Saving mothers’ lives _ Experiences from Cambodia
Celebrating Progress and Accelerating Action
23 April, 2012 Washington , DC
Ministry of Health
Saving
mothers’ lives
Experiences from
Cambodia
Interventions for Maternal Health In Cambodia
Saving mothers’ lives _ Experiences from Cambodia
• Peace, growth, education
• Roads, phones
• Health centers, midwives
80%
70%
50%
34%
40%
30%
19%
32%
22%
17%
20%
16%
36%
18%
71%
59%
61%
64%
61%
60%
70%
50%
46%
40%
26%
10%
0%
8%
2002
11%
2003
2004
2005
2006
% Skilled birth attendance
2007
2008
2009
2010
% Facility Delivery
Source: National Health Statistics MoH 2002-2011. Mainly public sector
2011
Interventions for Maternal Health In Cambodia
Saving mothers’ lives _ Experiences from Cambodia
• Peace, growth, education
• Roads, phones
• Health centers, midwives
• Removing financial barriers:
- Health equity funds
- Live birth incentive ($15-HC, $10 RH)
80%
64%
70%
71%
61%
60%
61%
46%
50%
34%
40%
30%
70%
19%
32%
59%
50%
36%
40%
22%
20%
26%
10%
8%
11%
17%
16%
18%
0%
2002
2003
2004
2005
2006
% Skilled birth attendance
2007
2008
2009
% Facility Delivery
Source: National Health Statistics MoH 2002-2011. Mainly public sector
2010
2011
The Midwife is available around the clock, all week
Saving mothers’ lives _ Experiences from Cambodia
Leaves her cell phone number
Resides close, can be reached
Secondary midwife at HC
AMTSL and MgSO4 use 2009 and 2011
Saving mothers’ lives _ Experiences from Cambodia
2009: 141 births in 31 hospitals, 2011: 61 births in 16 hospitals
100%
90%
80%
71%
70%
60%
50%
50%
MgSO4, % of hospitals
40%
30%
20%
10%
AMTSL, % of births
17%
0%
2009 May
2011 Dec
AMTSL improvement and bleeding
Saving mothers’ lives _ Experiences from Cambodia
Correct Use of AMTSL in 9 USAID/BHS-supported Hospitals
March 2011 (Partograph Review of 2657 Delivery Cases)
100%
97%
90%
8%
80%
9%
8%
84%
7%
70%
6%
60%
6%
5%
50%
4%
40%
3%
30%
20%
2%
17%
10%
1%
0%
0%
Baselines 2009
BHS PY2 ( Oct 2010)
Correct Use of AMTSL
BHS PY3 (March 2011)
Vaginal Bleeding >300 ml
Birth per woman (TFR) vs. Contraceptive prevalence
Saving mothers’ lives _ Experiences from Cambodia
10
100%
9
90%
8
80%
7
70%
6
60%
5
50%
4
40%
3
30%
2
20%
1
10%
0
0%
1980
1985
1990
1995
TFR
Source: CDHS, UN
2000
CPR
2005
2010
Maternal Mortality Ratio in Cambodia
Saving mothers’ lives _ Experiences from Cambodia
800
700
800
690
700
640
600
600
605
472
500
400
500
400
432
338
300
288
200
206
100
300
200
124
0
100
0
1990
1995
2000
2005
2010
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
Factors Leading to Success: “It takes a village”
Saving mothers’ lives _ Experiences from Cambodia
• Government Commitment
• “The Fast Track Initiative
Roadmap for Reducing
Maternal and Newborn
Mortality”
• Community Leadership
• Partnerships with donors
and other stakeholders
Challenges
Saving mothers’ lives _ Experiences from Cambodia
• Improve newborn survival
• Improve links HCs <=> hospitals
• Improve quality of care
• Regulate private sector
• Increase FP availability
• Maternal and child nutrition
Saving mothers’ lives _ Experiences from Cambodia
Thank you very much for
your attention!