USAID/Cambodia’s
Office of Public Health manages the Mission’s health
portfolio. Activities are closely integrated
and cover a range of areas, including maternal, reproductive
and child health. The program includes a significant
focus on the HIV/AIDS epidemic facing Cambodia. Along
with HIV/AIDS, the Mission also addresses concerns
related to other infectious diseases, such as TB,
malaria and dengue fever.
Over
the last several years, USAID has worked hard to help
restore health services in Cambodia. The intent
is to ensure that Cambodians have access to quality health
services. While cooperating closely with the Ministry
of Health, implementation is in part carried out by a
network of NGO partners, both US-based and Cambodian. Additional
support is channeled through multilateral organizations
such as WHO and UNICEF.
Funding
levels typically exceed $20 million in any given year. The
list of USAID partner organizations in Cambodia include
the Adventist Development and Relief Agency (ADRA); American
Red Cross; CARE; Catholic Relief Services; Khmer HIV/AIDS
NGO Alliance; Population Services International; RACHA;
Reproductive Health Association of Cambodia; University
Research Corporation; US Centers for Disease Control;
World Relief and World Vision.
HIV/AIDS: USAID
places primary emphasis on prevention. This focus supports
the apparent downward trend of HIV incidence among some
vulnerable groups such as uniformed personnel and commercial
sex workers. It also helps slow the spread of the
epidemic in the general population, especially among
women and infants. Care and treatment will become increasingly
important as Cambodians who are already HIV-infected
progress to symptomatic AIDS. Effective home-based treatment
models are being developed, tested and replicated, especially
for those unable to receive adequate treatment through
the formal health system. Innovatively, Buddhist monks
and other faith-based organizations are active participants
in AIDS care service delivery. As in the past, USAID
also continues to support, and expand, Cambodia’s premier, “second
generation” surveillance system to monitor the epidemiological
and behavioral trends of the epidemic.
Other
Infections Diseases: USAID
programs help strengthen surveillance of TB, including
drug-resistant forms of the disease; improve case detection
of new cases of TB, especially in people infected with
HIV; and expand service to patients. Activities
include training; improved testing and laboratory facilities;
better referral systems for TB and HIV/AIDS; and improved
strategies for dealing with issues. For malaria, USAID
has a long history of working with the World Health Organization
(WHO) in Cambodia to monitor drug-resistant malaria,
improve drug-use practices ensure and drug quality in
Cambodia. Similar approaches are in place for dengue
fever. In particular, USAID and WHO work together
to focus on high risk areas in Phnom Penh and Battambang. The
objective here is to expand and improve surveillance,
provide clinical management, introduce health education,
and support control activities.
Maternal
and Child Health: USAID
supports efforts to gradually shift deliveries from traditional
birth attendants to trained midwives. Activities support
training for midwives, including the introduction of
life-saving skills; strengthening the referral system
to provide emergency obstetric care; building the capacity
of doctors to support and supervise trained midwives;
and supporting partnerships between midwives and traditional
birth attendants. At the local level, USAID strengthens
child health interventions in government facilities,
in part by emphasizing appropriate responses to diarrhea
and malnutrition. Programs also emphasize the importance
of breastfeeding as well as infant feeding practices
that use micronutrients, especially Vitamin A. In addition,
USAID works with UNICEF and WHO to support the government’s
efforts to pilot test new and more integrated approaches
toward managing childhood illness.
Reproductive
Health: USAID
supports measures to make contraceptives routinely available
at the community level, in part by strengthening and
expanding deliver services in villages and small towns.
This approach extends and complements the outreach activities
of health center staff and community volunteers, who
are often older women village leaders with strong connections
to local pagodas. Such volunteers can play an important
role in educating women and men about birth spacing,
good child rearing practices, and sexual health. Given
that Cambodians rely heavily on private health providers,
USAID is also working to expand partnerships with the
private sector. |
