Experts Say Country Badly Needs Midwives

Despite government attempts to reduce maternal mortality rates by deploying more midwives and skilled birth attendants in rural areas, Cambodia is still far from reaching its goal, officials and experts said Wednesday.

Cambodia’s 3,300 trained midwives are too few to attend to the almost 370,000 births in the country each year, said Dr Keth Ly Sotha, training unit manager and deputy director of the National Maternal Child Health Center, who was speaking in Phnom Penh at a two-day forum on midwives.

Quoting numbers from the Ministry of Health, Dr Sotha said that about 53 percent of births are attended only by so-called traditional birth attendants, who have little or no medical experience.

“Attendance by skilled professionals is weak in Cambodia,” he told the forum, adding that training more midwives will take several years and that the government now should try to increase the performance of existing midwives if they want to see results.

With about four women dying in childbirth every day, according to the World Health Organization, Cambodia has the third highest maternal death rate in Southeast Asia, with only Laos and East Timor faring worse.

As those figures are based on 2005 figures, it is unclear if efforts already made by the government have had an impact, and a new health census will not be conducted until 2010.

More recent statistics from the WHO show that Cambodia has a critical shortage of health service providers, including doctors and midwives, with only one medically trained professional per 1,000 people, compared with three in Thailand and 10 in Japan.

Unicef representative Richard Bridle said that the government has prioritized education of midwives, but other areas also need improvement.

In order to dramatically reduce the maternal mortality rate there needs to be more equipment and skilled staff at referral hospitals, and emergency care should be completely free to prevent people dying while waiting for treatment, he said.

“There are still capacity gaps in the referral hospitals…[and] when people need emergency care they have to pay,” Mr Bridle said.

“Its an emergency, don’t fix the money first, fix the emergency,” he said.

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