MEDiCAM

MEDiCAM

Cambodia
Organization type: 
nonprofit/ngo/citizen sector
Budget: 
$100,000 - $250,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Civil Society Organizations (Local NGOs, HCMC members and representatives of the marginalized groups): The action will build capacity of local NGOs, community-based HCMCs, Village Health Support Groups, and representatives of the marginalized groups to advocate for community interests and engage community meaningfully, particularly the vulnerable and the poor, in planning, delivery and monitoring of health services. This will enable Cambodian grass roots CSOs to organize community health forums for promoting dialogue between providers and communities; and engage with Cambodian health policy processes to promote community participation and equitable health access for the poor and vulnerable groups in a sustained way.
Community Champions: The action will help in development of advocacy an

About Project

Solution: What is the proposed solution? Please be specific!

Community Health Forums/ Dialogues: This process helps to bring together communities, particularly the poor and vulnerable, CSOs and the local health and other authorities thereby creating opportunities for dialogue and interaction between them. These are attended by distinguished speakers from the Ministry of Health, from Provincial Health Department, and Referral Hospitals to speak about consumers’ rights and providers’ rights and duties, educate the communities of the public health services, and resolve the issues raised by the communities. Plus, importantly the local authorities—commune council and district governors are also there. The past experience of this kind of forum showed that they encourage common people, including the poor and the marginalized to voice their concerns and issues they are faced with in accessing health service at the health centers or the referral hospital . They also bring more accountability in health care delivery, particularly on the operational health system, to cater to the poor and the vulnerable groups. Result-oriented practical training: The action places emphasis on result-oriented practical training for all the capacity building activities. All the Master Trainers need to develop an annual plan of action at the end of the training so that they are clear about follow-up activities and their role. Similarly, in roll-out trainings for community members, Community Champion Groups will be selected who will receive a small grant to carry out the advocacy plan developed as part of the training in their communities.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Conduct Master Training on communicating for advocacy (CFA) CFA will be used to build the capacity of civil society organizations, representatives of marginalized communities and local health functionaries for effective advocacy at the grass-roots and operational district level involving community and local stakeholders. 25 CSO members (2 from each of 7 CSOs (14), 2 from each OD (6), one from each referral hospital (3), and one from each provincial health department (PHD) (2) will be trained as Master Trainers in the Communicating for Advocacy Approach. The MT training will be facilitated by MEDiCAM with technical support from Healthlink Worldwide. MEDiCAM has substantial experience in CFA training from the ongoing DFID-supported project. The CFA approach addresses poverty, gender inequalities, and the rights of marginalized and vulnerable communities for health and other development issues. This approach has been used successfully with health rights projects across Asia and Africa. Specifically, the aim of CFA is to create a community-centered, bottom-up advocacy approach for the promotion of health rights by creating informed and empowered resource teams at local, OD, and province levels with beneficiary participation who would identify, build issues and advocate with relevant authorities for health rights. This will be a minimum five-day residential training and at the end of the course participants will be able to: • train community group members on the CFA approach • provide support to community groups in conducting advocacy initiatives • conduct monitoring & evaluation at beneficiary level Conduct CFA rolling-out training for 476 community group members: 9 in Takeo and 6 in Koh Kong The Master Trainers will train 476 community groups in CFA so that they can carry out community-level advocacy activities in their communities. There are 34 health centers (HCs) in the three OD where the project will be implemented: 21 in Kirivong, 6 in Smatch Meanchey, and 7 in Sre Ambel. Each HC has one HCMC responsible for representing community interests in HC functioning with 11 members: one vice chief of commune council, one health centre chief, one midwife, one member from the commune council as focal person for women and children, and 7 village health support group leaders (VHSG). Thus, there are total 374 HCMC members from these 34 HCs who will carry out village and OD level advocacy activities. To ensure further inclusion of the marginalized groups in advocacy activities, 102 representatives of the most marginalized are included along with the HCMC members. Therefore, our total community group members who will be trained in CFA will be 476. 15 residential roll-out training sessions (9 in Kirivong, 3 in Smatch Meanchey, and 3 in Sre Ambel) of minimum five-day duration will be carried out to train these 476 community group members in CFA. Each roll-out training on CFA will be conducted by the 3 MTs (2 CSO trainers and 1 OD trainer) and supported by the MEDiCAM focal person on capacity building as the lead trainer.
About You
Organization:
MEDiCAM (A Membership Organization for NGOs Active in Cambodia’s Health Sector)
About You
First Name

Hak

Last Name

Ham

Twitter
Facebook Profile
About Your Organization
Organization Name

MEDiCAM (A Membership Organization for NGOs Active in Cambodia’s Health Sector)

Organization Phone

855 23 880 291

Organization Address

No. 21, Street 287, Boeung Kak 1, Khan Touk Kork,

Organization Country

, PP

Country where this project is creating social impact
How long has your organization been operating?

More than 5 years

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Innovation
What stage is your project in?

Operating for 1‐5 years

Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.

Improving the health status of the poor and the vulnerable communities in Cambodia through equitable access to health care services is therefore a pre-requisite to poverty reduction and meeting the human development objectives in Cambodia, including achievement of the Millennium Development Goals. Improving access to primary health care services (such as antenatal care, child immunization, HIV prevention programs, sanitation facilities) is particularly important in this context, as the benefits go a long way in preventing both communicable and non-communicable diseases; increase productivity; and reduce burden on the healthcare system. However, a lack of awareness of health rights among poor and marginalized communities and their poor perception of primary health care has created a gap in demanding and advocating for provision of primary health care services. This is preventing equitable and timely access to health services by them. The limited or no sustained engagement of these communities and non-state actors (NSAs) representing them with the operational health system is further widening the gap.

There is a need to create and foster mechanisms to increase access of the poor and vulnerable communities to primary health care services, and encourage their inclusion and participation in the planning and delivery of health services so that their voices are heard and their needs addressed. The project is rooted in the experience of MEDiCAM and its partner NGOs in promoting inclusion of marginalised communities in Cambodian health development processes It aims to build the capacity of marginalised communities in selected areas of Cambodia to demand and access their health rights and services. The action will promote increased interaction between community-based civil society organisations (local NGOs, Health Centre Management Committees, Village Health Support Groups) and local health functionaries at Operational Districts (OD), and Provincial Health Departments (PHD), thus enabling the poor and disadvantaged groups to engage with decisions that determine their health, and ultimately access and claim better primary health care.

Share the story of the founder and what inspired the founder to start this project

One of the first graduates of the re-opened school of journalism in Phnom Penh, Mr. Ham Hak established the Sakarach Thmei newspaper in 1998. He is now the publication and communications manager of MEDiCAM.

Dr. Sin Somuny is a strong believer in building a prosperous society through enhancing partnership, harmony, ownership and constructive engagement among the government, civil society, the private sector and citizens. He has played various roles in Cambodia since he began his career working with civil society in the 1990s. A medical doctor who obtained a Master degree in public health from the University of ALABAMA, U.S.A., he is Executive Director of MEDiCAM, a membership organization for more 100 health NGOs in Cambodia.

Social Impact
Please describe how your project has been successful and how that success is measured

Community’s perception on CHF Location< 5km from HC Location> 10km from HC
Baseline End line Baseline End line
No P No P No P No P
Ever attended CHF
Yes 42 20% 168 79% 9 16% 44 100%
No 160 78% 45 21% 47 84% 0 0%
CHF improve situation?
Yes 29 69% 161 96% 9 100% 44 100%
No 13 31% 7 4% 0 0% 0 0%
How can CHF improve
Talk about health 14 48% 130 81% 8 90% 33 75%
Improve seeking behavior 11 38% 56 35% 3 33% 19 43%
Improve understanding of health 9 31% 84 52% 1 11% 9 20%
Let community know consumer’s right 1 3% 50 31% 0 0% 17 39%
Complain on HSD 0 0% 38 24% 0 0% 9 20%
HP explain HSD 0 0% 21 13% 2 22% 11 25%
Deal with existing issues 3 10% 18 11% 0 0% 10 23%
Propose a better service 7 24% 24 15% 0 0% 4 9%
Understand limited health system 1 3% 13 8% 0 0% 1 1%
Understand health policy 0 0% 16 10% 0 0% 5 11%
Express ideas 1 3% 11 7% 0 0% 5 11%
Quick response to question 1 3% 12 7% 0 0% 6 14%
Clarify some concern 1 3% 7 4% 0 0% 0 0%
Receive some promise 1 3% 0 0% 0 0% 1 1%

How many people have been impacted by your project?

How many people could be impacted by your project in the next three years?

Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact
Task 1
Task 2
Task 3
Identify your 12-month impact milestone
Task 1
Task 2
Task 3
How will your project evolve over the next three years?

The partners have identified the following preconditions and assumptions. In designing the action in consultation with the partners we have sought to ensure that these are already in place
-Everyone should have equal access to primary healthcare services which often meet their needs
-Improved health will lead to poverty reduction
-A well functioning health care system can only meet the needs of its target communities if it consults them about what their needs are
-Principles of inclusion will ensure involvement of most marginalized and vulnerable communities
-The partners already have links with govt authorities and plan to use them
-That the RGC will continue its commitments to improving healthcare
-MEDiCAM members are willing to play an active role in and support the project

Sustainability
What barriers might hinder the success of your project and how do you plan to overcome them?

Financial sustainability of the action will be achieved in a number of ways. The action focuses on promoting access to primary health care including disease prevention and sanitation which are priority areas of MoH, RGC. The RGC is already mandated to guarantee health for all, particularly the poor and the marginalised. Thus the strategy of working within the public health delivery framework with government authorities and engaging with CSOs and community-level stakeholders will contribute to the financial and economic sustainability of the project. This not only offers good value for money to the European Union but means that at the end of the project the knowledge, skills and systems which will have been set up within these organisations for this work will continue long term. The majority of the approaches developed as part of the project are low cost and rely on existing resources at a community level to be implemented. Within project partners and local NGOs who will be sub-contracted, capacity building will address issues of financial management with a focus on proactive project accounting and financial systems strengthening. The advocacy initiatives will be focused on influencing policy makers and health authorities for inclusion of community participation in healthcare programming, and to provide ongoing and appropriate support to include this in health service provision. The commitment generated to ensure community participation and inclusion of marginalised groups together with working through existing community structures (like HCMC, VHSG) structures will ensure financial sustainability to continue without external assistance.
Building sustainability at an institutional level
The project has been designed to ensure the continuation of project activities and benefits after the end of the funding period. There is strong demand for the action evidenced through consultations with key stakeholders during implementation of the ongoing MEDiCAM project on increasing community participation in health policy planning. This institutional demand and ownership will ensure the perpetuation of activities beyond the project life-cycle. The project will create a cadre of Master Trainers from amongst local CSOs, OD staff and representative of marginalised communities which will ensure that learning remains within the communities and continue to support future endeavour for promoting community inclusion. Further, the action aims at increasing awareness of communities and service providers about health related consumer rights and provider rights and responsibilities that will bring about long-term changes as well. The Community mechanisms like Community Health Forums and Community Health Dialogue are also expected to outlast the project term and be integrated in public health service delivery system.
The project focus is on building advocacy skills of CSOs in CFA including developing a group of Community Champions, and this in itself will lead to creation of a group of “local and OD level advocates” for community participation and inclusion of marginalised voices in health service provision. The effect of this will to go beyond project term.
The 25 Master trainers from CSOs and OD health system who will receive training in advocacy and participatory research and information management approaches will contribute towards building local and national pool of resources and ensure they are able to provide support to similar development activities calling for increased participation of vulnerable groups.

Sustainability of partners: The initiative will develop the capacity of indigenous organisations (RACHANA and other local NGOs), most of whom are MEDiCAM members, working in Cambodia for a long time and will continue to work much beyond project end. This action aims to maximise the retention of skills and knowledge within the participating partners and the communities they serve, so that utilise these skills long after the project ends. Technical support to strengthen annual planning, financial reporting and budget control mechanisms and training on monitoring tools, will equip partners will skills and systems of value to other actions and their work in general. The long-term nature of the partnership with these organisations provides opportunities for MEDiCAM to jointly monitor the impact of this initiative, over a longer time-scale and to ensure that all partners have a common vision of the project and its intended impact.

Sustainability at policy level will be achieved through focusing on strengthening policy and practice at local and national levels to ensure that the needs of poor and vulnerable communities are addressed in health sector planning and delivery processes, and are identified and met by policy makers and health authorities. The project activities – particularly CHFs where higher level health authorities participate, publication and dissemination of MEDiCAM Annual Position paper and advocacy and lobbying with relevant authorities and decision-makers at local and national levels – are geared towards changes in health policy and programming by making it more inclusive to primary health care needs of the poor and vulnerable groups and demanding more budgetary allocation for the issue. Alongside this, strengthening the partners’ networks under the MEDiCAM umbrella along with strong CSO linkages at the local, province and national level will also contribute in effective policy advocacy, thus ensuring policy level sustainability.

Tell us about your partnerships

Rachana has 15 years experiences on promoting health issues, 6 years experiences on livelihood activities. Rachana is a member of MEDiCAM since 1994. It is 15 years. RACHANA has been working together with MEDiCAM in identifying the geographic areas and initiatives on having community health dialogue, and other actions on enhancing vulnerable communities. RACHANA will be the key partner in rolling out training, community health forums, community health dialogues, and implementation of community annual advocacy.

PARTNERSHIP STATEMENT
A partnership is a relationship of substance between two or more organizations involving shared responsibilities in undertaking the action funded by the European Commission (Contracting Authority).
To ensure that the action runs smoothly, the Contracting Authority requires all partners to acknowledge this by agreeing to the principles of good partnership practice set out below:
1. All partners must have read the application form and understood what their role in the action will be before the application is submitted to the Contracting Authority.
2. All partners must have read the standard grant contract and understood what their respective obligations under the contract will be if the grant is awarded. They authorize the lead applicant to sign the contract with the Contracting Authority and represent them in all dealings with the Contracting Authority in the context of the action's implementation.
3. The applicant must consult with its partners regularly and keep them fully informed of the
Progress of the action.
4. All partners must receive copies of the reports—narrative and financial made to the Contracting Authority.
5. Proposals for substantial changes to the action (e.g. activities, partners, etc.) should be agreed by the partners before being submitted to the Contracting Authority. Where no such agreement can be reached, the applicant must indicate this when submitting changes for approval to the Contracting Authority.
6. Where the Beneficiary does not have its headquarters in the country where the action is implemented, the partners must agree before the end of the action, on an equitable distribution of equipment, vehicles and supplies for the action purchased with the EU grant among local partners or the final beneficiaries of the action.
I have read and approved the contents of the proposal submitted to the Contracting Authority; I undertake to comply with the principles of good partnership practice.

Explain your selections
How do you plan to strengthen your project in the next three years?
Challenges
Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.

PRIMARY

SECONDARY

Health behavior change

TERTIARY

Lack of access to targeted health information and education

Please describe how your innovation specifically tackles the barriers listed above.
How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.

PRIMARY

SECONDARY

Influenced other organizations and institutions through the spread of best practices

TERTIARY

Other (please specify below)

Please describe which of your growth activities are current or planned for the immediate future.

Grown geographic reach within community

Do you collaborate with any of the following: (Check all that apply)

Government, NGOs/Nonprofits.

If yes, how have these collaborations helped your innovation to succeed?

Also with patients

randomness