Wednesday, September 7, 2016

Village members work together for healthier childhoods

By Pharin Khiev

Chanthan Yi watches her four-year-old son, Chanthea,
learn about warnings signs for pneumonia and sick newborns
© UNICEF Cambodia/2016/Pharin Khiev

It’s after lunch in Buy Sra village, a remote community in Cambodia’s rural Kampong Speu Province. A mother and her two sons, Chanthea and Sin Py, are seated under a thatched roof. Four-year-old Chanthea closely studies a leaflet with photographs depicting the warning signs of pneumonia and other dangerous illnesses that could put him or his new brother, who is just 3 months old, at risk. His mother, Chanthan Yi, looks on with pride.

About 20 families like Ms. Yi’s had spent the morning at a child health education session organized by the village health support group and the nearby Kroach Meas Health Centre. They received this important leaflet, designed by the National Centre for Health Promotion and UNICEF, along with other key messages and instructions about pneumonia and illness among children younger than 5.

Sokhourn Bun, village health support group volunteer in Buy Sra village,
Kampong Speu Province, educates parents, grandparents and pregnant
women on pneumonia and caring for sick newborns
© UNICEF Cambodia/2016/Pharin Khiev

Such events are organized quarterly for the 39 villages in the health centre catchment area, offering communities -- including pregnant women, new mothers, grandparents and children -- information that helps stem unnecessary death among newborns and young children. These gatherings also promote the value of receiving health care from trained professionals and recognizing when such care is necessary.

Since 2015, KOICA funding for UNICEF has been providing on-the-job training and supportive supervision to village health support group volunteers in 276 villages and health workers in nine health centres in two operational districts (ODs), Kampong Speu and Phnom Srouch, representing approximately 6,500 families. In the first quarter of 2016, about 1,700 families have learned valuable lessons from these volunteers that are working to protect their children from preventable illness and death.

These measures are particularly important in Kampong Speu and Phnom Srouch, which are vulnerable to a slew of health issues and as remote areas lack easy access to health care. They exhibit high prevalence of pneumonia, poor health services, poverty, low literacy and remoteness.

Less than half of pregnant women in these areas receive the four suggested antenatal care visits (46 per cent for Kampong Speu OD and 22 per cent for Phnom Srouch), and just over a third of women (36 per cent) receive appropriate postnatal care. Only one in three babies in Kampong Speu and one in five in Phnom Srouch are born with a skilled birth attendant. Furthermore, hepatitis B vaccination coverage rate is low and lower acute respiratory illness is common among children younger than 5.

Pneumonia and newborn illness are the main causes of childhood mortality in Cambodia; pneumonia-related deaths constitute 14 per cent of all newborn casualties according to a WHO 2010 study. A major factor contributing to the high level of child death from pneumonia is the delay in bringing the child to a health facility at the early signs of the illness. Families often wait and try other options rather than take the time, effort and financial resources to get a distressed child to a health facility. The trained village health support group is there to change this behaviour, providing key messages to mothers and families to act promptly, so that more Cambodian children live to see their fifth birthday, and beyond.

UNICEF-KOICA activities aim to reduce the prevalence and mortality rate associated with pneumonia among under-five children, including newborns.

“In the past, villagers did not trust the health staff and services provided by the health centre, but preferred traditional healers, birth attendants and beliefs,” Ms. Yi observes. “The villagers rarely used the health centre.”

Sokhourn Bun conducts a home visit with pregnant women to teach
them how vulnerable newborns and young children are to certain
illnesses and what actions caregivers should take
© UNICEF Cambodia/2016/Pharin Khiev

“Now, if villagers are sick, they will go to the health centre first to receive treatment.”

Ms. Yi has also noticed a difference in the way parents treat sickness in newborns.

“After the mother classes led by the village health support group volunteer, villagers understand the danger signs and symptoms of pneumonia and sick newborns,” she says.

Sokhourn Bun is one of two trained village health support group volunteers working in Ms. Yi’s village. UNICEF, with KOICA funding support, trains the volunteers to provide basic health education to prevent childhood illnesses, identify danger signs in children and support timely referrals to health facilities. Volunteers are elected by fellow community members.

The volunteers learn to recognize the symptoms and danger signs of pneumonia and sick newborns and provide an important bridge between the community and the health system.

“Bringing a child to the health centre is the first thing a mother should do,” Ms. Bun says. She also encourages mothers to participate in community child health fairs where they can learn more about proper health care for their children.

As a village health support group volunteer, she also routinely performs household visits to mothers and caregivers with babies younger than 2 months and children aged between 2 and 59 months, while also organizing classes for mothers once per quarter.

During a home visit to Soda Phan, who is pregnant, Ms. Bun tells Ms. Phan about danger signs in newborns. She stresses the value of protecting the child’s life during this time, just as the baby was protected in the womb for nine months. She explains how another two months of careful, attentive, loving protection can make all the difference between a wonderful life ahead or death. With pictures to illustrate danger signs of newborns and pneumonia of children aged 2 to 59 months, she shows mothers what to look out for.

“If you observe any of these symptoms – convulsions, difficult feeding, fast breathing, severe chest in-drawing, no spontaneous movement, fever or low body temperature and any signs of bleeding -- you have to quickly bring the child to the nearest health centre,” Ms. Bun explains to Ms. Phan.

Together, the community outreach of the village health support group volunteer and quality services at the health centre are helping to prevent and treat cases of childhood pneumonia and sick newborns and accelerate Cambodia’s progress on child survival and development.

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