Cambodia: Resilience and Nutrition Security
Cambodia has made great improvement in decreasing child and maternal mortality ratio, and has enhanced health care for new mothers and their newborns. Yet, the mortality rate still remains the highest in the region. We work in four provinces across rural and urban areas, in more than 30 health centres and with more than 90 obstetricians and 50 health care professionals. Thus we are able to help thousands of people.
We provide midwives and health care staff with quality trainings. Recently, we have launched an innovative programme using mobile technology. Registered mothers receive voice messages with information about baby care on a regular basis.
Disaster Reduction and Early Warning (DREW)
Many households in rural areas of Cambodia still do not have access to adequate and improved sanitation, which can lead to health problems for children and vulnerable people through ingesting contaminated food and water. An estimated 34% of children under-5 years old are stunted. In 2015, an estimated 40% of people in Cambodia still practiced ‘open defecation’, which is primarily due to a lack of adequate sanitation facilities.
The project aims to promote the use of latrines and increase the number of ‘Open Defecation Free’ villages within the rural target area. The SanMark approach aims to facilitate and enable local markets of sanitation products through both creating demand to purchase latrines among households, while also teaching businesses how to construct latrines. Household demand is promoted through a health education approach in target villages.
PIN is focusing on increasing the sustainability of the market for sanitation products through capacity building of local sanitation businesses. PIN’s support for local business includes components such as entrepreneurial training, book keeping, and marketing in surrounding villages.
Disaster Resilience and Water Management
Building Disaster Resilient Communities IV
Tepmachcha Scale Up
During this project, PIN’s Disaster Management and Innovations Teams were able to increase the coverage of the flood detection to 4 further provinces (from the original 2 in 2016) and therefore contributed to improving extreme weather resilience for more than 40,000+ people in the designated areas.
Changes to water systems in Cambodia are expected to increase the rate and severity of flooding and drought, which will significantly impact public health, especially in vulnerable populations. Flooding can cause the spread of pathogens and contamination to water sources, whereas drought can impact hygiene practices. Cambodia’s vulnerability to climate change is due to the fact that 80% of the country is within the Mekong River Basin, which experiences large fluctuations of water levels between the wet and dry seasons. Additionally, Cambodia is ranked 165th in the world for access to improved water, with huge economic and geographic disparities.
PIN’s report determined that flooding and drought cause significant impacts to livelihoods, primarily through reduced agricultural output (including causing livestock deaths). Droughts also affect hygiene practices, while flooding pollutes potable water supplies by overwhelming waste management systems. Both flooding and drought led to increased rates of open defecation, either from the flooding of latrines or a lack of water for flushing.
Nonetheless, PIN determined that implementing WASH systems could inoculate people from the risks caused by flooding and drought. The report also identified methods of practical improvements in resilience for community- and household-based WASH infrastructure.
Improvement of health care access in Takeo
In Takeo Province, People in Need has improved healthcare access and community infrastructure by building 3 health centres, and PIN also donated medical equipment for training HC staff in specialized eye care, diagnosis and treatment. Additionally, one primary school was refurbished in Takeo in (3rd quarter of) 2015, ensuring safe and suitable conditions for children to attend school.
Access to health care, safe water and sanitation for displaced communities in Koh Kong province
Disaster Resilience through Improve Education and Livelihoods
Koh Kong is a remote province located near the Thai border between the Cardamom Mountains and the Sea of Thailand. Climate change impacts, especially irregular rainfall patterns, increased rainfall intensity, and dry-season drought, are having negative impacts on the sustainability of livelihoods in the coastal communities’. This, combined with the effects of destructive livelihood practices including over-fishing, and significant mangrove and rainforest deforestation, the level of vulnerability to the effects of natural hazard for the people living in Koh Kong is one of the highest in Cambodia.
The Disaster Resilience through Improved Education and Livelihoods (DRIEL) project works directly with communities in Koh Kong to improve their understanding of and resilience to environmental hazards and disasters and a changing climate. Starting in 2014 and going through 2018 the DRIEL project aims to impact nearly 40,000 people living in 46 coastal villages of Koh Kong province. Our approach is two pronged; our partner Save the Children works directly through the education system, building on the demonstrated capacity of school children to be potent agents of change in family and communities regarding livelihoods, environment, DRR planning, and other life-skill dimensions, while People in Need works directly with community members and local authorities simultaneously, to give them the basic tools and techniques they need to build concepts of resilience into their community structures and livelihoods.
Improving the quality of mother and child health through sustainability of mHealth programming and content adaptation
As part of the project, we have been training clinicians in clinical skills or nutrition education in communities to prevent acute malnutrition of children. Thanks to the project, we have also expanded our innovative messaging system (mHealth), which provides services to families to improve neonatal health.
Healthy Family Community (mHealth)
Beginning in Kampong Chhnang Province in 2013, the Healthy Family Community project uses mobile phone technology to deliver health messages regarding maternal and child health. Mothers and pregnant women who have registered receive automatic prerecorded voice messages to their phone which are designed to improve health behaviours and increase health service demand. These messages provide information and advice on a range of topics, such as avoiding harmful traditional health practices, and improving nutrition of the mother and baby.
The first program implemented in Kampong Chhnang delivered messages for the first 28 days of the baby’s life. As a result of our mHealth programme in 2014: 64% fewer mothers used traditional remedies to treat their baby’s cord stump; 48% fewer mothers consumed alcohol after birth; Twice the number of mothers could recognise danger signs in their baby; Admissions of children to health centres increased by more than 2.6 times.
Due its popularity and success, a new expanded service will deliver messages for the first 1,000 days of life, spanning from pregnancy until a child’s 2nd birthday. This is known as the window of opportunity, whereby better nutrition can have a life-changing impact on a child's future and help break the cycle of poverty.
Recently we receive funding from UNICEF for expanding mHealth activities to Kratie province and have since begun training midwives on the First 1000 days, Healthy Family Community programme.
You can download more information here and here
Water, Sanitation and Hygiene (WASH)
Integral to its the community health promotion activities, PIN promotes healthy hygiene practices both within health centres and in the community. Together with social enterprise Wetlands Works!, PIN supported the pilot project of innovative flood proof latrines in a peri-urban community that is subject to annual flooding. In addition, PIN has partnered with Urban Poor Women Development (UPWD) to assess and improve the level of knowledge and awareness of hygiene practices within the impoverished communities of Phnom Penh. We have tailored lessons for community outreach based on our assessment of the knowledge, attitudes and practices of families within the community, in order to deliver the most relevant information to those who need it most.
PIN works to improve access and standards of health infrastructure in rural and disadvantaged communities. This has included construction and renovation of health centres, postnatal rooms and WASH. In the province of Koh Kong, we have constructed a health centre in a remote, hard-to-access area where people were forced to relocate from their homes and communities due to economic development. Previously, these communities had no choice but to travel long distances to access health care, and now approximately 1500 households will receive convenient healthcare as a result of this new centre.
Moreover we have a partnership with RWC (Rainwater Cambodia) in Koh Kong for implementing a subsidized water jars and latrines project. This has been supplemented by CLTS (Community Led Total Sanitation) activities promoting handwashing and safe water use.
Newborn care and nutrition
People in Need provides quality training to improve the level of care focused on midwives and the staff of health centres. Training specializes in various areas such as resuscitation of newborn babies and infection control. In addition, PIN trained and supported health centres in the promotion of health care at community level. It focuses on the problems associated with breastfeeding and complementary feeding, holds cooking classes and demonstrations by mothers teach how their families prepare simple and nutritious meals.
In 2016 specialised training has taken place for health centre staff across two operation districts in Kampong Chhnang. Following that training, Post-Partum Hemorrhage and Anti-Shock garments (NASG) were donated to the HCs.