1. Cambodia Innovative Training for Rural Health Workers
AAAH Conference
Beijing, 12-14th October 2007
Keat Phuong
Mey Sambo

2. Issues /challenges
Difficult to have staff to go to “unattractive” posts and to stay, especially in rural areas
Movement of staff from remote/rural to urban centers.
Resulting in
Imbalance / mal distribution of staff – shortages in areas where health needs are greatest
Inequity in access to health service & coverage

3. Strategies to Meet the Need
Long term strategy
Increase number of staff working at periphery level with regular course
Short term strategy
Increase number of staff working at periphery level by establishing alternative/innovative training to meet local community student educational background
Provide refresher course to upgrade knowledge and skills of staff working at periphery level

4. Innovative Training for Health Workers
Key aspects include, among others:
Situation analysis:
define vacant posts at each of the four provinces of the NE region;
identify education level of students living in the region & innovative training for them:
identify strategy to select appropriate students to the course.
Selection committee: to select potential candidates from the areas with vacancies /need for training
Mandatory period of service in rural areas
Refresher courses /continuing education
??? Incentives to retain workers in rural areas.

5. Outcomes
Increase in staff in rural areas, especially of nurses and midwives, but inadequate to meet needs.
Need for improvement in quality of services
Midwives
Nurses

6. Lessons Learned
Strategy to limit the frequency of staff movement, from remote/rural to urban/city
Institutional / teaching capacity, including clinical skills practice were inadequate for training needs.
Innovative Training Curriculum should be matched with the health situation of the region & the educational background of the students
Teaching and learning activities require close monitoring and evaluation to ensure the quality of graduates.