Cambodia has one of the highest maternal mortality rates in Southeast Asia. The number of women dying during pregnancy or childbirth has dropped in recent years. But it is still far short of the United Nations' Millennium Development Goals. The Cambodian government accepted those goals as part of its effort to help pregnant women.
Years ago, UN member nations and international agencies agreed on a plan of action in eight areas, including maternal health. They set the end of 2015 as a target date for reaching the goals.
More than 1,000 Cambodian women die each year during pregnancy or childbirth. That is down almost 50 percent compared to the number 15 years ago. However, it still is short of the Millennium Development Goals.
In Cambodia, the maternal mortality rate is 170 deaths for every 100,000 live births. At first, the government set a goal of 140 for every 100,000, but its target was later amended. The new target is 250 deaths for 100,000 live births, explained Tung Raththavy. She directs the Ministry of Health's National Maternal and Child Health Center. She said that is what the UN goals require -- to reduce to two-thirds of the deaths in 1990. Twenty-five years ago, Tung Raththavy explained, Cambodia had 900 deaths for 100,000 live births.
The UN Children's Fund, UNICEF, says many Cambodian mothers die during childbirth because they lack medical care, mainly in emergencies. There is a lack of trained medical workers across the country. In a recent report, UNICEF said that "even when mothers can access healthcare, overall quality of care is deficient." It said that makes for more challenges women face in overcoming possible health problems, both during and after childbirth.
Ke Sovannaroth is head of the Cambodian National Assembly's committee on health and women's affairs. She said the government needs to do more to help women during pregnancy and childbirth. The mortality rate for Cambodian women is higher than Thailand's rate of 48 or Vietnam's rate of 59. Only Laos received a lower rating -- with 470 deaths per 100,000 live births.
Cambodia has increased the number of skilled medical workers assisting in childbirth. Tung Raththavy noted that the country also has doubled the number of health centers over the past 10 years.
Tung Raththavy said Cambodian officials have plans to expand health care in the future, "to bring services closer to the people, especially women and children." She said that the country needs skilled health care workers, including midwives. "We still need more skilled midwives to do this work in these places, where we are still lacking," she said. "We won't stop. We have been working a lot to increase resources, especially skilled birth attendants."
Another area of improvement is a reduction in patients with anemia and iron deficiency. Tung Raththavy said that her country has reduced the level of severe anemia to lower than one percent. "We have been working hard on this," she added.
The government says that during pregnancy, poor women do not have to pay for health care services. But Ke Sovannaroth said she has received reports that pregnant women still have to pay for those services. "We have found that women died from childbirth due to the neglect of their doctors," she said. "But we do not see the government punish those who have done wrong."
Health officials have reported more success with expectant mothers at the national level. But women who live far from major cities still have higher maternal mortality rates than the national average.
The Cambodian Millennium Development Goals Report 2014 says only 75 percent of women giving birth in remote provinces had help from trained health workers in 2012.
I'm Anne Ball.