IMPROVING HEALTH OUTCOMES AND ACCESS TO HEALTH SERVICES

50% reduction in child malnutrition since 2011

57% less cases of severe acute malnutrion in children under 5*

25% less cases of moderate acute malnutrition in children under 5*

56,000 children have received weight monitoring since 2009

OUR

APPROACH

Health and sanitary conditions in Cambodia are still an ongoing matter of concern. In rural Siem Reap Province, infant and child mortality rates are 5 and 6% above national averages, impacted by low immunisation rates, and a lack of access to antenatal care or professionally assisted births. Children in Siem Reap Province display one of the highest rates of child malnutrition in Cambodia. Our goals are: to reduce malnutrition in children under the age of 5, to increase vaccination rates for under one, and to improve basic community health practices. TGF also focuses on health education in the areas of maternal and newborn health, as well as hygiene and sanitation behaviours. We work with village health volunteers (known locally as VHSGs) and local public health officers to implement Health Programme activities, so that they can eventually become sustainable health resources for their communities.

VILLAGE HEALTH SUPPORT GROUPS

Central to the Ministry of Health’s mission to improve healthcare services and delivery in rural Cambodia is the development and support of Village Health Support Groups (VHSGs). These groups of 2 (or more) community volunteers act as a vital bridge between the community and health system.  TGF staff and district health officials, supported through our Health Programme, provide technical training, resources and vital travel allowances to 118 village health volunteers that cover 59 villages in Chi Kraeng district. Village health volunteers are critical in delivering key health messaging to rural people, collecting local data on community health and additional human resources to Health Centres, improving the ability of the health system to deliver services effectively in the community. VHSGs are also key to TGFs work in Chi Kraeng providing assistance in conducting our biannual Health Assessment and supporting our work across the various programmes and projects TGF implements.

HEALTH EDUCATION FOR PREGNANT WOMEN AND NEW MOTHERS

TGF works to support the Ministry of Health’s goal of improving the availability and quality of skilled care for mothers and their newborns; and ensuring these services reach the most in need. TGF provides funding for VHSGs to conduct various activities in their villages, including providing health education to key target groups such as pregnant women and new mothers. Equipped with pictures, diagrams and the neccessary skills, volunteers counsel women on what they can expect during their pregnancy, what precautions should be taken and how to prepare for the birth; including advocating for delivery in a health facility by trained healthcare workers. The volunteers also provide essential information after delivery. During group sessions, they provide key health and nutrition messages, conduct regular monitoring of newborns and refer them, if necessary, to the local health centre.

MALNUTRITION SCREENING

Ten percent of Cambodian children under the age of 5 are acutely malnourished, 32 percent are considered stunted and 24 percent are underweight (*CDHS 2015) contributing to an estimated 4,500 deaths attributed to malnutrition in 2014. TGF works with the Ministry of Health’s, National Nutrition Programme (NNP) to implement Community-based Management of Acute Malnutrition (CMAM). CMAM is a proven approach to manage Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM) in children under 5 and is currently implemented in more than 70 countries. TGF facilitates training to VHSGs, health system staff and local authorities in the implementation of CMAM, as well as funding costs and providing resources to implememt activities in Chi Kraeng district. This includes malnutrition screening for all children under 5, delivering health messaging on nutrition, and supporting home based management of malnutrition children with SAM by village health volunteers.

REHABILITATION & NUTRITION EDUCATION

Another key component of Community-based Management of Acute Malnutrition (CMAM) is home based management and monitoring of children with Severe Acute Malnutrition (SAM). TGF Health Programme staff support VHSGs and Health Centre staff to conduct home visits to all children presenting with signs of acute malnutrition. During these home visits parents are provided with a Ready-to-Use Theraputic Food (RUTF) to immediately provide increased nutrition to their child. Parents are also advised on key aspects of child nutrition and how to cook nutritious food with low cost, easily available local products. Regular monitoring of weight gain continues until the child’s weight improves or, if no significant weight gain is achieved and/or the child has additional complications, they are referred for inpatient treatment at the local referral hospital.

EXPANDED PROGRAMME OF IMMUNISATION

The Expanded Programme of Immunisation (EPI) is a WHO programme initiated in 1974 with the objective to vaccinate children throughout the world. First developed to target diphtheria, whooping cough, tetanus, measles, poliomyelitis and tuberculosis, the Cambodian EPI programme now consists of vaccinations to prevent 11 childhood illnesses. In addition, vitamin A supplimentation and anti-parasite medication are provided to all children under 5, as well as Tetanus vaccination to all women of child bearing age and Iron and vitamin A suppliments for post-natal mothers. Supporting the Ministry of Health’s delivery of EPI, TGF provides funds for Health Centre staff to conduct monthly outreach work to implement EPI in remote rural villages; in cooperation with VHSGs. EPI reach and numbers of children fully immunised are monitored by TGF staff and reported to the Ministry of Health.

 

COMMUNITY HYGIENE & SANITATION

An estimated 801,000 children under 5 years old, die from diarrhoea each year, mostly in developing countries. This is around 11% of the 7.6 million deaths of children under 5 (WHO/UNICEF; 2012). Unsafe drinking water, inadequate availability of water for hygiene, and lack of access to sanitation together contribute to about 88% of these deaths. The World Bank estimated that poor sanitation in Cambodia has led to economic losses of US$448 million per year, equivalent to 7.2% of Cambodia’s GDP in 2005. TGF trained and resourced village health volunteers, in cooperation with both TGFs Health and Water Sanitation Programme provide every village with 4 workshops each year highlighting the importance of good sanitation and hygiene practices. They assist Community Assistants (CAs) supported by TGF to complete village WATSAN surveys to monitor changes in community behaviour and practices; as well as track access to improved sanitation facilities and hygienic water supplies.

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