray
technicians, physiotherapists, and
nutritionists at Technical School of
Medical Care (TSMC).
B. Improvements in Quality and Relevance of Training
1. In-Service Training
The Project will establish a The Project will assist training for
program of competency- health workers, including doctors,
based training programs. medical assistants, nurses, and
midwives. The training courses will
comprise field practice and
assessment of practical and clinical
skills.
2. Training of Trainers and The Project will develop training
Professional Development materials with special focus on
community health workers at the
village level, and will support training
workshops with the help of resource
persons and consultants. The
materials will be distributed to
trainees. Supervisors will be trained
to brief and motivate the health
workers.
Appendix 2 21
Actual
laboratory. The Project also upgraded
the TSMC by providing a building for
continuing education and an
auditorium for conferences, sem inars,
and workshops. The works were
completed on 23 September 2000.
The continuing education system
(CES) was established in 1998 to
facilitate and coordinate in-service
training for all national health
programs at provincial level. The
provincial CES coordinate with
master trainers at TSMC and regional
training centers (RTCs). Five core
trainers for continuing training were
trained in each province.
The provincial CES coordinates with
master trainers at TSMC and RTCs.
The RTCs conducted minimum
package of activities (MPA) curricula
development and training based on
13 modules developed through the
Project. About 4,800 copies of each
module were printed in Khmer and
distributed countrywide to health
center staff. About 4,652 health
center staff have been trained
through MPA module I on Health
Management at the Grass Roots
Level. Training through MPA module
II (Patient Assessment) and module
VII (Primary Health Care and Health
Education) was conducted for health
center staff in 17 selected provinces.
The same health center staff were
trained through MPA module VI
(Basic Infection Control) and module
XIII (Emergency Treatment and Minor
Surgery) (Appendix 6).
CES was established in 1998 to
facilitate the training program of all
vertical national health programs at
the provincial level. In-country training
for PHC services management, with
emphasis on health education, and
adult consultation for health center
staff was provided by TSMC and
NIPH. About 100 trainers for RTCs
have undertaken training of trainers
during the five 6-weeks training
courses conducted by the master
trainers trained by the World Health
Organization and the Australian
Agency for International
Development. At Project completion,
about 212 trainers had received
training in primary health care.
Through training programs conducted
under the Project, 4,652 trainers were
22 Appendix 2
Component/Activity
C. Expansion in Outreach of Training
1. Regional Training Centers
To improve the outreach
of training in the rural
areas, the training
programs will also be
conducted in four RTCs.
2. Demonstration and Training Center at the District Level
D. Training and Staff Development Programs
Appraisal
Certain PHC programs such as
immunization, control of diarrheal
diseases, rural water supply, and
sanitation, will also be conducted at
Ministry of Rural Development
training centers. According to need,
the facilities at these training
institutions will be selectively
upgraded to meet training
requirements.
To support health personnel training
in the field, a training and
demonstration center will be
established at the district level in
Prey Vang. This will serve as a
forum for training health workers
under real conditions.
Actual
trained in four RTCs in PHC
programs, including immunization,
control of diarrheal diseases, rural
water supply, and sanitation.
The Project completed the renovation
works at RTCs at Battambang,
Kampot, and Stung Treng by 21
March 2002, and equipped four RTCs
(including RTC at Kampong Cham)
aimed at improving outreach training
in rural areas. A training and
demonstration center proposed at
Prey Veng was dropped at the
midterm review because MOH had
decided to concentrate on in-county
training at the provincial level through
TSMC and the four RTCs in
Battambang, Kampot, Kampong
Cham, and Stung Treng.
During midterm review, MOH dropped
this sub-component because it would
continue to focus on training health
workers at the provincial level.
Eighteen staff participated in the
overseas fellowship program, which
had been planned for 14 staff
(Appendix 5). All of the staff currently
work in MOH and central MOH
institutions.
 Appendix 3 23

ESTABLISHMENT OF THE NATIONAL TRAINING BOARD (NTB)

AND NATIONAL TRAINING FUND (NTF)

I. The National Training Board

1. The NTB was established on 28 November 1996 and formally constituted through a sub-
decree on 11 March 1998 as the highest inter-ministerial and the main policy and planning body
for Cambodia’s TVET sub-sector. The NTB is specifically responsible for (i) establishing a stable
mechanism for long-term policy and planning approaches to TVET; (ii) developing an
organizational culture that promotes the provision of, and access to, quality skills training
programs; (iii) initiating reforms for the advancement of TVET institutions; and (iv) coordinating
collaborative programs between the public and private sectors in the delivery of demand-driven
TVET programs, taking into account internal and external resources of both sectors. The NTB
comprised 30 members of whom 15 were from Government ministries; 6 from the Phnom Penh
Chamber of Commerce and Employers’ Association; 2 from the Cambodian Federation Trade
Union; 3 from public and private TVET educational and training institutions; 3 from international
and local NGOs; and the executive officers or director generals of Higher Education and TVET.

2. The secretary of state chairs the NTB Board,27 assisted by with two vice chairs: the
undersecretary of the Ministry of Social Affairs, Labor, Vocational Training and Youth
Rehabilitation: and the chief of the Finance Committee of the Chamber of Commerce. Its
Executive Committee also serves as the MTF Management Committee, whose main function is
to review all policy documents before they are brought to the attention of the NTB. NTB has also
established an Industrial Advisory Training Committee (IATC) composed of representatives from
major industries to ensure that training programs are responsive to needs of the labor market.
The DTVET serves as the NTB secretariat (see the organizational chart below).

27
The Loan Covenant provided that the chairman of the NTB will be the Minister of Education, Youth, and Sport.
 24
NTB AND SUPPORT STRUCTURE

Appendix 3
NATIONAL TRAINING BOARD

Board President MOEYS

2 Vice Presidents • Chamber of Commerce

• MOSALVTYR
Executive Committee
(NTF Management
Committee)
IATC

Director General of
Executive Officer DGHE & TVET

Administration & HRD Policy & Planning NTTI Monitoring &

Evaluation
Curriculum Development
Industrial Liaison Units

MIS
Standards & Quality

Legal & Finance

HRM Learning Resource
Accreditation
Assessment

TENA
GEO
PSU

NTF

Teacher Training
Finance &
Administration

Maintenance
DEPARTMENT OF TECHNICAL AND VOCATIONAL
Clearing House EDUCATION AND TRAINING
(UNESCO Vocational Conference/SEAMEO)

DGHE = Department of GHE, GEO = Gender and Equal Opportunities unit, HRD = Human Resources Department, HRM = Human Resource Management,
IATC = Industrial Advisory Training Committee, MIS = management information system, MOEYS = Ministry of Education, Youth, and Sport, MOSALVTYR =
Ministry of Social Affairs, Labor, Vocational Training, and Youth Rehabilitation, NTF = National Training Fund, NTTI = National Technical Training Institute, PSU
= Provincial Support Unit, SEAMEO = Southeast Asian Ministers of Education Organization, TENA = training evaluation needs assessment, TVET = technical
and vocational and education and training, UNESCO = United Nations Educational, Scientific, and Cultural Organization.
 Appendix 3 25

3. The NTB has met 21 times since its establishment. Among major matters considered
were applications for training grants from NTF for which it has approved the first to eighth
phases; the proposed scheme for National Occupational Skills Standards, Testing, Accreditation
and Certification System (already submitted to the Council of Ministers); and the 5-year TVET
Strategic Plan (approved on 28 December 2002 and also submitted to the Council of Ministers
for action). The strategy paper set Cambodia's TVET development framework, including the
structure of the TVET system within the overall educational system (Appendix 3). The NTB has
also created a task force to study the introduction of a levy scheme on industry. A draft policy
paper has been submitted and discussed in the NTB. Some issues on the legal implications of
the scheme within the broader context of the Cambodian tax structure are still being resolved.
The NTB is operational and functioning effectively as envisaged at appraisal.

4. The IATC was established under NTB to respond to industry requirements for demand-
based TVET courses, and to expose TVET students to the world of work. The IATC will assure
the operationalization of the Industrial Liaison Units that were established at the Secondary
School of Business, Preah Kossomak Technical and Vocational Training College, and Russey
Keo Technical School. IATC comprises representatives from major industries in the private
sector such as manufacturing, hotel management, tourism, banking, power generation,
engineering, and construction. This formal arrangement is envisaged to generate a sense of
ownership in the private sector in the overall management and coordination of TVET
development at the institute or center level. The establishment and operationalization of the
Industrial Liaison Units and IATC are perceived as critical in ensuring that the training meets
changing market and societal needs. The NTB will coordinate with IATC on the development of
skills standards and plans for each sector.

II. Objectives of the National Training Fund

1. The National Training Fund (NTF) is envisaged as a medium and long-term mechanism
for the financing of training from both Government and non-Government funds. Initially, the NTF
will serve as a means for providing Project-financed support for demand-oriented training, such
as training programs that are relevant to employment needs and in accordance with the training
policy and strategy of the National Training Board (NTB). In the longer term, the NTF will evolve
into the main mechanism for funding of employment-related training, including enterprise-based
training. It will also become an instrument for providing incentives to training institutions,
enterprises, and the private sector to upgrade and extend their provision of training.

III. Features

A. Manageme nt

2. As designed at appraisal, a Managing Committee reporting to the NTB was to be

constituted to oversee NTF operations, including the identification and design of programs and
operating procedures, and the criteria and conditions for allocating and disbursing of funds. The
committee, which includes representatives of the private sector and employers, has been
constituted.

B. Operating Procedures

3. The NTF operates through contracting with training providers to implement training
programs that meet agreed criteria of quality, efficiency, and relevance to the needs of priority
target groups and employers. The contract scheme has the following features:
26 Appendix 3

(i) Contracts are based on approved schemes that specify such aspects as (a)
source of trainees, (b) size of intake, (c) details of training program, (d) facilities,
(e) staff and their qualifications, (f) evidence of job prospects or opportunities for
self-employment, and (g) links with industry.

(ii) Costs and budgets are specified in detail.

(iii) Staff follow evaluation guidelines to evaluate schemes.

(iv) Arrangements are specified for the monitoring of outputs.

(v) Disbursements are based on evidence of successful implementation and

outcome of the training programs.

C. Scope and Coverage

4. The NTF is flexible about the variety of training arrangements and delivery methods that
it supports including full-time long courses for job-seekers, skills upgrading for workers, training
programs that combine training in a center with on-the-job training in industry, training in
industry, and part-time training. It may also support setting up and running of a training program
in an enterprise, or help a firm analyze training needs. The NTF, however, will cover only part
of the cost of training programs. The balance will come from regular budget allocation and fees.

D. Replenishment of the Fund

5. The NTF was set up through the Project with loan funds. In the medium term, it will be
replenished from the following sources:

(i) Government budget allocations,

(ii) Assimilation into the NTF of the finance that external agencies presently provide,
and

(iii) Revenues from the introduction of a scheme for levy of enterprises.

IV. Performance

6. The NTF was established on 26 December 1997. All of 1998 was spent identifying and
designing the programs, developing systems and procedures, and training of staff. The NTB
eventually developed and approved three financing facilities:

(i) The Training Grant Fund (TGF), a grant facility for training providers contracted
to do training for certain group of trainees in certain skill areas;

(ii) The Innovative Skills Investment Assistance Fund (ISIAF), a loan facility for
private training providers offering innovative training to their own target clientele
for a fee; and

(iii) The Self-employment Generation Fund (SEGF), a micro-credit loan facility for
small entrepreneurs in both urban and rural areas.
 Appendix 3 27

A. Training Grant Fund

7. The first phase of the TGF was approved in April 1999 with contracts awarded to 16
training institutions to train 693 beneficiaries in 12 provinces or cities. By May 2001, seven more
phases of training grants were approved. Altogether, for the 8 phases, the TGF trained 13,084
beneficiaries from 24 provinces/cities in 53 skill areas at a cost of $1.92 million, or an average of
$146.82 per trainee. The TGF beneficiaries comprised the poorest people (38.1%), school
leavers (25.2%), orphans (15.1%), widows (9.9%), crippled demobilized soldiers (6.3%), and
handicapped (5.5%). About 50.3% of the beneficiaries were women.

8. Based on a tracer study on training outcomes, the average employment rate among
graduates was 66.2%. The employment rate among women was 74.9%? significantly higher
than that of men, which averaged only 57.5%. Categorized by type of beneficiaries, the
employment rate ranged from a low of 54.7% among school leavers to full employment among
demobilized soldiers. Rough estimate of the PTCs indicate that among those who found
employment, only about 20% were wage-employed while about 80% were self-employed.
Among the self-employed, a number were beneficiaries of the SEGF. The average income of
those who found employment ranged from $32-$73 per month. When benchmarked against the
$25 per month average salary of public servants, the impact of TGF on the income of
beneficiaries is very significant.

9. The TGF has no cost recovery. Training fees could not be charged because the
beneficiaries were very poor and even had to be provided assistance in transportation and food
during the training period. But, in terms of employment generation, the TGF is efficient, requiring
only an average investment of $221.60 per employed beneficiary.1 Those who were
unemployed at the time of the survey (tracer study) will eventually find employment, reducing
even further the average investment per employment generated. Thus, instead of considering
the amount spent in TGF as a cost, it would be more appropriate to consider it an investment in
human capital.

B. Innovative Skills Investment Assistance Fund (ISIAF)

10. The ISIAF disbursed $300,000 to five training providers? $200,000 during the fourth
phase in October 1999 and $100,000 during the sixth phase in May 2000. The ISIAF trainees
numbered 11,595. But no tracer study was conducted on outcome of the training. The ISIAF
was discontinued, and its fund allocation transferred to the SEGF, because one borrower, with
$1,000,000 loan, defaulted. (The money was eventually recovered from the guarantor.)

C. Self-employment Generation Fund

11. The Self-employment Generation Fund (SEGF) is a micro-credit program with approach
and features similar to that of the Grameen Bank of Bangladesh. Beneficiaries are selected from
poor families in a community, and are grouped into three to five members. Each member must
have an existing or a proposed business to engage in. One requirement for eligibility to borrow
from SEGF is that at least one member of the group must have graduated from TGF training.
Each group has a leader, a collector, and a treasurer. All members are solitarily liable for the
loans of other group members. Loan amounts generally range from $200–$3,000. Loan terms

1
Total TGF awarded ($1.92 million) divided by the number of beneficiaries employed (8,664).
28 Appendix 3

are: (i) an interest rate of 12% per annum; (ii) a grace period of 6 months is granted on principal
and interest (the grace period is not computed in the interest, so 12% is actually for 18 months);
(iii) a payment period of 12 months with monthly repayments; (iv) the actual amount received is
91% of principal after deducting group savings (5%), risk fund (2%), and service charges (2%);
(v) group savings are returned to the borrowers upon full payment of the loans; (vi) monthly
payments and collections given to the director who keeps the money in a safe until able to
personally deposit it to the SEGF central account in a Phnom Penh bank. Beneficiaries may
borrow again upon full payment.

12. The Project provided SEGF $1.17 million in capital. NTB approved the first phase (along
with the fifth phase of TGF) in December 1999, amounting to $20,250 for 42 micro-enterprise
groups. By December 2002 the SEGF, through the PTCs, had disbursed $1.36 million (including
relending) to 5,653 members in 1,754 groups in 15 provinces; 64.6% were women. But
distribution of disbursements has not been even, partly because Project assistance to the PTCs
came in batches. The last nine provinces were still in the start-up stage when the Project ended.
The disbursements ranged from a low of $3,900 in Kampong Chhnang to a high of $384,950.00
in Kampot. The next-highest disbursement was in Takeo with $317,650, followed by
Battambang with $167,200, then Kampung Cham with $110,450. These top four PTCs
comprised 72.2% of total disbursements.

13. The SEGF beneficiaries engaged in a wide variety of micro-enterprises such as algae
and seaweed growing, bamboo basket making, animal raising, food processing, hairdressing,
motorbike repair, onion growing, television and radio service and repair, silk weaving, masonry,
stone carving, worm raising. Selection of eligible businesses was preceded by a training and
employment needs assessment (TENA) conducted by the PTCs, and by rudimentary feasibility
studies. Procedures for processing, disbursements, and collection procedures have been
developed, and are being implemented. The high collection rates indicate that the SEGF
businesses are doing well. The average income from such businesses ranged from $32 to $73
per month, a significant amount, especially in the countryside. At this early stage, the
performance indicators of the SEGF micro-credit program suggests promising potential in
directly addressing the problem of rural poverty.

V. Financial Position of the NTF

14. To give a clearer picture of the NTF's financial position, standard financial statements
(unaudited) were prepared covering the period of April 1999 to December 2002. During this
period, the NTF posted a net income from operations of $86,161. The TGF of $1.92 million,
although it just “passed through” the NTF, was reflected in the income statement just to show
the total picture. The interest income from both the ISIAF and the SEGF totaled $80,847. The
2% service charge and 2% risk fund contribution contributed $54,280. Expenses included those
for operating and monitoring of the PTC and the central offices. But excluded were Government
salaries of staff involved in NTF operations. Also excluding the grant income, the net operating
income represents a net margin of 62.8%.

15. The balance sheet shows a total asset of $3.28 million, including the $1.92 million grant
for basic skills training through the TGF. Cash in the bank of $410,684 is comprised mainly of
the SEGF account of $374,382. The loans outstanding is also mainly of the SEGF, amounting to
$749,814. What appears to be an area of concern is the “Undisputed Collection from Field,” of
$192,075. Details of how this amount was derived are in the cash flow statement. The main
reason for this, according to SEGF staff, is the repayment procedure whereby the borrowers
make repayments directly to the ISIAF and SEGF savings accounts, causing the difference in
 Appendix 3 29

bank and record book balances. Bank and book records have not been reconciliated monthly.
This aspect of the SEGF operation needs immediate attention of NTF management. Overall, the
NTF has performed well financially, given its resources, but NTF may find it difficult to sustain
the same volume of activities without additional capital.

VI. Sustaining the NTF Programs

16. Currently, the NTF operations consists mainly of SEGF. The basic skills grant through
TGF has stopped, because all allocation for this purpose has been disbursed and the TGF has
no measures for cost recovery. The ISIAF was discontinued because past experience proved it
risky, and it did not seem effective for reaching the target beneficiaries. The ISIAF allocation
was transferred to the SGEF.

17. As envisaged at appraisal, replenishment of the NTF may come from any, or all, of three
sources: the Government budgetary allocation, a levy on local industry, and external agencies.
A tight financial position makes substantial Government budgetary allocation unlikely. The levy
on industry likewise cannot be expected to be a major source of fund for the NTF simply
because of the country’s small industrial base not to mention the natural resistance of industry
against such a scheme. The more promising prospects are external sources, in the form of
grants or soft loans, or a combination of both. But the NTF must be able to show that its
activities are worth supporting and that it has the capacity to manage the fund professionally.

18. Based on the past 3 years of operation, the NTF, under the NTB, has performed
creditably well. It has shown the resolve to aggressively pursue its mandate of providing
opportunities to the marginalized but, at the same time, it also exhibited prudence in making
changes in its plans and programs when necessary, as was the case with the ISIAF . The impact
of the two programs, the TGF and the SEGF, on the lives of the poor clearly suggest that they
are worth investing in. And there is synergy in their operations: the TGF provides the basic
employable skills, and the SEGF creates opportunities for such skills to be applied. The synergy
is maximized when the two programs are implemented in tandem in the same geographic area.
The challenge, then, is how to sustain the two programs.

A. The Training Grant Fund

19. The TGF has no cost recovery mechanism, so it can be sustained only if there is a
stable source of income to support the training contract grants. For this kind of operation, a
Trust Fund (the Fund) would be most appropriate. The Fund's principal should be large enough
to generate sufficient earnings to support the desired amount of training every year. The
principal should never be touched. To maximize earnings, the NTB may designate a trustee
bank so the Fund would be managed by a professional Investment fund manager.

20. The amount of principal for the fund depends on the number of training outputs that the
NTB would target annually. The 13,084 training outputs of the TGF were accomplished in about
2.4 years, or an average of about 5,500 per year. Assuming a target of 5,000 trainees per year
at an average cost of $150 per trainee, the required earnings from the Fund for this program
would be about $750,000 per year. Assuming an average earning of 5% per year, the principal
of the Fund should be about $15 million. A $20 million principal might be more appropriate in
30 Appendix 3

order to support other modalities of training contract provision and to cover charges and fees for
funds management.2

B. The Self-Employment Generation Fund

21. Indicators suggest that the SEGF has done quite well financially during the period under
review (January 2000 to December 2002). But, one major area of concern was raised: the
incentive allowance provided to staff involved in SEGF was discontinued when TGF activities
ceased, because it was taken from the TGF allocation. The incentive allowance ranged from
$140 to $180 per month, with an average of three staff per PTC. For someone receiving an
average of $25 per month, the incentive allowance was certainly a substantial help to family
income. Going back to the previous income level would require a major adjustment in “lifestyle”
and could be demoralizing. There is apprehension that this could affect efficiency in organizing
the beneficiaries, processing loan applications, monitoring, and collection.

22. In lieu of the incentive allowance, the NTF management allowed an equivalent of 9% of
disbursement to be allocated equally at 3% each for PTC operations, SEGF operations, and
monitoring by the central staff. The 9% represents 7% out of the 12% interest and 2% risk fund
collected from the micro-credit loan. Under this scheme, the PTCs with relatively large volumes
of lending are better off, while those with low lending have little to substitute for the incentive
allowance, which is a fixed cost. The SEGF operations of PTCs that are still in the startup stage
could be upscaled only to a certain level because of limited available capital. The fact that there
is no TGF skills training in tandem with SEGF also constrains upscaling of SEGF operations of
the new PTCs.

23. Assuming that absence of the incentive allowance would not significantly affect the
enthusiasm of SEGF staff, with the collection rate maintained at 90% and a recovery rate of 7%
on overdue accounts, the entire SEGF operations would be financially viable, even without
additional infusion of capital, in five years. Based on the projected volume of lending provided
by the PTCs, except for Kampong Chhnang and Kratie which did not submit their projections,
the projected gross income from interest on SEGF, service charges, and risk fund would
steadily increase from about $104,064 in 2003 to $138,726 in 2007. The corresponding net
income from operations, after deducting expenses equivalent to 9% of disbursement will
increase from $26,016 in 2003 to $34,681 in 2007. That represents an average net margin of
15.6%? quite a thin margin to serve as buffer against a rather optimistic assumption.

24. When taken as a whole, the SEGF may appear viable. But only a few of the individual
PTCs have sufficiently large lending volume to earn sufficient income to pay for their operating
expenses, including incentive allowances. To give an idea of the lending volume that might be
necessary to make SEGF operations in a PTC viable, two models were prepared: model 1, a
small operation with a lending volume of $150,000; and model 2, a relatively large PTC with a
lending volume of $250,000. For model 1, the expected income from interest, service charge,
and, risk fund is about $18,000 per year under the same terms and conditions currently
implemented. After deducting operating expenses of $9,960, the expected net income from
operations is $8,040 or a net margin of 44.7%, which is high enough to provide some buffer for

2
For comparison, the required trust fund for the Skills Development Fund under the Technical Education and Skills
Development Authority in the Philippines was estimated at P5 billion, or about $92 million at current exchange rate
of $1:P54.
 Appendix 3 31

contingencies. For model 2, the expected gross income is $30,000, and net income is $13,416
with the same net margin of 44.7%.
25. Figures in paragraph 25 suggest the need to upscale the volume of SEGF lending in
each PTC, both to help more beneficiaries and, simultaneously, make the SEGF program
sustainable. This implies additional capital infusion to SEGF. Assuming that of the 15 PTCs3
that participated in SEGF, 7 will be upscaled to $250,000 and 8 to $150,000, the implied capital
requirement would be about $2.95 million. But not all of the capital will be outstanding at the
same time. Assuming 70% is outstanding at any time, the total capital required would be about
$4.21 million. Since $1.17 million is already available, an additional $3.00 million seed capital for
SEGF would be needed. At such lending volume, a total net operating income of about
$158,232 per year can be expected. Part of the n et income may be used for operating
expenses at the central office while part should be retained for relending.
VII. Conclusions and Recommendations
A. Conclusions

26. The experience of the NTF programs, the TGF and SEGF, during the past 3 years has
been encouraging. Their impacts on the poor have been direct, concrete, and substantial? and
with relatively small investments. The TGF proved to be an efficient way to empower the poor
by providing employable skills, either for wage or self-employment. The SEGF provided
concrete opportunities for TGF graduates to apply acquired skills for self-employment. The
systems, processes, and structures of the two programs have been put in place with some
refinements that could be incorporated based on the lessons learned during the past 3 years.
There is a need to upscale the operations of both programs to reach out to more target
beneficiaries. This requires additional investments.

B. Recommendations

1. For the Training Grand Fund

27. Establish a trust fund for TGF with principal amount of $15–$20 million. A trust
fund of this size could provide a stable stream of income to sustain the TGF and related
programs. As envisaged at appraisal, the NTF should serve as a mechanism for various
modalities of output-based training contracts with public and private providers. Because of the
amount involved, a combination of grant and loan from external sources might be tapped for this
purpose. The fund should be managed for investment by a reputable trustee bank that the NTB
might designate.

28. Conduct TENA regularly. The TENA unit of the DTVET, being the secretariat of the
NTB, should regularly update the training and employment needs of the country to ensure a
demand-based contract scheme for training.

29. Conduct tracer study on training outcome . Tracer studies to monitor results of
training should be conducted regularly so that priority skills can be changed to suit labor market
demands for wage or self-employment.

3
There are 16 PTCs: Established through the International Labor Organization (ILO) before the Project were PTCs
at Banteay Meachey, Battambang, Kampot, Kampong Cham, Pursat, Sihanoukville, and Takeo. After the midterm
review, nine more PTCs were established at Kandal, Kampong Chhnang, Kampong Speu, Kampong Thom, Kratie,
Prey Veng, Siem Reap, Stung Treng, and Svay Rieng.
32 Appendix 3

2. For the Self-employment Generation Fund

30. Provide additional seed capital of $3 million. Additional capital of about $3 million
would be needed to provide a critical mass of SEGF lending in each of the 15 PTCs (the Kandal
PTC has no SEGF operation). Additional capital of about $1 million may be needed if PTCs are
established, and SEGF operations be also implemented, in the remaining seven small
provinces. This amount might be raised through external or loans.

31. Enforce more stringent controls in the remittance of collections. Payments from
borrowers should be deposited in a safe place, preferably in a bank near the PTC, within a
specified number of hours upon receipt. As much as possible, funds should be remitted
electronically to the central account in Phnom Penh. Special rates should be negotiated with the
bank to make the cost reasonable.

32. Require monthly reconciliation of bank and book records for each PTC and the
entire SEGF. Monthly reconciliation should be strictly enforced to ensure that all funds are duly
accounted for and actions are taken to correct inconsistencies as soon as possible.

33. Require standard financial statements on SEGF operations at the PTC and at the
consolidated level. Standard financial statements (income statement, balance sheet, and cash
flow) should be prepared monthly for the SEGF operations in each PTC, and on a consolidated
basis. This is in addition to the data gathering and reports that they are currently underway. A
similar set of financial statements should also be prepared for the entire NTF on a consolidated
basis.

34. Growth should managed and controlled. Even if capital were available, growth of the
number and geographic coverage of SEGF operations should be managed and controlled.
Social preparation, including organizing and training, should be particularly emphasized; loans
should be provided only when the beneficiaries are prepared.
 Appendix 4 33

ORGANIZATION CHART OF THE MINISTRY OF EDUCATION, YOUTH, AND SPORT

(MOEYS) BEFORE AND AFTER THE PROJECT

Director General
Higher, Technical and
Vocational Education

Director Director Director Director

Higher Education Teacher Training Technical and Research
and Retraining Vocational
Education

DGHTVET
Director General

Department of Technical and

Vocational Education and Training
Director

Deputy Deputy
Director Director

Administration Planning Management Vocational National Training

Office Office of Institution Training Office Fund Office
Office

• Administration • Planning • Technical • Legislation & • Commercial

• Personnel • Cooperation Institution Structure promotion
• Finance • Staff • Agriculture • Standard • Proposal
• Maintenance Development Institution • Accreditation Inspection
• Monitoring and • Service Institution • Examination & • Contract
Evaluation and • Provincial Testing arrangement
Management Vocational • Training • Providing Fund
Information Training Center Evaluation Needs • Monitoring and
System Assessment Evaluation
(TENA)
• Gender and Equal
Opportunities
(GEO)
 34
ORGANIZATION CHART OF MINISTRY OF HEALTH

Senior Minister & Minister of Health

Appendix 4
Two Secretaries of State

Six Undersecretaries of State

Cabinet

Directorate General for Administration and Finance Directorate General for Health Directorate General for Inspection

Secretariat Bureau of ASEAN Affairs

Secretariat Secretariat
Bureau of International
Relations Bureau of
Inspection
Department of Administration
Bureau of
Control
Department of Personnel Department of Health Planning and
Information
Department of Budget and Department of Human Resource Pasteur
Finance Development Institute

Department of Drug, Food &

8 National Institutes a Cosmetics
6 National Hospitals b Department of Hospital Services National
Pharmaceutical
4 Regional Schools of Department of Preventive Medicine
------------------------------------------------------- Technical Medical Care c Factory
Department of Communicable
a
National Center for HIV/AIDS and STDs Disease Control
(NCHADS), National Center for Tuberculosis
and Leprosy (NCTB/Lepr), National Center for
24 Provincial Health Departments
Malaria (NCMalaria), National Center for
Maternal and Child Health (NCMCH), UNIVERSITY OF MEDICAL
National Institute of Public Health (NIPH), SCIENCES
National Center for Traditional Medicine 76 Operational Districts Health
(NCTraMed), National Center for Drug Faculty of Medicine
Quality Control (NCDrugQuaCon), National Faculty of Odontostomatology
Center for Blood Transfusion (NCBloodTran) Faculty of Pharmacy
b
Excluding hospitals in NCMCH and School of Technical Medical Care
69 Referral Hospitals 942 Health Centers
NCTB/Lepr
c
Battambang, Kampot, Kampong Cham, and
Stung
Treng 67 Health Posts
 Appendix 5 35

ENROLLMENT AT TECHNICAL AND VOCATIONAL EDUCATION AND TRAINING

(TVET) INSTITUTIONS
1996–97 to 2002–03

Applicants Enrollment
TVET Institution Year
(no.) (no.)

Cert Dip B.A. Total Cert Dip B.A.

National Institution of Business 1996–97 1,538 185 185
1997–98 2,062 187 187
1998–99 3,395 164 164
1999–00 100 3,733 205 40 165
2000–01 250 3,056 376 183 193
2001–02 199 3,462 313 90 223
2002–03 1,850 1,646 1,687 753 934

Industrial Technical College (Russey Keo) 1996–97 48 119 111 34 77

1997–98 41 182 119 35 84
1998–99 53 176 135 42 93
1999–00 139 224 192 95 97
2000–01 114 239 180 90 90
2001–02 110 205 194 86 108
2002–03 207 434 206 98 108

Preah Kossamak Polytechnique 1996–97 308 239 207 147 60

1997–98 410 217 171 111 60
1998–99 2112 114 208 134 74
1999–00 584 234 271 189 82
2000–01 444 356 400 315 85
2001–02 487 457 432 337 95

National Technical Training Institute 1996–97 0

1997–98 0
1998–99 0
1999–00 0
2000–01 245 792 245 145 402
2001–02 365 530 110 420
2002–03 406 575 125 450

Cert = certificate, Dip = diploma, B.A. = Bachelor of Arts.

Note: Cambodia's TVET system has formal and non-formal sectors. The formal TVET sector comprises (i) National Institute of
Business, (ii) the Russey Keo Industrial Technical College, (iii) the Preah Kossomak Polytechnic Institute, and (iv) the National
Technical Training Institute. The informal TVET sector (outreach program) comprises Provincial Training Centers and Women in
Development Centers. Enrollment in the formal sector has continuously increased, with no corresponding increase in the number
of instructors or in evening classes. The quality of instruction is implied to have improved because of new equipment and better-
trained instructors. In the informal TVET sector, an average cost of $147 per trainee has been computed as cost-effective. This
was based on the consultant's experience in Philippines, Thailand, and Malaysia, although there was no data for comparison in
Cambodia.
Source: Supplied by individual TVET institutions.
36 Appendix 6

INTERNATIONAL FELLOWSHIPS AND IN-COUNTRY TRAINING

AND STAFF DEVELOPMENT

Planned Person- Actual Person-

Training Programs Staff Duration Months Staff Duration Months
(no.) (mos.) (no.) (no.) (mos.) (no.)
Part A: Technical and Vocational Education and Training (TVET)
A. Overseas/Regional Fellowships 127 30–48 3,810–6,096 148 30–48 4,440–7,104
B. Study Tours/Visits 20 0.5 10 22 0.5 11
C. Counterpart Training
1998 40 12 480 42 12 504
1999 120 12 1,440 129 12 1,548
2000 100 12 1,200 115 12 1,380
2001 60 12 720 83 12 996
2002 20 12 240 20 12 240
D. In-Country Workshops
a. Module I 75 2 days 7.5 78 2 days 7.6
b. Module II 100 2 days 10 104 2 days 10.4
c. Module III 50 2 days 5.0 59 2 days 5.9
E. In-Country Training
a. Module I 60 1 60 68 1 68
b. Module II 60 1 60 78 1 78
c. Module III 60 2 120 64 2 128
d. Module IV 60 1 60 60 1 60
e. English language 700 6 4,200 730 6 4,380
f. Computer 500 3–6 1,500–3,000 519 3–6 1,557–3,114

Part B: Health Personnel Training

A. Overseas/Regional Fellowships 12 9 108 18 9 162

B. In-Country Training
a. Training of Trainers 100 1 100 212 1 212
b. Nurse Anesthetist 10 24 240 16 19 304
c. Minimum package of 3,000 2 6,000 4,652 0.5 2,326
activities (MPA)
modules/RTCs

Planned
National Training Fund (NTF) Actual No. of
Staff Duration Duration (mos.)
Training Programs Trainees
(no.) (mos.)

F. Basic Skills Training under NTF

a. Training Grant Fund 13,000 4–12 13.084 4–12
(with micro-credit)
b. Innovative Skills Investment 10,000 4–12 11,595 4–12
Assistance Fund
(with loan facility)
c. Self-Employment Generation 5,000 4–12 5,653 members 4–12
Fund
(1,754 groups)
(with micro-credit)
Sources: Project Implementation Units, Department of Technical and Vocational Education and Training, Ministry of
Education, Youth, and Sport, and Ministry of Health, February 2003.
 MINIMUM PACKAGE OF ACTIVITIES (MPA) TRAINING MODULES

MPA Module Developed by: Progress Remarks

1. Operation of HCs International Tested in Kampong Thom. Approved by MOH. Translated into Khmer
consultant/BSP Printed 7,500 copies. Training: 138 sessions,
and attended by 4,652 staff. Provided by
Technical Liaison Group (TLG)/Dynamic
Pharma
2. Patient Assessment International Tested in Kampot. Revised and approved by Translated into Khmer
consultant/BSP the National MPA Committee. Printed 3,800
copies. Training: 77 sessions, attended by
3,943 staff. Provided by TLG/Dynamic Pharma

3. Acute Pediatric Problem TLG/BSP Finalized by MOH IMCI Committee.

Printed 4,800 copies.
Training: Organized by MOH
4. Adult Common Diseases Health Management Tested in Kampot. Approved by the National Translated into Khmer
Center Co. Ltd. MPA Committee. Printed 4,800 copies.
Training: Organized by MOH. Provided by
TLG/Dynamic Pharma
5. Chronic Diseases Health Management Tested in Kampot and Kampong Thom. Involved Kampot RTC, PHD
Center Co. Ltd. Revised and approved by National MPA Kampong Thom and master
Committee. Printed 4,800copies. Training: trainers and provincial CEC
Training organized by MOH; Provided by Translated in Khmer
TLG/Dynamic Pharma
6. Basic Infection Control Consultant/RTC Tested in Kampong Cham. Revised and Translated into Khmer
Kampong Cham/ submitted to the National MPA Committee for
AusAid approval. Training: Organized by MOH.
Provided by TLG/Dynamic Pharma
7. Health Promotion Consultant/RTC Tested in Kampong Cham; Revised and Translated into Khmer
Kampong Cham/ submitted to the National MPA Committee for
AusAid approval; Training: 60 sessions and attended by

Appendix 7
1,549 staff; Provided by TLG/Dynamic Pharma
8. HC Management Health Management Tested in Kampot; Revised and submitted to Involved Kampot RTC, PHD
Center Co. Ltd. the National MPA Committee for approval; Kampong Thom, master
Printed 4,800 copies; Training: Organized by trainers and provincial CEC;
MOH; Provided by TLG/Dynamic Pharma Translated in Khmer

37
 38
MPA Module Developed by: Progress Remarks

9. EPI Health Management Tested in Kampot. Revised and submitted to English version by
Center Co. Ltd. the National MPA Committee for approval. MCH/MOH. Involved Kampot

Appendix 7
Printed 4,800 copies. Training: Organized by RTC, PHD Kampong Thom;
MOH. Provided by TLG/Dynamic Pharma master trainers and
provincial CEC. Translated
into Khmer
10. General Nutrition Health Management Tested in Kampot. Revised and submitted to English version by
Center Co. Ltd. the National MPA Committee for approval. MCH/MOH. Involved Kampot
Printed 4,800 copies. Training: Organized by RTC, PHD Kampong Thom,
MOH. Provided by TLG/Dynamic Pharma master trainers; and
provincial CEC. Translated
into Khmer

11. ANC/PNC Health Management Tested in Kampot; Revised and submitted to English version by
Center Co. Ltd. the National MPA Committee for approval; MCH/MOH; Involved Kampot
Printed 4,800 copies; Training: Organized by RTC, PHD Kampong Thom,
MOH; Provided by TLG/Dynamic Pharma master trainers and
provincial CEC; Translated
in Khmer.
12. Normal Delivery Health Management Tested in Kampot; Revised and submitted to English version by
Center Co. Ltd. the National MPA Committee for approval; MCH/MOH; Involved Kampot
Printed 4,800 copies; Training: Organized by RTC, PHD Kampong Thom,
MOH; Provided by TLG/Dynamic Pharma master trainers and
provincial CEC; Translated
in Khmer.
13. Emergency Treatment and Minor Surgery Health Management Tested in Kampot; Revised and submitted to Involved Kampot RTC, PHD
Group the National MPA Committee for approval; Kampot Thom, master
Printed 4,800 copies; Training: Organized by trainers and provincial CEC;
MOH; Provided by TLG/Dynamic Pharma Translated in Khmer.

ANC/PNC = ante-post-natal care, AusAid = Agency for International Development, BSP = Basic Skills Project, CEC = continuing education coordinator, EPI =
expanded immunization program, HC = health center, IMCI = Integrated Management of Childhood Illnesses, MCH = maternal and child health, MOH = Ministry of
Health, MPA = minimum package of activities, PHD = provincial health department, RTC = regional training center, TLG = technical liaison group.
Source: Ministry of Health, February 2003.
 PROJECT COST AND FINANCING PLAN
($'000)
Appraisal Estimate Actual
Component
Foreign Local Total Foreign Local Total
A. Civil Works
TVET Component 600 900 1,500 1,214 879 2,093
Health Personnel Training 490 730 1,220 626 445 1,061
Subtotal 1,090 1,630 2,720 1,830 1,324 3,154
B. Equipment and Furniture
TVET Component 2,900 250 3,150 3,446 11 3,457
Health Personnel Training 680 220 900 1,212 2 1,214
Subtotal 3,580 470 4,050 4,658 13 4,671
C. Consulting Services
TVET Component 1,710 350 2,060 1,382 49 1,431
Health Personnel Training 760 220 980 686 1 687
Subtotal 2,470 570 3,040 2,068 50 2,118
D. Staff Development
TVET Component 4,050 3,660 7,710 4,615 1,442 6,057
Health Personnel Training 1,340 390 1,730 1,943 141 2,084
Subtotal 5,390 4,050 9,440 6,558 1,583 8,141
E. Operation and Maintenance
TVET Component 110 420 530 45 27 72
Health Personnel Training 80 80 160 81 1 82
Subtotal 190 500 690 126 28 154
F. Project Implementation Unit
TVET Component 170 210 401 401 39 440
Health Personnel Training 70 210 220 220 31 251
Subtotal 240 420 621 621 70 691
Project Base Cost (including taxes and duties)
TVET Component 9,540 5,790 15,330 11,103 2,447 13,550
Health Personnel Training 3,420 1,850 5,270 4,757 621 5,378
Subtotal 12,960 7,640 20,600 15,860 3,068 18,928

Appendix 8
G. Contingencies
Physical 1,200 600 1,800 0 0 0
Price 820 1,380 2,200 0 0 0
H. Service Charge 400 0 400 333 0 333

Total Project Cost 15,380 9,620 25,000 16,194 3,068 19,262

39
Percentage 62% 38% 100% 84% 16% 100%
TVET = technical and vocational education and training.
Source: Ministry of Education, Youth, and Sport, February 2003.
40 Appendix 9

DISBURSEMENT SUMMARY
($'000)

Year Quarter Amount Cumulative

1996 II 250 250

III 250 500
IV 39 539

1997 I 435 974

II 66 1,040
III 191 1,231
IV 303 1,534

1998 I 726 2,260

II 1,200 3,460
III 360 3,820
IV 1,806 5,626

1999 I 435 6,061

II 1,110 7,171
III 283 7,454
IV 1,046 8,500

2000 I 631 9,131

II 645 9,776
III 908 10,684
IV 1,659 12,343

2001 I 259 12,602

II 780 13,382
III 785 14,167
IV 954 15,121

2002 I 152 15,273

II 645 15,918
III 103 16,021
IV 33 16,054

2003 I 140 16,194

Total 16,194
 IMPLEMENTATION SCHEDULE
Implementation Period (Years)
Year 1 Year 2 Year 3 Year 4 Year 5 Year 6
Description
(1996) (1997) (1998) (1999) (2000) (2001)
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4

I. Technical and Vocational Education and Training (TVET)

A. Building of TVET Planning and Management

1. Establishment of National Training Board (NTB)

2. Establishment of National Training Fund (NTF)

3. Strengthening of Department of Technical and

Vocational Education and Training (DTVET)
B. Improvement in Quality and Relevance of Training
1. Rehabilitation of Training Institutions
a. Russey Keo Training Center

b. Preah Kossomak Technical Vocational Training

Center
2. Establishment of National Vocational Training Center
(NVTC), at the National Technical Training Institute
(NTTI)
C. Expansion of Outreach Programs
1. Provincial Training Centers (PTCs)

2. Additional PTCs

3. Women in Development (WID) Centers

Appendix 10
4. Additional WID Centers

5. Mobile and Outreach Training

41
Source: Department of Technical and Vocational Education and Training (DTVET) and Ministry of Education, Youth, and Sport (MOEYS), February 2003.
 Implementation Period (Years)
Year 1 Year 2 Year 3 Year 4 Year 5 Year 6
Description

42
(1996) (1997) (1998) (1999) (2000) (2001)
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4

II. Training of Health Personnel (HPT)

Appendix 10
A. Building Planning and Management in the Ministry of Health
1. Strengthening of Human Resource Department

2. Professional Training Institutions

a. National Institute of Public Health (NIPH), of the
National Center for Hygiene and Epidemiology
(CNHE)

b. Technical School of Medical Care (TSMC, also

known as the Ecole des Cadres Sanitaires
Secondares, or ECSS
B. Improvement of Quality and Relevance of Training
1. In-service Training

2. Training of Trainers and Professional Development

C. Expansion and Outreach of Training

1. Regional Training Centers

2. Demonstration and Training D R O P P E D

Source: Human Resources Development (HRD), Ministry of Health, February 2003.

 Appendix 11 43

COMPLIANCE WITH MAJOR LOAN COVENANTS

(as of 21 February 2003)

Reference
Covenant in Loan Status of Compliance
Agreement

1. The Borrower shall have the Project Loan Complied with

carried out with due diligence and Agreement
efficiency, and in conformity with sound Section
administrative, financial, engineering, 4.01(a)
environmental, and educational
practices.

2. The Borrower shall make available, as Loan Complied with

promptly as needed, the funds, facilities, Agreement
services, land, and other resources that Section 4.02
are needed, in addition to the Loan
proceeds, to carry out the Project, and to
operate and maintain Project facilities.

3. In the carrying out of the Project, the Loan Complied with

Borrower shall cause competent and Agreement
qualified consultants and contractors, Section
acceptable to the Borrower and the 4.03(a)
Asian Development Bank (ADB), to be
employed to an extent and upon terms
and conditions satisfactory to the
Borrower and ADB.

4. The Borrower shall cause the Project to Loan Complied with

be carried out in accordance with plans, Agreement
design standards, specifications, work Section
schedules, and construction methods 4.03(b)
acceptable to the Borrower and ADB.
The Borrower shall furnish, or cause to
be furnished, to ADB, promptly after their
preparation, such plans, design
standards, specifications, and work
schedules, and any material
modifications subsequently made
therein, in such detail as ADB shall
reasonably request.
5. The Borrower shall ensure that the Loan Complied with
activities of its departments and Agreement
agencies with respect to the carrying out Section 4.04
of the Project and operation of its
facilities are conducted and coordinated
in accordance with sound administrative
policies and procedures.
44 Appendix 11

Reference
Covenant in Loan Status of Compliance
Agreement

6. The Borrower shall make arrangements Loan Complied with

satisfactory to ADB for insurance of Agreement
Project facilities to such extent and Section
against such risks, and in such amounts, 4.05(A)
to be consistent with sound practice.

7. Without limiting the generality of the Loan Complied with

foregoing, the Borrower undertakes to Agreement
insure, or cause to be insured, the goods Section
to be imported for the Project and to be 4.05(b)
financed out of the proceeds of the Loan
against hazards incident to the
acquisition, transportation and delivery
thereof to the place of use or installation,
and for such insurance any indemnity
shall be payable in a currency freely
usable to replace or repair such goods.
8. The Borrower shall maintain, or cause to Loan Complied with
be maintained, records and accounts Agreement
adequate to identify the goods and Section
services and other items of expenditure 4.06(a)
financed out of the loan proceeds, to
disclose their use in the Project, to
record the progress of the Project
(including costs), and to reflect, in
accordance with consistent and sound
accounting principles, the operations
and financial condition of the agencies of
the Borrower that are responsible for
carrying out the Project and operating
Project facilities.

9. The Borrower shall (i) maintain, or cause Loan Complied with

to be maintained, separate accounts for Agreement
the Project; (ii) have such accounts and Section
related financial statements audited 4.06(b)
annually, in accordance with appropriate
auditing standards consistently applied,
by auditors acceptable to ADB; (iii)
furnish to ADB, as soon as available but
no later than 12 months after the end of
each fiscal year, certified copies of such
audited accounts and financial
statements and the auditors' report
relating thereto (including the auditors’
opinion on the use of the loan proceeds
and compliance with the covenants of
the Loan Agreement, as well as on the
use of the procedures for imprest
account and statement of expenditures),
all in English; and (iv) furnish to ADB
 Appendix 11 45
Reference
Covenant in Loan Status of Compliance
Agreement

all in English; and (iv) furnish to ADB

other information concerning such
accounts and financial statements and
the audit as ADB shall reasonably
request.

10. The Borrower shall enable ADB, upon Loan Complied with
ADB's request, to discuss the Borrower’s Agreement
financial statements for the Project and Section
its financial affairs related to the Project 4.06(c)
from time to time with the Borrower’s
auditors, and shall authorize and require
any representative of such auditors to
participate in any such discussions
requested by ADB, provided that any
such discussion is conducted only in the
presence of an authorized officer of the
Borrower, unless the Borrower otherwise
agrees.
11. The Borrower shall furnish, or cause to Loan Complied with
be furnished, to ADB all such reports Agreement
and information as ADB shall reasonably Section
request concerning (i) the loan, and the 4.07(A)
expenditure of its proceeds and
maintenance of service; (ii) the goods
and services and other items of
expenditure financed from loan
proceeds; (iii) the Project; (iv) the
administration, operations, and financial
condition of the agencies of the
Borrower responsible for carrying out the
Project and operation of Project facilities;
(v) financial and economic conditions in
the territory of the Borrower and its
international balance-of-payments
position; and (vi) any other matters
relating to the purposes of the loan.
12. Without limiting the generality of the Loan Complied with
foregoing, the Borrower shall furnish, or Agreement
cause to be furnished, to ADB quarterly Section
reports on the carrying out of the Project 4.07(b)
and on the operation and management
of its facilities. Such reports shall be
submitted in the form and detail, and
within a period that ADB reasonably
requests, and shall indicate progress
and problems during the quarter under
review, steps taken or proposed to
remedy these problems; and the
proposed program of activities and
46 Appendix 11

Reference
Covenant in Loan Status of Compliance
Agreement

proposed program of activities and

expected progress during the following
quarter.
13. Promptly after physical completion of the Loan Complied with.
Project, and no later than 3 months Agreement
afterward or a later date if agreed by the Section
Borrower and ADB, the Borrower shall 4.07(c)
prepare and furnish ADB a report, in
such form and in such detail as ADB
shall reasonably request, on the
execution and initial operation of the
Project, including its cost, the Borrower's
performance of its obligations under the
Loan Agreement, and the
accomplishment of the loan's purposes.

14. The Borrower shall enable ADB's Loan Complied with

representatives to inspect the Project, Agreement
the goods financed by loan proceeds, Section 4.08
and any relevant records and
documents.
15. The Borrower shall ensure that the Loan Complied with
Project facilities are operated, Agreement
maintained, and repaired in accordance Section 4.09
with sound administrative, financial,
engineering, environmental, educational,
maintenance, and operational practices.

16. It is the mutual intention of the Borrower Loan Complied with

and ADB that no other external debt Agreement
owed a creditor other than ADB shall Section
have any priority over the loan by way of 4.10(a)
a lien on the Borrower's assets. The
Borrower agrees that (i) unless ADB
agrees otherwise, any lien on any assets
of the Borrower as security for any
external debt, will ipso facto equally and
ratably secure the payment of the
principal of, and service charge and any
other charge on, the loan; and (ii) the
Borrower, in creating or permitting the
creation of any such lien, will make
express provision to that effect.
17. The provisions of paragraph (a) of this Loan Complied with
section shall not apply to (i) any lien Agreement
created on property, at the time of Section
purchase price; or (ii) any lien arising in 4.10(b)
the ordinary course of banking
transactions, and securing a debt that
matures no more than 1 year after its
 Appendix 11 47
Reference
Covenant in Loan Status of Compliance
Agreement

matures no more than 1 year after its

date.
18. The term “assets of the Borrower” as Loan Complied with
used in paragraph (a) of this section Agreement
includes assets of any administrative Section
subdivision or any agency of the 4.10(c)
Borrower, and assets of any agency of
any such administrative subdivision,
including the Banque Nationale du
Cambodge and any other institution that
performs the functions of a central bank
for the Borrower.
19. Except as ADB may otherwise agree, Loan Complied with
the Borrower shall establish immediately Agreement
after the effective date, an imprest Schedule 3,
account for each Project Executing para. 9
Agency at the Foreign Trade Bank of
Cambodia to expedite loan
disbursements. The imprest account
shall be established, managed,
replenished and liquidated according to
ADB's “Guidelines on Imprest Fund and
Statement of Expenditures Procedures”
dated November 1986 and amended
from time to time, and detailed
arrangements agreed upon between the
Borrower and ADB. The initial amount to
be deposited into the imprest account
shall not exceed the equivalent of
$500,000.
20. Within six months of the effective date, Loan Complied with.
the Ministry of Education, Youth, and Agreement
Sport (MOEYS) shall submit to ADB for Schedule 4,
information the draft tender documents para. 7(b)
for the rehabilitation of the office building
for the office of technical and vocational
education and training (TVET) under
Part A of the Project.
21. The Project executing agencies, through Loan Complied with
their respective project implementation Agreement
units (PIUs), shall be responsible for Schedule 6,
planning, organizing, and implementing para. 1
their respective parts of the Project.

22. The Borrower shall cause both PIUs to Loan Complied with.
be fully staffed within 2 months of the Agreement
effective date. Each PIU shall be headed Schedule 6,
by a project director, assisted by a full- para. 2
time project manager, with experience
48 Appendix 11

Reference
Covenant in Loan Status of Compliance
Agreement

time project manager, with experience

and qualifications acceptable to ADB.
Each PIU shall be staffed with adequate
numbers of full-time staff throughout
Project implementation. The PIU for Part
A shall be established within the office of
TVET. The PIU for Part B shall be
established within the Human Resources
Department (HRD).
23. Project Advisory Committees (PACs)
(a) Within 1 month of the effective date, Loan Complied with
the Borrower shall establish PACs for Agreement
Part A and Part B. Each PAC shall Schedule 6,
convene at least once every quarter. para.3(a)
(b) The PAC for Part A shall ensure Loan Complied with
coordination between its PIU and the Agreement
relevant TVET agencies. The PAC for Schedule 6,
Part A shall be chaired by the para. 3(b)
undersecretary of MOEYS in charge of
TVET, and shall include as members the
Project manager, who shall also serve
as secretary. Other members will include
senior representatives from, among
others, Ministry of Planning (MOP);
MOEYS; Ministry of Economy and
Finance (MEF); the Ministry of Social
Welfare, Labor and Veterans Affairs; the
Ministry of Industries; the secretariat of
state for Women’s Affairs; the Ministry of
Industry, Mines and Energy; directors of
training institutions; and representatives
of nongovernment organizations
(NGOs).

(c) The PAC for Part B shall ensure Loan Complied with
coordination between the PIU for Part B Agreement
and agencies involved in in-service Schedule 6,
training for the health sector. The PAC para. 3(c)
for Part B shall be chaired by the
undersecretary in charge of HRD and
shall include as members the Project
manager who shall also serve as
secretary; senior representatives from
MOP, MOH, MOEYS, and MEF; the
directors of National Center for Hygiene
and Epidemiology (CNHE) and Ecole
des Cadres Sanitaires Secondairies
(ECSS); and representatives of NGOs
and each RTCs under the Project.
 Appendix 11 49
Reference
Covenant in Loan Status of Compliance
Agreement

24. National Training Board (NTB) Loan Complied with

(a) Within 12 months of the effective Agreement
date, the Borrower shall cause NTB to Schedule 6,
be established and to commence para. 4(a)
operations. NTB’s organizational
structure and functions shall be in
accordance with the arrangements
agreed upon between the
subparagraphs (b) and (c) below.

(b) NTB shall be chaired by the MOEYS Loan Complied with.

secretary of state, and its membership Agreement The chairperson is the MOEYS
shall include representatives of MOEYS; Schedule 6, secretary of state.
MOP; MEF; Ministry of Social Welfare, para. 4(b)
Labor, and Veterans Affairs; Ministry of
Industry and Energy; Ministry of
Agriculture; Ministry of Public Works and
Tourism; Secretariat of State for Rural
Development; secretariat of state for
Women’s Affairs; and representatives of
the private sector.
(c) The responsibilities of NTB shall Loan Complied with
include: (i) to provide guidelines for the Agreement
development of a TVET policy, (ii) to Schedule 6,
advise on overall resource allocations for para. 4(c)
TVET, (iii) to coordinate nationally and
externally funded TVET activities, and
(iv) to manage the NTF.

25. National Training Fund (NTF)

Within 18 months of the effective date, Loan Complied with, but delayed.
the Borrower shall (i) cause NTF to be Agreement Establishment of NTF was
established and commence operations Schedule 6, delayed for 7 months, but NTF
in accordance with arrangements on its para. 5 was eventually able to catch up
organization and operating procedures with target goals.
agreed upon by the Borrower and ADB,
and (ii) submit to ADB for comments
proposals for replenishment of NTF from
the national budget and other sources.
During the midterm review referred to in
para. 7 of Schedule 6, the arrangements
for replenishment of NTF shall be
confirmed.
26. Training and Overseas Fellowships
(a) For in-country training to be provided Loan Complied with
under the Project, the Borrower shall Agreement
submit to ADB for approval, before Schedule 6,
implementation of the training, an outline para. 6(a)
of the proposed courses and details
50 Appendix 11

Reference
Covenant in Loan Status of Compliance
Agreement

of the proposed courses and details

regarding participants, budgets, and
schedules. Such information shall be
submitted as part of the quarterly reports
referred in Section 4.07(b) of the Loan
Agreement.
(b) The Borrower shall prepare and Loan Complied with.
submit to ADB for approval before its Agreement
implementation a program for overseas Schedule 6,
fellowships to be provided under the para. 6(b)
Project. The program shall include
details of contents and costs of
proposed training courses, criteria of
selection of candidates for the
fellowships, including details of their
qualifications.
27. Midterm Review
Within 30 months after commencement of Loan Complied with.
Project implementation, the Borrower and Agreement The midterm review was on
ADB shall carry out a midterm review of all Schedule 6, 15–25 March 1999.
aspects of the Project, with a particular para. 7
focus on the capacity building activities
(Part A.1 and part B.1). Based on the
outcome of midterm review, any necessary
adjustments in the Project's design and
implementation arrangements shall be
made by agreement between the Borrower
and ADB.
28. Benefit Monitoring and Evaluation
(BME)
The Project Executing Agencies shall, in Loan Complied with
close collaboration with MOP, carry out Agreement
BME activities related to their respective Schedule 6,
parts of the Project in the following three para. 8
stages: (i) within 3 months of Project
inception, a baseline indicator study
shall be completed to determine targets
reflecting the anticipated Project
benefits; (ii) before the midterm review
referred to in para. 7 of Schedule 6, a
monitoring study shall be conducted to
compare actual and projected Project
performance; and (iii) after Project
completion, a final evaluation of Project
achievements shall be conducted in
accordance with a time schedule and
terms of reference to be agreed on by
the Borrower and ADB.
 Appendix 12 51

CAPACITY BUILDING FOR TECHNICAL AND VOCATIONAL EDUCATION

AND TRAINING (TVET)

I. Description of Technical Assistance (TA) 2516: Capacity Building for Technical

and Vocational Education and Training
1. The socioeconomic environment of the technical and vocational education and training
(TVET) institutions in Cambodia changed dramatically with the 1992 adoption of a market-
oriented framework for economic development. The most important changes identified as
necessary during the TA design included: (i) development of a policy framework for TVET, (ii)
introduction of demand-based training programs, and (iii) linking of TVET institutions with the
private sector.

II. TA Objectives and Scope

2. The overall objective of the TA was to help the Government develop TVET policies to
improve the effectiveness and efficiency of planning, management, and delivery of ongoing and
planned TVET programs. Other specific objectives were to (i) strengthen institutional capacity of
the Department of Technical and Vocational Education and Training (DTVET) to develop TVET
policies and manage its training programs, (ii) develop action plans to change the supply-driven
TVET system to a demand-based system, and (iii) organize the National Training Board (NTB)
to effectively coordinate with the private sector.

III. Evaluation of TA Inputs

3. The TA provided the services of a team of four experts: (i) a policy and organizational
development specialist for 12.5 person-months, (ii) institutional and staff development specialist
for 6 person-months, (iii) a strategic planner for 6 person-months, and (iv) a program
coordination specialist for 6 person-months. DTVET provided adequate support for successful
TA implementation by organizing the Project Steering Committee, appointing competent
counterpart staff, and providing adequate office space and equipment. The TA consultants
submitted the inception, interim, draft final, and final reports as scheduled. ADB supervision of
the TA was adequate and timely.

IV. Evaluation of TA Outputs

4. One of the most outstanding achievements of the TA was the establishment of the NTB
in August 1997 to develop a demand-based TVET system involving senior Government officials,
representatives of the private sector, nongovernment organizations, employers' organizations,
and labor unions. An executive committee was formed under NTB to discuss policy issues and
to rapidly reflect labor market changes in training programs. Three action plans (a staff
development plan, a plan for establishment of the National Training Fund, and a project
evaluation and monitoring plan) were developed to assist the Basic Skills Project (Loan 1368-
CAM). Twenty DTVET staff were trained in project administration, labor market monitoring,
program development, and computer operations. A policy study from the TA, Employment
Strategies for Women in Cambodia, will be published as an ADB document.

V. Overall Assessment of the TA

5. The TA successfully achieved its objectives. DTVET's institutional capacity was

improved markedly, enabling it to participate actively in human resource activities. The
52 Appendix 12

establishment of NTB and its executive committee enhanced coordination among DTVET
stakeholders considerably. Changes in the labor market, including skills requirements for the
private sector, are expected to be better reflected in the TVET programs. The detailed action
plans will help in implementing the Basic Skills Project.

VI. Key Lessons Learned

6. The TA helped the Executive Agency develop TVET policies and demand-based training
programs. It will ease imperfections in the labor market and provide skilled workers needed by
the private sector and foreign investors in the country. The detailed action plans for
implementing the basic Skills Project will not only help the Executing agency implement the
Basic Skills Project effectively, but will also encourage private sector participation in TVET.

7. The TA consultants initially experienced difficulties in coordinating with other

stakeholders in TVET, including international consultants engaged on other TVET projects. But
these difficulties were overcome by the timely intervention of ADB's TA review missions which
consulted various stakeholders and held formal donor coordination meetings. Close ADB
involvement to assist in stakeholder consultations and donor coordination is necessary,
because consultants may not have adequate experience.

VII. Follow-Up Actions and Recommendations

8. The Cambodian Government established NTB, so ADB should support Government

actions to make NTB sustainable, and capable of coordinating various stakeholder interests and
ensuring private sector participation in TVET. NTB’s performance should be monitored closely.
 CONSULTANCY SERVICES
Appraisal Estimate Actual
Persons Person- Total Persons Person- Total Person-
(no.) Months Person- (no.) Months Months
Consulting Services
(no.) Months (no.) (no.)
(no.)
I. Technical and Vocational Education and Training (TVET)
A. International Consultants
1. TVET Policy, Planning, and Management Specialist 1 36 36 2 (14.5+25.5) 42.0
(Team Leader)
2. Training Fund Specialists 1 7 7 2 (4+5) 9.0
3. Training Management Program Development Specialist 1 12 12 1 12 12 UNDP/ILO
4. Training Specialists:
a. Technical and Industrial 1 12 12 1 12 12UNDP/ILO
b. Business Development 1 12 12 1 12 12
c. Infrastructure and Construction 1 12 12 4 4+6 10
5. Enterprise-based Training Specialists 1 9 9 3 (2+3+1.5) 6.5
6. Non-formal and Women-in-Development Training Specialists 1 8 8 1 8 8 UNDP/ILO
7. Project Implementation Specialists 1 6 6 2 (0.5+5.5) 6.0
Subtotal TVET 114 85.5+32=117.5
B. Domestic Consultants
1. MIS and Domestic Team Leader 1 19 19
2. Business Development 1 6 6
3. Community-Based Training 1 6 6
4. Civil Engineering 1 12 12
5. Mechanical Engineering 1 15 15
6. Electrical/Electronic Engineering 1 11 11
7. Training Fund 1 14 14
8. Microcredit 1 6 6
9. Standards and Accreditation 1 12 12
Subtotal TVET 101
II. Health Personnel Training (HPT)
A. International Consultants
1. Health Sector Human Resources Development Policy 1 24 24 2 1+23 24
and Management Specialist
2. Public Health Training Specialist 1 3 3 1 3 3
3. Primary health Training Specialist 1 12 12 1 12 12
4. In-service Training and Education Specialist 1 12 12 1 12 12

Appendix 13
Subtotal HPT 51 51
B. Domestic Consultant
1. BME Consultant
Subtotal
Total 165
BME = benefit monitoring and evaluation, ILO = International Labor Organization, MIS = management information system, UNDP = United Nations Development
Programme.

53
Source: Department of Technical and Vocational Education and Training, Ministry of Education, Youth, and Sport, January 2003; Ministry of Health, January 2003.
54 Appendix 14

HEALTH CADRE BEFORE AND AFTER THE PROJECT

Before Project After Project

1. Health Staff Per 10,000 Population Ratio
(1993–1994) (2001–2002)

• Doctors: 10,000 population 2.11 1.55

• Medical Assistants: 10,000 population 1.37 1.10
• Pharmacists: 10,000 population 0.39 0.31
• Dentists: 10,000 population 0.11 0.07
• Primary Nurses: 10,000 population 3.03 2.62
• Secondary Nurses: 10,000 population 4.86 3.09
• Anesthetic Nurses: (actual numbers) 7.00 39.00
• Physiotherapists: (actual numbers) 51.00 47.00
• Primary Midwives: 10,000 population 0.94 1.15
• Secondary Midwives: 10,000 population 1.98 1.45
• Primary Laboratory Technicians: 10,000 population 0.09 0.10
• Secondary Laboratory Technicians: 10,000 population 0.31 0.33

2. Health Coverage Plans and Health Facility (no.)

• Health Centers a 929

• Staff per Health Center 2–5 4–9
• Operational District Offices b 96
• Staff per Operational District Office 5–9 12–20
• Referral Hospitals c 68
• Staff per Referral Hospitals 70–15 10–30

3. Ministry of Health (MOH) Training Institutions, including Regional Training Centers (no.)

1 2
• MOH Training Institutions 6 6
3 4
• Regional Training Centers 5 5
• Staff per Regional Training Centers 3–12 10–70

a. Health Centers were formerly called Khum clinics, established for every Khum or commune with poor
infrastructure (some had no building) and staffed with two to five personnel, most of whom were untrained. Services
included general consultation, referral immunization. The Health Centers are a completely new system, provided with
specific coverage for each population (of about 10,000), standard buildings, equipment, staff trained to deliver
minimum packages of activities or primary health care services. Information on the transformation from Khum clinics
to Health Centers is unclear. Not all Khum clinic staff were transferred to Health Clinics, and only some Khum Health
Centers. The others ceased operation.
b. Through the MOH Health Coverage Plan, each operational district office supervises all health centers and referral
hospital under its jurisdiction. Each covers a population of 100,000 persons.
c. Each referral hospital covers a population of 100,000. MOH upgraded 13 referral hospitals through the Asian
Development Bank-assisted Loan 1447-CAM: Basic Health Services Project.
 Appendix 14 55

Health Staff and Facilities in the Public Before Project After Project
4. Legality
and Private Sectors (no.) (1993–1994) (2001–2002)

• Private Clinics in Phnom Penh Legal 176 140

Illegal 361 517
• Polyclinics with 5–30 beds Legal 25 12
Illegal 20 35
• Private Pharmacies Legal 1,014
Illegal 2,461
• Private Dentists Legal 27 16
Illegal 168 114
• Private Laboratories Legal 5 1
Illegal 23 22
• Private Hospitals 0 0
• Maternity Homes (Private Sector) Legal 6 4
Illegal 11 3
• Doctors and nurses (Private Sector)
• Doctors (Public Sector) 2,008
• Nurses (Public Sector) 7,636
• Ratio of Doctors to Nurses (Public Sector) 1:3.8
• Health Personnel (Public Sector) 17,874

5. Health Staff Trained Through the Project (no.)

• Pre-service Training
• In-service Training 4,652
• Continuing Education 212
• Overseas Training 18
• In-country Training 4,864

6. Training Institutions (no.)

• National Institute of Public Health 42

• Technical School of Medical Care 129
• Regional Training Centers
• Battambang 14
• Kampot 14
• Kampong Cham 11
• Stung Treng 0
1
Including National Center for Hygiene and Epidemiology (CNHE).
2
Institutions were upgraded, including National Institute of Public Health (NIPH).
3
Including Ecole des Cadres Sanitaires Secondairies (ECCS) or the Central Health Workers' School, now known as
Technical School of Medical Care (TSMC).
4
Including TSMC.

Source: Ministry of Health, February 2003.

56 Appendix 15

ASSESSMENT OF OVERALL PERFORMANCE OF THE PROJECT

Weighted
Rating
Criterion Weight Assessment Rating Value
(weight x
assessment)

1. Relevance 20% Highly Relevant 3 0.60

Relevant 2

Partly Relevant 1

Irrelevant 0

2. Efficacy 25% Highly efficacious 3 0.50

Efficacious 2

Less Efficacious 1

Inefficacious 0

3. Efficiency 20% Highly Efficient 3 0.40

Efficient 2

Less Efficient 1

Inefficient 0

4. Sustainability 20% Most Likely 3 0.40

Likely 2

Less Likely 1

Unlikely 0

5. Institutional Development and 15% Substantial 3 0.45

Other Impacts
Moderate 2

Little 1

Negligible 0

Overall Ratinga 2.35

a
Sum of the weighted ratings.
Note: Highly Successful (HS): Overall weighted average (OWA) is >2.5 and none of the 5 criteria have scores of less
than 2; otherwise, the rating would be downgraded by 1 level.
Successful (S): OWA is between 1.6 < S < 2.5 and none of the 5 criteria has a score of less than 1; otherwise, the
rating would be downgraded by 1 level.
Less than Successful (LS): OWA is between 0.6 < S < 1.6 and the number of criteria receiving a rating of less than 1
does not exceed 2; otherwise, the lowest rating would be given.
Unsuccessful (U): OWA is <0.6.
 Appendix 16 57

BENEFIT MONITORING AND EVALUATION

Project Start Midterm Review Project End

1. National Training Board (NTB)
(1995) (Mar 1999) (May 2002)

Composition of NTB and No inter- NTB was established NTB is the main policy
representatives of other ministries ministerial on 28 Nov 1998, and planning body for
and departments such as Ministry of management comprised of 30 MOEYS.
Education, Youth, and Sport body for members from
(MOEYS), technical ministries, and technical and Government, industry,
sectoral bodies representing vocational labor, academe,
employers, workers organizations, education and NGOs, and foreign
nongovernment organizations training (TVET) development
(NGOs), private training institutions, institutions. It is
and women. chaired by the
MOEYS secretary of
state.

Salient features of its functions and – NTB established NTF Has met 14 times since
proceedings (e.g., regularity of on 26 Dec 1997 1997
meetings and effectiveness of
procedures)

Analysis of key decisions of NTB – Established a NTB constituted the

and a brief description, including committee for Industrial Training
policy measures instituted by NTB, standards, Committee (IATC),
such as preparation of legislation on qualification, and comprising
the licensing and employment of accreditation on 8 Jan representatives from
skilled workers in accordance with 1997 major industries.
agreed standards and certification, NTB guides in preparation
and establishment of a national of annual TVET plans
system of standards, testing, and and programs. NTB
certification of vocational skills and developed a skills
qualifications. development bill and
decree. Reviewed NTF
application; proposed a
scheme for skills
standards, testing and
certification; and proposed
policy and strategy for
TVET development.

Analysis of NTB's long-term national – – Approved the 5-Year

plans for TVET, and its periodic TVET strategic plan on 28
coordination with incoming Dec 2000
development projects

Establishment of an effective – – Developed manuals,

system for the coordination of inputs guidelines, and skills for
into TVET (including procedures, management information
data, and criteria for project system (MIS)
approval)
58 Appendix 16

Project Start Midterm Review Project End

2. National Training Fund (NTF)
(1995) (Mar 1999) (May 2002)

Assess support to private and public No NTF NTF was established NTF provided training
training providers in terms of on 26 Dec 1997, and funds through output-
organization, public-private functions directly under based contractual
partnership, funding system NTB direction agreements with public,
(including financing and monitoring private, and NGO training
arrangements for funding the providers.
contract system), training, and
future development.

Existence and suitability of system, – – Since April 1999, NTF has

procedures, criteria, contract forms,
management, and financing and
monitoring arrangements for the
contract system
Nature of public and private sector
participation on NTF, e.g., in
organization, membership, staffing,
decision-making
Description of analysis of training
activities funded by NTF (e.g., area
of training, type of institution
providing training, funding amount,
cost sharing by employees, by
students)
Completion of study of feasibility for
introducing a levy scheme to finance
the fund recommendations. An
action plan drawn up.
3. National Technical Training Institute (NTTI)
(National Vocational Training College (NVTC) in Preah Kosomak Vocational Training College (VTC)
Assess functions of NTTI:
organization and coordination; type
of training programs; production of
training curricula and materials; and
establishment of occupational
standards, skill testing, and
certification.
Number and type of programs for
which curricula development and
production of teaching-learning
materials has been done. Training
courses conducted for trainers of
other institutions, sectors, special
groups, etc.
Type and extent of coordination and
inter-institutional linkages with other
institutions, sectors, special groups,
etc.
provided assistance under
the following schemes:
• Training Grant Fund
($1.92 million)
• Innovative Skills
Investment Assistance
Fund ($300,000)
• Self-Employment
Generation Fund
($1.36 million including
relending)
– – Drafted levy grant policy
paper
Existing NVTC Proposed to convert Conducted 8 in-service
at Preah Preah Kossomak, Tuk training courses for TVET
Kossomak VTC Thla I as NTTI in faculty and staff with
December 1998 and a about 60 participants per
sub-decree approved course
on 29 Dec 1999
Established public-private
partnerships through
evening training courses.
Developed curricula for 2-
year diploma and 3-year
certificate TVET courses.
Now offering bachelor of
engineering courses in
civil, electrical/electronics
engineering
Constituted management
– –
and advisory committees
with wide participation of
private and industrial
 Appendix 16 59

Project Start Midterm Review Project End

(1995) (Mar 1999) (May 2002)

sectors and NGOs. But

committees have not been
meeting regularly.
4. Upgrading Planning and Management of TVET
Effectiveness of organizational TVET as a unit New Department of DTVET continues to
structure in relation to its goal of a in MOEYS Technical and improve TVET sector
demand-driven training system and Vocational Education through reforms and
to foster planning and management and Training (DTVET) coordination with the
(for example, clear definition of established on 23 industrial sector.
responsibilities of personnel) March 1998. A Project
Advisory Committee
(PAC) was established
in June 1997.

Emergence of clear functional roles – Training Needs DTVET established units

with accountability and Assessment Unit to improve skill standards,
responsibility, particularly in (TENA), Curriculum accreditation, benefit
provincial and district training Development, and monitoring and evaluation
centers Gender and Equal (BME), training,
Opportunity units were employment needs
established in Oct assessment, industrial
1997. liaison, gender and equal
opportunity, and
management information
system

Staff training and development and – BME unit was 148 completed
its evaluation in relation to established in March overseas/regional TVET
improvements in planning and 1997 training. In-country
delivery of training courses training programs in
English were conducted
for 519 participants and in
computer skills for 211
participants.

Development of a 5-year strategic Ad hoc TVET Conducted workshop 5-year strategic plan
plan for the TVET program program on 5-year strategic plan discussed by the NTB on
24 Oct 2000
5. TVET Delivery: Formal and Nonformal
A profile of trainees in terms of their In 1995, 468 In 1998–99, no 650 trainees completed
training needs and relevant socio- trainees in the significant change in training in the formal
economic data (for example, formal sector the formal and non- sector in 2000–01 and
gender, educational background, and 731 in formal sectors. No 1,063 trainees in 2001–
age, job history, employment, and nonformal reported drop-outs. 02. Competency-based
earnings) sector in curricula were introduced
Kampot, in Nov 1999 in the formal
Takeo, and sector. 1,960 trainees
Kampong completed training in the
Cham. 20 training centers in the
non-formal sector in 2001.
60 Appendix 16

Project Start Midterm Review Project End

(1995) (Mar 1999) (May 2002)

Drop-out was No reported drop-out.

63%.

Employment outcomes by area of Limited employment Information still being

training (for example, number of information collected through TENA
employed and unemployed, type of and industrial liaison unit
employer) of DTVET

Increase in utilization of training Low utilization Low utilization of Utilization increased with
facilities, particularly hands-on training facilities increased enrollment
training and use of workshops.

Specialized courses revised or No short Short courses provided Short courses also
introduced to match industry needs courses (1–4 in non-formal sector provided in formal sector
with a system for internal and months) to generate income and
external quality evaluation sustainability. No system
of quality evaluation yet in
place.

Evaluation of overall adequacy and Formal courses Curricula were 3– and 2–year curricula
efficiency of TVET system in the (1–2 years) improved based on based on CBT system
light of output of system and were Competency Based implemented through
available evidence of employment inadequate. Training (CBT) system. TVET systems reforms.
demands Different Too soon to evaluate
courses were impacts of these new
conducted in curricula. Delivery system
non-formal inadequate to reach out to
sector. remote areas. Quality
needs improvement
6. Increasing the Role of Women through Women in Development (WID), and of Other Vulnerable Groups
(Returnees, Refuges, Demobilized Soldiers, Disabled, etc.) in Training
A profile of trainees in terms of their 1,131 trained in A basic skills project 9,905 trained from 1995 to
training needs and relevant non-formal began supporting 2001? more than the
socioeconomic data (for example, sector provincial training 8,000 targeted for the
gender, educational background, centers (PTCs) in 1998. period. Females
age, job history, employment, and comprised 48% of the
earnings) trainees..

Number and type of training programs
Mostly simple, Training programs of 3 Training courses were
mobile, on-site days to 4 months were demand driven and
training demand-driven. targeted to women and
Microcredit facilities vulnerable groups, with
were provided. microcredit facilities
provided, through the Self-
employment Generation
Fund (SEGF). Training
was for 5,613 members of
1,754 micro-enterprises
(65% were females). The
repayment rate was
92.9% as of Dec 2002.
 Appendix 16 61

Project Start Midterm Review Project End

(1995) (Mar 1999) (May 2002)

Employment outcomes by area of Minimal Minimal employment Based on NTF,

training employment information available employment rate ranged
information from 43% to 88%. Of
available 13,084 trainees, 10%
were widows, 15%
orphans, 25% drop-out
students, 6% disabled, 6%
crippled demobilized
soldiers, and 38% poor
adults.

Mobile and outreach training Some training New courses being PTCs have expanded the
available developed through the mobile training system
SEGF and outreach services.

Availability of micro-credit scheme No microcredit Microcredit scheme Total capital for SEGF
scheme being developed was $1.17 million
through the SEGF (including $279,000
transferred from ISIAF).
Credit disbursed to
borrowers through 16
PTCs.
7. Human Resource Development
Number and type of staff Minimal About 20 staff Total 148 fellows trained.
development programs and profile information on undergoing training and Teacher training, skill
of trained staff TVET 30 staff completed upgrading, curriculum
training. Conducted development,
workshops. management training and
study visits to the region
completed, resulting in
improved capacity to plan
and to deliver TVET
courses.
8. Upgrading of Training Institutions
– Completed renovation Completed 16 civil works
works in training packages and additional
centers in Phnom Penh 12 packages, including 8
new PTCs and 4 WID
centers. Equipment,
furniture, and training
material provided to 16
PTCs and 9 WIDs.
Officers and staff among
the participants of the
international fellowships
and in-country training.

BME = Benefit Monitoring and Evaluation, ISIAF = Innovative Skills Investment Assistance Fund, MOEYS = Ministry of Education,
Youth, and Sport, NGO = nongovernment organization, NTF = National Training Fund, PTCs = provincial training centers, SEGF =
Self-employment Generation Fund, TVET = Technical and Vocational Education and Training, WID = Women in Development.
Source: Ministry of Education, Youth, and Sport (MOEYS), 2002.
62 Appendix 16

Part B: Training of Health Personnel

Midterm Project
Project Start
Review End
(1995)
(Mar 1999) (May 2002)

A. Strengthening Management at the Central Level, Department of Human Resources, MOH

Activities in teaching materials: design, field testing, No such Only MPA 13 MPA
production, and distribution (MPA and CPA) materials module I modules

Number of teaching materials per specific health subject No such Based on MPA Based on 13
distributed: materials; module I; MPA modules;
few materials About 7,500 About 64,100
(specific subjects included EPI, MCH, HIV/AIDS, malaria, and in Khmer copies copies
ARI)

Number of PHC trainers trained for in-service training About 15 About 30 About 75

Number of trainers per RTC 3–12 6–38 10–54

Type and extent of support of a liaison with professional NGO support to Ongoing NGO
associations and NGOs develop MPA 11, support for
12, 10 TOT

Formulation of detailed staff development plans and HWP

implementation procedures HSP

Extend commissioning of NGOs and private sector to perform NGO support to Ongoing NGO
in-service training and related development work develop MPA 11, support for
12, 10 TOT

B. Strengthening Management at the Provincial and District Levels

Number of trainees in management at the RTCs Began monthly Began

meeting (HRD quarterly
and RTC regional
managers) meeting (RTC
and Project
provinces

Number of trainees per batch trained TOT for CES 60 CES staff
staff per province trained

Type and extent of management changes and reforms CES introduced CES in place,
following training database of
staff
established
 Appendix 16 63

Midterm Project
Project Start
Review End
(1995)
(Mar 1999) (May 2002)

C. Strengthening In-Service Training Capabilitya

Number of trainees and types of training programs 4 staff per RTC 48 CES staff
trained as master re-trained to
trainers to support MPA
support CES

Establishment of internal systems for monitoring teaching CES by HRD,

quality MOH

Extent of application by trainees (full-time teachers) of training TOT for selected Capacity of
on teaching methodology staff to RTC and CES
implement MPA to implement
module 1 MPA modules

Formulation of operation procedures for health care workers Few materials Only MPA 13 MPA
as well as general techniques such as community involvement in Khmer module I modules
and health education

Preparation of learning materials on the above-mentioned Information not About 4,300 About 62,540
operation procedures, and the extent of distribution of such easily copies distributed copies were
materials available. All in distributed.
Khmer

Number and type of health workers receiving in-service 4,666 health 3,567 health
training personnel personnel
received MPA received MPA
module 1 modules 2 and
7, and 3,531
received MPA
modules 6 and
13

ARI = acute respiratory infection, CES = continuing education systems, CPA = complementary package of activities, in referral
hospitals, EPI = expanded immunization programs, HIV/AIDS = human immunodeficiency virus/acquired immune deficiency
syndrome, HRD = Human Res ource Department, HSP = Health Strategic Plan, 2000–2005, HWP = Health Workforce Plan,
1995–2005, MOH = Ministry of Health, MPA = minimum package of activities, MCH = maternal and child health, NGO =
nongovernment organization, PHC = primary health care, RTC = regional training center, TOT = training of trainers.
a
Health Centers were formerly called Khum clinics, established for every Khum or commune with poor infrastructure (some had
no buildings) and staffed with two to five personnel, most of whom were untrained. Services included general consultation,
referral, and immunization. The Health Centers are a completely new system, provided with specific coverage for each population
of about 10,000, standard buildings, equipment, and staff trained to deliver minimum package of activities or primary health care
services. Information on the transformation from Khum clinics to Health Centers is unclear. Not all Khum clinic staff were
transferred to Health Clinics, and only some Khum clinics, in relatively high-density populations, were selected for the building of
new Health Centers. The others ceased operation.
Source: Ministry of Health, February 2003.