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Project profile

Improvements in Health Service Delivery in Remote & Marginalised Communities (GSK)

Cambodia’s 2010 Demographic Health Survey reflects remarkable decreases in maternal mortality from 472 to 206 per 100,000 live births. This is due to improvements at the health facility level with activities such as increased access to skilled birth attendants and facility based deliveries, which nationally are at 71% and 53.8%, respectively. Such improvements, though commendable, do require strong systems of preventative care in order to be sustained. According to national statistics, postpartum care coverage is 40%, falling to less than 20% in populations representing the rural poor. Uptake of modern family planning methods at 22% further speaks to the need for improvements with postpartum care for women.


Barriers to health service access in Koh Kong province include the inability of households to secure funds for treatment and distance between health facilities and communities. In addition to these issues, gaps exist in health service delivery and demand creation. CARE is working to strengthen components of the health system to improve health service delivery as a means to improve utilisation of services. The project works with midwives and nurses from selected health centers in the province to receive in service training, mentoring and coaching through a process of supportive supervision. These activities serve as a means to increase capacity and understanding of pertinent health issues to ensure accountability and motivation. Improving outreach activities following the Ministry of Health protocols and best practices to increase immunisation coverage and family planning services as a means to improve access and utilisation of health services.



To increase community access to health services in remote and marginalized villages of Cambodia through:

  • Improving the effectiveness and quality of health services by enhancing the capacity and motivation of health workers to facilitate more comprehensive and integrated services

  • Enhancing health centre outreach mechanisms to improve access and utilization of health services, including prevention services such as vaccination

  • Advocating with key Ministry of Health partners and stakeholders through leveraging the visibility and successes of project activities to inform future MoH protocols, guidelines and policies

  • Galvanize local government commitment to activities currently being implemented under GSK through increased engagement and capacity building, in order to achieve a smooth exit from Koh Kong.



Key activities
  • Facilitating Midwifery Coordination Alliance Team (MCAT) meetings for technical health staff to share knowledge and experiences.
  • Providing clinical skills on conditions such as eclampsia training for MCAT meeting attendees and conducting supervisory visits to mentor health staff.
  • Conducting refresher training for village health support group (VHSG) members to ensure they have the necessary skills, knowledge, confidence and motivation to deliver health messages to the community.
  • Supporting health centres to develop clear monthly outreach service plans so that communities receive regular services such as vaccinations, monitoring of pregnant women and new mothers, vitamin supplements, or care for minor injuries or ailments, as well as referrals to health centres or hospitals when necessary.
  • Supporting health centres to conduct outreach visits to some of the most remote villages in the operation district.
  • Working with VHSGs to develop monthly work-plans for community health education and supporting the facilitation of VHSG bi-monthly meetings in three health centre catchment areas.

Oct 2012 - Nov 2016



Sre Ambel operational district in Koh Kong province 


Beneficiaries(direct & indirect)
  • Over 130 Village Health Support Group (VHSG) members from the five health centres

  • 60 midwives and doctors participating in MCAT meetings

  • 15 health providers conducting outreach sessions

  • Community members reaching health services

  • Community members receiving VSHG health education information.

Project partners


  • Ministry of Health, Provincial Health Department (PHD), Operational district, health centers

  • Local authorities and health-related NGOs

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