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Indigenous women working towards improved maternal health: Ratanakiri Province, Cambodia
– Reported, July 26 2014
The Health Unlimited programme in Ratanakiri Province, Cambodia has been running for 14 years and employs over 65 local staff (including staff from indigenous groups), funded by various donors. The programme supports more than 100,000 poor and vulnerable indigenous people throughout the province on issues including: Maternal and child health Support and supervision of health centre staff in the provision of outreach services
HIV/AIDS, STIs and sexual and reproductive health Support to Village Health Support Groups and Health Centre Management Committees
Malaria, Water and sanitation.
Traditional Birth Assistants (TBAs) usually learn their skills from the experience of older TBAs in the village. They are often told in a dream or selected by their community to perform the role. TBAs assist in the delivery, but also provide advice on what foods are taboo. Donor programmes have supported training for TBAs to encourage healthy eating and dissuade against the common practice of pressing on the woman’s abdomen to push the baby out during delivery.
A major barrier to accessing treatment is that care is not guaranteed for the patient even if they have managed to make the journey to the health centre/referral hospital. Several factors quoted were the doctor won’t treat if you don’t have money – they blame you instead, when you arrive, there are no staff working and no medicine. These factors clearly describe some of the systemic failures of the health system in Ratanakiri. The research revealed that health staff often refuse to treat patients who have no money, or require them to buy drugs in private pharmacies (often run by health staff or their families). They also do not work regular hours and will not accept patients outside of those working hours.
Perceptions of Ante Natal Care (ANC)
Seeking ANC was often a response to problems during pregnancy (such as lack of foetal movement) rather than planned access. ANC is supposed to be provided in the villages by health centre midwives, but there are persistent problems in getting midwives to go to villages on a regular basis. The study indicated that only 20 percent of women had accessed
ANC in the health centres and only 10 percent of women were able to access ANC from visiting midwives (Mackay, 2002).
CREDITS:
http://www.eldis.org/
