Small steps and big goals: Two countries' experiences in achieving MDGs 4 & 5

Source: World Health Organization (Press Release)

MANILA, 21 December 2010—Complex problems can sometimes be solved with simple solutions. For maternal and child health, significant progress has been achieved in Viet Nam by providing weekly supplements of iron and folic acid, and in the Philippines by encouraging breastfeeding. In the process, both countries have taken a step closer to achieving Millennium Development Goal (MDG) 4, which calls for a two thirds reduction in under-5 mortality between 1990 and 2015, and MDG 5, which calls for a three quarters reduction in the maternal mortality ratio.

Viet Nam: preventing anaemia in women of reproductive age

In a developing country such as Viet Nam, children and young women often suffer from iron and folate deficiency, resulting in anaemia and increased risk of death. In addition, the negative consequences of iron deficiency anaemia on the cognitive and physical development of children and on the work productivity of adults are of major concern for the Government.
A simple solution is to provide a regular supplement of iron and folic acid for women during child-bearing years. Evidence suggests that this is a desirable intervention in those parts of the world where women do not yet have access to fortified foods or to diets that are high in bioavailable iron.
In 1998, the World Health Organization's Western Pacific Regional Office initiated a weekly iron and folic acid supplementation (WIFS) project. The project was piloted in four Member States: Cambodia, the Lao People's Democratic Republic, the Philippines and Viet Nam.
Viet Nam became the first country in the Region to implement this anaemia prevention programme in women of reproductive age, using WIFS, combined with twice-yearly deworming. This was piloted in Than Mienh province in the late 1990s. The same initiative was introduced in 2006 in the Yen Binh and Tran Yen districts of Yen Bai province, covering 50 000 women ranging from 15 to 45 years of age. In 2008, the project was expanded to cover the whole province for a total of 250 000 women. Options to further scale up the programme from the provincial to national level are under discussion.
Thanks to the programme, anaemia prevalence in Yen Bai was reduced from 37.5% to 18%, and hookworm infestation decreased from 78.2% to 12%, according to a November 2010 evaluation of the nearly 5-year-old project. The birth weight of infants increased by about 130 grams. WHO is now working to support Yen Bai to secure a sustainable supply of iron and folic acid and to find viable ways to expand the programme.

The Philippines: a push for breastfeeding

A National Demographic Health Survey conducted in 2003 highlighted the dangerously low breastfeeding rates in the Philippines. The results came just after UNICEF and WHO launched the Global Strategy on Infant and Young Child Feeding (IYCF). In response to the survey and the strategy, the Philippines launched a national policy on IYCF and a five-year national action plan to provide strategic direction for improving breastfeeding practices in the country.
Among the follow-up initiatives is the Essential Newborn Care (ENC) protocol under the slogan "The First Embrace", which encourages early skin-to-skin contact and non-separation of the newborn child from the mother in order to promote breastfeeding. The exclusive breastfeeding rate at 28 days of life in the pilot hospital was double the national average for all hospitals.
Supportive supervision for IYCF was stepped up in health centres, with regular visits by national and regional coordinators. Key IYCF indicators were included in the Integrated Child Survival Monitoring Tool.
Progress has been encouraging, but much work remains to be done. Other areas that need attention include:

• the implementation of the Essential Newborn Care protocol in hospitals to increase breastfeeding initiation rates within the first hour of life;
• reaching 1 million pregnant women through an integrated marketing communication effort;
• full implementation of the Expanded Rooming-In Act, which includes provisions for breastfeeding breaks and support for working women;
• the integration of IYCF in the curricula of all health workers; and
• the strengthening of implementation, monitoring and reporting of violations of the Milk Code, which regulates the marketing of breastmilk substitutes.

The latest national data (2008) show that the exclusive breastfeeding rate for the first six months remains unchanged at 34% and the rate of initiation of breastfeeding within the first hour remains at 54%. The figures may not be very dramatic, but they suggest the decline in breastfeeding in the Philippines is reversible.

Cambodia:Fortune-telling the Kingdom's future (2011)

The Phnom Penh Post 

Wednesday, 22 December 2010 18:59 Vong Sokheng and Adam Miller

 

Photo by: Heng Chivoan

Veteran soothsayer San Vannak, 53, plies his trade outside the Royal Palace. According to the city’s “spirit guardians”, he says increased political stability is likely to be on the cards for 2011.

When a new calendar year approaches, many Cambodians look to fortune-tellers for a glimpse of what lies in wait for the year ahead. While not all cosmic news is good news, Phnom Penh’s leading soothsayers say that after a grim 2010, more prosperity is in the stars for next year. 

After a year of predicted pestilence, famines and other misfortunes, 2011 – a traditional year of tevada (angels) – will apparently herald a growth spurt for the national economy, an increase in effective law enforcement and a decrease in violent conflicts.

Im Borin, director of the National Committee of Khmer Customs and Horoscopes at the Ministry of Cults and Religion, has published about 5,000 copies of a horoscope handbook in the run-up to the New Year. Im Borin, a long-time mystic, said his predictions are based on “geocentric planetary phenomena”, which he claims are reliable, a decent proportion of the time.

“I have read and analysed the characters of tevada as a traditional fortune-teller for about 10 years and about 80 percent of my predictions have been accurate,” he said.

While his most recent prophecies for 2011 augur an increase in this year’s spate of natural disasters – including flash floods and serious fires – he says that people across the country should generally remain in greater spiritual harmony than they did in 2010.

Im Borin’s cosmic predictions for 2010 were ominous at best, claiming that many people would be tragically killed in a year filled with famine, conflict and pestilence. He even goes as far as to say that his predictions foreshadowed last month’s tragic stampede at the Diamond Island bridge, which killed 353 people.

“The prediction became accurate if you compare it with the Koh Pich bridge stampede, which caused the deaths of hundreds of poor people, many of whom were working in factories,” he said.

Luckily, however, Im Borin’s darker premonitions for the past year – including a prediction of falling crop yields and a rash of human casualties as a result of declining “social morality” – have failed to come to fruition in 2010.

“The farmers must take care of the crops they have already harvested because crops this year will not be good,” he said in January, adding that “about half of the vegetable and fruit crops will be destroyed” by insects.

Window into the future

San Vannak, a 53-year-old “spirit guardian” fortune-teller who also plies his trade in front of the Royal Palace, said soothsayers are usually asked to divine the future on matters such as romance, finances, job opportunities, marriage plans, divorce and the outcome of illnesses.

He said that for generations, Cambodians have consulted fortune tellers to gain self-understanding and knowledge which could lead to personal power or success in some aspect of life.

“Individual people need to learn about their life when there are problems and they come and consult with a fortune-teller to help them make decisions,” he said.

San Vannak said his clients include government officials and business people who look to the stars to tell them “whether their rank or business will increase or decline”.
     

LESOTHO: Better Work programme launches in Africa

Source:

By: just-style.com | 21 December 201

Buyers from Gap Inc, Levi Strauss and Wal-Mart attended the launch earlier this month of the Better Work programme in Lesotho – the first time the scheme, which aims to improve working conditions in the garment sector, has been rolled out in Africa.

The initiative, which was first developed in Cambodia ten years ago, will help Lesotho’s garment factories improve compliance with national labour law and the International Labour Organization’s (ILO) core international labour standards.

It will also promote the industry – where garment factories employ around 40,000 workers, mainly women, and account for about 80% of Lesotho’s manufacturing jobs – to international buyers and investors.
“Gap Inc has collaborated with Better Works since its inception in Cambodia, and has supported its expansion into Jordan, Haiti, Vietnam, and now Lesotho,” said Cathy Dix, manager, global responsibility for Gap Inc.

“We believe partnerships are key to improving global working conditions, and look forward to working with Better Work and other brands in Lesotho.”

The Better Work programme is a partnership between the International Labour Organization (ILO) and the International Finance Corporation (IFC).

Cambodia on track for two MDGs

The Phnom Penh Post Tuesday, 

14 December 2010 15:01 Mom Kunthear

 

CAMBODIA is on track to meet two of its nine nationally set Millennium Development Goals by 2015, according to a presentation made by the Ministry of Planning during a regional conference in Phnom Penh yesterday.

Officials speaking at the opening of the three-day conference – held to discuss the implementation of MDG strategies in Asia-Pacific countries – the Kingdom is on track to meet targets to reduce child mortality rates and to combat HIV/AIDS, malaria and other diseases.

However, the country is unlikely to meet targets to eradicate extreme poverty and hunger, improve maternal health and ensure environmental sustainability. It is also making slow progress toward targets to achieve universal primary education, promote gender equality and de-mining goals.

During his opening remarks, Minister of Planning Chhay Than said Cambodia had made some “substantial” achievements, but faced some particular challenges.

“The challenges in our case are much more severe compared to other countries at our level of socio-economic development because of events in our recent history,” he said, adding that the country’s civil war only ended in 1999.

“Our main development challenge is the availability of development resources to carry out the massive task of rebuilding our physical infrastructure and institutions,” he said.

According to a presentation from the United Nations Economic and Social Commission for Asia and the Pacific, countries across the region are struggling to meet targets related to hunger, health, primary education, child mortality, maternal health and sanitation.

Representatives from 12 Asia-Pacific countries are attending the meeting.

US Department of Labor announces a grant of more than $5 million for Better Work program in Bangladesh, Cambodia and Vietnam

Source: Trading Markets.Com

Thu, 16 Dec 2010 07:33:22 EST

Symbols: IFK

Dec 16, 2010 (Labor Department Documents and Publications/ContentWorks via COMTEX) --
WASHINGTON -- The U.S. Department of Labor today announced a grant award of more than $5.3 million to the International Labor Organization to support the global Better Work program by implementing projects in Bangladesh and continuing projects in Cambodia and Vietnam. The grant was awarded by the department's Bureau of International Labor Affairs.

Better Work is a unique partnership program of the International Labor Organization and the International Finance Corp. that seeks to improve labor conditions in global supply chains. The Better Work program monitors conditions in export factories, publishes the results in a transparent manner and assists suppliers to comply with labor standards that many buyers and customers demand.

"The goal is to replicate this highly successful strategy, first developed in Cambodia 10 years ago, in countries that protect their workers' rights while promoting development," said Secretary of Labor Hilda L. Solis.
Under the grant, the Better Work program will focus on compliance with labor standards in the garment and other industries in these three countries. The project will engage the ministries of labor, factory managers, multinational buyers, employer organizations and trade unions, and provide guidance and solutions to improve compliance with labor laws in ways that increase the viability of companies, as well as the livelihoods and working conditions of workers.

ILAB News Release: [12/15/2010]
Contact Name: Gloria Della or Clarisse Young
Phone Number: (202) 693-8666 or x5051
Release Number: 10-1718-NAT
For full details on (IFK) IFK. (IFK) has Short Term PowerRatings at TradingMarkets. Details on (IFK) Short Term PowerRatings is available at This Link.

Midwives get mobile

  The Phnom Penh Post

Thursday, 16 December 2010 21:45 Brooke Lewis and Mom Kunthear

Kampong Thom province

Sem Phai, a 35-year-old rice farmer in Kampong Thom province’s Prasat Sambor district, has three children and says she cannot afford any more.
But living in Tang Krasao village, which lies a bumpy hour-long drive from Kampong Thom town, means that Sem Phai’s options for preventing unwanted pregnancies are limited.
She tried using a contraceptive pill but soon stopped after noticing that it was causing her to become “thinner and thinner”.
“I don’t want more children because I’m poor and I’m afraid I can’t earn enough to support them when they grow up,” she said. “I want to spend time working to support my family.”
Local healthcare workers say some women in Sem Phai’s position prefer to abort unwanted pregnancies than to seek family planning services, citing accessibility, affordability and expediency as major considerations.
Authorities have long cited a lack of healthcare services in rural and remote areas as one of the major obstacles to reducing the Kingdom’s maternal mortality rate which, based on 2008 census data, is pegged at 461 deaths per 100,000 live births and is widely cited as among the highest in the region.
Up to a quarter of these deaths are related to unwanted pregnancies, meaning that “roughly one woman dies every 10.5 hours from unsafe abortion”, according to the NGO Marie Stopes International, which has recently introduced Midwives on Motos, a new programme designed to improve access to safe family planning services in remote areas.
Along with 14 other women, Sem Phai visited her local health centre last month to receive a hormonal implant. The implant, which is inserted just beneath the skin on the woman’s upper arm, protects against pregnancy for three to five years and is not usually accessible for women in remote villages like Tang Krasao.
Sitting on a wooden bench outside the open door of the healthcare centre while waiting her turn to receive the implant, Sem Phai said her initial fears about side effects had been quashed after a consultation with Khy Sophorn, an MSI midwife visiting from Kampong Thom town.
“At first, I felt scared about this because I heard the rumour that it hurts women,” she said.
In a group discussion before beginning individual consultations, Khy Sophorn explained to the women assembled that the implant would not “walk around their bodies” or make them too weak to do physical work.
Sosy Vorn, a midwife based in Tang Krasao village who has been practicing in Kampong Thom province for more than 20 years, said such rumours were common and that there was often an initial distrust of modern contraceptives like the implant.
“Family planning methods are new to Cambodia and lots of women have heard stories of bad side effects. It will take some time to build trust in family planning methods,” she said. “Some women just want to see what happens with their neighbour’s implant; if it goes well then maybe they will do that too.”
She said that some women in remote areas still use abortion as a form of family planning and see it as preferable to medium-term contraception methods.
“Some of the women like to use abortion rather than family planning,” she said. “A surgical abortion takes only five minutes and doesn’t hurt after, but for family planning, they have to take some time to do that.”
The need for accessible family planning services was made evident in the 2005 Cambodia Demographic and Health Survey, which found that 59 percent of married women in Kampong Thom province did not want any more children, yet only 30 percent of them reported using modern contraceptive methods.
An estimated 1,700 women die during childbirth or as a result of becoming pregnant in Cambodia every year, according to a May report from the Ministry of Health, which cites transportation problems as one of the top three “critical delays [to accessing services] that can make the difference between life and death”.
The report also highlights the importance of access to family planning, noting that, “Globally, there is strong association between low MMR and high rates of family planning”.
Nationwide, the number of married women using family planning methods rose from 18.5 percent in the year 2000, to 28 percent in 2009, according to the report. The Kingdom has set a target to more than double this number to 60 percent by 2015, as part of a wider goal to reduce maternal mortality rates to less than 250 deaths per 100,000 live births by 2015.
Che Katz, MSI’s country director, said taking services to people in remote areas was one of the most immediate ways to work toward such goals.
“Midwives on Motos is about how to access women and men who are really underserved with family planning services and sexual reproductive health services,” she said.
“People in urban centres have more access to health services, or [semi-urban] centres, but when you move further out to into the rural or remote areas, it’s quite hard for them to get access to services. The cost of travel can be just prohibitive for poor women.”
Midwives on Motos began in Kampong Thom province in March following the introduction of similar programmes in Battambang, Siem Reap and Koh Kong provinces in January. MSI claims to have provided more than 660 women with family planning services through the programme.
Katz said, along with other MSI programmes, Midwives on Motos had a notable impact on reducing the number of maternal deaths.
“This year we will have averted 315 maternal deaths directly from our work.... and more than 4,000 infant deaths, and we’ll have saved the government of Cambodia and the people of Cambodia US$21 million in health services costs,” she said. “So that’s a very measurable impact that we’re having.”

MDG scorecards to chart areas of concern

The Phnom Penh Post

Tuesday, 07 December 2010 15:02 Tep Nimol

The Cambodian government and United Nations Development Program unveiled a new measurement tool yesterday aimed at helping the Kingdom achieve its Millennium Development Goals and track development disparities across the country.

The Ministry of Planning and the UNDP have developed and tested a scorecard designed to help policy makers in all provinces identify and address short-falls in nine target areas “The Commune Database shows regional disparities ... at all levels – province, district, commune,” said Elena Tischenko, country director of UNDP Cambodia, at a press conference yesterday.

As an example, she said that commune data from 2010 showed poverty levels in northeastern Cambodia (Preah Vihear, Ratanakkiri, Mondulkiri, Kratie, Stung Treng) at 37 percent, while in the coastal areas (Sihanoukville, Kampot, Kep, Koh Kong) the rate was 25 percent or lower.

“I believe [the scorecards] will prove crucial to ensuring we meet the goals Cambodia has set for itself in the five years we have left until the MDG target date of 2015,” said Elena Tischenko.

Sherif Rushdy, a CMDG advisor, said via email that the lowest average scores for millennium goals came in ensuring environmental sustainability, eradicating poverty and hunger, and achieving universal nine-year primary education, adding that the highest average score came in the reduction of child mortality.