Implementation of maternal death audits and changes in maternal health care in Cambodia, 2010-2017.

Objective: Cambodia is one of seven countries globally that met Millennium Development Goal 5A: reduction of maternal deaths by at least 75% between 1990 and 2015. The maternal death audit (MDA) was instituted in 2004 to support the improvement of maternal care. We evaluated progress in MDA implementation and maternal health services in Cambodia between 2010 and 2017.

Faecal microbiota and cytokine profiles of rural Cambodian infants linked to diet and diarrhoeal episodes.

The gut microbiota of infants in low- to middle-income countries is underrepresented in microbiome research. This study explored the faecal microbiota composition and faecal cytokine profiles in a cohort of infants in a rural province of Cambodia and investigated the impact of sample storage conditions and infant environment on microbiota composition. Faecal samples collected at three time points from 32 infants were analysed for microbiota composition using 16S rRNA amplicon sequencing and concentrations of faecal cytokines.

Residual risk of mother-to-child transmission of HBV despite timely Hepatitis B vaccination: a major challenge to eliminate hepatitis B infection in Cambodia.

Background: In countries with intermediate or high hepatitis B virus (HBV) endemicity, mother-to-child transmission (MTCT) represents the main route of chronic HBV infection. There is a paucity of information on HBV MTCT in Cambodia. This study aimed to investigate the prevalence of HBV infection among pregnant women and its MTCT rate in Siem Reap, Cambodia.

A prospective, comparative study of clinical outcomes following clinic-based versus self-use of medical abortion.

Background: To determine whether clinical outcomes differ among women accessing a combined medical abortion regimen from a health clinic when compared with those accessing it from a pharmacy.

Methods: We conducted a multicentre, prospective, comparative, non-inferiority study of participants aged ≥15 years seeking medical abortion from five clinics and five adjacent pharmacy clusters in three provinces of Cambodia. Participants were recruited in-person at the point of purchase (clinic or pharmacy).

Early essential newborn care in national tertiary hospitals in Cambodia and Lao People's Democratic Republic: a cross-sectional study.

Background: Ministries of health in collaboration with the World Health Organization Regional Office for the Western Pacific (WPRO) have been scaling up early essential newborn care (EENC). This study was carried out to understand current EENC practices at hospitals in two priority countries: the Kingdom of Cambodia (Cambodia) and Lao People's Democratic Republic (Lao PDR).

Methods: EENC is subdivided into 79 checkpoints, referencing the self-monitoring checklist developed by the WPRO.

Factors influencing the retention of secondary midwives at health centres in rural areas in Cambodia: the role of gender-a qualitative study.

Background: Retention of skilled midwives is crucial to reducing maternal mortality in rural areas; hence, Cambodia has been trying to retain at least one secondary midwife who can provide basic emergency obstetric care at every health centre even in rural areas. The factors influencing the retention of midwives, but not solely secondary midwives, have been identified; however, the security issues that affected female health workers during the conflict and the post-conflict years and gender issues have been unexplored. This study explores these and other potential factors influencing secondary midwife retention and their significance.

"Why did our baby die soon after birth?"-Lessons on neonatal death in rural Cambodia from the perspective of caregivers.

Introduction: Neonatal deaths represent around half the deaths of children less than five-years old in Cambodia. The process from live birth to neonatal death has not been well described. This study aimed to identify problems in health care service which hamper the reduction of preventable neonatal deaths in rural Cambodia.

Challenges to neonatal care in Cambodia amid the COVID-19 pandemic.

Since mid-February, 2020, coronavirus disease-2019 (COVID-19) has been spreading in Cambodia and, as of April 9, 2020, the Ministry of Health has identified 119 polymerase chain reaction (PCR)-positive cases. However, the PCR test is available in only two specialized institutes in the capital city Phnom Penh; therefore, exact and adequate identification of the cases remains still limited. Many vulnerable newborn infants have been admitted to the neonatal care unit (NCU) at the National Maternal and Child Health Center in Phnom Penh.

Determinants of growth measurements in rural Cambodian infants: a cross-sectional study.

Background: Inappropriate feeding and hygiene practices and poor environment are associated with malnutrition. We aimed to investigate the contributions of feeding, hygiene practices and recent illness to the nutritional status of rural Cambodian infants and any sex-specific differences.

Methods: In a cross-sectional study, nested within an ongoing birth cohort, trained fieldworkers conducted anthropometry and collected information from the main caregiver during home visits.

Frequent unregulated use of antibiotics in rural Cambodian infants.

Background: Despite a high prevalence of antibiotic resistance in Cambodia, few studies have assessed health-seeking behaviour and the use of antibiotics by caregivers of young children in Cambodia.

Methods: We conducted a cross-sectional survey of infants <12 months of age and their caregivers, assessing the frequency of reported illness, common symptoms and associated health-seeking behaviour through structured questionnaires administered by trained fieldworkers at a home visit. In a subset of these participants, ages 4-8 months with no acute malnutrition, we conducted a 3-month surveillance with fortnightly home visits.

One year outcome of high-risk newborn infants discharged from the neonatal care unit of the National Maternal and Child Health Center in Cambodia.

Background: In the National Maternal and Child Health Center in Cambodia, about 7,500 newborn infants are born every year. Around 10% of them are admitted to the neonatal care unit. After recovery from the acute phase that presented neonatal care unit admissions, they are discharged even if they are very low birth weight infants, but there is no official follow-up system available after discharge.

Integrated approach for triple elimination of mother-to-child transmission of HIV, hepatitis B and syphilis is highly effective and cost-effective: an economic evaluation.

Background: The Regional Framework for Triple Elimination of Mother-to-Child Transmission (EMTCT) of HIV, Hepatitis B (HBV) and Syphilis in Asia and the Pacific 2018-30 was endorsed by the Regional Committee of WHO Western Pacific in October 2017, proposing an integrated and coordinated approach to achieve elimination in an efficient, coordinated and sustainable manner. This study aims to assess the population impacts and cost-effectiveness of this integrated approach in the Cambodian context.

Methods: Based on existing frameworks for the EMTCT for each individual infection, an integrated framework that combines infection prevention procedures with routine antenatal care was constructed.

IDPoor: a poverty identification programme that enables collaboration across sectors for maternal and child health in Cambodia.

describe how Cambodia’s national poverty identification system, IDPoor, has provided a nexus for different sectors’ contributions to maternal and child health among the poor

The unfinished health agenda: Neonatal mortality in Cambodia.

Background: Reduction of neonatal and under-five mortality rates remains a primary target in the achievement of universal health goals, as evident in renewed investments of Sustainable Development Goals. Various studies attribute declines in mortality to the combined effects of improvements in health care practices and changes in socio-economic factors. Since the early nineties, Cambodia has managed to evolve from a country devastated by war to a nation soon to enter the group of middle income countries.

Increasing Uptake of Long-Acting Reversible Contraceptives in Cambodia Through a Voucher Program: Evidence From a Difference-in-Differences Analysis.

Objective: This article evaluates the use of modern contraceptives among poor women exposed to a family planning voucher program in Cambodia, with a particular focus on the uptake of long-acting reversible contraceptives (LARCs).

Methods: We used a quasi-experimental study design and data from before-and-after intervention cross-sectional household surveys (conducted in 2011 and 2013) in 9 voucher program districts in Kampong Thom, Kampot, and Prey Veng provinces, as well as 9 comparison districts in neighboring provinces, to evaluate changes in use of modern contraceptives and particularly LARCs in the 12 months preceding each survey. Survey participants in the analytical sample were currently married, non-pregnant women ages 18 to 45 years (N = 1,936 at baseline; N = 1,986 at endline).

Supplementation with vitamin B6 reduces side effects in Cambodian women using oral contraception.

Unlabelled: Hormonal contraceptives may produce side effects that deter women from their use as a method of family planning. In nutritionally vulnerable populations these effects may be more pronounced due to micronutrient deficiencies and health status. Previous studies have been unable to resolve whether micronutrient supplementation may reduce such side effects.

Achieving universal access and moving towards elimination of new HIV infections in Cambodia.

Introduction: In the mid-1990s, Cambodia faced one of the fastest growing HIV epidemics in Asia. For its achievement in reversing this trend, and achieving universal access to HIV treatment, the country received a United Nations millennium development goal award in 2010. This article reviews Cambodia's response to HIV over the past two decades and discusses its current efforts towards elimination of new HIV infections.

MObile Technology for Improved Family Planning Services (MOTIF): study protocol for a randomised controlled trial.

Background: Providing women with contraceptive methods following abortion is important to reduce repeat abortion rates, yet evidence for effective post-abortion family planning interventions are limited. This protocol outlines the evaluation of a mobile phone-based intervention using voice messages to support post-abortion family planning in Cambodia.

Methods/design: A single blind randomised controlled trial of 500 participants.

Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health): a cross-sectional study.

Background: We report the main findings of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS), which aimed to assess the burden of complications related to pregnancy, the coverage of key maternal health interventions, and use of the maternal severity index (MSI) in a global network of health facilities.

Methods: In our cross-sectional study, we included women attending health facilities in Africa, Asia, Latin America, and the Middle East that dealt with at least 1000 childbirths per year and had the capacity to provide caesarean section. We obtained data from analysis of hospital records for all women giving birth and all women who had a severe maternal outcome (SMO; ie, maternal death or maternal near miss).

Evaluation of the impact of the voucher and accreditation approach on improving reproductive behaviors and status in Cambodia.

Background: Cost of delivering reproductive health services to low income populations will always require total or partial subsidization by government and/or development partners. Broadly termed "demand-side financing" or "output-based aid", these strategies include a range of interventions that channel government or donor subsidies to the user rather than the service provider. Initial pilot assessments of reproductive health voucher programs suggest that they can increase access, reduce inequities, and enhance program efficiency and service quality.

Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08.

Background: There has been concern about rising rates of caesarean section worldwide. This Article reports the third phase of the WHO global survey, which aimed to estimate the rate of different methods of delivery and to examine the relation between method of delivery and maternal and perinatal outcomes in selected facilities in Africa and Latin America in 2004-05, and in Asia in 2007-08.

Methods: Nine countries participated in the Asia global survey: Cambodia, China, India, Japan, Nepal, Philippines, Sri Lanka, Thailand, and Vietnam.