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Community health through family planning

Marie Stopes International opened its clinic in Siem Reap in 2009.

IN February, 2009, Marie Stopes International, a worldwide sexual reproductive health and family planning organisation with clinics in more than 40 countries, opened its doors in Siem Reap.

Since then, it has achieved 100 per cent cost recovery and has been helping individuals from every socio-economic group.

“They felt the need for Cambodia to have family planning, and that it needed our support,” Marie Stopes International Cambodian program director Che Katz says.

“Marie Stopes Cambodia was started in 1998 as a local NGO. In 2008, it became an international NGO in Cambodia and is one of   the leading sexual reproduction NGOs in the country.”

Marie Stopes International Cambodia undertakes various projects to improve reproductive health in Cambodia with financial support from a number of donors.

Its aims are to ”test, innovate, pioneer and scale up successful sexual and reproductive health interventions.”

It offers state-of-the-art, highly qualified and welcoming clinical services in seven clinics across Cambodia: in metropolitan Phnom Penh and the provinces of Kandal, Battambang, Koh Kong, Kampong Thom, Siem Reap and Svay Rieng.

Each clinic provides comprehensive family planning, counselling and clinical services including     condoms, birth-control pills, emergency contraceptives, injections, IUDs, implants, tubal ligations     and vasectomies.

The clinics also provide pregnancy tests, safe abortion (medical and surgical), pre-natal and post-natal care, diagnosis and treatment of reproductive tract infection and sexually transmitted diseases, and voluntary HIV testing and counsell-ing. It also offers special male sexual-health services.

MSI provides short-, medium- and long-term programs for family planning. Short-term comprises condoms and birth control; medium-term would be a contraceptive injection (Depo Prevera) that the woman has to receive every three months; and long-term is an IUD that lasts for as long as 10 years, or a hormonal implant that lasts for three to five years.

The final resources MSI provides are vasectomy and tubalisation.

“If a client wants another child, they will choose an IUD, but if they have had enough children and don’t want any more, they will choose sterilisation. We are also a one-stop shop for testing for sexually transmitted infections and HIV,” Katz says.

The Pill is the most common form of birth control in Cambodia, and MSI provides a Pregnancy Advice and Options Hotline that advises women on pre-natal care and where to go if they decide to terminate.

MSI gives the pros and cons of both surgical and medical abortions.If a woman opts for a medical abortion, she is given Medabon, which are tablets that induce a miscarriage and can be taken at home.

Safe abortion lowers maternal mortality, which is MSI’s goal.

“It’s a revolution in abortion because it puts it in the hands of women,’’ Katz says.

“IUDs cost $5 and implants $15. IUDs are hard to get and difficult to access. Implants are extremely expensive, but when MSI receives a donation, they are given out.

“We charge affordable fees and any surplus we make goes back into getting more services. We will never send anyone away.”

Clinical service manager Khemrin Khut says MSI also has an outreach service in the community to reach closer to its clients in rural areas.

“We have 60 referral hospitals and more than 100 centres across the country in remote areas such as government facilities that we work with. We have three outreach teams in Cambodia,” he says.

Community-based health aims to educate individuals on sexual reproduction, and MSI provides one-on-one counselling, big groups, mass media and various channels to get their message across.

Its focus is primarily on garment- factory workers, entertainment workers, young people and those living in rural communities.

Currently they are working with garment-factory infirmaries.

More than 300,000 workers are employed in Cambodia’s export garment sector. More than 90 per cent of them are women, mostly with limited education, long working hours, low incomes and limited access to comprehensive sexual and reproductive health services.

The MSI  project involves partnering with garment factories to strengthen access for these workers to sexual reproductive health services.

Marie Stopes will work with 40 garment-factory infirmaries, increasing access for these at-risk populations to quality women’s health services by training, behaviour change, communication and technical assistance.

MSI has a staff of female and male counsellors so clients have a gender preference.

“All of our providers are trained to be non-judgmental about a  client’s sexual orientation and socio-economic standing. Our program’s philosophy is that everyone has the right to sexual reproduction educat-ion and services,’’ Katz says.

“Eighty-five per cent of our clients go to family planning post-abortion, which is helping to stop repeat abortions. Don’t think of  family planning as a woman being sick, but as helping her future health.
“Our facilities are warm and welcoming, not sterile, so anyone can come in.”

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