Cambodia - TeachBox

A collaboration involving University Hospitals Plymouth, the University of Plymouth, and Angkor Hospital for Children, created a Neonatal Life Support (NLS) training program.

Following positive trials, the plan was for subject matter experts to teach courses nationally in a traditional manner using presentation slides. But, the context of Cambodia meant that this approach would fail in terms of time, cost and quality.

Infant mortality in Cambodia

3 million babies who die each year.

Babies die at six times the UK rate, and triple the UNWP average.

Infant deaths in rural areas are triple those of urban areas.

Formative research in the local setting found gaps in essential newborn care practice.

The health-education context

The USA has a doctor-to-population ratio of 1 to 332, Cambodia’s ratio is just 1 to 5,263.

80% of Cambodia’s population live in rural areas, but 70% of medical specialists are concentrated in urban areas.

For training to take place, either large numbers of rural health workers must travel to cities, or specialists have to traverse the country. Both scenarios are financially and operationally impractical.

On-line training barriers in Cambodia

79% of the country has internet coverage, but only 60% of people can access it.

Rural regions have slow internet speeds.

Most internet-capable devices are outdated, have limited storage and poor security.

Internet infrastructure is frequently vandalised or stolen.

Newborn Life Support Training

The NLS course provides detailed knowledge and practical instruction in the resuscitation of babies at and immediately after birth.

It involves a set of straightforward, low-cost procedures that save lives.

Key skills include: drying and covering the newborn baby to conserve heat; assessing the need for any intervention; managing the airway; lung aeration; rescue breathing; chest compression; administration of drugs.