Monday, June 15, 2009

Government To Reduce Child and Mother Mortality

BY BUTH REAKSMEY KONGKEA

The Royal Government of Cambodia has taken measures to improve the provision of midwifery care, alongside improvements in reproductive, maternal and neonatal health.

Sok An, Deputy Prime Minister and Minister for the Council of Ministers, said that encouraging improvements in performance, deployment, competency and the status of midwives was part of the Millennium Development Goals (MDG); and these improvements should be effected by 2015. In essence, the plan is quite simple: “No Woman Should Die Giving Life”.

The government gives full support to midwives operating in public health facilities. There will be increased wages for midwives at all state referral hospitals and health centers, according to Sok An. There will also be training for midwifery students and at least one midwife will be present at all health centers from 2009.

“Despite the government’s hard work, the child and mother fatality rate is still high compared to other countries in the region,” Sok An said during his opening remarks at the “2nd National Midwifery Forum” in Phnom Penh on June 11.

The Forum was organized by the National Committee for Population and Development, the Office of the Council of Ministers and the Ministry of Health. Additional support came from the German Government, channeled through the United Nations Population Fund.

“I appeal to ministries, institutes and the United Nations Population Fund and World Health Organization to join us in our drive to reduce mother/infant mortality rates by 2015,” he said at the Forum.

Men Sam An, Permanent Deputy Prime Minister, said that a generation of midwives had been slaughtered by the Khmer Rouge, leaving expectant mothers in critical need. Subsequent government strategies allowed a steady redress of the personnel imbalance. The government recently provided training institutions for all aspect of the medical profession, resulting in an increase in both quantity and quality of health care.

“The Royal Government recognizes that women are the mothers of the world, the backbone of the national economy. Their wellbeing is at the heart of government strategy. If women continue to lose their lives by giving new lives, families cannot have happiness and the country will not enjoy prosperity,” she said at her opening remarks to the Forum.

The Permanent Deputy Prime Minister said that the government acknowledges the critical role of midwives in poverty eradication. Overall, she said, poor health leads to an increase in poverty and poverty leads to poor health. To combat this vicious cycle, the government has directed much effort building more health centers, referral hospitals and general hospitals. She continued to say that midwives are key health agents and have crucial roles to play in social development and poverty reduction, as required by national strategy.

She also appealed to development partners to continue to support Cambodia’s efforts to improve the health sector, in particular the midwifery services. She was particularly keen to support midwives in health centers in rural areas.

Dr. Mam Bunheng, Minister of Health (MoH), said that according to the Ministry’s Strategic Plan 2009, extra money had been provided to cover midwives’ salaries through schemes such as the Priority Mission Group (PMG), Merit-Based Payment Incentive (MBPI) and Special Operation Agency (SOA).

To illustrate the proposal, the Minister Bunheng said a professional midwife who provides safe delivery of a child in a rural area will receive 60,000 riel (US$15) and the health center professional midwife who provides safe delivery of a child in an urban area will receive 40,000 riel (US$10).

The Minister added that the number of primary midwives increased from 1,079 to 1,339. Numbers of Secondary midwives have increase from 1,790 people to 1,848. This occurred during the 2003 – 2008 timeframe. Furthermore, the proportion of deliveries assisted by skilled birth attendants stood at 44 percent in 2005 but has rose to 58 percent in 2008. Importantly, the proportion of women who gave birth in a health facility also rose, from 22 percent in 2005 to 39 percent in 2008.

Dr. Michael J. O’Leary, Representative of the World Health Organization (WHO), said that despite these developments, constraints remained, especially related to the shortage of midwives, and concerns about the quality care at the health facilities. He said that quality of service provision is crucial for positive health outcomes, and for ensuring that health services are able to attract patients and to retrain the support the community.

“This is a high-level commitment by the Royal Government of Cambodia to accelerate the progress under the relevant MDGs. This has focused increased attention to the issue of skilled birth attendants, and maternal health in general,” he said. “Midwives clearly have a key role to play in improving reproductive, maternal and newborn health, and in reducing maternal mortality. All midwives should be proud of their profession.”

Alice Levisay, UNFPA Representative in Cambodia, said that worldwide, every minute a woman dies in childbirth. He said that having a skilled professional at birth protects the lives of the mother and the child by recognizing problems early, and by intervening quickly.

She added that worldwide, about 350,000 midwives are needed. Addressing this shortage is critical to achieving universal access to reproductive health by 2015.
According to a MoH report released in 2009, there are about 3,300 midwives serving almost 15.5 million people in Cambodia. There are over 900 health centers in the nation, about 80 of them without midwives. ////

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