Efforts To Stem Child Mortality Undermined

Despite efforts to reduce Cam­bodia’s infant mortality rate, health experts this week predicted the rate of infant deaths will continue to rise due to widespread poverty and lack of public health resources.

According to the Ministry of Health’s last Cambodian Dem­ographic Health Survey 2000, about 124 out of 1,000 infants under the age of 5 died that year. But officials from Medicam, an umbrella organization for health-related NGOs in Cambodia, said they anticipate the ministry’s next report due in 2006 to show a higher rate of child deaths.

“The infant child mortality rate will probably increase or [be] stagnant, due to the fact that within the past few years, there was less and less resources that have been invested in child health by [the] donors’ community,” Med­icam Executive Director Dr Sin Somuny said.

“The child survival program is 25 times less than the money for HIV/AIDS,” he said.

Last year, the US Agency for International Development, one of the biggest donors to health care in Cambodia, gave $2.4 million, and donated $4 million this year to the child survival programs of various NGOs working with the Ministry of Health, including Reproductive and Child Health Alliance and World Vision, a USAID official said.

In comparison, USAID gave $13.3 million for HIV/AIDS programs in 2003 and the same amount this year, the official said.

At a conference on child health hosted by Medicam this week, doctors and health experts said one of the main contributing factors to child mortality is the high cost of delivering a baby at public hospitals and clinics.

Though public hospitals do not charge fees to poor pregnant women, many are required to pay between 5,000 riel and 30,000 riel (about $1.25 and $7.50) for a hospital bed and services, said Dr Bun Mao, program health officer for Voluntary Service Overseas.

Dr Tung Rathavy, acting program manager for national reproductive health at the Ministry of Health, admitted that public hospitals do charge basic fees. But if patients are really poor, the fees are waived, she said.

Still, hospital fees—and travel costs of getting to hospital from remote areas—cause many wo­men to opt for home deliveries, helped by often-untrained traditional birth attendants.

Dr Koum Kanal, director of the Health Ministry’s National Child Health Center blamed the child mortality problem on the lack of coordination among the NGO community with the ministry.

“The donors should pressure NGOs to better coordinate and align with the Ministry of Health strategy,” he said. “To decrease child morality rate, we need to have clear strategies first.”


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