The history of midwifery education in Cambodia
A young student
A young student


The first school for nurses and midwives was established as the ‘Ecole d’ Infirmieres et de Sages Femmes’, based at Preah Ket Mealea Hospital in Phnom Penh.   A two year midwife education program was offered between 1950and 1960.


The school became the “Ecole Royale d’Infimieres et de Sages Femmes d’Etat’ and was located on the site of what is now the famous Kuntha Bopha Children’s Hospital in Phnom Penh   A three year midwifery curriculum was introduced.

During these 10 years midwives became highly regarded and received good salaries


The school moved to its present location next to the Khmer Soviet Friendship Hospital and became known as the Technical School for Medical Care (TSMC)


The school was obliged to close down by the Khmer Rouge regime.


The school at TSMC reopened and the MOH established 4 Regional Training Centres for paramedical professions located in the provinces of Battambang, Stung Treng, Kompot and Kampong Cham, in order to quickly replenish the health workforce. Midwifery training was reintroduced across the country with an overall goal of producing a large number of trained midwives in very basic skills of normal midwifery in order to increase access to midwives throughout the country.

There were two basic skills training programmes. One programme delivered qualifications to become a primary level midwife, the other a secondary level midwife.  The primary midwife training programme was one-year in duration with an entry requirement f a secondary school education. The secondary midwife-training programme was three years in duration. The first year was a common year with secondary nursing students, and the last two years were dedicated to midwifery thereby developing midwifery specific knowledge and skills.  The primary midwife was primed to work at Health Centres (HCs) in a supportive role to secondary level midwives. it was envisaged that secondary level midwives would form the bulk of midwives in Referral and Provincial hospitals.


A 2-year midwifery curriculum was introduced to upgrade primary midwives to secondary midwives.


The 2 year curriculum was revised and organised into modules and was taught only in TSMC in Phnom Penh and was later phased out in 2002.


A decision was made by the government to discontinue midwifery training. The midwifery courses were phased and consequently there were a limited number of midwives produced in Cambodia for 6years from 1996 to 2001.  


A post-basic midwifery programme was introduced, this required one year training in midwifery following three years of nursing training and entry requirements for the nurse programme had to have completed 12th grade at school.   This became commonly known as the 3+1 Post basic midwifery programme, the first graduates entered the service as midwives in 2003. 


The Ministry of Health introduced a 1year Primary Nurse-Midwife course which was designed to address the severe shortage of midwives in the North-East, of the country and had much lower entry requirements of minimum of  grade 7 of school this was adopted to ensure that local women willing to live and work in the region were eligible for the course. The course shared nursing content with those following the Primary Nurse programme. This was taught in Provincial Health Departments in the provinces from the North-East region.


The Ministry of Health decided to expand this one year program nationwide and revise the curriculum and responsibility for this training passed to the four regional training centres (RTC). Under the revised curriculum guidelines, entrants outside of the North-East must have completed grade 10 Successful graduates who followed this course received a Diploma in Primary Midwifery, and were eligible to enter the civil service as Primary Midwives.   

At the same time a private sector post-basic midwifery training programme (1 year after a 3 year nursing course) was initiated at the International University in Phnom Penh. The University produced 20 graduates per year and follows the national 1year post-basic midwifery curriculum.


To address continued shortage of midwives,a three year direct entry associate degree midwife was introduced and is currently being taught in TSMC and the 4 RTCs. The course was attractive as the number of applicants for this training far exceeded the number of seats offered by the schools for this curriculum.


The Ministry of Health and Ministry of Education Youth and Sport recognised the 3+1 midwifery course as degree course


The Ministry of Health introduced a 4 year direct entry Bachelors Degree in midwifery programme being offered at TSMC and two independent universities in Phnom Penh.


There are now at least 16 private and public providers of pre service midwifery education in Cambodia and the challenge is to ensure that the midwives completing these programmes have the core competencies to deliver high quality services to women their newborn, families and communities.

History of Midwifery Regulation in Cambodia
Madam Ing Rada President of CMC representing Cambodia at ICM conference Vietnam 2012
Madam Ing Rada President of CMC representing Cambodia at ICM conference Vietnam 2012


As far as we are aware no records exist relating to midwifery regulation before 2006  when the Midwifery Council was established following a Royal Decree issued on the 18 September 2006. The Royal Decree enshrines the Midwives Council as an autonomous health profession regulatory authority and responsible for handling all financial aspects and ensuring professional dignity, interest and morality within the profession.


The Council formed a Temporary Working Group on 27th November for establishing National, Regional and Provincial/Municipal council for midwives .A group of seven senior midwives working in key positions in the hospitals and the Ministry of Health formed this interim committee.

In terms of the development of the Midwives Council, the working group had the following responsibilities:
1. To organise a national seminar on dissemination of the Royal decree establishing the midwifery council for provincial health directors and chief of nurses/midwives;
 2.. To select  national, regional and provincial council members.


Madam Ing Rada was appointed as President in May by the Minister of Health to serve a six year term of office and 32 midwives were selected to the national Midwives Council and included one midwife from each province, the list of names was approved by Council of Ministers on 8th June and in November 7 of those members were chosen to serve on the Council’s Executive Committee.

Madam Ing Rada was sponsored to attend the International Confederation of Midwives (ICM) congress in Scotland UK

An office for CMC was allocated by the Minister of Health and opened in April it was refurbished with new office equipment including computers and a learning resource by UNFPA.
UNFPA has committed to support the CMC with a programme assistant to the Council from April 2010 to date.

2011 - 2012
Working groups were established to begin the process of developing core competencies for midwives and a code of ethics
Internal rules were agreed and approved for finance and other aspects of governance for the Council and w
orkshops on disseminating the role of the Council took place across the country.
Regional Midwives Councils (RMC) were established and
draft procedures for investigating complaints and dealing with disciplinary issues were completed
Provincial Midwives Councils (PMC) were established and registration of midwives was commenced
A VSO  Organisational Development Adviser appointed to work with the Council in June 2011
In May 2012 Madam Ing was sponsored along with other health professions council presidents to attend a study tour of Thailand where she learned at first hand from their Nursing and Midwifery Council how midwifery regulation was being successfully implemented and a ’twinning’ relationship was established. 

In January the Prime Minister approved the Sub Decree ’Code of Ethics for Midwives’ and the Council started the process of disseminating the code through regional workshops across Cambodia
A ’Handbook’ for midwives registered with the Council was published.
Work on the Council’s website began and was completed in November and work on developing an electronic registration process began with technical support from URC Cambodia.
In September the Ministry of Health approved the ’Core competency framework for midwives’ and work begun on a process for disseminating the competencies to all providers of pre service training.
A part time administrative assistant was appointed and the Council took on responsibility for financing its own office running costs from registration fees.. 

The United Nations Population Fund (UNFPA) has provided both technical and financial support to the Council in its establishment, capacity building and in its future direction from inception to the present time.