The financial cost of having a baby in rural or remote Cambodia can leave a family in debilitating debt. For young mum, Nay Norm, the cost of having her third child at a health centre was 33 times more expensive than the amount she paid for a TBA to deliver her first two children.
And even though the local commune leader picked up half of the $25US debt, it still left this family with a difficult balance to repay. At an average daily wage in the local community of just $2.50, it will take some time before the slate is wiped clean.
With her husband currently out of work, a three month old, a four year old and a two year old to feed, Nay Norm is unlikely to seek out help from the local health centre for a long time to come.
But spare a thought for the skilled birth attendants. Each of the 967 government health centres spread across Cambodia now have a skilled birth attendant attached. On average they earn somewhere around 15-20 US dollars per month. It’s easy to see that the government expenditure on healthcare of $4.09 per person is failing everyone; mothers, babies, traditional birth attendants and skilled birth attendants.
Providing quality health outcomes needs funding. Recently Prime Minister Jens Stoltenberg of Norway pledged one billion US dollars to reduce maternal and child deaths. But what does that mean for countries like Cambodia? Well the Cambodian Ministry of Health have now introduced an incentive for midwives – those who work in rural health centres are paid $15US for each live birth.
In this way, as Norway’s Prime Minister notes, “treatment becomes a source of income rather than a cost, and the finance system a driver for improved results”.