The Girl-Child and Government Service Provision.pdf - Tanzania ...

constrained by low funding; the national health budget representsonly 1 per cent of the GDP, and most of that goesto pay staff salaries.Cambodia is experiencing a serious HIV/AIDS epidemic.The estimate for cumulative HIV infections in 1999 wasslightly over 24,000, representing 3.75 per cent of the sexuallyactive population (15–49 years), and new infections in2000 were estimated to be just under 50,000. Significantrates of infection were initially present in populationgroups such as commercial and indirect sex workers, policeand military, but there are signs that the wider populationis increasingly affected. Currently 2.4 per cent of marriedwomen have tested HIV-positive.Although extensive education campaigns about preventionof the spread of HIV/AIDS are being conducted by the governmentand NGOs, it is expected that the number ofcases will continue to rise. An increasing number of peoplewill be seeking care and support for HIV/AIDS, and becausemany people with AIDS cannot afford hospital care, theburden of caring for them and their orphans will place significantstress on extended families and communities overthe coming years. In 1998 there were an estimated 50,000children who had lost both parents in Cambodia, with thatnumber expected to increase significantly due to the HIV/AIDS epidemic. The epidemic will result in a significant lossof human life and also of social and economic capital. 10Information from the survey (see Appendix) shows thathigh rates of immunisation were recorded for both malesand females, with only 8 per cent of families indicating thattheir children were not immunised. A gap of 20 per centemerged between the first and second girl in a family to beimmunised compared to a gap for boys of 10 per cent.All families surveyed indicated that there was no differencein access to health services for boys and girls. However, 5per cent said there was a difference in access to education.Health workers were known to 20 per cent of the targetgroup and there was no difference in the number of urbanand provincial visits. Health was the most visible of governmentservices listed.The first of 27 reasons that families listed as barriers toservice access for girl children was that regular access tohealth care and treatment was not possible. Access wassporadic and subject to factors the families could not control:staff not in attendance, the distance to a health centre,lack of supplies at the health centre, lack of money to payfor service and transportation problems due to floods.Actions to remove these barriers would include increasingthe number of health centres with trained medical staff andsupplies; providing free health care and treatment; and increasingcommunity education on health care, sanitationand clean water.Child protectionThe government in Cambodia is unable to recognise andrespond to the scale of issues children experience. Countryreports indicate that the following areas are most frequentlyreported to the Cambodian National Council forChildren:• Children’s treatment by the juvenile justice system;• Child abuse, neglect and exploitation, including corporalpunishment in schools;• Child labourers and child migrants;• Discrimination against girl children, children born outsideof marriage and non-nationals who are displaced;and• Children in welfare institutions.In Cambodia 70 per cent of working children are not inschool. Child labour is widespread, often hazardous andhidden. More children are working away from their homeand outside of the family environment, which greatly increasestheir risk of being exploited. Child workers areyounger as more children under 10 are being involved inwork. The sex industry is a leading employer of children.Some 30–35 per cent of the prostitutes surveyed werebetween 12 and 17 years of age. These children are at riskof contracting STDs and HIV/AIDS and of suffering violentphysical and/or psychological abuse. Many children are furtherexploited by being trafficked.As well as being victims, children are themselves also inconflict with the law. Juvenile delinquency, which has beenincreasing in Cambodia, is partly fuelled by the increasingavailability of amphetamines. The number of children inadult prisons increased from a monthly average of 10 in1995 to 111 in 1999.Some progress has been made. In 1996 the governmentintroduced laws to suppress trafficking. Greater application16 The Girl-Child and Government Service Provision