Ensuring women and babies are healthy during pregnancy, birth, the first weeks of life and throughout infanthood
We take for granted that when we decide to start a family that the mom to be is healthy, she is not suffering from iron deficiency anemia nor is she iodine deficient. Most probably she is not underweight. She is in the prime of health, ready for the task of bringing a baby into the world. She is aware of what food is nutritious and how much she should eat and not once does it occur to her that she cannot avail of what she and her baby needs to be well nourished to help in building organs, blood and bones. She knows she has to see her obstetrician for regular pre-natal visits and has to take her pre-natal vitamins daily. She knows where exactly she will deliver her baby, most often than not it will be in a tertiary medical facility by a highly competent obstetrician. She knows what to avoid, smoking and alcohol of course, excess salt and too much caffeine definitely. She knows she has to exercise, get enough sunshine and fresh air. She is well prepared for an uneventful pregnancy. She knows what it takes to deliver a healthy, definitely smarter child into the world. If she is one of the more progressive moms, she is preparing to breastfeed exclusively for six months, she knows that her newborn needs the colostrum during the first hour for the baby’s protection and she knows better than to give her baby anything but breast milk for the first six months. Trips to the pediatrician for immunization shots and growth monitoring are scheduled in. This is the not reality for most of the poorest of the poor Cambodian mother. She will most probably not have these givens that we take for granted.
This is her reality. She is most often underweight, iron deficient, iodine- deficient and definitely not ready to host another life. She may opt not to take the iron folic if it is available at the local health center due to ignorance and misplaced beliefs. She may not have enough access to healthy food that she and the baby needs, so the baby may be born premature or with low birth weight. She may miscarry the fetus that is not well nourished or has developed congenital anomalies. She may die in childbirth from hemorrhage or tetanus or maternal hypertension because she gave birth at home with or without the traditional helot.
If both mother and child make it through, she may not breastfeed despite the fact that there is no money for formula. If she does breastfeed, she’s not eating enough to sustain her nutrition during the time she is breastfeeding. And who is giving her moral support? Does her husband know what he can do to assist her during these critical times when mother and child are most vulnerable?
And what’s about the baby? From the womb, he or she is already disadvantaged, not getting enough nutrition from an already malnourished mother .If he is not breastfed long enough, he is less safe from diarrhea, more likely to have asthma and allergies, and to top all that, he is less smart, and in adulthood more apt to develop diabetes and have higher cholesterol and suffer from hypertension. If by some stroke of luck, he lives until adulthood, he will be more prone to obesity.
The babies who are born to the luckier ones will be healthy, smarter and will definitely be healthier during childhood and even into adulthood. They will not be stunted during the first two years unlike the poorest of the poor counterparts. Stunting or having a low weight for height during the critical window from birth to two years of age will last until adulthood. So no matter if circumstances change later in their young life and they can eat more nutritious food, the stunting is permanent.
And so the cycle goes on, undernourished mother produces undernourished baby, who grows into an undernourished child. Weak bodies produce weak minds, they cannot learn as efficiently and later cannot get an education that will give them better economic opportunities. Even as adults, they are often less productive. This is the cycle of poverty where we, you and I can be part of the solution.
In the worse situation, when a woman die, her child her family her community and ultimately the country lose one of its most valuable source of happiness and prosperity every year, estimated 1,600 women die in Cambodia during child birth or on a result of becoming pregnant. 1000 days will work hard.
To significantly improve maternal health and the new born up to two years, the program will take critical factors such as: The dangerous “Three critical delays” that can make a difference between life and death:
- The time it taken to decide whether to get help
- The transport problems women face in going for help
- The lack of skill staff once they arrive at the health center or hospital.
What we plan to do:
Deliver the necessary inputs for the pregnant mother and newborn child to two years (Mother-Child pair) in the poor areas in the Cambodia through partnership with the local government with each partner pledging their available resources. The delivery of the services will be more personalized via an IMPACT Mother and Child Club utilizing the Health Centers nurses and village Health Volunteers workers as well as mother volunteer’s service and inputs delivered in a participatory way.
We partner with the local government for sustainability and ownership for the project, bringing with us innovative ways to deliver inputs as well as funding the inputs themselves where none are allotted.
From the past experiences of IMPACT Cambodia in the area of
- Early Identification and Treatment
- Affordable accessible surgery
- Safer motherhood and Child Survival
- Ending Malnutrition
- Immunization
- Safe Water and Sanitation
Considering the actual situation of Health Care in Cambodia (2010 Demographic and Health Survey) that:
- Only 59 % of households have improved water during dry season ( 87% in urban, and 53% in rural )
- 57% of households have no toilet facility.
- No official data on the hearing impairment or deafness.
- Infant mortality rate is 45 deaths per 1000 live births
- Under five mortality is 54 deaths per 1000 live births: 77 deaths per 1000 live births from the poorest families (23 deaths per 1000 live births from the rich families)
- 54 % of the births in Cambodia occur in health facilities
- 59% women received a recommended four or more visits for prenatal care
- 40% of children under five are stunt and 28% are under weight, IMPACT Cambodia provides the following inputs:
For the Mother:
- Iron/folic vitamins for 6 months during pregnancy, and three months while breastfeeding.
- Nutrition Classes
- Arrangement for pre-natal visits at the health center at least 40 during pregnancy with proper immunization.
- Arrangement for birth delivery at a health facility in the locality, or at the referral hospital.
- Breastfeeding Classes to ensure exclusive breast feeding for 6 months and first hour after birth breastfeeding as well as prolonged breastfeeding up to two years
- Health Awareness (Pregnancy health Slips) and Cooking classes during pregnancy and during first two years of the child.
- Feeding of pregnant mothers extra calorie needed per day (200 cal) at least 2-3 days a week.
For the child:
- Ensure breastfeeding for first hour after birth and for six months exclusive (no solids or other liquids) for first six months and encourage prolonged breastfeeding up to two years of age.
- Complete immunizations
- After six months, teach mothers how to prepare complementary food that is nutritious and adequate.
- Access to medicines for diarrhea and upper respiratory illnesses that can lead to pneumonia.
- Avail of mental feeding or stimulation of the growing child from the Mothers Club Classes by age in months.
- Growth: Weight/ Height monitoring.
- Complimentary feeding 2 to three 3 times a week for those in need
How we plan to measure:
- Each Mother and Child Pair as well as the village health worker assigned to them will have a Mother and Child 1000 Days Card and where all the inputs are check-listed.
- At the end of nine months and monthly during 0-6 months and every quarter thereafter, reporting will be done to assess the progress.
- A checklist of outputs and outcomes that will serve as a scorecard for the individual Mother/ Child Pair as well as Mother and Child: 1000 days for IMPACT club will be kept up to date.
Documentation:
The project will be documented by video, stills at each stage of implementation. All data will be captured and analyzed according to plan for analysis and presented in graphic form as well as report format. You can check on the progress of your sponsored Mother and Child Pairs online.
What you can do:
- Sponsor a Mother and Child Pair for USD 200 for the whole 1000 days.
- Receive updated reports on the progress of the mother upon birth, at 6 months, at one year and at two years and a summary of your whole donation effort by email and on the website.
- Invite others to your worthy cause. Give as gifts for those who have everything that money can buy: Give the gift of life. Give our future a chance.
- IMPACT will sponsor the equivalent amount in your name.
