Celebrating Progress and Accelerating Action 23 April, 2012 Washington , DCSaving m

others’ lives _ Experiences from Cam

bodia

Saving mothers’ lives

Experiences from Cambodia

Ministry of Health

Source: National Health Statistics MoH 2002-2011. Mainly public sector

2002 2003 2004 2005 2006 2007 2008 2009 2010 20110%

10%

20%

30%

40%

50%

60%

70%

80%

19%22%

34% 32%36%

46%

61%64%

70% 71%

8% 11%

17% 16%18% 26%

40%

50%

59% 61%

% Skilled birth attendance % Facility Delivery

Interventions for Maternal Health In Cambodia

• Peace, growth, education • Roads, phones• Health centers, midwives

Saving mothers’ lives _ Experiences from

Cambodia

Source: National Health Statistics MoH 2002-2011. Mainly public sector

2002 2003 2004 2005 2006 2007 2008 2009 2010 20110%

10%

20%

30%

40%

50%

60%

70%

80%

19% 22%

34% 32%36%

46%

61%

64%70%

71%

8% 11% 17% 16% 18%

26%

40%

50%

59%

61%

% Skilled birth attendance % Facility Delivery

Interventions for Maternal Health In Cambodia

• Peace, growth, education • Roads, phones• Health centers, midwives

• Removing financial barriers: - Health equity funds - Live birth incentive ($15-HC, $10 RH)

Saving mothers’ lives _ Experiences from

Cambodia

Secondary midwife at HC

Leaves her cell phone numberResides close, can be reached

The Midwife is available around the clock, all week

Saving mothers’ lives _ Experiences from

Cambodia

2009 May 2011 Dec0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

17%

71%

50% AMTSL, % of birthsMgSO4, % of hospitals

AMTSL and MgSO4 use 2009 and 2011

2009: 141 births in 31 hospitals, 2011: 61 births in 16 hospitalsSaving mothers’ lives _ Experiences from

Cambodia

Baselines 2009 BHS PY2 ( Oct 2010) BHS PY3 (March 2011)0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

17%

84%

97%8%

6%

Correct Use of AMTSL in 9 USAID/BHS-supported HospitalsMarch 2011 (Partograph Review of 2657 Delivery Cases)

Correct Use of AMTSL Vaginal Bleeding >300 ml

AMTSL improvement and bleeding

Saving mothers’ lives _ Experiences from

Cambodia

Source: CDHS, UN

1980 1985 1990 1995 2000 2005 20100

1

2

3

4

5

6

7

8

9

10

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

TFR CPR

Birth per woman (TFR) vs. Contraceptive prevalence

Saving mothers’ lives _ Experiences from

Cambodia

1990 1995 2000 2005 20100

100

200

300

400

500

600

700

800

0

100

200

300

400

500

600

700

800690

640

432

472

206

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

Maternal Mortality Ratio in Cambodia

Saving mothers’ lives _ Experiences from

Cambodia

Factors Leading to Success: “It takes a village”

• Government Commitment

• “The Fast Track Initiative Roadmap for Reducing Maternal and Newborn Mortality”

• Community Leadership

• Partnerships with donors and other stakeholders

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

Challenges

Saving mothers’ lives _ Experiences from

Cambodia

Saving mothers’ lives _ Experiences from

Cambodia

Thank you very much for your attention!