yin chhay ly_maternal mortality reduction in cambodia
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5/17/2018 Yin Chhay Ly_Maternal Mortality Reduction in Cambodia - slidepdf.com
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CAMBODIAN’s Successful Efforts to
Reduce maternal mortality and its
challenge
Presented by
H.E. Yim Chhay LyDeputy Prime Minister, Chairman of council for Agricultural and Rural
Development, Cambodia
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Cambodia background
• located in the SEA, members of ASEAN• Land of 181035 square kilometer• Population 13.4 millions
• In 2005:- MMR 472/100000LB- Infant Mortality: 89/1000LB- Low ANC rate 42% one visit
- Home delivery high 85%- 56% assist by TBA( traditional Birth attendant)- Caesarian section rate very low 0.5%
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Cambodia background
Main causes of maternal deaths are:
• ante natal and post natal bleeding,bleeding during childbirth,
• obstructed labor,
• eclampsia,
• infection,
• abortion
• and anemia due to malnutrition.
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Political commitment• Suggestions of the First National Midwifery forum 13-14 December
2005 – 1)Increase the number of midwife with appropriate civil servant carderfor better staff distribution.
– 2) have the special constitution for midwife to motivate the midwiferecruitment
– 3) Revise the midwife’s motivation especially who work at the rural andremote area
– 4)continue to support for the opportunity to the midwife skill throughscholarship improving the teaching environment, incentive, andaccommodation
• RG Cambodia commitment 02 February 2007 to motivate themidwives to provide services : – giving the financial incentives of 60000riels for midwife assisted a live
birth at the Health Center and 40000 riels at the Referral Hospital andNational Hospital. Samdech Decho HUN SEN, Prime Minister of TheRGC has committed and supported these recommendations.
– In 2007 the RGC revise the constitution of the civil servant carder bygiving a special accreditation to the midwife qualification through theRoyal Kret in 13 June 2007.
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Political commitment cont.
• In February 21, 2011, on behalf of the UnitedNations, the Asia Pacific Director of the UnitedNations Population Fund (UNFPA)acknowledges
the Cambodian First Lady
lok Chumteav Bun Rany-Hun Sen,
head of Cambodian Red Cross,
as National Champion for Cambodia’scommitment to the UN Secretary General’s
Action Plan for women’s and children Health.
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The main purposes of the FTIRM are:• 1. To outline major areas and evidence-based
interventions which, if provided at scale, have apotential to dramatically reduce maternal and
newborn mortality• 2. To identify resources needed for rapidlyexpanding recommended interventions and tohighlight funding gaps which could informresource mobilisation strategy
• 3. To suggest specific maternal health activities tobe included in the annual operational plans ofvarious implementing units at the national andsub-national level
Source: Fast Track Initiative Road Map for Reducing Maternal & Newborn Mortality, 2010-2015 7
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Core Components
1) Emergency Obstetric and Newborn
Care
2) Skilled Birth Attendance
3) Family Planning
4) Safe Abortion
Enabling Environment Components
5) Behaviour Change Communication
6) Removing Financial Barriers
7) Maternal Death Surveillance &
Response
Source: Fast Track Initiative Road Map for Reducing Maternal & Newborn Mortality, 2010-2015 8
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9
1. Political commitment from the government and developmentpartners.
2. Policies, guidelines and strategies developed, updated and revisedaccording to the current requirements of the national programs.
3. Participative development of Annual Operational Plan from the
national programs, sub-national levels and health developmentpartners.
4. Technical and financial supports from the MoH and healthdevelopment partners.
5. Leadership and commitment of national and sub-national levels.
6. Participation of local authorities and communities to improve theaccessibility and utilization of health care facilities and referral ofemergency situation.
Key successful factors
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Source: National Health Statistics MoH 2002-2011. Mainly public sector
Interventions for Maternal Health In Cambodia
• Peace, growth,
education• Roads, phones• Health centers, midwives
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Source: National Health Statistics MoH 2002-2011. Mainly public sector
Interventions for Maternal Health In Cambodia
• Peace, growth,
education• Roads, phones• Health centers, midwives
• Removing financial barriers:
- Health equity funds,vouchers
- Live birth incentive ($15)
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MMR development in Cambodia 1990-2010. Estimates for 1990 and 1995 from WHO, the remainder from CDHS For 2005 and 2010 with 95% confidence intervals
Maternal Mortality Ratio in Cambodia
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Challenge
Move forward
from Quantity to Quality
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Thank you for your attention
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