Building trust and saving lives
For decades, community outreach has helped rural families overcome their fear of health workers. Today, more babies and mothers survive and thrive thanks to maternal and child health education
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23 April 2025, Kratie – Chhneang Lina, a midwife working in rural Kratie province, remembers a time when many of the communities around her health centre didn’t trust health workers.
“Their understanding was very limited,” she recalls. “They were afraid.”
Health workers were seen as strangers among the tight-knit rural communities, she explains, where entire lives are lived alongside your neighbours and the nearest health centre is many kilometres from home. For ethnic minority populations, cultural and language barriers proved additional challenges.
“They were even more scared,” says Lina.
Back in 2000, only 10 per cent of women in Cambodia chose to give birth in a health facility, and many pregnant women would miss their pre- or post-natal checkups.1 Without essential information usually provided through the health centre, pregnant women also risked serious harm to themselves and their unborn babies if they weren’t able to spot danger signs that require urgent medical attention. Many communities relied on traditional healers and birth attendants, even though they knew these services were available to them at the health centre, where they would only go if they were seriously ill.
But times and perceptions are changing. Today, a group of mothers, fathers and caregivers have eagerly gathered at a neighbour’s house to attend a parenting class led by the nurses and midwives from Sambok Health Centre. Supported by UNICEF, the session is part of the health centre’s regular community outreach, which brings education on maternal and child health and nutrition directly to rural villages around the district.
“After they attend the outreach, I see a lot of change,” says Lina. “They feel more comfortable with health workers. They’re not afraid anymore. Next time, when they have an issue with their health, it’s easier for them to seek support.”
In Cambodia, the number of people seeking health services has improved dramatically over the past decades. Efforts to educate remote communities on maternal and child health and nutrition have empowered more pregnant women to give birth in health facilities and attend their pre- and post-natal checkups, leading to safer deliveries and saving the lives of mothers and their babies. In 2021, the proportion of women giving birth in a health facility reached an impressive 98 per cent.
Thanks to health education, more caregivers also understand the importance of eating nutritious food during pregnancy, the benefits of breastfeeding, and how appropriate infant and young child feeding practices help their children thrive. This increased awareness has helped reduce stunting – a condition which refers to impaired growth and development caused by undernutrition during pregnancy – among children under 5 from 34 per cent in 2014 to 22 per cent in 2021.
But despite decades of progress, not every child gets the chance to grow healthy and strong, and not every mother gets the support they need to take care of their own health. The number of women dying due to complications during labour or pregnancy remains high at 154/100,000 live births. And despite dramatic decreases in neonatal, infant and under-five mortality rates in the past two decades, newborn deaths still make up almost half of deaths of children under 5. While stunting has reduced, the prevalence of wasting – an acute condition that occurs when a child does not eat enough nutritious food – has remained stagnant at 10 per cent.2
With funding from the China International Development Cooperation Agency (CIDCA) and the Australian Government through the Australian NGO Cooperation Program (ANCP), UNICEF continues to support the Ministry of Health to empower caregivers with health education, encourage health seeking behaviours, and build trust in the health system. By creating comfortable, relaxed spaces for communities to gather and learn closer to home, the outreach aims to reach more mothers with information on how to prepare themselves for delivery, how to take care of themselves and their newborns after birth, while also encouraging fathers to learn about child health and nutrition. In 2024 alone, more than 35,000 caregivers attended UNICEF-supported parenting classes across five target provinces.
Before she had her first child, mother-of-three Tuoch Navy admits she used to fear health workers, too. But now she never misses a chance to be a better parent.
“I feel less afraid now,” she says. “When I met the health worker, I felt more comfortable because they explained everything I needed to know. Before I met them, I thought they would speak harshly. But now I can see that they are actually very polite.”
She’s been learning about the most nutritious food to help her now two-year-old grow strong, that breastfeeding as opposed to milk powders offers optimal nutrition, and that she needs to take care of her own diet while breastfeeding. The sessions also provide essential information on danger signs during pregnancy, labour, and after delivery, the importance of exclusive breastfeeding until six months, complementary child feeding after six months, and routine vaccination, among other topics.
“I really want to learn about how to take care of myself, my baby and my husband, so I come every time anyone organises an information session,” she says. “I always practice what I’m taught, and I deliver the message to other mothers and my neighbours.”
1 Cambodia Demographic and Health Survey (CDHS), 2000
2 CDHS, 2014; CHDS, 2021–22
