From 2000 to 2003, JOICFP in collaboration with the National Center for Health Promotion (NCHP), Ministry of Health, operated a model project in Cambodia under the UNFPA-supported Asia Regional Project, "Strengthening of National Capacities for RH/BCC through Community-based RH/FP Programs" (RAS/00/P06). Even one year after project assistance from outside ended the project is still continuing, and from 24th to 29th January, Kei Yoshidome, Program Officer, JOICFP, visited the Put Sar Commune, Bati Operational District, Takeo Province, to observe project results, how it has been sustained and what motivates health personnel and community people.

Health Center

The chief of the Health Center (HC) explained activities carried out in 2004, highlighting that over 220 babies had been delivered there compared to 18 in 2003. Furthermore, the number of women taking antenatal care (ANC) had increased by four-fold to nearly 180 in the same period. He identified four main reasons for the success of the center: a clear fee-charging system; 24-hour service; good teamwork among health center staff; and close cooperation among HC staff, community leaders and the community.

Two of the beneficiaries of the Health Center

The activities at the HC have been so well received that clients have been disseminating information themselves, which has even led to people outside the HC catchment area visiting it. Also, Yoshidome learned that necessary cases were being referred to hospital, highlighting effective cooperation among the health center, local authorities and village health volunteers.

The HC chief explained that no monetary incentive was paid to volunteers, instead they received a fee-charging exemption at the center.

The Heath Center hires an experienced and locally known traditional birth attendant (TBA), and collaboration between midwives and the TBA creates an atmosphere of trust and comfort for pregnant women to use the center for delivery. Further recommendation came from a midwife who said that she used to perform deliveries at her home but now used the HC in order to help promote it.

Health Center staff

Speaking with a village chief and health volunteers, Yoshidome found that most volunteers stay with the project, and conduct health promotion outreach activities on, for example, ANC, birth-spacing, dengue fever and diarrhea. The volunteers were grateful that Japan had come to Cambodia to promote community health, and they felt that it was now Cambodia's turn to respond by promoting health themselves.

Due to a lack of funds, the community-operated monitoring (COM) system has not been operationalized. However, all parties concerned recognize the usefulness of the data board and are discussing how to restart its use.

A village chief and health volunteer

Model site

A NCHP member explained how the Put Sar HC, as well as other villages covered under the project, was used for participatory evaluation training, organized in cooperation with the Asia Health Institute, a Japan-based NGO.

In addition, a local NGO has is planning to organize a study tour at Put Sar to learn about community networking for health promotion and sustainability, after one of its members had received training at Put Sar.