The number of women giving birth at public health facilities more than doubled between 2005 and 2009, data released on Wednesday showed. Facility-based deliveries increased from 21.5 percent in a 2005 survey to 46.3 percent in a 2009 survey.
“There was a significant improvement in the deliveries assisted by skilled birth attendants in general and health facility based deliveries in particular,” said Viorica Berdaga , chief of Unicef’s Child Survival and Development program. The improvements are attributed to government efforts to tackle a lack of accessibility and quality of maternal health services, which contribute to high mortality in Cambodia, Ms Berdaga said.
Cambodia has the highest maternal mortality in the region, according to Unicef, which estimated 1,200 to 2,200 women dying before, while and after giving birth each year.
The statistics on delivery come from the 2005 Cambodia Demographic and Health Survey and the 2009 Cambodia Socio-Economics Survey released yesterday by the Planning Ministry’s National Institute of Statistics.
However, large gaps remain between access to facilities in rural and urban areas.
In rural areas the proportion of home deliveries dropped from 82.9 percent in 2005 to 60.5 percent in 2009 while in Phnom Penh home deliveries declined from 21.6 percent to 8.5 percent. Also deliveries attended by traditional birth attendants in rural areas decreased from 59.5 percent to 33.1 percent yet fell from 14 percent to 1.7 percent in Phnom Penh.
High inequalities continue because there are fewer rural services, which are harder for poor women in particular to reach, Ms Berdaga said. “The inadequate quality of obstetric services due to a lack of qualified midwives is another important barrier.”
A UNDP report released last month stated that Cambodia remained “off track” in its efforts to improve maternal health, one of nine UN Millenium Development Goals the country is trying to meet by 2015.
Pascale Hancart Petitet, researcher and social anthropologist at Amsterdam University and Pasteur Institute, said that recent donor commitment to combat maternal mortality explained why more births occurred at facilities.
Nevertheless many rural women cannot afford or get to places where they can deliver safely, Ms Hancart Petitet said. Also “the reluctance of midwives to work in rural areas is a very big problem,” she said, noting that traditional attendants do not have the knowledge or means to deal with obstetrical emergencies.