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Project Background

In Cambodia, a majority of rural hospitals and healthcare facilities are poorly equipped. Most have limited access to safe clean water, handwashing stations and proper toilets. All this means the hygienic conditions in maternity wards are extremely poor, increasing the spread of infection and risk of deadly disease for babies and mothers.

As Cambodia, grapples to assist the 8.1 million people living in extreme poverty, public health continues to remain an important challenge and development priority for Cambodia.

  • 170 women per 100,000 die in childbirth each year
  • 79% of the Cambodian population do not have access to a safe and clean water supply
  • 58% have no access to a toilet or hand washing facilities

The links between dirty hands, dirty water and unclean facilities during birth with a link to infant and maternal mortality are well established. Access to clean water, toilets and improved hygiene practices in hospitals is fundamental for reducing the spread of infection. While a hygienic and safe hospital environment increases the experience of care and trust, thus ensuring more women choose to deliver their baby in a healthcare facility instead of delivering at home.

The WHO estimates that healthcare associated infections cause up to 56% of all neo-natal deaths amongst babies born in developing countries and that 11 % of maternal deaths are linked to unhygienic conditions. 
In October 2014, in partnership with the World Health Organisation (WHO), WaterAid Australia undertook research in two rural provinces of Cambodia, Kampong Speu and Prey Veng to understand the status of water, sanitation and hygiene in health care facilities who provide services in maternal and newborn health. Results showed:

  1. Almost no facilities provided drinking water for patients
  2. Pregnant women were unable to access a suitable toilet
  3. There were limited hand washing facilities or soap in maternity wards
  4. Many doctors and nurses were not washing their hands properly or practicing proper infection control measures
  5. There were no proper bio-medical waste systems in place and most parents were required to dispose of their own placentas.

Project Objective

The project has two main goals:

  • Support the Cambodian Ministry of Health to prioritize policies , guidelines and standards to improve and monitor water, sanitation and hygiene in healthcare facilities throughout Cambodia
  • Improve water, sanitation and hygiene at 60 health care facilities and provincial hospitals in rural Cambodia (30 in year one and 30 in year two)

To achieve the project goals, WaterAid will:

  • Lead and coordinate advocacy plans that will result in improved policies and guidelines for improved water, sanitation and hygiene (WASH) in healthcare facilities at a local, district and national level
  • Work with healthcare staff to identify the WASH challenges that are unique to their facilities
  • Support healthcare staff to plan and implement WASH improvement strategies
  • Work with training institutions to improve infection prevention and control training for midwives and other medical staff
  • Invest in the replacement and installation of improved water, sanitation and hygiene infrastructure (i.e. taps, toilets and hand washing stations)
  • We will share successes with the Camobdian Government, World Health Organisation (WHO) and research institutes to encourage a wider spread of WASH improvements in healthcare facilities

What's covered in project costs

Footprints funding will contribute to supporting healthcare facilities and provincial hospitals to plan for improved water, sanitation and hygiene solutions that benefit patients and staff.

Project Beneficiaries

Sixty rural healthcare facilities will have access to safe clean water, sanitation and hygiene. This will help reduce the risk of deadly infections and improve the experience of care for up to 1,800 mothers and their babies.  

In addition, approximately 200 staff, including doctors, nurses, midwives and cleaners will benefit from working in a safer and more hygienic environment.

Dr Voeun, Director of the Boeung Kontout Health Centre | Photo credit: WaterAid/Tom Greenwood

Case Study: Dr Voeun - Boeung Kontout Health Centre

"My health centre only has one source of water. Water quality testing shows a high concentration of arsenic. Patients must not drink this water, so we tell them to buy their own.

"We have no toilets for women on the maternity ward, this means pregnant women have to walk outside the building to go to the toilet. This is a terrible challenge for these women. I also know staff and patients are not cleaning their hands properly after using the toilet because we have no soap. I worry this will spread infection.

I want to improve the water and sanitation at my centre and make it safer for my patients, but I cannot find a way to do it."

How does this project fit into a larger strategy?

The ‘Putting the lives of mothers and babies in safe (clean) hands’ project is aligned with the government of Cambodia’s new five-year strategy to improve access to equitable and quality health services by 2025. WaterAid is working in partnership with the Ministry of Health, local and international NGO’s and research partners to prioritize and inform new government policies that aim to reduce disease and improve patient care by improving water, sanitation and hygiene in all Cambodian hospitals and healthcare facilities.

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