Health and Nutrition

Situation

Maternal, newborn and child health services

Nutrition

 

Situation

Situation
© UNICEF Cambodia/Nicolas Axelrod

Between 2000 and 2010, Cambodia has made significant progress in improving the health of its children. The infant mortality rate has declined from 95 to 45 deaths per 1,000 live births, setting Cambodia on track to reach its Millennium Development Goal 4 to reduce child mortality.

Progress has been attributed to successful immunization programmes and breastfeeding promotion, and factors such as poverty reduction, improved education and better roads. Nevertheless, child mortality levels in Cambodia remain high by regional standards. Every day, an estimated 50 children under five die, mainly because of preventable and treatable diseases, such as diarrhoea and pneumonia. A further decline in child mortality will largely depend on the country’s ability to address newborn survival and accelerate coverage of pneumonia and diarrhoea related interventions.

Despite dramatic reductions over the last five years, Cambodia’s maternal mortality ratio remains high at 206 deaths per 100,000 live births. This means an estimated 1,700 mothers die unnecessarily every year, which negatively impacts families, communities and particularly children whose mothers die.

Malnutrition remains a significant problem in Cambodia and is a cause in approximately one third of child deaths. In the past five years, the number of children suffering from chronic malnutrition has decreased only slightly and the number suffering from acute malnutrition may have increased. Major drivers of poor nutrition in young children are inadequate complementary feeding practices, poor hygiene and high prevalence of diseases, including diarrhoea. High food prices that have persisted since the 2008 food price crisis have contributed to slowing down progress in the area of nutrition.

Situation
© UNICEF Cambodia/Nicolas Axelrod

Micronutrient deficiencies remain widespread. Anaemia is common among children under five, with a prevalence of more than 80 per cent among children under two. It also affects a significant percentage of pregnant women. However, iodine deficiency in children, which impedes mental development, is no longer considered a major threat as a result of improved accessibility of iodized salt and public awareness campaigns.

Immunization against deadly infections is reaching more children, especially in remote areas. Child immunization rates are routinely above 90 per cent, but less than half of children receive other preventive services such as deworming and vitamin A supplementation.

Among the key factors leading to poor health and nutrition in Cambodian children are inadequate accessibility, quality and utilization of health services, as well as poor health and nutrition practices in families. There is a widespread shortage of skilled health personnel, particularly midwives; insufficient supply of some essential drugs and equipment; and weak communication and referral among various levels of care, including inadequate linkages between communities and health facilities.

Inequities in health and nutrition outcomes and in health care utilization continue to persist between rural and urban areas, across provinces and between people with different educational levels and economic status. Despite reductions, poverty remains one of the most important underlying causes of high maternal and child mortality and undernutrition. One in three Cambodians still lives below the poverty line and 20 per cent of Cambodians cannot afford enough food.

Poverty leads to a lack of materials and knowledge for proper sanitation and hygiene, causing Cambodian children to still suffer from high rates of infectious diseases such as diarrhoea and pneumonia. Poverty is also an important barrier to other more direct causes of mortality: proper nutrition and health care. Tackling poverty and reducing financial barriers to health care require new approaches and different strategies to help save children’s lives.

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Key partnerships

UNICEF works closely with the government to support the Second Health Sector Support Programme. Our main government partners in this area are:
• Ministry of Health
• Council for Agriculture and Rural Development

UNICEF contributes to national coordination efforts through its participation in the Technical Working Group for Health, led by the Ministry of Health and co-facilitated by the World Health Organization, and the Technical Working Group for Food Security and Nutrition, led by the Council for Agriculture and Rural Development, cofacilitated by the World Food Programme.

Other key partners include Agence Française de Développement, AusAID, BASICS, Belgian Technical Cooperation, UNFPA, USAID, WFP, World Bank and WHO.


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