Cambodia Innovative Training for Rural Health Workers AAAH Conference Beijing, 12-14th October 2007 Keat Phuong Mey Sambo

Issues /challenges Difficult to have staff to go to “unattractive” posts and to stay, especially in rural areas Movement of staff from remote/rural to urban centers. Resulting in Imbalance / mal distribution of staff – shortages in areas where health needs are greatest Inequity in access to health service & coverage

Strategies to Meet the Need Long term strategy Increase number of staff working at periphery level with regular course Short term strategy Increase number of staff working at periphery level by establishing alternative/innovative training to meet local community student educational background Provide refresher course to upgrade knowledge and skills of staff working at periphery level

Innovative Training for Health Workers Key aspects include, among others: Situation analysis: define vacant posts at each of the four provinces of the NE region; identify education level of students living in the region & innovative training for them: identify strategy to select appropriate students to the course. Selection committee: to select potential candidates from the areas with vacancies /need for training Mandatory period of service in rural areas Refresher courses /continuing education ??? Incentives to retain workers in rural areas.

Outcomes Increase in staff in rural areas, especially of nurses and midwives, but inadequate to meet needs. Need for improvement in quality of services Midwives Nurses

Lessons Learned Strategy to limit the frequency of staff movement, from remote/rural to urban/city Institutional / teaching capacity, including clinical skills practice were inadequate for training needs. Innovative Training Curriculum should be matched with the health situation of the region & the educational background of the students Teaching and learning activities require close monitoring and evaluation to ensure the quality of graduates.