On behalf of Ms Thoraya Obaid, UNFPA Executive Director, and my colleagues at UNFPA, it is my honour to join you today for Cambodia’s second Midwifery Forum.

I would like to express our thanks to the Royal Government of Cambodia, in particular the National Committee for Population and Development and The Ministry of Health, for organizing today’s event.

The 2nd Midwifery Forum is very timely. Significant progress has been made since the 1st Forum at the end of 2005, yet significant challenges remain. It is important that the 3rd government mandate is updated and briefed on these important issues, and that outstanding challenges are urgently addressed.  

Over the course of the last two days, there have been important presentations and discussions about reproductive, maternal and neonatal health, and specific achievements and challenges related to midwifery training, recruitment, deployment and scaling up of midwifery as a profession. We have heard from experts in multiple sectors, we have seen an impressive video documentary, and we have heard from midwives themselves.  This situation in the field is clear, and the real challenges and needs of midwives are also clear.  I am impressed with the achievements made to date, and the high level commitment to address outstanding challenges.  The Royal Government of  Cambodia, The Ministry of Health and Midwives should be commended for the significant increases in deliveries by skilled birth attendants and antenatal care, and for the increase in the civil service status of midwives and the introduction of a midwifery incentive system. In 2009, the government has committed to ensuring that every health center has at least one midwife, and midwifery training institutions now have their largest intakes ever.  These are impressive achievements, and were key issues raised during the last forum.  

However, important challenges remain. Despite efforts to date, many locations still need more and better skilled midwives. Midwives themselves noted the need for additional competency training, and the need for additional improvements to HCs and midwifery training institutions including improved water and electricity supplies, and additional classrooms, Khmer text books and practice sites. They also noted the need for more and better skilled and motivated midwifery teachers.    

In moving forward it is important that we keep our eyes on the commitments and targets already set for 2010 and 2015: improved maternal health and universal access to reproductive health services. We must intensify our support and work together to achieve these goals and overcome the above challenges.  We must have a holistic approach and ensure that there is an enabling environment for change to happen, both within the health sector and within communities themselves.  

Midwives need to be rewarded for good performance and willingness to work in remote postings. They also need professional support and regulation that reinforces competence and continuing education.  Communities need more and better midwives, national coverage of equity funds so that all Cambodians can access life saving services, and improved local participation and infrastructure.

Cambodia's 2nd Midwifery Forum has highlighted what has been achieved and the challenges that lie ahead. It has reconfirmed the Royal Government of Cambodia’s and donor partner’s commitment to address the outstanding challenges and to work together to achieve MDG 5.

In closing, I would like to thank The National Committee for Population and Development of the Office of the Council of Ministers, The Ministry of Health, midwives and donor partners for their organization and participation in this important forum.  

The causes of maternal and newborn mortality are known, and interventions to effectively prevent and treat them are also known. Now is the time for action and the Royal Government of  Cambodia, the Ministry of Health, midwives and donor partners must work together to improve maternal health and reduce maternal mortality.  We can’t afford not to deliver – no Cambodian woman should die giving life.