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Cambodia: Difference between revisions
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During the Khmer Rouge period (1975-79), the Cambodian health care system was destroyed. After the fall of the Khmer Rouge to Vietnamese forces, the government entered a period of Vietnamese control, which showed little progress related to family planning. However, in 1994, Cambodian family planning efforts were finally reinstated with international support. Since 2000, the efforts of the Cambodian government along with non-governmental agencies have helped boost contraceptive usage, ushering in improved reproductive health and lower fertility rates. Between 2000 and 2005, the rate of contraceptive use jumped from 11% to 24%, and the fertility rate dropped from 4.0 to 3.4.<ref>[https://www.guttmacher.org/journals/ipsrh/2010/09/role-social-support-and-parity-contraceptive-use-cambodia The Role of Social Support and Parity in Contraceptive Use in Cambodia]</ref> | During the Khmer Rouge period (1975-79), the Cambodian health care system was destroyed. After the fall of the Khmer Rouge to Vietnamese forces, the government entered a period of Vietnamese control, which showed little progress related to family planning. However, in 1994, Cambodian family planning efforts were finally reinstated with international support. Since 2000, the efforts of the Cambodian government along with non-governmental agencies have helped boost contraceptive usage, ushering in improved reproductive health and lower fertility rates. Between 2000 and 2005, the rate of contraceptive use jumped from 11% to 24%, and the fertility rate dropped from 4.0 to 3.4.<ref>[https://www.guttmacher.org/journals/ipsrh/2010/09/role-social-support-and-parity-contraceptive-use-cambodia The Role of Social Support and Parity in Contraceptive Use in Cambodia]</ref> | ||
Despite progress, there is still significant room for growth. There is a lack of comprehensive sex education in Cambodia, and family planning is still a relatively taboo issue for some people to discuss.<ref>[https://www.phnompenhpost.com/national/sex-education-%E2%80%98big-challenge%E2%80%99 Phnom Penh Post: Sex education a ‘big challenge’]</ref> Generally speaking, Cambodian women who are older, more educated, live in higher income brackets, or live in urban areas are more likely to use contraceptives. Women who low-income, less, educated, or live in rural areas are less likely to use contraceptives, and they may face stigmas and misconceptions related to contraceptives. For example, it is a common misconception in Cambodia that contraceptives cause infertility or that only married women can purchase contraceptives. Furthermore, many women have men in their lives (such as their husbands, fathers, or community leaders) who are opposed to contraceptives, and they may be heavily influenced by these opinions.<ref>[https://www.guttmacher.org/journals/ipsrh/2010/09/role-social-support-and-parity-contraceptive-use-cambodia The Role of Social Support and Parity in Contraceptive Use in Cambodia]</ref> These various factors contribute to a lower rate of contraceptive adoption among women in certain areas or communities. | Despite progress, there is still significant room for growth. There is a lack of comprehensive sex education in Cambodia, and family planning is still a relatively taboo issue for some people to discuss.<ref>[https://www.phnompenhpost.com/national/sex-education-%E2%80%98big-challenge%E2%80%99 Phnom Penh Post: Sex education a ‘big challenge’]</ref> Generally speaking, Cambodian women who are older, more educated, live in higher income brackets, or live in urban areas are more likely to use contraceptives. Women who are low-income, less, educated, or live in rural areas are less likely to use contraceptives, and they may face stigmas and misconceptions related to contraceptives. For example, it is a common misconception in Cambodia that contraceptives cause infertility or that only married women can purchase contraceptives. Furthermore, many women have men in their lives (such as their husbands, fathers, or community leaders) who are opposed to contraceptives, and they may be heavily influenced by these opinions.<ref>[https://www.guttmacher.org/journals/ipsrh/2010/09/role-social-support-and-parity-contraceptive-use-cambodia The Role of Social Support and Parity in Contraceptive Use in Cambodia]</ref> These various factors contribute to a lower rate of contraceptive adoption among women in certain areas or communities. | ||
===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== |
Revision as of 18:33, 26 May 2019
OVERVIEW
In Cambodia, you can purchase contraception (birth control) without a prescription. You can also obtain emergency contraception (the morning after pill) without a prescription at a pharmacy, or at a health center. There are no travel or residency restrictions attached to STD/STI status. You can get tested for STDs/STIs at health care facilities in the city, which we recommend below, and there are some HIV-related NGOs and organizations in the city. There is currently no PrEp program in Cambodia. There is an HPV vaccination pilot program. Regarding menstrual products, you should be able to find pads throughout Cambodia. You can tampons in larger cities, like Phnom Penh, as well as some menstrual cups. Abortion is legal for the first 12 weeks of pregnancy.
Contraception (Birth Control)
General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.
Laws & Social Stigmas
In Cambodia, you can purchase oral contraceptives (birth control pills) and condoms without a prescription. For many other forms of contraception (such as IUDs, shots, and implants), you can find them available at certain clinics and family planning centers, such as Marie Stopes Cambodia. In 2015, it was estimated that 57.9% of Cambodian women used some form of contraception, and that 40.4% used modern contraceptive methods. Furthermore, 12.5% of Cambodian women have unmet family planning needs.[1]
During the Khmer Rouge period (1975-79), the Cambodian health care system was destroyed. After the fall of the Khmer Rouge to Vietnamese forces, the government entered a period of Vietnamese control, which showed little progress related to family planning. However, in 1994, Cambodian family planning efforts were finally reinstated with international support. Since 2000, the efforts of the Cambodian government along with non-governmental agencies have helped boost contraceptive usage, ushering in improved reproductive health and lower fertility rates. Between 2000 and 2005, the rate of contraceptive use jumped from 11% to 24%, and the fertility rate dropped from 4.0 to 3.4.[2]
Despite progress, there is still significant room for growth. There is a lack of comprehensive sex education in Cambodia, and family planning is still a relatively taboo issue for some people to discuss.[3] Generally speaking, Cambodian women who are older, more educated, live in higher income brackets, or live in urban areas are more likely to use contraceptives. Women who are low-income, less, educated, or live in rural areas are less likely to use contraceptives, and they may face stigmas and misconceptions related to contraceptives. For example, it is a common misconception in Cambodia that contraceptives cause infertility or that only married women can purchase contraceptives. Furthermore, many women have men in their lives (such as their husbands, fathers, or community leaders) who are opposed to contraceptives, and they may be heavily influenced by these opinions.[4] These various factors contribute to a lower rate of contraceptive adoption among women in certain areas or communities.
What to Get & Where to Get It
- If you want birth control pills, you can purchase them at pharmacies without a prescription. Some of the brands you can expect to see are FMP, Anna and Microgynon ED. One of the most common brands is called OK. It's been reported that some wealthier locals don't feel that they can trust OK pills because they're cheap. But, according to the Phnom Penh Post, "The pills and condoms are heavily subsidised and quality-controlled by Population Services International, a global health NGO, who target the OK brand at poor women. According to Watson the OK pill is the same as a very popular pill called Microgynan, currently prescribed to 70 percent of women in the UK."[5]
- Please visit our local city pages, like the Phnom Penh page, for recommendations on getting IUDs, patches, shots, implants and other contraceptive methods.
Tips about pharmacies: Look for the green cross to find a pharmacy. The better pharmacies will have air-con and English-speaking staff. Be careful to go to a trusted pharmacy. Some of the pharmacies in Phnom Penh sell expired or fake medicine. So be sure to only buy medication that is clearly brands, doesn't look damaged or blistered, and hasn't expired. Don't buy unmarked tablets or medicine.
Costs
You can buy Anlitin at Western Pharmacy for $2.30 (as of 2016).
Emergency Contraception (Morning After Pill)
Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.
Laws & Social Stigmas
You can purchase emergency contraception (the morning after pill) without a prescription in Cambodia. It's very common for women to visit pharmacies and purchase EC over-the-counter. Some brands, like Anitlin and Pregnon, may require a prescription, according to Cambodian law,[6] but we're not sure how widely this law is enforced. Furthermore, some other brands may not require a prescription. Some health clinics and NGOs, like Marie Stopes, require that you have a brief consultation with a midwife before they give you EC.
What to Get & Where to Get It
Here is the most critical information about emergency contraception (the morning after pill) in Phnom Penh:
- You can purchase dedicated emergency contraception at pharmacies. You can expect to find Pregnon (take 2 pills within 120 hours after unprotected sex). Another brand you may find is Anlitin.[7]
- If you can't access dedicated emergency contraception, you can use oral contraceptives (birth control pills) as EC. You can purchase oral contraceptives at pharmacies as well. For progestin-only pills, you can take Microval (take 50 pills within 120 hours after unprotected sex). For progestin-estrogen combined pills, you can take FMP (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also take Anna or Microgynon ED (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later). You should remember that, in 28-day packs, only the first 21 pills can be used.[8]
Here are some places where you can access emergency contraception (the morning after pill) that aren't pharmacies. These places also usually provide emergency contraception for free or at a reduced price:
- Marie Stopes Cambodia: This NGO sells emergency contraception (the morning after pill) for 20,000 riel (for Cambodian nationals). It will be a different price for non-Cambodians.
- Population Services Khmer (PSK): This NGO may give you Next 72, an emergency contraceptive pill that they launched in 2013, or an IUD. You can get ahold of PSK by phone (855-23) 210 814 / 9 87 404 / 987 406 or email: generalinfo@psk.org.kh. Here's more information on Next 72. Address: No. 29, 334 Street, P.O.Box 153, Boeung Keng Kang 1, Chamkarmon, Phnom Penh, Cambodia. Facebook: link here.
- Anna Women-Baby's Center: This is a private clinic - not an NGO - so they probably don't provide EC at a reduced price. However, they can probably give sensitized and higher quality care than some public clinics. "Women-Baby’s Center offers the “Morning After Pill” for those who need emergency contraception. We recommend going through our family planning counseling for fertility awareness and for learning how to practice safe sex." Schedule your family planning appointment today by dialing 098 800 921. Email: info@wbcanna.com
Costs
Sexually Transmitted Infections (STIs/STDs)
Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.
Laws & Social Stigmas
There are no travel restrictions attached to STD/STI status in Cambodia. Furthermore, foreign residents who are found to have an STD/STI will not be deported.[9]
What to Get & Where to Get It
Testing Facilities
- Please visit our local city pages, like the Phnom Penh page, for testing sites.
Support
- Marie Stopes Cambodia: "Counselling and support is offered however it would be difficult to offer this service to non-Cambodian nationals primarily due to language barriers. Whilst there are staff with a good command of English this is not always appropriate for counselling. Although it is case by case and via booking through email we would endeavor to find an appropriate solution. Family planning and abortion counselling is free and part of any service."
- Hospital Calmette: This hospital has an HIV treatment center. Address: No. 3 Monivong Blvd., Phnom Penh. Phone: +855 23 426 948. Fax: +855 23 810 785.
- Norodom Sihanouk Hospital: This hospital has an HIV treatment center. Address: No. 363, St. 241. Phone: +855 23 723 273. Fax: +855 23 982 571.
- Center of Hope: This is an HIV-focused NGO in Cambodia. Address: c/o Municipal Hospital, No. 169, St. 134, Phnom Penh. Phone: +855 23 982 571. Fax: +855 23 822 808.
- Cambodian HIV/AIDS Education and Care: "Since 1994, Cambodian HIV/AIDS Education and Care (CHEC), formerly Quaker Services Australia, has been reducing the spread of HIV/AIDS and helping Cambodians cope with the epidemic. Training people is its core service. And since inception, more than 10,000 people have received CHEC is HIV/AIDS training."
- National Center for HIV/AIDS, Dermatology and STD: "The National Centre for HIV/AIDS Dermatology and STDs (NCHADS) was established in 1998 following the amalgamation of the National Aids Programme (NAP) and the National STD and Dermatology Clinic. Since then, its primary purpose has been to respond to the HIV/AIDS epidemic through the implementation of HIV/AIDS Strategic Plans." Address: #245H, Sreet 6A, Phum Kean Khlang, Sangkat Prekleap Russey Keo, Phnom Penh, Cambodia. Tel/Fax: (855) 23 432 090. Email: info@nchads.org.
Costs
Medications & Vaccines
Laws & Social Stigmas
What to Get & Where to Get It
- There is a pilot HPV vaccination program in Cambodia.[10]
- There is no known PrEP program in Cambodia.[11]
Costs
Menstruation
Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.
Laws & Social Stigmas
What to Get & Where to Get It
In Cambodia, pads can be easily found in supermarkets and mini-marts. You should be able to find tampons in larger cities at larger supermarkets or pharmacies, like Lucky’s Supermarkets or a U-Care Pharmacy. You can purchase menstrual cups at Western Pharmacy in Phnom Penh, Peace Cafe in Siem Reap and Bantreay's Women Spa in Kampot. You can also purchase Lunette online through LiveLoveLuna, which delivers to Cambodia. There appears to be no official sellers of DivaCup, MoonCup or LadyCup in Cambodia, so they should be purchased online.
Costs
Gynecological Exams
Laws & Social Stigmas
What to Get & Where to Get It
- Please visit our local city pages, like the Phnom Penh page, for recommendations.
Costs
Pregnancy
Laws & Social Stigmas
What to Get & Where to Get It
- Marie Stopes Cambodia: Ultrasound $5, plus post natal family planning counseling services, pregnancy tests ($1.25).
- Please visit our local city pages, like the Phnom Penh page, for recommendations.
Costs
Abortion
Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.
Laws & Social Stigmas
In Cambodia, abortion is legally available on request for the first 12 weeks of pregnancy. After 12 weeks, abortion is only permitted if the life of the woman is endangered by the pregnancy, if the the pregnancy causes health issues to the woman, if the pregnancy was the result of rape, or or if the fetus runs the risk of being born with defects. To receive an abortion after 12 weeks, a woman must receive official approval from at least two medical personnel.[12]
Since 1997, Cambodia has had official abortion laws. Before that time, the country's abortion laws were unclear from a legal standpoint. In practice, however, abortion was a widely accepted in Cambodia, though in an informal capacity and with no official guidelines or standards. Most often, health care workers provided clandestine abortion services, though they were often not trained to perform abortion procedures. They also often charged exorbitant prices for these services. During this period, people who performed abortions were not prosecuted.[13]
Today, abortion in Cambodia is officially legal. However, many Cambodians remain unclear on the laws. Studies have found up to 80% of Cambodian women falsely believe that abortion is illegal. Forty percent of government providers believe that abortion is prohibited by the Cambodian Ministry of Health (MoH). In the past, many NGO workers also falsely believed that they would go against USAID policy if they referred women to safe abortion services.[14] Later, with the reinstatement of the global gag rule under the Trump administration in the States, such organizations did face a loss of potential USAID if they referred people to such services.[15] As a result, some women are referred to clandestine abortion providers. These "back alley" or clandestine abortion providers are often untrained, and their procedures can lead to complications or even death.
What to Get & Where to Get It
- Marie Stopes Cambodia: "We perform safe abortions within the parameters of Cambodian law... We offer two procedures – Medical abortion (up to 9 weeks) usually with Mariprist or Medabon. This is 100,000 riels ($25) and Surgical Abortion (9-12 weeks) 130,000 riels ($32.50)."
- Please visit our local city pages, like the Phnom Penh page, for recommendations.
Costs
Advocacy & Counseling
Laws & Social Stigmas
What to Get & Where to Get It
- Women's Resource Center Cambodia: "Women’s Resource Center (WRC) provides women and girls in Cambodia with emotional support, referral services and informal education so they can be empowered to make informed decisions about their lives." Call +855 92 373 693. Email: info@wrccambodia.org.
Costs
List of Additional Resources
Women's Organizations
- Women's Resource Center Cambodia: "Women’s Resource Center (WRC) provides women and girls in Cambodia with emotional support, referral services and informal education so they can be empowered to make informed decisions about their lives." Call +855 92 373 693. Email: info@wrccambodia.org.
- RACHA (Reproductive and Child Health Alliance): "RACHA's vision is to be a leading and dynamic NGO which advances the health of the Cambodian people through sustainable, relevant, and responsive community-based health programs." Address: #160 Street 71, Tonle Bassac, Chamkar Mon, P.O.Box 2471, Phnom Pen, Cambodia. Phone: 023 213 724 Phone: 023 726 257. Fax: 023 213 725. Email: office@racha.org.kh.
- Banteay Srei: "Banteay Srei is a Cambodian women’s non-governmental organisation that empowers women and their families to improve their political, economic and psycho-social situation through mobilising communities for sustainable development, advocacy work for gender justice and engaging men on gender equality." Telephone: +855 (0) 232 169 22. Email: banteaysrei@online.com.kh
- UN Women - Cambodia: "UN Women is the global champion for gender equality, working to develop and uphold standards and create an environment in which every woman and girl can exercise her human rights and live up to her full potential. We are trusted partners for advocates and decision-makers from all walks of life, and a leader in the effort to achieve gender equality."
- Connecting Hands Training Cafe: "Connecting Hands is opening a training restaurant/cafe for young women who have been victims of trafficking and sexual slavery in Cambodia. Connecting Hands works with rehabilitated young women and provides them with vocational training within the hospitality industry as a cook/chefs. In addition to the providing training, Connecting Hands will take financial responsibility of all our trainees and provide them with a protected and safe environment, access to meals, medical care and a training allowance." Address: #13(show room) Samdach Preah Sokun Meanbon St. (178), Phnom Penh. Phone: 078 588 810.
Human Rights Organizations
- Cambodian Center for Human Rights: "We believe that every Cambodian has the right to participate in democracy and to have their fundamental human rights respected. We work towards ensuring that each Cambodian's voice is heard in society."
- LICADHO: "LICADHO is a national Cambodian human rights organization. Since its establishment in 1992, LICADHO has been at the forefront of efforts to protect civil, political, economic and social rights in Cambodia and to promote respect for them by the Cambodian government and institutions." E-mail: contact@licadho-cambodia.org
- Cambodia Human Rights and Development Association: "The Cambodian Human Rights and Development Association started its activities in December 1991. The association was founded by, a group of former political prisoners who had been detained in the late 1980s... Throughout the years, ADHOC has investigated thousands of human rights violations and trained tens of thousands of people in human rights." Phone: (855-23) 218-653. E-mail: adhoc@bigpond.com.kh
LGBTQ Organizations
- Equaldex Cambodia: You can learn about LGBTQ rights and laws in Cambodia on this website.
- CamASEAN Youth's Future: "CamASEAN have mission of combating discrimination against minority diversity people include lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ), young girls live with HIV/AIDs, sex workers, drug user, people with disability, widowed/single parent, elderly people, indigenous and other ethnic people in Cambodia and ASEAN through strengthening capacity of as many activists as possible." Email: info@camasean.com or ssrorn07@gmail.com
- Rainbow Khmer Portal - The Rainbow Krama: "The Cambodia Center for Human Rights' ("CCHR") Sexual Orientation and Gender Identity ("SOGI") project is working to protect and promote human rights for the Lesbian Gay Bisexual and Transgender ("LGBT") community in Cambodia who are often misunderstood, mistreated, threatened and have their human rights violated."
- Cambodia Gay: This website provides information on the LGBT community in Cambodia, and it also provides lists of recommended resources and venues in Cambodian cities.
- Lonely Planet - LGBT Travellers, Cambodia: You can find basic information about LGBT travel in Cambodia here.
References
- ↑ Trends in Contraceptive Use Worldwide 2015
- ↑ The Role of Social Support and Parity in Contraceptive Use in Cambodia
- ↑ Phnom Penh Post: Sex education a ‘big challenge’
- ↑ The Role of Social Support and Parity in Contraceptive Use in Cambodia
- ↑ Your guide to women's health in Cambodia
- ↑ [http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/cambodia/ EC Status and Availability Cambodia]
- ↑ Princeton EC Website
- ↑ Princeton EC Website
- ↑ CAMBODIA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV
- ↑ Cambodia: Human Papillomavirus and Related Cancers, Fact Sheet 2016
- ↑ PrEPWatch Global Map
- ↑ Abortion in Cambodia
- ↑ Abortion Policies - UN Report
- ↑ ASAP Country Profile: Cambodia
- ↑ 'Global gag rule' jeopardises future of Asia health initiatives, campaigners say