Cambodian Health Center Services Improve Significantly after Introduction of the Maternal and Child Health Book

Cambodian health care workers’ use of the Maternal and Child Health (MCH) Book is resulting in significant improvements in the quality of maternal, newborn, and child health and nutrition services and counseling at health centers. This key finding emerged from follow-up conducted by operational district health staff and the USAID Better Health Services project implemented by University Research Co. LLC (URC). 

The follow-up coaching and assessment found that midwives and nurses were using the MCH book routinely to provide better quality maternal, newborn, and young child health and nutrition care. Health center scores on competency indexes improved dramatically between the first and second quarterly visits. For example, in Angkor Chum district, overall health center competency scores had improved from 46% before the introduction of the MCH book to 62% by the second follow-up visit. The most improvement was seen for competency in providing child health and nutrition care, which increased from a 30% score to 57%.

The MCH book has information on how to care for the health of pregnant and postpartum women, newborns, and young children; it includes counseling messages that health workers should use at each health center visit from pregnancy through the postpartum period and the child through age five, with a focus on the first two years of life. It also works as a job aid, serving as a checklist for health workers to remind them to provide all necessary services at each visit. A Peace Corps volunteer working in one health center corroborated the data: “I no longer have much to do as the health center now works so well!”

The MCH book is part of a broader activity in 50 health centers in three operational districts. That activity includes 1) training and strengthened supportive supervision and coaching at health centers for health care providers to improve the quality of care and 2) health financing interventions to increase demand for and use of services at health centers. The financing interventions include community-based health insurance and conditional cash transfers.

A health worker at Sar Sar Sdum Heath Center (right) uses the MCH book to counsel a mother on infant feeding.
A health worker at Sar Sar Sdum Heath Center (right) uses the MCH book to counsel a mother on infant feeding.
Date 
October 25, 2012
Authors 
Ms. Bou Savy, Behavior Change Communication Team Leader
Regions/ Countries