Increasing health facility deliveries in Cambodia and its influence on child health

Abstract

Background A growing number of women in Cambodia are seeking support from health facilities during delivery, up from 8% in 2000 to 82% in 2014. This growth may be attributed to increased national level attention to incentivize hospital births and reduce potential barriers. This paper address three related questions regarding the impact of increased utilization of health care in Cambodia. First, did increasing health facility deliveries occur most among disadvantaged women? Second, as health facility utilization increased, did the benefit of delivery location on child health outcomes weaken? Finally, did socioeconomic disparities in child outcomes decline as a result of increased health facility deliveries? Methods Data is from the 2010 and 2014 Cambodian Demographic and health surveys. Regression models include logistic regression to predict utilization of a health facility, linear regression to predict child nutritional status and Cox regression to measure child survival. Propensity score matching was used to account for selectivity. Results Analysis shows that health facility delivery is associated with better nutritional status and survival and the effectiveness of a health center delivery remains with this rapidly increasing care. However, the largest increases in delivery at a health facility did not occur among less educated, less wealthy, and rural Cambodian women, and inequalities in child health outcomes remain. Conclusions Cambodian women have participated in a rapid increase in health center deliveries and those health facility deliveries remain beneficial for future child outcomes. However, initiatives to increase care are not addressing inequity in access to care among disadvantaged women. Additionally, disparities in children’s health outcomes remain, suggesting that health facility births are not sufficient in reducing disparities among children of disadvantaged mothers. Moving forward, current initiatives are rapidly increasing facility deliveries and maintaining their efficacy, but further efforts need to be placed on targeting disadvantaged women and their children.

Trend and projection of skilled birth attendants and institutional delivery coverage for adolescents in 54 low- and middle-income countries, 2000–2030

“…In Cambodia, the substantial narrowing of wealth-based gaps in both INSD and SBA has been attributed to several initiatives, chiefly, the 'health equity funds' and the 'community-based health insurance' schemes that specifically cover healthcare reimbursements for the poorest in the population [32,33]. Meanwhile, studies have also shown decreases in delivery care inequalities after the introduction of the National Health Insurance Scheme (NHIS) in Ghana [34,35].…”

Association between place of birth and timely breastfeeding initiation among Cambodian women: a population-based study

“…From 2000 to 2014, public health facility births increased in Cambodia by 82 percent [ 23 ]. The growing trend of exclusivity and timely breastfeeding initiation in Cambodia may be correlated with public health facilities that adopted the WHO/ UNICEF BFHI [ 22 ].…”

“…Use of prelacteal feeds in Cambodia dramatically decreased from 2000 (94.5%) to 2010 (19.1%), likely due to extensive public health efforts and breastfeeding campaigns [ 21 ], however the rate increased in 2014 to 27.7% [ 19 ]. It should be noted that prelacteal feed increases from 2010 to 2014, coincide with a rise in facility-based births in Cambodia, 54% in 2010 [ 22 ] to 82% in 2014 [ 23 ]. A 2016 study conducted in Phnom Penh, the capital and most populous city in Cambodia, revealed 43.1% of children age 0 to 5 months consumed breastmilk substitutes [ 17 ].…”

Difference of sociodemographic characteristics among the disabled population in Cambodia: a cross-sectional study of the demographic and health survey data

“…This was the only questionnaire that included data on residents aged over 50. The 2014 CDHS defined the difference between urban and rural areas in terms of living space, with the degree of population concentration or density 12 ) . The present study extracted data on age, gender, economic status, residence, and disability status from the household questionnaire.…”