Yin Chhay Ly_Maternal Mortality Reduction in Cambodia

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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


http://slidepdf.com/reader/full/yin-chhay-lymaternal-mortality-reduction-in-cambodia 2/1424 Provincesabout13.4million



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%



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.



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.



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.



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



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



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



Source: National Health Statistics MoH 2002-2011. Mainly public sector

Interventions for Maternal Health In Cambodia

• Peace, growth,

education• Roads, phones• Health centers, midwives



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)



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



Challenge

Move forward

from Quantity to Quality



Thank you for your attention

Yin Chhay Ly_Maternal Mortality Reduction in Cambodia

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