Essay On Health In Cambodian Context: Imagining Social And Cultural Perspectives.

Historical Factors and their Influence on Maternal and Child Healthcare in Cambodia

Discuss about the Imagining Health in Social and Cultural Context.

Cambodia is a third world country situated in Southeast Asia neighboring Thailand, Laos, and Vietnam (Tyner, 2014).  Recent studies by the World Bank showed that the country's population by the year 2015 was at 15.3 million with a relatively low gross national income of US$ 1, 020.00 thus termed a low-income level state (World Health Organization and UNICEF, 2014). That said, it is evident that poverty has its roots deeply immersed in the economy of the country making the country rely heavily on foreign aid to several mainstream sectors such as education, HIV/AIDS, and the health system: maternal health care being the basis of the study (McKinnon, 2014).  The current health status in Cambodia is based on the evaluation of life expectancy, diseases, HIV/AIDS, and maternal and child healthcare is improving as contradicted to the previous political and social model of analysis (Peou and Zinn, 2015). As of the year 2015, the mother and child healthcare report recorded a drastic improvement with an estimated mortality rate per 100,000 live birth being 161 (Barroso et al., 2016). The latter is contradicted by the analysis conducted by the World Health Organization in the year 2010 and recorded a mortality rate of 100,000 per 100 live birth (World Health Organization and UNICEF, 2014). The available statistics provide a platform for the analysis of the health industry in Cambodia with the realization of target 1 of SDG 3: by 2030 to reduce the country’s maternal mortality ratio to less than 70% live births. As such, ideas in this paper seek to illustrate the actions and efforts put in place by the Cambodian government to combat increased cases of maternal mortality ratio as a  target 1 of SDG 3 by 2030. Notably, the paper is divided into several sections with the aim of making the work readable. The first section will discuss the historical factors that influence the health issue. Secondly, the paper will set a discussion on cultural factors affecting the health sector in Cambodia. Thirdly, the section will analyze critical factors responsible for the current health issue citing evidence from academically peer reviewed journals. Lastly, the paper will conclude the discussed ideas by restating the thesis statement and providing an opinion on the future of the health industry in Cambodia as shown below.

In Cambodia, several significant historical events related to politics, natural disasters, economic issues, and conflict have helped to shape the health industry either positively or negatively. Therefore, the paper's section will descriptively analyze some of the mentioned factors to show their significant role in developing the Cambodia's progress in the realization of the target 1 of the SDG 3. To start with, the political regime in Cambodia has directly influenced the allocation of funds from the government to health facilities and access to improved healthcare through policies. Previously, the governance of Cambodia was purely communist, and it saw approximately 1.7 million citizens die as a result of genocide, extreme hunger and poverty, and inadequate and poorly managed medical facilities (Kuruvilla et al., 2014). Subsequently, Cambodia went into a poor state both financially, in education and access to information as a result of genocide and oppression of the poor.

Cultural Factors Related to Maternal Mortality in Cambodia

As a result of genocide, there was a conflict which saw the United Nations Transitional Authority in Cambodia (UNTAC) intervene to restore back to peace and implement democracy under the constitutional monarchy through electoral process (Rogers, 2016).  Moreover, the aftermath of the conflicts paralyzed the country's economy as both local and international businesses schemes were interfered with for several months. Notably, the health sector in Cambodia was compromised and had to rely on foreign aid from donor countries such as the United States of America to help combat the ever increasing rate of maternal and child mortality.  Research showed that the government received international assistance from the United States and disbanded them to the local health facilities to help reduce the less than five years child mortality rate: Likewise, the aid improved the health status of mothers in the maternity wards (Whitfield et al., 2016). That said it is important to recognize the efforts made by the Cambodian government t overcome the condition. After complete implementation of democracy in Cambodia through the help of the UNTAC, the Cambodian politics has political leaders elected on merit and have the best of interest at heart for the citizens: this, in turn, has helped in achieving better health care through decision making by the politicians. Equally, the government has transformed its economy from a planned model to a market-oriented system where attention is paid to the agricultural sector and the service industry (Kuruvilla et al., 2014).  Having discussed the historical factors responsible for shaping the area of health in Cambodia: maternal mortality, it is considered wise to analyze the cultural factors associated with developing the industry too.

Despite attaining development goals to suit the scale of measure in today's world, Cambodia still has traditional beliefs which act as barriers to the realization of the target 1 of SDG 3. Recent studies revealed that most o f the cases of maternal mortality were located in rural set-ups where cultural beliefs were central to decision making (Le Blanc, 2015). Furthermore, a report by the World Health Organization indicated that most rural based citizens in Cambodia were rigid on the uptake of biomedical treatment geared towards reducing maternal mortality: and opted for traditional delivery models where a child's life is compromised. The risks associated with traditional child delivery are many, and a child's well-being is not promised to start with the type of equipment used.

Structural Factors Affecting Maternal Mortality in Cambodia

Again, a survey by the Ministry of Health department of planning and health information showed that the society in Cambodia socializes women to be submissive where access to information and education is limited (World Health Organization and UNICEF, 2014). As such, uneducated women in Cambodia opted for traditional child delivery as contradicted to educated women who defied the rules of conventional traditional and challenge the status quo: the educated women sought medication in certified heath facilities and delivered in hospitals (Finlayson and Downe, 2013). To enhance our understanding of the efforts put in place by the Cambodian government to realize the target 1 of SDG 3, it is of significant role to understand the structural factors influencing the maternal mortality.

Progressively, it is important to assess the progress of Cambodia towards realizing the Millennium Development Goal of reducing maternal mortality. The section, therefore, examines the models implemented by the Cambodian government in improving health, evaluating the health sector, and prevention strategies put in place. First, the government has reviewed its health policies and factors impacting the maternal mortality ratio (historical and cultural) and resorted to increasing the number of skilled health personnel in public hospitals (Duff, 2015). Likewise, the ministry of health in Cambodia is reported to advocate for the inclusion of antenatal care to realize the targets and goals.

What is more, is the integration between public and private health sector in Cambodia to combat increased death cases. Additionally, research shows that there is an increase in the number of allocation of skilled midwives as well internship salary to undergraduates working in the public health sector (Duff, 2015). Noteworthy is the fact the ministry of health has initiated a 24-hour operating antenatal care unit with qualified supervisor and data collection staff (Gresh, 2016). Another key thing to remember is the role played by the government to create awareness nationally on the use of family planning and practicing of safe abortions as a means to realize the MDGS. Again, the paper will set a discussion on the critical factors affecting the maternal mortality ration in Cambodia as shown below.

Notably, historical, social, and cultural factors are models through which the effectiveness of a health organization plan is realized. Analysis of Cambodia's health industry in the realization of target 1 of SDG 3 is a step by step build process that entails stakeholders, citizens, and health professions to achieve results. Throughout the discussion, it is evident that the health industry in Cambodia had a rough time to implement its plan: ranging from extreme poverty and hunger, genocide up to democracy to have improved healthcare. However, social models for health and professionals such as teamwork, innovation, learning, and empowerment made it possible for the government to have the MDGs achieved in Cambodia (Kassebaum et al., 2014). For instance, the government integrating both the public and private health sector to help reduce the mortality rate in Cambodia.

In the same way, we perceive information from the media; we are obliged to interpreting health information similarly. In the world today, most health issues are associated with lifestyle (Blum and Nelson-Mmari, 2004). For instance, eating junk and less training makes one susceptible to obesity. Therefore, it is evident that by analyzing social patterns among individuals and groups, health sociology sets a discussion on how personal health issues are related t social patterning of illness and the solution lies in the social habits.

As part of the case study, an example of a success story on how Cambodia managed to curb TB and turned it into an opportunity will set a platform for expansion and implementation of the health industry mechanism to realize the target 1 of SDG 3 (Hackett et al., 2016). A report by Dr. Mario Raviglione, Director of WHO's Stop TB Department recorded that ‘after the genocide, the health system in Cambodia got weak and TB was on rising.' (Grundy et al., 2016) However, new technological approaches to curbing TB were implemented through the establishment of primary care facilities and halved the number thus helping the country meet its MDGs. Base on the success story I strongly recommend the integration of both traditional and modern biomedical techniques in combating maternal mortality: the model will reduce cases of ethnocentrism.

Conclusion

Finally, it is possible to discern that Cambodia is working hard to combat the problem on the increased maternal mortality ratio: as the government is implementing health care plans to help the citizens. Moreover, to realize the short terms MDGs and long term SDG 3, the government together with the health ministry is reviewing health policies and making informed decisions to improve health care. Additionally, evaluation of social, cultural and historical factors provide evidence on strength and weaknesses of the health sector in Cambodia. For instance, the analysis of the uptake of modern medicine in rural set ups in Cambodia proved a case study to allow the government invest on creating awareness on health issues. Sidelining of the rural people due to their traditional beliefs will create a barrier to the implementation of the proposed therapeutic strategies while increasing maternal mortality. To that end, it is wise for Cambodia to invest in the agricultural sector to avoid relying on foreign aid.

Reference

Le Blanc, D. (2015). Towards integration at last? The sustainable development goals as a network of targets. Sustainable Development, 23(3), 176-187.

Rogers, D. S. (2016). 74. A proposal to monitor intersecting inequalities in the post-2015 Agenda. World social science report, 2016: Challenging inequalities; pathways to a just world, 294.

Gresh, A. K. (2016, July). Building the Capacity of Nurses to Achieve the Sustainable Development Goals (SDGs) Through Knowledge Gateways. In Sigma Theta Tau International's 27th International Nursing Research Congress. STTI.

Barroso, C., Lichuma, W., Mason, E., Lehohla, P., Paul, V. K., Pkhakadze, G., & Yamin, A. E. (2016). Accountability for women’s, children’s and adolescents’ health in the Sustainable Development Goal era. BMC Public Health, 16(2), 799.

Tyner, J. A. (2014). Dead labor, landscapes, and mass graves: Administrative violence during the Cambodian genocide. Geoforum, 52, 70-77.

Grundy, J., Hoban, E., & Allender, S. (2016). Turning Points in Political and Health Policy History: The Case of Cambodia 1975–2014. Health and History, 18(1), 89-110.

McKinnon, K. (2014). Cambodia. Aid dependence in Cambodia: How foreign assistance undermines democracy By Sophal Ear New York: Columbia University Press, 2013. Pp. 185. Figures, Tables, Notes, Bibliography, Index. Cambodia. The Cardamom conundrum: Reconciling development and conservation in the Kingdom of Cambodia By Timothy J. Killeen Singapore: NUS Press, 2012. Pp. 354. Maps, Figures, Tables, Photographs, Notes, Index. Journal of Southeast Asian Studies, 45(03), 457-462.

Peou, C., & Zinn, J. (2015). Cambodian youth managing expectations and uncertainties of the life course–a typology of biographical management. Journal of Youth Studies, 18(6), 726-742.

Whitfield, K. C., Karakochuk, C. D., Kroeun, H., Chan, B., Borath, M., Lynd, L. D., & Green, T. J. (2016). Consumption of Novel Thiamin-Fortified Fish Sauce Improves the Thiamin Status of Rural Cambodian Women of Childbearing Age and Their Children< 5 Years. The FASEB Journal, 30(1 Supplement), 891-9.

Duff, K. P. (2015). Investigating the role of structural determinants in shaping sex workers' reproductive health access and outcomes (Doctoral dissertation, University of British Columbia).

Kuruvilla, S., Schweitzer, J., Bishai, D., Chowdhury, S., Caramani, D., Frost, L., & Cohen, R. (2014). Success factors for reducing maternal and child mortality. Bulletin of the World Health Organization, 92(7), 533-544.

Finlayson, K., & Downe, S. (2013). Why do women not use antenatal services in low-and middle-income countries? A meta-synthesis of qualitative studies. PLoS Med, 10(1), e1001373.

Blum, R. W., & Nelson-Mmari, K. (2004). The health of young people in a global context. Journal of Adolescent Health, 35(5), 402-418.a

World Health Organization, & UNICEF. (2014). Trends in maternal mortality: 1990 to 2013: estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division: executive summary.

Hackett, J. D., Hudson, R. F., West, E. A., & Brown, S. E. (2016). Cambodian Inclusive Education for Vulnerable Populations: Toward an Ecological Perspective Policy. Journal of International Special Needs Education, 19(1), 3-14.

Kassebaum, N. J., Bertozzi-Villa, A., Coggeshall, M. S., Shackelford, K. A., Steiner, C., Heuton, K. R., ... & Templin, T. (2014). Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 384(9947), 980-1004.