Joint Annual Performance Review 2007 - Ministry of Health

challenges certainly remain, for example in ensuring the nutritional status of children after
weaning, and of adult women, and in the adequate availability of micronutrients.
But overall child survival efforts appear to be bearing fruit. The Cambodia Child Survival
Strategy should be officially disseminated this month. A major costing exercise has been
undertaken, which can sharpen the resource focus on scorecard interventions.
These significant achievements are supported by and consistent with the average 6-7% socioeconomic
growth in Cambodia until 2004, which increased to 13.5% in 2005 and is estimated
at almost 10% for 2006.
But of course not every effort has yet proven successful. The preliminary information of the
CDHS 2005 also indicates no significant change of the Maternal Mortality Ratio compared to
the previous CDHS in 2000. This impact indicator is difficult to measure, and reliable
adjustments are reflected only if a major change in the actual number of maternal deaths
occurs. In addition, it is an indicator less sensitive to socioeconomic changes than are the
Infant Mortality Rate and the Total Fertility Rate, and more dependent on a wider variety of
factors within and outside the health sector. Thus reducing the MMR requires attention to a
broad range of challenges in the health and other sectors, as reflected in the overall status of
health care systems and in the supporting environment.
The Ministry of Health focused preparations for this JAPR by identifying in more detail the
bottlenecks to progress in improving reproductive, maternal, newborn, and child health, and
in the continuum of care for mothers and children, and what would be required to remove
these bottlenecks. A pertinent one was reinforced by the midwifery review in late 2006: the
need for more and better skilled midwives in remote areas. The government has taken an
essential step to improve the payment of midwives to facilitate their deployment. Some donor
agencies are providing support through new initiatives for safe motherhood; others are
working to ensure that mothers and children have access to quality health services, and to
meeting basic needs for healthy life. But more is needed if the success in fighting HIV/AIDS,
is to be matched. Besides additional donor funding, an increased government allocation to the
health sector needs to complement these initiatives to ensure sustained outcomes.
The Ministry of Health’s focus on maternal and child health is a priority shared and endorsed
by health partners. Improved maternal and child health and a continuum of care includes
convincing mothers to use regular antenatal care, to deliver their babies with a skilled birth
attendant who can refer to a hospital in case of problems, and to protect themselves and their
children through vaccination and well baby clinics.
Even more fundamentally, this requires attention to the basic needs of all people – for an
adequate supply of clean water and nutritious food, good sanitation, proper housing, personal
security and the protection of human rights, and equity of access to health services and
education. These are goals which we all share.
I wish you much success these coming days in analysing the progress of the health sector
during the past year and in determining the priorities for the Annual Operational Plan 2008.
Thank you.
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