|Reporting Organization:||ADRA Canada|
|Total Budget ($CAD):||$ 1,999,500|
|Timeframe:||October 1, 2012 - September 30, 2015|
|Cambodia - $ 1,999,500.00 (100.00%)|
|Nutrition (51.7 %)|
|Reproductive Health & Rights incl. Maternal Health (48.3 %)|
The Securing Mothers’ and Infants’ Lives with Equity (SMILE) project was implemented from January 10, 2012 through to June 30, 2015 in 80 villages of 21 communes in the three districts of Chieb, Chey Sen and Rovieng of Preah Vihear Province. SMILE contributed to a better overall prognosis for the future health of women of reproductive age, boys and girls. There has been positive change which can be sustained in the future through the network of human resources remaining in the community.
SMILE worked through three gender-sensitive project components; promoting gender equality in improved health care practices, improving the capacity of health care providers in reproductive health (RH) and integrated management of childhood illnesses (IMCI), and improving the consumption of nutrient-rich foods by mothers and children under 5.
|Gender and age:||Adult women Adult men Adolescent females Adolescent males Under-5 children Newborns Older adults, women Older adults, men|
|Total Direct Population:||38,032|
|Total Indirect Population:||167,995|
|13||Health centres equipped|
|160||traditional birth attendants trained|
|23935||People attending awareness raising sessions|
|8||Waiting and delivery rooms constructed|
The SMILE Project achieved the following intermediate outcomes: 1)More equal participation in improved health care practices by mothers, women of reproductive age (WRA) and other caregivers (m/f) relating to RH and IMCI, women and caregivers are now more confident in consulting with partners regarding reproductive health and childhood illness issues; women and caregivers have improved communication skills to be able to make better consultative decisions with their partners; exclusive breastfeeding has increased especially for female infants (up from 68% at baseline to 82% at endline) , as before the project interventions mothers followed the cultural practice of giving precedence in breastfeeding to boys over girls. Boys must be groomed to be strong to be the providers of the family ; and caregivers and WRA are more knowledgeable about environmental health and what they can do to prevent illness; and they are more confident than before that they were actually doing these actions; 3) Improved capacity of health care providers (f/m) ) to provide reproductive and IMCI quality health services with more engaged support from Traditional Birth Attendants (TBA), health services have improved and are being better utilised with more mothers engaging skilled health professionals for the delivery of their babies (up from 46% of live births at baseline to 71% at endline); health services for women and children are being perceived as having improved; and levels of satisfaction have increased among caregivers and mothers of the services for reproductive health and children. SMILE’s intermediate outcomes contributed to the ultimate outcome of reduced mortality of mothers, and boys and girls under 5 by reducing child mortality, severe stunting, wasting and underweights. The SMILE Community Information System (CIS) shows a reduction in underfive mortality in the project sites (down from 19 to 1 per 1000 at baseline versus endline). Nutritional indicators of growth monitoring showed short term change had occurred as wasting had been reduced, but stunting (less than 2 standard deviations (SD)) was still at a similar level as the baseline, and targets which were set too high have not been achieved yet. However, stunting rates measured at less than 3 SDs show improvements in the % of children who are severely stunted. Severe stunting dropped from baseline figures of 18.2% to 14.31.9% at endline for girls, and from 23.1% to 14.5% for boys. This reflects the success of the project in reaching out to the most vulnerable segments of the targeted children. It is expected that the stunting rates (less than 2 SDs) will eventually go down given more time.
Results achieved as of the end of the project (September 2015) include: (1) eight waiting and delivery rooms were constructed and 13 health centres were equipped to provide essential mother and child health services; (2) 53 midwives and 160 traditional birth attendants were trained on safe birthing practices, including referring pregnant women to health centres when needed; (3) 23,935 people, including more than 10,000 men, attended awareness raising sessions on how to prevent illnesses impacting mothers and children under five; (4) health centers staff, including midwives and traditional birth attendants having increased their ability to administer appropriate maternal care has increased to 88.5%, which is above the target of 50.0%; (5) live births attended by skilled health personnel increased from 46% at the beginning of the project to 70.7%, which is above the target of 55.0%; (6) mothers’ levels of confidence regarding consulting their partners on reproductive health and childhood illness issues increased from 69.6% to 90.2%, which is above the target of 90.0%; and (7) the level of satisfaction among pregnant women and mothers regarding the availability of skilled professionals for their deliveries at health centres increased from 50.4% to 78.7%, which is above the target of 70%. These results are contributing to improving health facilities and systems capacities, improving the quality of health care, and improving women’s health care practices.