Cambodia has put in place measures of improving maternal health. As such, maternal deaths have overtime declined as infant mortality rates drop. Despite these improvements, neonatal and maternal mortality are still high when compared to the surrounding regions and nations across the world. Inadequate or poor-quality maternal healthcare is associated with high rates of maternal and neonatal mortality (Rice, & Manderson, 2014). Again, antenatal, postnatal, and delivery care are factors of consideration in maternal healthcare. Maternal service is rated according to the antenatal care provided in a bid to improve a wide range of health results for women (Brickell, & Springer, 2016). The paper presents the healthcare issues for women in Cambodia.
Indigenous people Mondulkiri and Ratanakiri contribute to a huge proportion of the population where maternal health issues are a great concern (Brickell, & Springer, 2016). Mortality rates in these provinces double the national average, whereas maternal mortality rates have escalated as most of the women deliver their babies at home.
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Various factors make women in Cambodia vulnerable to these health issues. One of them is nutrition, whereby women who are expecting children should follow a balanced diet which is expected to supply the necessary nutrients during the pregnancy term. Another risk factor is complicated deliveries. For that reason, the number of complicated deliveries has been decreased through the provision of increased, skilled health staff (Hellwig, 2009). Reducing the rate of maternal mortality have benefited the society as the risk of widespread poverty has declined as a result of the prevention of maternal mortality and widespread promotion of care provision, especially by public health facilities. Report from the World health organization depicts Cambodia as a country whose children are three times more likely to die from complications during childbirth especially those in the poorest segment of the country (Rice, & Manderson, 2014). The challenge inequity ought to be addressed in a bid to ensure that population groups in the country experience health benefits. Therefore, poverty turns out to be a contributing factor to the health issues of women in Cambodia.
There have been both economic and social impact on the country as a result of addressing issues of women in Cambodia in the sense that, international donors impose particular regulations that tend constrain the nation. In addition, most of the women who are affected by maternal health issues are mainly in their productive age. As such, these women are likely to be less productive, thus hurting the economy. These women health issues also have a social effect. Socially, when women die out these health complications, they leave behind children who may tend to spend more time out of schools to do other house chores, and some even look for better opportunities for themselves and their siblings to feed themselves.
There have been policies adopted with the aim at renewing emergency, obstetric, and newborn care for purposes of decreasing maternal and neonatal mortality, improve delivery, and newborn care. Facilities of comprehensive emergency, obstetric, and newborn care have been incased and equipped with the workforce as well as the need infrastructure (Nakaya, 2012). As such, care for mothers and their newborn has assumed a greater quality. Throughout there is permanent monitoring in these centers by the obstetricians, pediatricians, staff nurses, lab technicians, doctors, as well as the support staff who are always on duty accompanied by anesthetics on call.
Again, the number of basic emergencies obstetric and newborn care facilities have been increased at district health centers as well as in provincial hospitals. The improvements are geared towards curbing maternal mortality and morbidity. The are other challenges of maternal and child health care that require to be addressed. Therefore, the royal government of Cambodia has put up projects to work together with the ministry of health in a bid to solve these issues. In addition, midwives have to be qualified to continue improving the standards of healthcare services and promoting chances of vulnerable groups to access health care, particularly persons with disabilities. Cambodia’s project of improving maternal and newborn care is in the second phase, where the first phase ran from 2012 to 2015. The initiative is part of the Cambodian-German social health protection program whose goal is to strengthen health care through financing the delivery of health service (Rice, & Manderson, 2014). Promotion of systems of health and governance and incorporating the vulnerable groups in then society is part of the initiative.
The main goal of the initiative is to ensure that families that have small children are benefiting from the improvement of health services, particularly for mothers and children. Among the provinces in Cambodia where the program is active, are Kep, Kampong Speu, Kampot, and Kampong Thom. The project is involved in three critical areas, and one of them is the quality improvement of maternal and neonatal emergency care services through coordination with the departments of provincial health. Activities such as strategic planning, supervision, and a strengthened monitoring system are incorporated. Additionally, the initiative helps in developing pathways for referral services, especially cases of emergency. As s result, a better comprehension of birth preparation as well as newborn care among the population is enhanced. Again, possibilities of a reduction in maternal deaths are guaranteed as pregnant women are referred to the services offered by emergency obstetric quickly if need be. Referral to an emergency in Cambodia is challenged by the geographical terrain, cost of transportation to the hospitals, inadequate vehicles and ambulances, and inaccessibility of health facilities from certain locations (Rivenbark, Martyn, Whetten, & Vasudevan, 2018).
The other essential area is improving the qualifications of staff and equipping skills through training medical practitioners. Since medical doctors in close collaboration with midwives and the department of provincial health, training will help strengthen the connection of emergency obstetric and facilities of newborn care together with their supervisors (Rivenbark, Martyn, Whetten, & Vasudevan, 2018).
Thirdly, the initiative promotes the inclusion of persons with disabilities through an introduction of tools and competencies to adapt them to health services and other related requirements. There have been developed tools for early detection of disabilities in children which are being revised to provide the ministry of health with a correct package of instruments that require official adoption (Brickell, & Springer, 2016). As such, the project has included human rights and principles by advocating for equality and non-discrimination of opportunities for persons with disabilities. Initially, the project involved maternal health care indicators which have been improved through the provision of skills in mid wifely, especially during emergency care. For that reason, the number of deliveries per month in emergency facilities has increased between the year 2012 and 2015 (Rivenbark, Martyn, Whetten, & Vasudevan, 2018).
International organizations, local stakeholders, together with the ministry of planning, have come up with an information system termed as ID poor, which will facilitate policy formulation and ultimate decision making. Again, several social health protection schemes have been put in place which is tailored to meet the needs of poor households in society (Ozano, Simkhada, Thann, & Khatri, 2018). Health equity funds form part of the most prominent scheme which aims at enabling access of people to public health service at affordable costs, particularly the poor.
References
Brickell, K., & Springer, S. (Eds.). (2016). The handbook of contemporary Cambodia . Taylor & Francis.
Hellwig, K. (2009). Caring for Vulnerable Children in Cambodia. Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional , 27 (4), 249-252. doi:10.1097/01.nhh.0000349912.20484.21
Nakaya, S. (2012). Victimization, empowerment and the impact of UN peacekeeping missions on women and children: Lessons from Cambodia and Timor-Leste. doi:10.18356/d72f1193-en
Ozano, K., Simkhada, P., Thann, K., & Khatri, R. (2018). Improving local health through community health workers in Cambodia: challenges and solutions. Human resources for health , 16 (1), 2. doi:10.1186/s12960-017-0262-8
Rice, P. L., & Manderson, L. (2014). Maternity and reproductive health in Asian societies . Routledge.
Rivenbark, J., Martyn, L., Whetten, K., & Vasudevan, L. (2018). A survey of healthcare-seeking practices and related stigma among community- and street-based children in Cambodia. International Health , 10 (3), 211-213. doi:10.1093/inthealth/ihy00
