The Cambodia Nutrition Project (CNP) is a five-year project to anchor the RGC’s enhanced and coordinated response to accelerate the human capital formation focusing on MCHN in the early years. The CNP addresses Cambodia’s persistent high levels of stunting and aims to close equity gaps in nutrition, routine immunization, and neonatal survival.
The project will enhance supply-side delivery and quality of priority health and nutrition services in health facility and health outreach activities. It will also extend service provision beyond health facilities through enhanced integrated health outreach activities for pregnant and lactating women children and a harmonized approach to community mobilization and service delivery for health and nutrition. In so doing, the project will aim to increase demand for priority services. The project will also build capacity from the central to the frontline levels in functional, technical, and financial management aspects.
Two main platforms are used to deliver CNP interventions: health facilities and communities (C/S administrations). For simplicity, the key interventions across these components are summarized as health facility and community-based interventions:
Health Facility-Based Interventions - Key interventions include
o Cambodia has a national performance-based financing scheme in which all health centers nationwide now receive quarterly assessments through the NQEM process assessment accompanied by a performance-based grant Service Delivery Grants (SDGs). The project supports quality improvement in priority services through the addition of a MCHN Scorecard to the quarterly National Quality Enhancement Monitoring (NQEM) Tools the addition of systematic coaching, and an accompanying SDG top-up payment. Performance on the scorecard will be accompanied by a grant to health centers, paid on a quarterly basis, which can be allocated to individual staff incentives (up to 80% of total grant amount) and operational costs. The staff incentives are distributed across all health centers staff according to individual staff performance and other criteria determined at the health center level.
o Expansion of the Health Equity Fund (HEF) system to provide transport allowances for poor women and children to use health facilities for antenatal care, deliver, postnatal care, and well-child visits; and expand HEF benefits to cover children of informal workers to receive fee waivers for priority services
o Upgrading the package of social behavior change communication materials, training, and coaching to be provided to health centers
Community-Based Interventions - Key intervention includes:
o Development and delivery of group- and home-based health, nutrition, and HEF promotion activities through a commune program for women and children (CPWC)
o Performance-based grants to C/S for effectively delivering the CPWC
o Update of the package of Social and behavior change communication materials, C/S and village-level coaching, and training to be provided in communities
The project’s primary beneficiaries are women and children: pregnant and lactating women and children under the age of two (e.g. the first 1,000 days of life). The project prioritizes seven of Cambodia’s 25 provinces: Mondul Kiri, Ratanak Kiri, Kratie, Steung Treng, Preah Vihear, Kampong Chhnang, and Koh Kong. The seven priority provinces were purposively selected through multi-stakeholder consultation based upon the following characteristics: lagging Reproductive, Maternal, Newborn, Child and Adolescent Health and Nutrition (RMNCAH-N) outcomes, coverage and equity gaps of key RMNCAH-N services, multidimensional poverty index score, and gaps in supply side health service readiness.