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COUNTRY DIAGNOSTICS ASSESSMENT DECEMBER2024 THE ENABLING ENVIRONMENTFOR DISASTER RISK FINANCINGIN CAMBODIA COUNTRY DIAGNOSTICS ASSESSMENT DECEMBER 2024 Creative Commons Attribution 3.0 IGO license (CC BY 3.0 IGO) © 2024 Asian Development Bank6 ADB Avenue, Mandaluyong City, 1550 Metro Manila, PhilippinesTel +63 2 8632 4444; Fax +63 2 8636 2444www.adb.org Some rights reserved. Published in 2024. ISBN 978-92-9277-110-2 (print); 978-92-9277-111-9 (PDF); 978-92-9277-112-6 (ebook)Publication Stock No. TCS240606-2DOI: http://dx.doi.org/10.22617/TCS240606-2 The views expressed in this publication are those of the authors and do not necessarily reflect the views and policiesof the Asian Development Bank (ADB) or its Board of Governors or the governments they represent. ADB does not guarantee the accuracy of the data included in this publication and accepts no responsibility for anyconsequence of their use. The mention of specific companies or products of manufacturers does not imply that theyare endorsed or recommended by ADB in preference to others of a similar nature that are not mentioned. By making any designation of or reference to a particular territory or geographic area in this document, ADB does notintend to make any judgments as to the legal or other status of any territory or area. This publication is available under the Creative Commons Attribution 3.0 IGO license (CC BY 3.0 IGO)https://creativecommons.org/licenses/by/3.0/igo/. By using the content of this publication, you agree to be boundby the terms of this license. For attribution, translations, adaptations, and permissions, please read the provisionsand terms of use at https://www.adb.org/terms-use#openaccess. This CC license does not apply to non-ADB copyright materials in this publication. If the material is attributedto another source, please contact the copyright owner or publisher of that source for permission to reproduce it.ADB cannot be held liable for any claims that arise as a result of your use of the material. Please contact pubsmarketing@adb.org if you have questions or comments with respect to content, or if you wishto obtain copyright permission for your intended use that does not fall within these terms, or for permission to usethe ADB logo. Corrigenda to ADB publications may be found at http://www.adb.org/publications/corrigenda. Notes:In this publication, “$” refers to United States dollars and “KR” refers to Cambodian riel.ADB recognizes “Vietnam” as Viet Nam. Cover design by Edith Creus. On the cover (from left to right) A fisher paddles his canoe on the Tonle Sap River in Chong Kneas, Cambodia.Street vendors wearing face masks during COVID-19 pandemic (photos by ADB). Contents Acknowledgmentsvi Executive Summaryix 1.1Background11.2Risk Layering Approach41.3Diagnostics Methodology6 2Public Sector Disaster Risk Financing Landscape11 2.1Background112.2Institutional Setup to Manage Disasters142.3Disaster Risk Financing Mechanisms and Instruments15 3Diagnostic of the Availability and Utilization of Insurance, Reinsurance,and Capital Markets for Disaster Risk Financing 3.1Economic Conditions and Other Support Functions213.2Government policy303.3Credibility of the Private Sector Offering Risk Transfer Solutions473.4Product Availability and Affordability553.5Social Protection Policy643.6Unlicensed Competition67 4Conclusions684.1Rating Summary and Recommended Main Actions68 References77 Tables, Figures, and Boxes Tables 1People Affected by Disasters and Damage, 1991-2020122Damage of Major Disaster Events as % of GDP143Long-Run Impacts of Climate Change Scenarios on Cambodia’s GDP144Health Equity Fund Sources, 2017–2019355Benefit Limits for NSSF Income Replacement During COVID-1939Confinement and Recovery6Loans and Aid to Cambodia in the Fight Against COVID-19407Insurance Sector Indicators508Insurance Sector Indicators569Listed Companies on the Cambodia Securities Exchange as of August 20226310CSX Statistics Second Quarter 2021 to Second Quarter 202263 Figures1 Timeline and Area of Loss Impact of Selected Disasters32Layered Approach to Disaster Risk Financing53W&W Insurance, Reinsurance, and Capital Markets Solutions10Development Framework—Hypothetical Example4National Committee for Disaster Management Structure155GDP growth from 2020 to 2023 (forecast)216People Affected and Deaths by Disasters: 2000–2021227Hospital Beds per 1,000 Population, 2019 or Nearest Available Year238Physicians Per 1,000 Population, 2019 or Nearest Available Year239Nurses and Midwives per 1,000 Population, 2019 or Nearest Available Year2410Diagram of Data Flows—CamEWARN2611Health Expenditure by Revenues of Health Care Financing Scheme,35Cambodia, 201912Social Health Insurance Contributions as Share of Employee36Salary, 2019 or Latest Year13Expenditure by Health Care Function as Share of Central Health38Expenditure, 201914Gross Premium Development5015Insurance Density and Insurance Penetration, 2017 to 20215116Cambodia Reinsurance T