Services for the Health in Asian ＆ African Regions (SHARE) = SHARE is a citizen sector organization (NGO) that engages in international cooperation mainly through providing health service.
Previously SHARE worked in a province called Prey Veng, which is about halfway to Vietnam from Phnom Penh. In 2008, Prey Veng was one of the poorest provinces and so too was its health indices. Beginning with one district, Svay Anthor, SHARE conducted a maternal child health program in 5 health centers and its 79 villages in Prey Veng. This program had three phases. During the first phase, we tried to improve both maternal and child health by strengthening the community level health system. We did so by intervening and facilitating community level networks, building the relationships and coordinating work with the health center staff and their *(1)Village Health Volunteers. Additionally, we introduced new and improved management skills, developing the capacity of the health center personnel and the volunteers. Finally, to improve rural maternal and child health, health services needed to be upgraded and broadened so that villagers could access some clinical services that were not available before. So, SHARE also contributed to the construction of two health center buildings.
Photo (left) A mother holds her baby while she receives a vaccination during a general monitoring session supported by SHARE.
Photo (center) SHARE staff attend a government meeting on child nutrition and health in Kuleaen district.
Photo (right) A village volunteer provides health education on child nutrition to new mothers at a general monitoring supported by SHARE.
In continuation of the maternal and child health improvement project, during our second phase, SHARE promoted child health with a strong emphasis on the nutritional condition of children under 2 years old. SHARE worked with the health centers and VHSG (Village Health Support Group) in Svay Anthor district to implement "*(2)Integrated Growth Monitoring Services (IGMS)" . IGMS is a service that a health center should provide in their outreach per the Ministry of Health's guidelines. Offering regular IGMS workshops at the community level, children's nutrition condition could be monitored regularly. Also, together with IGMS, mother support groups from Baby Friendly Community Initiatives were integrated. These support groups promoted Infant and Young Children's Feeding, providing workshops for mothers on appropriate complementary age-specific feedings. Through supporting these activities, by the end of the second phase, we achieved almost 10% reduction of the underweight children, and the caregivers' displayed important behavior changes in their feeding practices and childcare. We also helped foster sustainable intellectual and technical skills in health center staff and VHSGs in child health promotion activities. Finally, for the third phase, we focused on inter-sectorial work to make of child health promotion activity sustainable. To do this, we coordinated with key government officials, collaborating with Svay Anthor district health officials, officials from multiple Commune Women and Children's Committees, and local authorities to support programs. At this point, we began to see a bud of financial independency.
Photo (left) A health center staff member provides health education on breast-feeding to new moms at a SHARE supported general monitoring.
Photo (center) SHARE staff attend a district planning meeting to make connections with key officials and promote health programming.
Photo (right) A grandmother weighs her baby at a SHARE supported general monitoring.
SHARE completed the project in Prey Veng in 2017, to move our programming to Preah Vihear province. However, when we returned to Prey Veng last year, we discovered the district committee where our programming took place continued to fund the social program for health promotion SHARE supported. In all of Prey Veng province, only in Svay Anthor district, where SHARE helped to support health-related programming services, is a portion of the district budget spent on social projects. In contrast, other districts use their budget only for infrastructure. With this local government funding, the health programs supported by SHARE were able to become sustainable, even after our departure. We hope to replicate this success in the current program site.
Photo : A SHARE senior staff member teaches program assistants about the Ministry of Health's child health report card so they can support HC staff in the future.
*(1)Village Health Volunteer: MOH have revised the guideline and called Village Health Supporting Group, (VHSG)
*(2)Integrated Growth Monitoring Services (IGMS) is activity comprised of physical growth monitoring, basic health check, vaccination, distribution of micro-nutrient and de-worming tablets, and health education.
SHARE Cambodia is currently implementing programs to improve child and maternal health in Preah Vihear, Cambodia, a province just south of the Thai boarder. *(3)While the economic development of Cambodia over more the past decade has been remarkable, with over a 7% increase yearly, Preah Vihear and its neighboring province Stung Treng, are considered the poorest provinces in Cambodia. Some of the vital health indicators in Cambodia, like the maternal mortality rate (MMR), infant mortality rate (IMR), and children under fiver mortality rate (U5MR) have also shown much improvement. Yet the nutritional condition of Cambodian children has had a much slower rate of reduction in malnutrition since 2005. The most current statistics show the prevalence of the national malnutrition, underweight 23.9%, and stunting 32.4% (CDHS 2014). In Preah Vihear province, rates are higher, with 30.7% underweight and 44.3% stunting pointing out the need for improvement and intervention. Cambodian children in rural areas face significantly worse nutrition rates compared to urban areas. According to CDHS 2010 and 2014, Preah Vihear and Stung Treng provinces hold the highest stunting rate in both studies. Stunting indicates chronic malnutrition and it is very important to prevent before a child falls into this zone. SHARE's experience from Prey Veng province shows that it is very difficult to recover from severe underweight conditions because they are closely interrelated with the family diet practices. Changing these practices to help a child requires educating the adult members of the family. To improve children's health conditions, SHARE works in three rural districts of Preah Vihear, Takoeung, Baribo, and Chamroeun.
*(3)While～in Cambodia.: Asia Development Bank. 2014. "Cambodia Country Poverty Analysis."
SHARE Cambodia's mission is to improve the overall health of children under two years old and pregnant women through health education, replicating the successes of the previous project in Prey Veng. The current project focuses on the first 1000 days of a child's life, an essential time for brain development, and malnutrition at this time can cause irreversible consequences in later life. SHARE reaches out to underserved areas offering IGMS for prevention and early treatment. The program provides children under two years old with a chance to develop full brain function in this period, the foundation of health that dictates adulthood health and future potential. SHARE supports local government staff and village leaders in child health monitoring workshops and health education trainings, like cooking workshops. These health education workshops help rural families in Preah Vihear advance their nutrition practices. Finally, as it did in Prey Veng, SHARE continues to help local government staff to advocate their officials for a budget to social programs so that health education can continue even after the SHARE program comes to an end.
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