Cambodia is one of the poorest countries in South East Asia with a high rate of maternal mortality. Every year, nearly 2,100 women and adolescent girls die from complications from pregnancy, childbirth and induced abortion and a further 80,000 suffer associated injuries such as prolapse of the womb, infection leading to infertility and chronic pain. Many pregnancies are unwanted and more than a third of women who die from pregnancy related causes die from unsafe abortions. The Reduction in Maternal Mortality Project (RMMP) is worked alongside the Government's Health Sector Support Programme, a large scale, multi-million dollar scheme to rebuild the country's severely damaged health system. RMMP is helped to reduce maternal mortality rates by increasing the poor's access to affordable maternal health services, with a focus on improving access to safe abortion care and long term contraceptive methods.

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Women in Cambodia face many obstacles to high quality reproductive health care. They often cannot afford to access the right health services because of the high cost of transport and expensive hospital services fees. There are cultural issues as well: many women are still undergoing terminations carried out by unskilled health providers, unaware that abortion was legalised in 1997. Most significantly the availability of abortion care delivered by skilled and equipped providers is very low.

RMMP ran from 2006--2010 and addressed some of those problems. We worked with the Government of Cambodia to train health providers and ensure health facilities were properly equipped to improve access to high quality services. In addition the project worked closely with local and national officials and health professionals to raise awareness about the legality of abortion and ensure that at all levels individuals working within the system understand their obligations with respect to this legal right and do not create unnecessary barriers to access.

We also worked with women and communities to increase awareness about the legality of abortion and improve knowledge of services and obligations of those services to provide a high quality and confidential service. In this work we aimed to identify and reduce any real or perceived barriers to accessing reproductive health services (including financial barriers). Improving knowledge about new services and changing attitudes was crucial to the success of RMMP. TV, radio, newspapers and magazines put out messages to advocate safer maternal health to a wide audience while video documentaries highlight the problem of unsafe abortions. RMMP also promoted better research, monitoring and evaluation of services.

 

RMMP was funded by the UK Department for International Development (DFID) and works in partnership with Ipas, leaders in improving access to safe abortion services and Marie Stopes Cambodia who are supported the design and delivery of training in long term contraceptive methods.