Voluntary Surgical Contraception Sterilization Conference (26 – 27 June 2003) Family planning as a priority component of RH in Cambodia- Voluntary Surgical Contraception Sterilization as a method to be expanded. Dr. Chhun Long

Having children and Maternal Deaths  Every day at least 1,600 women die from the complications of pregnancy and childbirth (more than 585,000 women each year).  In addition to each maternal deaths, about 100 women experience pregnancy-related complications, many of which lead to long-term illness or disability.  During the ages 15 to 49, one out of every 48 women in the developing world will die from pregnancy- related complications.  In Cambodia, more than 2000 Cambodian women are dying each year.  35.2% of Cambodian currently married women want no more children.

Reproductive Health Care (ICPD 94) All countries are called upon to strive to make reproductive health accessible through the primary health-care system to all individuals of appropriate age as soon as possible. Reproductive health-care programmes should be designed to serve the needs of women. Such programmes must both educate and enable men to share more equally in family planning, domestic and child rearing responsibilities.

Recommended Family Planning Actions  Actions are recommended to help couples and individuals meet their reproductive goals; prevent unwanted pregnancies and reduce the incidence of high risk pregnancies and morbidity and mortality; make quality services affordable, acceptable and accessible to all who need and want them; improve the quality of advice, information, education communication, counseling and services;

Recommended Family Planning Actions (continued) increase the participation and sharing of responsibility of men in the actual practice of family planning; and promote breast-feeding to enhance birth spacing.  The emphasizes should support the principle of voluntary choice in family planning.  As part of the effort to meet unmet needs, all countries are asked to identify and remove all major remaining barriers to the use of family planning services.

Family Planning Actions in Cambodia  From 1994 to 1997, the MOH provided BS services in 30 service delivery sites in the Capital and 5 provinces, and to training material development on a national scale.  From 1997 to 2000 made significant efforts were made to: the expansion of BS services to be provided in all provinces and municipalities. the increase of modern CPR from 7% in 1995 to 16% in 1998 and 19% in  In 2003, 899 HCs are providing COC, POP, condoms and injectables; IUDs insertion services are available in 229 service delivery sites.

Family Planning Actions in Cambodia (continued)  The modern Contraceptive Prevalence rates and the Public Sector Coverage by trained providers have increased quickly to 24.50% and 18% respectively.  However, VSC is not widely available even in referral hospitals for those who need them. The number of tubectomy has increased, but the number of vasectomy has dropped in 2002 compared to 2001.

Voluntary surgical contraception

Recommendations  Quality of service depends on quality and availability of the facility (setting, equipments, supplies), and provider-client relationship. The quality adds up with client's expectation to the satisfaction.  The concept of "one stop service" should be considered as one part for the quality improvement of BS/contraceptive services in Cambodia.  VSC are to be expanded quickly to all referral hospitals.

Thank you for your for attention!