February 28, 2024

Bringing non-communicable disease and eye health services one step closer to homes in Cambodia

The Cambodian government trains health workers countrywide in providing integrated NCD and eye health services

At the end of 2023, only one in four of Cambodia’s health centers had staff trained to provide noncommunicable disease (NCD) prevention and care services. This includes screening and treatment for diseases such as high blood pressure and diabetes. However, in 2024, the Royal Government of Cambodia has started implementing an ambitious plan to scale up access to high blood pressure and diabetes prevention and care as recommended in the World Health Organization (WHO) package of essential NCD (PEN) disease interventions. The government will also be leveraging the expansion of the program to increase access to eye care via an integrated approach. Staff across all 1,288 health centers in the country will be trained on NCDs, bringing care closer to all people at risk of and living with NCDs.

Health workers at an NCD and eyesight screening training in Kampot Province, Cambodia

Figure 1: Training for health center workers kicks off in Kampot province

In January 2024, the government, with CHAI’s support, kicked off intensive training for health center staff throughout the 24 provinces.

“This is what we have been waiting for, for a long time, but it is just the starting point,” reflected Dr. Nhea Bunrath of Kampot Provincial Health Department, who is supporting the rollout of NCD services in the province.

“High blood pressure and diabetes have been killing Cambodians for many years, but this is the first time health center staff across the province have received training on NCDs”. Indeed, these services are crucial for the population—NCDs are responsible for 64 percent of all deaths in the country, and at least 14 percent of the population live with high blood pressure, and nearly 10 percent live with diabetes.

Doctor is having a consultation with elderly woman in Kampot Province, Cambodia

Figure 2: In 2023, only 1% of the Cambodian population had been screened for NCDs. The Royal Government of Cambodia is now making efforts to change that in 2024 and beyond

Ms. Chheav Sokunthea, a midwife at Krang Ampil Health Center, was one of those receiving training on NCD and eye care. She was equally excited to learn new skills and inform her local community of the new services her health center would be providing.

“I have never received training on eye health before. Now, I have learned the risk factors for developing NCDs and the impact of high blood pressure and diabetes on eye health, and I feel confident to provide counseling, screening, and basic treatment for these conditions. I now also feel confident about referring patients with complications to the local referral hospital and vision center.”

Midwife at Krang Ampil Health Center, Cambodia is interviewed by CHAI staff about NCD and eye health screening

Ms. Chheav Sokunthea, a midwife at Krang Ampil Health Center speaks to CHAI staff

NCDs impact the livelihood and financial well-being of many families in the country. Mr. Hang Soeun, who lives in Samrong village, is one such example. His mother lives with high blood pressure and diabetes, which impacted her ability to work. She lost her job, and the family lost an additional income stream, leaving Mr. Soeun to take care of the family alone. Because of his first-hand experience of the economic impact of NCDs, he stepped up to be a volunteer patient to help the health center workers practice their new skills in screening for NCDs. He wants other families to have access to early screening and treatment that his mother did not receive so that they do not have to go through the same misfortune.

Mrs. Ngin Pheap also volunteered as a practice patient for the training. Her story provides a snapshot of the impact the training will have on the lives of many Cambodians when services become available in health centers throughout the country in the coming year.

“I am so happy to get screened for NCDs and eye diseases because I have never been screened before. I did not have the time to travel to the Referral Hospital because of my job as a farmer. Today, the healthcare worker was able to screen me for high blood pressure, diabetes, and eye conditions and gave me advice on how I can improve my health through my diet and exercise. It was easy for me to come to the health center because it is so close to my house—I even brought my grandchild with me to get vaccinated as I got screened!”

“Thanks to the generous support of Vision Catalyst Fund and the Clinton Health Access Initiative, Kampot province has been able to take the standard NCD training and adapt it more closely to people’s needs. We have trialed a new approach of combining training on high blood pressure and diabetes with training on basic eye health prevention, screening, and treatment,” said Dr. Lim Chan, Deputy Director of Kampot’s Provincial Health Department.

“Such integration is crucial as both high blood pressure and diabetes can have a negative impact on vision if uncontrolled. Not only does combining these services help improve people’s health and reduce blindness, but it also helps reduce the cost of care for those accessing services,” he continued.

Written by Lan Mao, Deputy Country Director and Dr Grace Dubois, NCD Program Manager, Cambodia
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