After years of civil strife under the Khmer Rouge and subsequent years of neglect to the social services sector, the needs of the Cambodian population were tremendous in 1992, when Partners for Development established its first programs in the isolated and underserved northeast of the country. PFD’s initial focus was on meeting post-crisis needs in clean water and health, with a participatory approach, community organization, and training serving as the foundation for all work.

Over the course of the last decade, PFD’s strategy to improve the quality of life for underserved and vulnerable groups in Cambodia has taken on a more long-term focus. Despite several years of relative political stability and strong economic growth, average annual income in Cambodia is only $272, with 40% of the population falling below the poverty line in rural areas. Malnutrition is widespread and helps to contribute to the country’s extremely high infant and under-five mortality rates (95 and 124.4 per 1,000 live births, respectively). The maternal mortality rate is the highest in the region at 437 per 100,000 live births.

Partners for Development has moved, in recent years, to address issues of entrenched poverty, malnutrition, and the prevalence of fatal but preventable diseases through an integrated approach in the sectors of health, water, agriculture, veterinary health, and income generation. The cornerstone of all PFD program interventions is training of village volunteers, community groups, and institutions that can take the lead in implementing interventions.

Current Programs

Spien Sokhapheap, Bridges for Health is an integrated health program funded by USAID and designed to bridge the gap between the formal public health system and communities. It provides a comprehensive package of activities in the Kratie and Koh Kong provinces, executed through networks of village health volunteers (VHVs) and community-based distributors (CBDs). The VHVs and CBDs are linked to the formal health system through supervision and support by provincial health center staff. The program’s objectives are the empowering of village communities through health education, demonstration, and support, as well as strengthening of the public health system through training activities. PFD provides training and support to both the VHVs and CBDs as well as to the health center staff who support them. Interventions focus on prevention of malaria and dengue fever, as well as sexually transmitted infections and HIV/AIDS, promotion of birth spacing, safe motherhood (correct breastfeeding practices, immunizations, diarrhea prevention and treatment), and improvement of nutrition levels.

With funding from USAID since 2000, the goal of the Northeast Cambodia Child Survival Project (NCCSP) is to reduce the morbidity and mortality of children under five. The program consists of interventions designed to prevent diarrhea and reduce malnutrition, as well as to increase immunizations and increase the practice of breastfeeding. The NCCSP accomplishes its work through training of Provincial Health Center staff to educate communities. Health Center staff reach local populations through a network of village health volunteers and community-based organizations who interact directly with their local communities to disseminate positive health practices and feedback.

The goal of Krus Kumru L'ol, the Family Nutrition Project, is to improve the nutritional status of children under the age of 5 and thus to reduce mortality and morbidity. The main objective is to reduce malnutrition in small children through community education and through implementing the Hearth Model in villages with significantly high rates for malnutrition. The Hearth Model uses a positive deviance approach that rehabilitates malnourished children through identifying and promoting existing successful childcare, child feeding, and health-seeking behavior practices amongst mothers through key village persons and Village Health Volunteers. This project is complementary to the Child Survival Program (NCCSP) and is currently funded by the Canadian International Development Agency’s Canadian Cooperation Office.

The School Health Education project is one of PFD’s longest running programs, starting in the mid-1990’s in Steung Treng and Kratie provinces. The program’s objective is strengthening local capacity to deliver basic health and hygiene messages through the child-to-child education methodology, using students as peer communicators in their villages. Students are taught health, sanitation, and hygiene related topics at school while teachers receive training as facilitators in child-to-child teaching methodologies. The implementing partner for this project is the Cambodian Ministry of Education while funding comes from the McKnight Foundation through Voluntary Services Overseas.

In its work on the Global Fund Malaria Prevention Program, PFD is one of three international NGO partners of the Cambodian Ministry of Health in the implementation of the 2nd round of the Global Fund to Fight Aids, Tuberculosis and Malaria. Partners for Development implements the malaria component of the program working in partnership with the National Malaria Institute, the Provincial Health Departments, and District Health Centers in Kratie and Koh Kong Provinces, in a manner consistent with the Ministry of Health’s policy of decentralization in health activities. PFD’s Global Fund malaria prevention activities are integrated with and complementary to the Spien Sokhapheap Program and focus on building community awareness and self-help in malaria prevention as well as the distribution of insecticide-impregnated bed-nets.

The Agricultural Development Program (ADP) is a new PFD program recently approved for funding by the US Department of Agriculture (USDA). The ADP is a scaled-up version of PFD’s successful agricultural support program in the Northeast Cambodia Community Development Program (NCCDP). The main objectives of the ADP are to further increase agricultural productivity of smallholder farming, increase family nutrition, strengthen the formal extension system, and increase access to markets by supporting and establishing a Farmers’ Association. The ADP follows a community-based approach and will be linked to the health and nutrition program activities of PFD. Activities are expected to begin mid-2004 and will be implemented for a period of 2 years.

In cooperation with the Australian Foundation for the Peoples of Asia and the Pacific (AFAP) and funded by AUSAID, PFD started with a Dengue Operational Research project in October 2002, initially for a period of 2 years. The objective of the program is to implement a community-based pilot program for dengue control by using a biological agent known as Mesocyclops (tiny, prawn-like predators that are the natural enemy of the Aedes aegypti mosquito, the vector for dengue fever). The approach of the program is to strengthen knowledge and skills in community-based dengue vector control as a sustainable alternative to the use of chemicals. The Dengue project helps to facilitate and proliferate the practice of nurturing naturally-occurring Mesocyclops in household water containers. This is done by executing entomology surveys, and by training national and provincial health staff and Village Health Volunteers. Results after the first year are very promising in the pilot areas. Density of the larvae of the vector has significantly reduced, as have cases of dengue fever. As the project is gaining increasing interest from donors (including AUSAID and USAID), it is expected that it will be extended from an operational research project to an implementation project for the wider community. To see a video of the Mesocyclops in action, click here.