Monday, July 21, 2008

Cambodia Still Lacks Midwives

By Soy Sophea

Cambodia requires the services of more midwives to serve the needs of expectant mothers, according to health officials.

Chheang Sena, Deputy Director of Kampong Cham Provincial Health Department, said around a third of the 98 health centers in his province lacked midwives.

He stated, “We always ask the Ministry of Health to send 40 midwives per year to serve the public in our province but we receive no more than three or four.”

Sena said that this shortage could be explained by the low salaries a professional midwife can expect, working in a Public Health Center. These compare unfavorably with the wage a qualified midwife can expect to command in the private sector.

Huot Than, Director of Kampong Speu Provincial Health Department, told the Cambodia Weekly that his province also lacks midwives.

“Clearly, we want our mothers-to-be to deliver their babies safely,” he said.

It would seem then that the demand for the services of midwives in Cambodia is outstripping the supply of properly qualified practitioners.

Oum Sophal, Rector of the University of Health Science, said that for this study year (2008-2009), only 20-25 students had chosen courses in midwifery. This statistic gives cause for concern as the Ministry of Health requires his university to offer 40 scholarships in midwifery.

“I am concerned about the number of students registering for these courses as we are unable to meet the Ministry of Health’s goals. This means that large swathes of the remoter parts of our nation are not as properly covered as they should be,” the Rector said.

Kom Kanal, Director of the National Maternity Center, told local newspaper, Rasmei Kampuchea that today Cambodia needs the services of thousands of fully trained midwives to serve the 900 health centers throughout the country.

According to a 2005 World Health Organization (WHO) survey, there is a ratio of 473 maternal deaths per 100,000 live births in Cambodia. This compares to 370 in Papua New Guinea, 172 in the Philippines and 158 in Mongolia. This information, often referred to as the Maternal Mortality Ratio (MMR) reflects a woman's basic health status, her access to health care and the quality of care that she receives.

The report added that in fact 40 percent of the Region's maternal deaths occur in Cambodia, the Lao PDR, Mongolia, Papua New Guinea and the Philippines. Tragically, the majority of these deaths are preventable.

So far the Cambodian government has employed a significant portion of the national budget to improve the quality and increase the number of health centers and health center officials. This is according to Prime Minister Hun Sen’s statement on the occasion of World Population Day, held July 11. The statement announced that the number of secondary midwives had increased from 1,790 in 2003 to 1,848 in 2007. Furthermore, the statement added that the Cambodian government has continued to strengthen the public health sector by cooperating with other development partners.

Kim Chantha, Phnom Penh-based ADB Communications Officer, told the Cambodia Weekly that ADB and the Royal Government of Cambodia signed an agreement in February 2003 amounting to US $20 million. The goals of this project are to improve the delivery of health services, especially to women and the less well-off in rural areas. The fund also serves to provide training for staff at health centers and referral hospitals in nine provinces.

He added that the targeted provinces of the project include Kampong Cham, Kampong Chhnang, Koh Kong, Mondulkiri, Sihanoukville, Svay Rieng and Takeo provinces.

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