Cambodia is not meeting many of its UN Millennium Development Goals, which are coming due this year, but it has made progress in the reduction of infant mortality.
Currently, 28 of 1,000 children born in Cambodia die before reaching the age of one. That number is down from 95 per thousand in 2000. Another 35 of 1,000 children die before the age of 5, down from 124 in 2000. And while those numbers are not great, they are an improvement beyond expectation.
By comparison, Afghanistan has the worst infant mortality rate in the world, at 114 per thousand live births; the US has 6 per thousand; and Japan has a rate of 2 per thousand.
Cambodia’s success has come from programs that improve vaccination, increase breastfeeding and improve mothers’ health. Midwife training, and pre- and post-natal care have also been improved.
Tung Raththavy, director of the National Maternal and Child Health Center, said the improvements are due to commitment by the government and the Ministry of Health.
Public campaigns have raised the percentage of children breastfeeding from 11.4 percent in 2000 to 74 percent in 2014. Rates were highest in the remote jungle provinces of Mondolkiri and Ratanakkiri.
Cambodia has done less well on vaccination improvement. Its goal for 2015 was 90 percent vaccination. It reached 79 percent.
“In fact, our figures and our goal are that we have been very serious not only providing measles vaccination to reach the target, but in eliminating measles,” Tung Raththavy said.
Ke Sovannaroth, head of the National Assembly’s committee on health and women’s affairs, said the figures are not encouraging. “Sometimes the figures do not reflect the reality,” she said. “Why do I say that? Because for the period from 2000 to 2014, there were 14 years, and if we look at reforms in the health sector, there are still gaps.”
Public services remain “discriminatory,” she said. “For maternal and child health, the government says that it’s free, but we see no effect. And on another point, it’s very difficult to reduce these high rates once we simply look at transportation. Sometimes, in a remote area, they cannot deliver a baby at the commune health clinic. They have to come to the district or province, depending on the state of their health. Sometimes the car is available, but there is no gasoline. And sometimes there is no driver.”
Other challenges remain, particularly for those living in remote areas, where children under the age of five are up to three times as likely to perish than those in urban areas. That’s due to uneven distribution of development and wealth, officials say.
Malnutrition remains a problem, too.
“Every year, more than 6,000 children under the age of five die from malnutrition of their mothers, being underweight, or skinny, having minimal infant feeding practices, and micro-nutrient deficiencies,” said Lao Sokha Phirum, secretary-general of the Council for Agricultural and Rural Development.
Cambodia lags behind its neighbors. Thailand has mortality rate of children under five of 13 per thousand. Vietnam’s rate is 24 per thousand. Still, Cambodia is ahead of Laos, which has a rate of 71 per thousand, and Myanmar, at 51 per thousand.