KAMPONG THOM, Cambodia (October 1, 2012) — Eighteen-year-old Srey Neang is eight months pregnant with her first child. Because there are few employment opportunities in her village, Neang and her husband work in a neighboring village in Kampong Thom. A laborer in a rice field, Neang has had little access to health services and information.
Cambodia has made impressive gains in reducing child and infant mortality. According to a 2010 Demographic and Health Survey, between 2000 and 2010, the infant mortality rate declined from 95 to 45 deaths per 1,000 live births.
Nevertheless, neonatal mortality—deaths that occur in the first 28 days of life—has remained high and accounts for about half of all infant deaths.
Cambodia’s maternal mortality ratio also remains high, despite dramatic reductions over the past five years. Two hundred and six mothers die per 100,000 live births. That is, an estimated 790 mothers die in childbirth every year.
UNICEF has been supporting the Ministry of Health with supplies and technical assistance to improve the availability and quality of skilled care for mothers and their newborns. To strengthen demand for these services and ensure they reach people like Neang, UNICEF has initiated a package of interventions known as Community Care of Mothers and Newborns, implemented in 17 districts across the country.
Village health support groups are at the heart of this initiative. Equipped with the necessary knowledge and skills to counsel women during pregnancy and in the postnatal period, volunteers from these groups provide an invaluable bridge between the community and the health system.
Armed with a simple set of pictorial counseling cards, village health volunteers visit the home of a pregnant woman as soon as her pregnancy has been confirmed. During this visit and subsequent ones throughout the pregnancy, these women: counsel the mother on care to be taken during pregnancy; encourage her to prepare for the birth by arranging for skilled providers, transport and money for the childbirth; and promote delivery in a health facility with trained healthcare workers.
The volunteers also provide essential information after delivery. During follow-up visits, they provide key health and nutrition messages, screen mother and newborn for danger signs and refer them, if necessary, to the nearest health center.
The work of the village health volunteers has brought about changes in the behavior and practices of women. In areas in which Community Care of Mothers and Newborns has been implemented, women demonstrate a higher level of knowledge of birth preparedness. And, as a result of concerted efforts by the volunteers to promote delivery in health centers, women are less likely to deliver at home.
Neang has been visited by the volunteers: “I received all the information from the village health support volunteers,” she says. “I plan to deliver my baby at the health center because it’s far safer to deliver where they have qualified health staff.”
Neang will stay in the village for several months after delivery to benefit from the advice of the volunteers. They have already been teaching her about hygiene, good nutrition and the importance of antenatal care. After delivery, they will provide further information about breastfeeding, how to position the baby, the warning signs of illnesses, and extracting and storing breast milk.
Efforts continue to improve the availability of skilled and quality care for all newborns and mothers, especially among poor, ethnic minority, remote and mobile populations. The goal is to reduce child mortality to below 20 child deaths per 1,000 births.
Support at the community level is helping to ensure that more mothers and their babies are staying fit and healthy at this critical stage of the baby’s life. Programs such as Community Care of Mothers and Newborns and its critical village health support groups will help Cambodia stay the path to reaching its Millennium Development Goals to reduce child and maternal mortality by 2015.