Disparities in rural-vs-urban achievement of millennium development goals in Cambodia: implications for current and future child health.
BACKGROUND
Cambodia has made significant economic, political, and health advancements with the implementation of the millennium development goals (MDG). Important gaps in child health still exist, however, and accurate assessments of lingering disparities within the country will be essential for meeting the Sustainable Development Goals by 2030.


AIM
This investigation hypothesised that child-health improvements in rural areas of Cambodia continue to lag behind urban areas. The study objective was to identify specific disparities in rural achievement of MDG within Cambodia to direct future work in child health.


METHODS
Surveys were conducted in 230 rural households in four villages in Kampot and Kampong Speu provinces to assess risk factors contributing to lack of village-level achievement of MDG. National urban and rural data were used for comparison.


RESULTS
An under-5 death in the preceding year was reported by 11.5% (n = 26) of the households surveyed. Under-use of common public health interventions (vaccinations, clean drinking water, oral rehydration therapy, iodised salt, bed nets, antenatal care, and improved sanitation facilities) was observed in all villages. Under-use of the interventions was more common in rural than urban areas.


CONCLUSION
Achievement of child-health-related MDG lags in rural areas of Cambodia. Child health risk factors varied widely among villages. Village-specific risk factors for which immediate action can be taken are a priority, particularly vaccination in Angkcheay and Takoa and clean drinking water in Pos Pong. Elimination of disparities in rural child health will ultimately require significant resource allocation in rural areas, e.g. improved sanitation facilities, piped water supply and sustained public health initiatives.
['McClure|Karen|K|0000-0003-3261-6646', 'Jun|Jeany K|JK|0000-0003-4732-2675', 'Johnson|Casey R|CR|0000-0001-9948-1243', 'Fischer|Philip R|PR|', 'Lu|Lydia|L|', 'Vy|Sophakna|S|', 'Knutson|Dale|D|0000-0002-9305-1602']
D000293:Adolescent D000328:Adult D002160:Cambodia D002648:Child D000067576:Child Health D002675:Child, Preschool D005191:Family Characteristics D005260:Female D054624:Health Status Disparities D054625:Healthcare Disparities D006801:Humans D007223:Infant D007231:Infant, Newborn D008297:Male D008875:Middle Aged D012307:Risk Factors D012424:Rural Population D011795:Surveys and Questionnaires D016019:Survival Analysis D014505:Urban Population D055815:Young Adult
Millennium Development Goals Cambodia Child health sustainable development goals rural health disparities malnutrition under-5 mortality