Excellency Tao Seng Huor, Senior Minister and President of the National Committee for Population and Development
HE Dr. Mam Bunheng, Minister of Health
Ms. Alice Levisay, UNFPA Representative in Cambodia
Dr. Michael O’leary, WHO Representative in Cambodia and Health Partner Representative
Excellencies, distinguished guests, ladies, gentlemen and midwives

It is a great honor and pleasure to be here today and to address this distinguished gathering at the opening of the 2nd National Midwifery Forum in Cambodia. I would like to express my sincere appreciation to the National Committee for Population and Development, Ministry of Health and the United Nations Population Fund (UNFPA) who have jointly organized this important forum under the critical theme “No Woman Should Die Giving Life”.

Excellencies, ladies and gentlemen,

I would like to recall that during the Khmer Rouge time, most of the intellectual people including experts and skilled midwives were killed. Soon after the victory day of 7 January 1979, we were faced with the shortage of midwifery skilled practitioners while there was a critical need for most women. The government since then gathered the remaining people who had some medical background for training on the ground that "those who know more teach those who know less and those who know less teach those who have no knowledge." This strategy allowed us to steadily tackle the shortage of health staff, in particular midwives.

As noted in  the remarks by HE Dr. Mam Bunheng’s, currently we have training institutions for medical profession for all levels including medical doctor, midwife and nurse, resulting in an increase in both quantity and quality of health professionals annually. The government has been investing tremendous resources in medical care training and, as a result, a number of those trainees are serving at health centers, referral hospitals and hospitals, while some others are working at clinics and private hospitals and for civil society. The Royal Government of Cambodia under the great leadership of the Samdech Akka Moha Sena Padei Techo Hun Sen, together with our people, had to start from scratch and step by step we have managed  to develop our human resources in health sector as we can see now.

Excellencies, ladies and gentlemen,

During the health congress held in March by the Ministry of Health, Samdech Akka Moha Sena Padei Techo Hun Sen recognized the shortage of health workers, especially midwives in particular in the remote areas. It does not necessarily mean that we have insufficient number of midwives, but the important point is that serving in remote rural areas may not be a first choice for those professional midwives. Step by step the Royal Government of Cambodia has been addressing this issue as it is central to achieving our goals of reducing child and maternal mortality, strengthening reproductive health services and  implementation of the National Population Policy as enshrined in the Rectangular Strategy II, no. 4 of the Royal Government of Cambodia.

The Royal Government recognizes that women are the mother of the world,the backbone of the national economy and women are the precious gems that the National Strategic Development Plan, Rectangular Strategy and Neary Rattanak’s Strategic Plan all include the promotion of women’s status, and women's well-being as main priority areas. If women continue to lose their lives giving new lives, families cannot have  happiness and the country will not enjoy prosperity.

The government, under the leadership of Samdech Akka Mohasena Padei Techo Hun Sen acknowledges the critical roles of midwives in relevance to poverty eradication: (I) poor health leads to the increase in poverty, in return, poverty leads to poor health; (II) health is the precious and valuable asset of the people and the key to getting themselves out from poverty with sustainable livelihood; and (III) health sector contributes to reducing poverty in many ways and promotes social and economic  development.

Recognizing the above,, the government has been directing much effort towards the following: (I) building more health centers, referral hospitals and hospitals to allow convenient access by the people but also  towards making available of health staff including midwives at all health centers nationwide. Midwives are key health agents working closely with people and providing health services effectively, thus midwives have crucial roles in contribution to programmes for social development and poverty reduction;  and (II) prevention and caring of people’s health have been integrated in the National Strategic Development Plan.

Excellencies, ladies and gentlemen,

Midwives and midwifery skilled practitioners have important role in promoting maternal and child health and reducing maternal and child mortality rate. The presence of midwife at child births means the safety and warmth of mothers and children are ensured. To give birth is to face many risks and that's why it is termed by our ancestors in Khmer as “Crossing the River”. However, so long as there is presence of skilled midwife ready to provide assistance, we have a reliable means to cross the river safely and the chance for mother and child to survive is also high. This is due to the fact that we are forewarned and ready to undertake necessary action to seek  solutions to the problems that might befall the mother and child in a timely manner.

The Khmer people since the old day cannot exclude the effort made by the traditional birth attendants in their service provision. We may recall that during the time there were no medical services in rural areas, it was these traditional birth attendants (TBA) or Yey Morb that played  a key role in assisting delivery and taking care of the mother and child health. We are very grateful for this service. Nonetheless given the current scientific advance, and the emerging of new and fierce communicable diseases and infection and sometimes the inability of these TBA  to respond effectively to the evolution of these diseases, it requires continued attention on the part of . relevant ministries, institutions and development partners to to support TBA in order for them to receive new knowledge related to the maintenance of hygiene and health of the rural people.

Although the government provides 60,000 riels as incentive to any health center professional midwife who provides safe delivery of a child at rural areas, it doesn’t mean that the government forgets TBA becoming less appreciate of their services.

More imporatny, the midwives and skilled attendants are key human resources who help deliver and save the life of mother and child during delivery. From a faith standpoint, the midwives and skilled attendants receive double merits which is one for helping the mother and another for rescuing the live of the child. Helping to deliver a child is an act of merit making and a respect for morale, conscience and professional ethics.

Therefore, I call on all health personnel, those who work for the health sector as a whole including medical doctors, pharmacists, nurses and midwives to provide a caring service to those who come to consult, especially for poor pregnant women and giving birth mothers by primarily basing on the morale, conscience, professional ethics and building merits.

Excellencies, ladies and gentlemen,

This two-day forum is a good opportunity for us, particularly the central level, to gather together and hear on first-hand account directly from the midwives and skilled attendants about their achievements and challenges faced during the implementation of their tasks. In addition, we will have a chance to find out a joint solution that would help ensure women to have full access to safe and quality delivery services.

While the Ministry of Health together with relevant institutions and all development partners are striving for women to receive universal reproductive health services which contributes to the poverty reduction for women and families, I suggest that additional effort should be made to ensure quality of education and capacity of health service providers and the quality of services. Once we have  skilled service providers, women and children will also receive quality services and women will not die giving life.

I call on all development partners to continue support to the Royal Government of Cambodia to improve the health sector particularly the midwifery services through any possible means which aims at enhancing the quality of services and encouraging midwives to serve at the health centers in rural areas. This is in conformity with the International Conference on Population and Development (ICPD) held in Cairo in 1994 and Goal #5 of the Cambodian Millennium Development Goals (MDGs).

Excellencies, ladies and gentlemen,

I finally hope that this forum will present us potential recommendations which will serve as a roadmap for us to reach our goal stipulated in the Fourth Mandate of the Rectangular Strategy Phase II of the Royal Government of Cambodia.

I thank UNFPA for providing technical and financial support for enhancing the reproductive health services including the maternal and child health in the Royal Kingdom of Cambodia. My thanks also go to the National Committee for Population and Development for actively cooperating with the Ministry of Health, relevant institutions, civil society and development partners in ensuring the health, reproductive health and maternal and child health in the Royal Kingdom of Cambodia.

I wish the 2nd two-day National Midwifery Forum smooth and fruitful discussions and I wish to declare the opening of this second forum from now on.

Thank you.