AHC 2019 Mid-Year Impact Report ANGKORHOSPITAL.ORG

AHC in 2019

Milestones marked the first half of 2019 at AHC.

We unveiled our new Strategic Plan and celebrated our 20th anniversary.

Looking ahead to the next six months, our reputation for quality and the momentum of a new framework guide us.

As we work to deliver on our mission, we’re able to succeed because of your support.

In this mid-year report, we're sharing our impact across our three strategic goals.

Providing Paediatric Specialty Care – When It’s Needed Most

AHC's Dr Pheaktra talks about the dengue situation in Siem Reap.

In early May, an alarming increase in patients arrived at AHC with dengue. Uncharacteristic rainfall early in the year spurred reproduction and transmission of the mosquito-borne disease.

By the end of the month, the number of dengue treatments provided at AHC was seven times the number last year. In June, that figure doubled.

Today, the dengue outbreak is on track to be the largest in the organisation’s history. The challenge has reinforced our focus on the need for providing high quality, specialist care when it’s needed most.

AHC’s worst dengue outbreak on record occurred in 2012. This year’s outbreak is on track to surpass that year’s number. An alarming increase in patients is overshadowed by the severity of cases arriving. The bar plots here illustrate the number of cases admitted to our ICU requiring critical care.

AHC Responds To The Dengue Outbreak

Patients often arrive in critical condition, requiring inpatient, intensive or emergency care. Complications, due to delay in treatment or improper diagnosis, can be life-threatening.

Healthcare facilities in Cambodia lack the infrastructure and medical expertise to provide effective symptom management and monitoring for dengue. For every critical dengue patient who arrives at AHC, we provide high quality diagnostic support and care.

Many Cambodians have low health literacy and little understanding of methods to protect children from exposure to dengue. Many are unaware of the simple, yet effective measures that can prevent the spread of the disease.

AHC provides preventative education to thousands of children and villagers within rural communities through educational cinema and volunteer health worker training sessions. By helping the community understand mosquito-borne diseases like dengue, we’re helping to reduce their vulnerability to infection.

Earlier this year, AHC, in partnership with COMRU, published a study on the characteristics of dengue. The study sought to answer what proportion of children have had dengue, and at what age the first infection occurs.

The study analysed samples of Cambodian children and found half were infected with dengue virus – with the prevalence of it steadily increasing with age. It's important research to improve early diagnosis and care of children presenting with a fever at hospitals or health centres in Southeast Asia, and may guide prospective vaccine development.

Read the The American Journal of Tropical Medicine and Hygiene.

Capacity Building Beyond Our Walls – And Demonstrating Impact

Gauging Effectiveness in the Community

Two years after AHC was founded, the Community Health Awareness and Education (CHAE) department was established to improve rural health.

The programme has a three-pronged approach: strengthen government health systems, increase health literacy in communities, and support training carried out independently, beyond AHC involvement.

Throughout the programme's activities, baseline and endline surveys are conducted to monitor the programme’s impact on health and health awareness.

In early 2019, a deep dive into the programme’s data was conducted, revealing the effectiveness of the programme’s initiatives. In a five-year period, positive outcomes were measured on a range of areas of health knowledge, attitudes and behaviours related to child health, proving the longstanding impact of AHC’s community arm.

Update: Saving Babies’ Lives

On 15 February, our Saving Babies' Lives (SBL) programme marked a milestone when we recorded the first newborn whose life was saved because of our training in Preah Vihear province. A village health centre midwife performed neonatal resuscitation on a newborn after a difficult delivery, a procedure she had learned the week prior from SBL staff.

In the following weeks, case after case was reported where training, mentorship and AHC-provided equipment saved babies' lives.

While data can demonstrate the programme’s success in just these first months, Baby Sopheak’s story illustrates the reality of the programme’s impact.

Impact Beyond

On a broader scale, AHC is using learnings from SBL to contribute to the global dialogue on neonatal mortality.

At the Royal Collage of Paediatrics and Child Health Conference in Liverpool, staff presented research conducted on SBL programme design and assessment tool creation, which can be used as a blueprint to develop similar programmes in other low-resource settings.

Read the abstracts:

Transforming neonatal learning in rural Cambodia: design of a comprehensive neonatal training programme for midwives, nurses and doctors in a rural province in Cambodia

Design of an assessment tool to evaluate neonatal care practice across a rural province in Cambodia

Accountability – In Cambodia and Beyond

In partnership with COMRU, AHC takes an integrated approach to combating antimicrobial resistance (AMR) – from within our hospital walls to rural villages – working alongside the government and other healthcare partners.

Our combined expertise in clinical microbiology and antibiotic resistance enables us to lead the way in antibiotic stewardship, as representatives in the Ministry of Health's (MOH) AMR Technical Working Group.

The AMR Working Group was formalised in 2012 to develop and implement an antibiotic resistance national action plan and surveillance system. Today, the group meets monthly at the MOH Department of Communicable Disease Control to discuss common problems, solutions, and other activities around antibiotic resistance.

AHC brings expertise to the group, through years of building clinical and laboratory proficiency, along with conducting in-house infectious disease and AMR surveillance.

Early this year, on behalf of the working group, COMRU and AHC conducted a review of all published AMR research in Cambodia — over 18 years' worth – and the resulting study was accepted by the International Journal of Infectious Diseases.

The study found that existing data was insufficient in providing a clear understanding of the AMR situation in Cambodia, and reinforces the need for high quality AMR surveillance moving forward. It's a data gap that the recently implemented national AMR surveillance system will begin to bridge — a system which AHC helped develop and actively participates in.

In the article selection procedure, 176 articles were identified from an initial literature search. This was reduced to 42 after screening, with 24 studies included in the final review.

While led by AHC-COMRU, the study was a collaborative effort with the MOH and other organisations, including the US Centers for Disease Control and Prevention, the UN Food and Agriculture Organization, the World Health Organization and the University of Health Sciences, Phnom Penh.

2019 YTD In Numbers



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