2017

Country Report
CAMBODIA SOCIAL SECURITY
Brief summary of Cambodia country profile, history
of country social security, national social security
schemes and rehabilitation services.

Prepared by Ranine ROTH

April 2017


COUNTRY REPORT
CAMBODIA SOCIAL SECURITY

Table of Contents
Abbreviation List .......................................................................................................................................................... 2
I. CAMBODIA ECONOMIC AND SOCIAL OVERVIEW ...................................................................................... 3
1.1. Cambodia Country Profile ................................................................................................................................ 3
1.2. Demography ........................................................................................................................................................... 3
1.3. Economic Update ................................................................................................................................................. 3
1.4. Health and Education ........................................................................................................................................ 4
1.5. Labour Force and Employement ................................................................................................................... 5
II. SOCIAL SECURITY IN CAMBODIA .................................................................................................................... 6
2.1. Laws and Legal Documents promoting Social Security in Cambodia ........................................... 6
2.2. National Social Security Fund (NSSF) ......................................................................................................... 7
2.3. Employment Injury Insurance (EII) ............................................................................................................. 8
2.4. Health Insurance Scheme .............................................................................................................................. 10
2.5. Challenges and Future Plan .......................................................................................................................... 11
III. REHABILITATION SERVICES ........................................................................................................................ 12
3.1. General Rehabilitation in Cambodia ........................................................................................................ 12
3.2. NSSF Rehabilitation Services ....................................................................................................................... 12
REFERENCES .............................................................................................................................................................. 14


Abbreviation List
GMAC : Garment Manufacturing Association of Cambodia
MoLVT : Ministry of Labor and Vocational Training
NSSF : National Social Security Fund
RGC : Royal Government of Cambodia
UNICEF : United Nations Children’s Fund
WHO : World Health Organization

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I. CAMBODIA ECONOMIC AND SOCIAL OVERVIEW

1.1. Cambodia Country Profile

Cambodia,
officially known
as the Kingdom
of Cambodia, is
a country
located in the
Southeast Asia.
It is 181,035
square
kilometers in
area, bordered
by Thailand to the northwest, Laos to
the northeast, Vietnam to the east and
the gulf of Thailand to the southwest.

(Source: CIA World Fact book, World Bank)

1.2. Demography
Based on the United Nations Department of
Economic and Social Affair, as of 2016,
Cambodia has an estimated population of
about 15.8 million people, of which more
than 51% is under 25 years old, and more
than 50% are female.

Percentage of population by ages:

0-14 years : 31.4%
15-24 years : 19.7%
25-54 years : 39.6%
55-64 years : 5.2%
Over 65 years : 4.04%

1.3. Economic Update

According to World Bank report, with more than two decades of strong economic growth, Cambodia
has attained gross national income per capita reaching US$1,070. Driven by garment and tourism
exports, Cambodia has sustained an average growth rate of 7.6 percent in 1994-2015, ranking sixth
in the world.

Poverty continues to fall in Cambodia, albeit more slowly than in the past. In 2014, the poverty rate
was 13.5 percent compared to 47.8 percent in 2007. Two decade of economic growth have helped
make Cambodia a global leader in reducing poverty. The success story means the Southeast Asian
nation that overcame a vicious civil war now is classified as a lower-middle income economy by the
World Bank Group.

China is Cambodia's biggest source of foreign direct investment. China planned to spend $8 billion in
360 projects in the first seven months of 2011. It is also the largest source of foreign aid, providing
about $600 million in 2007 and $260 million in 2008.

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Figure 1: Cambodia GDP Growth Rate

According to preliminary
estimates, economic growth
slightly eased to 6.9 percent in
2016, compared to 7 percent
in 2015. However, it is
expected to remain strong
over the next two years as
recovering tourism activity
coupled with fiscal expansion
compensate for some moder-
ation in garment exports and
construction growth.

Source: Ministry of Economic and Finance, Cambodia

In spite of good achievements, Cambodia still faces a number of development challenges, including
good quality public service delivery impeding inclusive development, land administration and natural
resources management, environmental sustainability, and good governance. Going forward, the
success of addressing these challenges will rest not only on maintaining macroeconomic stability and
enhancing economic diversification and export competitiveness, but also on improving the quality
of public service delivery to be accompanied by enhanced allocation and use of public financial
resources and human resources.

1.4. Health and Education

According to WHO, Cambodia life expectancy was 72 years old in 2014, a major improvement since
1999. Cambodia health care is offered by both public and private practitioners. The government
plans to increase the quality of healthcare in the country by raising awareness of the deceases and
improvement of the healthcare insurance service system.

Cambodia's infant mortality rate has decreased from 115 per 1,000 live births in 1993 to 54 in 2009.
In the same period, the under-five mortality rate decreased from 181 to 115 per 1,000 live births. In
the province with worst health indicators, Ratanakiri, 22.9% of children die before age five, according
to National Child Mortality and Malnutrition and UN World Food Program, 2008.

The Cambodian education system is heavily decentralized, with three levels of government, central,
provincial and district – responsible for its management. The 2008 Cambodian census estimated that
77.6% of the population was literate (85.1% of men and 70.9% of women). Male youth age (15–24
years) have a literacy rate of 89% compared to 86% for females, according to UNICEF Cambodia
Statistics, 2013.

The education system in Cambodia continues to face many challenges, but during the past years
there have been significant improvements, especially in terms of primary net enrolment gains, the
introduction of program based-budgeting, and the development of a policy framework which helps
disadvantaged children to gain access to education. The country has also significantly invested
in vocational education, especially in rural areas, to tackle poverty and unemployment, according to
UNESCO-UNEVCO and Cambodia National TVET Development Plan.

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1.5. Labour Force and Employement

Cambodia's total population was estimated as 14.9 million in 2012, with a labor force, aged 15 and
older, of 8.4 million engaged actively on the labour market. In 2006, the labour force of youth (age
group 15-24 years) peaked with 2.5 million and has afterwards decreased yearly, reaching 2.2 million
in 2012. This trend of youth is part of the growing migrating outflow to find jobs with higher wages.

Men have a higher employment rate. Rates increases more after the age of 25, as men are often
prioritized in education and women work instead. The youth have similar rates.

Asia has seen a strong growth in the middle class during the last decade. Cambodia’s has smaller
middle class with especially the upper middle class growing slower than the average for East Asia
and the Pacific: In East Asia and the Pacific 26% lived for US$2-4 a day and 12% for US$4-20 in 1999.
In 2008 33% lived for US$2-4 a day and 33% for US$4-20. In Cambodia 25% lived for US$2-4 a day
and 8.9% for US$4-20 in 2004.

Figure 2: Employment Rate (2012), Age and Sex Distribution

Source: ILO, Key Indicators of the Labour Market Database, Cambodia Labour Market
Profile 2012, Danish Trade Union, Council for International Development and
Cooperation

Figure 3: Characteristic of Working Age Population

Highest level attained and years of schooling in the population

(2010), Population 25+, Total and Female

Source: 2013 by Robert J. Barro and Jong-Wha Lee,

Cambodia Labour Market Profile 2012, Danish Trade Union,
Council for International Development and Cooperation

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II. SOCIAL SECURITY IN CAMBODIA

The social security of Cambodia has been guaranteed by the kingdom’s constitution and laws; and
it is also assured by the national social protection strategy.

2.1. Laws and Legal Documents promoting Social Security in Cambodia

The Kingdom covers the right of all Cambodian people to obtain social security and other
of Cambodia benefits, as well as making specially provisions for social security in the formal
Constitution sector. As stated in the Cambodia constitution:

Article 36: Every Khmer citizen shall have the right to obtain social security and
other social benefits as determined by law. Article 75: The State shall establish
a social security system for workers and employees. Others articles have
mentioned the social benefits for different groups of population and
employments.

The Labor Governs relations between employers and workers resulting from employment
Law 1997 contracts in order to ensure better employment conditions, keep harmony,
strengthen security and healthy employment in work place. Following the
Constitutional Law, the Labor Law is basic of the establishment of the Law on
Social Scheme for Persons Defined by the Provisions of the Labor Law. This
Labor Law determined the dismissal compensation of termination of the labor
contract and the definition of employment injury, the employer’s responsibility
on work injury that happened to their workers, the medical insurance,
provision of cash and other social benefits

Section III Termination of the Labor Contract, Article, 73-95 and Chapter 9,
work-related accidents, Article. 248-257.

Law on Social This law aims at organizing the Social Security Schemes for persons defined by
Security the provisions of the Labor Law, which applies to the formal sector workers
Schemes for include Pension Scheme which is in charge of providing old age benefit,
Persons invalidity benefit and survivors' benefit and Occupational Risk which is in
Defined by the charge of providing employment injury and occupational disease benefit. This
Provision of law is also mentioned the other contingencies of social security scheme shall
Labor Law 2002 be subsequently determined by sub-decree base on the actual situation of the
national economy.

National Social This strategy is based on a participatory consultation process led by the Council
Protection for Agriculture and Rural Development (CARD). The strategic consists of social
Strategy for the protection interventions include, at a minimum, social insurance, labor market
Poor and policies, social safety nets and social welfare services.
Vulnerable
2011-2015 “Social Protection as a Priority of the Royal Government of Cambodia,”
details the need for and importance of the development of such a strategy,
based on the Constitution, the Rectangular Strategy for Growth, Employment,
Equity and Efficiency Phase II, the NSDP 2009-2013 and national legislation, as
well as international conventions to which Cambodia is a signatory.

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2.2. National Social Security Fund (NSSF)

Brief History of National Security and NSSF

Social security was initiated in Cambodia since 1955 in accordance with
the Royal Kret No. 55 and 306. Unfortunately, during the genocidal
regime: 1975-1979, it was completely demolished. After the war, election
and establishment of new government, the department of Social Security
was established in 1993. The department was responsible for preparation
of all of the ministry regulation for the implementation of social security
protection for the general population.

Social security law was stipulated by the National Assembly in September 2002, which currently is
known as Law on Social Security Scheme for Pensions, defined by the provision of the Labour Law.
NSSF has been founded with a view to manage the protection of social security in conformity with
the National Law on Social Security and the Provisions of Social Security in pursuance of Sub-Decree
and has been implemented since late 2008.

Vision, Mission and Objectives

Vision To ensure the social security effectively for Persons Defined by the Provisions
of the Labor Law.

Mission To provide the social security services with effectiveness, transparency,

accountability, and punctuality for persons defined by the provisions of the
Labor Law in the purpose of relieving hardship such as Old Age, Invalidity,
Death, Work Injury, or other contingencies such as Sickness and Maternity.
Objectives 1. Strengthening and extending the implementation of Employment
Injury Insurance (EII): accident at workplace, commuting accident, and
occupational disease
2. Launching Health Care Scheme: health prevention service, medical
care, daily allowance, and maternity
3. Launching Pension Scheme: old-age, invalidity, and death.

Key Achievements
According to the Annual Report 2015, NSSF has implemented Phase I, Social Security Scheme on
Occupational Risk successfully and gained support from both national and sub-national levels.

By the end of 2015, NSSF has expanded the coverage of the occupational risk nationwide—It has
registered 7,796 enterprises with about 1 million workers, of which 70.7% are women.

(Source: NSSF, Annual Report 2016)

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Figure 4: Number of Work Injuries vs. Registered workers: 2014-2015

Registered Workers Work Injuries Percentage

(Source: NSSF, Annual Report 2015)

2.3. Employment Injury Insurance (EII)

Employment Injury Insurance is a compulsory social insurance covering all employees as defined by
the Law on Social Security Schemes for Persons Defined by the Provisions of Labor Law. In accordance
with this Law, the social security scheme for private sector was administered by the National Social
Security Fund (NSSF) which is public administration with the mission of serving public services in
social section.

Employment Injury
An accident is considered to be employment injury, the accident inflicted on the body of the worker,
regardless of the cause, if it happens to a worker working or during the working hours, whether or
not the worker was fault; it is the accident inflicted on the body of the worker or an apprentice with
or without wage, who is working in whatever capacity or whatever place for an employer or manager
of an enterprise. The employment injury scheme covers the contingencies of (i) Accidents at Work,
(ii) Commuting Accident and (iii) Occupational Diseases.

Accident at Accident at work refers to the accident inflicted on the body of the employee
Workplace during working hours, regardless of the cause and employee’s fault.

Commuting Accident occurs along the direct route between the employee’s residence and
Accident workplace is considered as commuting accident.

Occupational Occupational disease arises out of the exposure to the harmful substances or
Disease hazardous condition in the processes. The employment Injury Scheme covers
an extensive list of occupational diseases, which is expanded with the discovery
of new diseases.

Registration and Contribution Procedures

Registration: Every employer or owner of enterprise/establishment under the law of Social Security
Scheme for persons defined by the provisions of the Labor Law is obliged to register its own
enterprise or establishment in the National Social Security. Employer and owner of enterprise shall
send the list of employees of its enterprise to the National Social Security Fund for registration.
Sending employees’ list and sending the form of enterprise/establishment registration shall be done
simultaneously.
Every month employer or owner of enterprise shall send the report of number of employees to NSSF
before the 15th of the next month. The report of number of employees shall be done as the form of

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‘Employees registration’ by clarifying about the number of all employees in the report. The report of
number of employees sent to the NSSF shall be done by ‘Paper Form’ or ‘Electronic Form’ with the
sending letter signed by manager of enterprise.

In the first phase of the process of NSSF, registration of enterprises shall apply only for enterprise/
establishment with 8 or more employees.

Contribution: Every employer or owner of enterprises/establishment registered with the National
Social Security Fund (NSSF) and having from 8 employees shall have a compulsory to pay
contributions for occupational risks to NSSF. Workmen Compensation Contribution is a separate
compulsory of employer or owner of enterprise/establishment. Workers/employees are not obliged
to pay such contributions.

Belong to the first step of implementation, a uniform contribution rate is applied regardless of the
risks or hazards in the establishment or in the industry to which the establishment belongs. The
monthly wage for contribution payment starts from (200,000 Riels, approximately USD 50 up to
1,000,001 Riels approximately UDS 250). Calculation of contribution rate for occupational risks is an
agreeable rate which is determined by 0.8% (zero point eight) percent of average wage in the level
of monthly wage of employees.

The Benefits

Every employee of enterprises registered with the National Social Security Fund of the Ministry of
Labor and Vocational Training has the right to receiving benefits of Occupational Risks when they
sustain working accident. The benefits of Employment Injury Insurance include:

Emergency Service In case any work-related accident takes place within the work place, the
employer shall support the nearest emergency place and then dispatch
the victim to any hospital or clinic recognized by NSSF. Expenses over the
emergency care and dispatch are covered by the NSSF. In case accident
happening during commuting, the titular or employer can claim
reimbursement from NSSF for medical expenses.

Provision of Caring Employee sustaining working accident has the right to receiving
Services and treatment and hospitalization at hospital or poly-clinics recognized by
Treatment the NSSF for free.

Provision of daily For employment injury or commuting accident or occupational disease
allowance causing temporary disability, daily severance pay for temporary loss of
working ability shall be equal to 70% of daily average wage from the
second day after the date of accident. Daily severance pay for temporary
loss of working ability shall be given to the victim within 180 days at the
latest.

Benefits for Employee sustaining working accident causing permanent loss of
Permanent Loss of working ability less than 20% has the right to receiving the lump sum for
Working Ability loss of working ability. Employee sustaining working accident causing
loss of working ability from 20% and over has the right to compensation
for permanent loss of working ability. Employee sustaining working
accident causing 100% permanent loss of working ability has the right to
additional payment for his care taker. Additional payment for the care
taker is 50% of the pension of the victim.

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Payment for the Employee sustaining working accident causing 100% permanent loss of
Victim's Care Taker working ability has the right to additional payment for his care taker.
Additional payment for the care taker is 50% of the pension of the victim.

Contribution for In the case that the working accident results in death, those responsible
Funeral for the funeral shall receive the contribution of 1,000,000 Riels. This
contribution shall be directly given to the person in charge of funeral
management of the victim.

Survivors / Beneficiary benefit is pension made to the beneficiary of the victim. The
Beneficiary Benefit beneficiary has husband or wife, children or parents or elder people
under the victim charge.

Rehabilitation Service Employee sustaining working accident causing permanent loss of
working ability has the right to receiving tools or artificial limb as
determined by official doctor or doctor organized by the National Social
Security Fund and has the right to skills coordination service and
vocational training. More detail, see Section 3.

Membership and Coverage

Since the beginning of its operation in 2008 to the end of 2015 Employment Injury Insurance (EII) has
covered 25 capitals/provinces all over the country. It also has contracted with 1200 health providers
for treatment employees sustaining working accident. Up to date NSSF has accepted the registration
of enterprises/establishments of 7,796 with 1,077,079 workers/employees and provided benefits
around 20 thousand persons annually.

The Claim of Occupational Risk Benefits: 2014-2015

(Source: Adapted from NSSF, Annual Report 2016)

2.4. Health Insurance Scheme

Background
The study of the health insurance scheme started in 2009 when the RGC allows GRET to implement
Health Insurance Project (HIP)—as a partnership with Ministry of Labor and vocational training and
GMAC, sponsored by AFD—to launch the pilot project of health care for garment workers, which is
borne by the National Social Security Fund in the aim of conducting survey and gaining the working
experience prior to national implementation.

In May 2013, the Governing Body of the NSSF decided unanimously on Organization of the
Implementation of Social Health Insurance (SHI Road Map) approved by both of ministries (under the
technics of Ministry of Labor and Vocational Training and the finance of Ministry of Economy and
Finance) with a view to implementing the Health Insurance Project (HIP) in late September 2013 which
is borne by the National Social Security Fund.

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The achievements of its effort, the Health Insurance Project (HIP) for 11 enterprises/ establishments
with 7,200 works was transferred to the NSSF on October 2013. Nowadays, the NSSF has been
organizing team work to go to the garment and footwear factories with a view to collecting the data of
workers for determining workers’ identity code precisely, managing conveniently, and gaining the
health care services with quality, transparency, accountability, and effectiveness for the
implementation of health care insurance in early 2015.

Health Insurance: Benefits

Health Care Benefits comprise the health benefit packages and the defined health prevention
services. Based on the Prakas 109, from MoLVT, dated 17 March 2016, on Health Care Benefits:

• The term Health Benefit Packages refer to (i) Medical Care, (ii) Patient Referral Service, Corpse
Transportation Service, and (iii) Daily Allowance.

• The term Health Prevention Service refers to the punctual diagnosis, persons with health risk
and ill-health identification, consultation, and other necessary interventions with a view to
preventing from health problems composed of screening, health education, and vaccination
program.

Health Insurance: Membership and Coverage

Since the inception of its operation in May 2016, the Health Insurance Scheme has covered 500
factories, only in Phnom Penh. However, going forward the scheme will cover all other provinces
country wide.

The current Health Insurance Scheme has contracted with 1200 hospitals/health providers to
facilitate the services. This will base on the existing of the NSSF’s EEI base, which by the end of 2016,
has accepted the registration of enterprises/establishments of 6,618 with 1,042,143 workers and
employees and provided benefits around 10 thousand persons annually.

2.5. Challenges and Future Plan

For social security, Cambodia has not reached nationwide coverage yet, especially the Health
Insurance Scheme. Line social ministries, initiated social security in their different sector the social
security for private sector, for civil servant and for general population (the poor and vulnerable
group). The provision of social security net in Cambodia is in limitation; currently, only employment
injury insurance for private formal economic sector and pension scheme for civil servant was
introduced to its population since 2008.

Challenges for Social Security Scheme under the provision of the Labor Law
• Further human resources improvement
• Medical service providers (still to be improved)
• Has to improve information technology system
• Awareness of employers and employees on the scheme

Future Plan for Social Security Scheme under the provision of the Labor Law
• Expand Health Insurance Scheme in 2017
• Provide Pension Scheme in 2017
• Extend coverage of Employee Injury Insurance (EII) in 2018

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III. REHABILITATION SERVICES

3.1. General Rehabilitation in Cambodia

Physical Rehabilitation program has been implemented in the Cambodia since 1992 under the
cooperation between the Ministry of Social Affairs, Veterans and Youth Rehabilitation and national
and international NGOs1—through the establishment of 1 factory, 12 centers2 for physical
rehabilitation, to produce devices and provides physical rehabilitation to disable peoples.

Separately, for vocational training has training centers training people with disabilities in Kandal
province, which has a training cart, clothing, shoes, wallets, sculptures, wood, mechanic, phone
repair, workshops, machinery, recycling tuk-tuk for the disabled and agriculture.

According to Annual report 2014 of People with Disabilities Fund, physical rehabilitation centers at
national and sub-national has provided rehabilitation services for all kinds of possibilities for people
with disabilities 68.171, female 24.367, girl 6.235, men 28.820 and boy 8.749 people. In which the
majority is the production service and equipped artificial limbs, orthopedic, aids, therapy,
community service work, surgical treatment ofhands and face.

3.2. NSSF Rehabilitation Services

The NSSF Rehabilitation service is a part of the National Social Security Fund’s schemes: Employment
Injury Insurance and Health Care Insurance. Up to date, the rehabilitation services to eligible
individuals with disabilities has not been running at its full-scale support yet—majority of the services
covered only on provisions of medical equipment and therapy. Other vocational rehabilitations and
social services are in plan.

As an achievement by end of 2016, the rehabilitation service team accomplished:
• Development of Rehabilitation Service Flow Chart and necessary Forms to manage the
Application, Transfer of people with disabilities, Monitoring and Evaluation of Rehabilitation
Services, etc.
• Development of a Draft PRAKAS on the Rehabilitation Service for the Employment Injury
Insurance scheme
• Preparation of legislation and procedures for the Rehabilitation Service management
• Cooperation with IT department to develop Database to manage NSSF data on ‘Disability’
and ‘Provision of Rehabilitation Service’
• Phone communication and data collection, from NSSF’s members about employment
injuries and permanent disabilities, to facilitate rehabilitation and payment services
• Cooperation with Payment Division to visit 11 Rehabilitation Centers, 1 Vocational Training
Center, and a private company providing relevant rehabilitation services
• Cooperation with the Health Care Division to inspect and evaluate the direct rehabilitation
services to 76 NSSF’s members
• Cooperation with the Battambang Spinal Cord Rehabilitation Center to visit the injured
workers/employees and provided rehabilitation services to 04 people
• Cooperation with Banteay Preap Vocational Training Center for Persons with Disability to
provide training to 05 NSSF members

1
The national and international NGO includes: Committee of Red Cross (ICRC) Cambodia Trust (CT) Handicap
International Belgium (HIB) Handicap International France (HIF) and the Organization for Veterans
International Cambodia (VIC)
2
The 12 centers are located in some provinces, include: Preyveng, Takeo, Kampong Cham, Battambang,
Kampong Cham, Kampong Chhnang, Kampong Thom, Preah Vihear, Siem Reap, Preah Sihanouk, Kratie,
Kampong Speu and Kean Kleang

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• Cooperation with the ‘Benefit Division’ and ‘Policy Division’ to inspect work injuries and
provided rehabilitation services to 29 members
• Meeting with ‘People with Disabilities Foundation’, ‘Exceed’ Company, ‘Kean Kleang
National Rehabilitation Center’—to understand rehabilitation services and discuss the MOU
• Preparation of ‘Discharge Report’ for the work injury insurance
• Understanding Cambodia and International legislation and strategy to provide rehabilitation
services
• Development of 12 Case Studies on Rehabilitation Services: 08 cases about Injuries, 02 cases
about Centers, 02 cases about Hospital.
• Conduct management meeting and delegating decision on team work structure and
mechanism in Rehabilitation Services
• Documentation about relevant ministries, institutions, centers, organizations and private
companies providing rehabilitation services.

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REFERENCES

1. Annual Report of the National Social Security Fund 2016
2. Annual report of People with Disabilities Fund 2014
3. Cambodia Demographic and Health Survey (CDHS) 2010
4. Cambodia Economic Overview, World Bank, www.worldbank.org
5. Danish Trade Union, Council for International Development Cooperation,
Cambodia Market Profile, 2014
6. General population census of Cambodia, 2008
7. Macro-Economic Indicators, Ministry of Economic and Finance
8. National Child Mortality and Malnutrition (Food Insecurity Outcome) Maps.
UN World Food Programme, Retrieved 4 May 2008
9. Life Expectancy Leap 18 years, World Health Organization
10. The Constitutional Law of the Kingdom of Cambodia, 1993
11. The Labour Law, 2007
12. The Law on Social Security Schemes for Persons Defined by the Provisions of the
Labour Law, 2002
13. Prakas on Benefit of Occupational Risks
14. Prakas on Registration of Enterprise/establishment and Employees in the
National Social Security Fund.
15. Prakas On Determination of Contribution Rate and Procedure of Contribution
Payment for Occupational Risks
16. Sub-degree on the establishment of National Social Security Fund (NSSF) 2007

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