Manila Prak
Cambodia borders Vietnam to the east, Laos to the north, Thailand to the west, and the ocean to the Southwest. It has a population of 16 million people and is considered a lower-middle income country. During the period of 1975 to 1979, the Khmer Rouge regime took power and civil war engulfed the country. Over half of the healthcare workforce, including nurses, were killed during that time. After the Khmer Rouge fell from power in 1979, the country started from zero.
Since then, Cambodia has observed significant improvements in population health due to strong economic growth—particularly in infant, child and maternal mortality, as well as continuing decline in HIV prevalence and deaths from malaria. Overall life expectancy at birth increased from 65.6 years in 2000 to 71.4 in 2012.
Due to the country’s turbulent history, the needs of nurses in Cambodia are great. They include building up the professional status of nurses, creating infrastructure, strengthening education, developing national protocols and guidelines, and establishing an ethical framework for nursing. The Ministry of Health and the Cambodian Council of Nurses have taken significant action by developing nursing policy, including the implementation of evidence based protocols, introduction of the nursing process framework in 2004, implementation of the code of ethics for nurses in 2013, and finalization of standards of practice for nurses in 2015.
I am one of the nurse leaders in Cambodia who is committed to improving the quality of care and the nursing profession in Cambodia. As a nurse and a woman, I have faced significant challenges in my career path. Educational opportunities for nursing in Cambodia are limited, and as a result, I am one of only eleven master’s degree level nurses practicing in the country. The nurse-to-patient ratio remains below recommended targets. To pursue my educational goals, I received my bachelor’s and master’s degrees in Thailand. As part of my thesis in 2017, I developed neonatal nursing standards of practice to improve quality of care for neonatal patients and advance the nursing profession.
In my previous role, I was the director of the Global Child Health Department at Angkor Hospital for Children. I led a community program, “Saving Babies Lives,” to improve outcomes for neonates in a rural province in Cambodia. This role required me to work with different levels of healthcare staff, from the ground to leadership levels. In these settings, having difficult conversations to build consensus is common, but it is my duty to convince people to support quality nursing care for the population and to strengthen the nursing profession. In 2013, I helped launch the Cambodian Association of Nurses (CAN) and in 2019 the organization became the official nursing association in Cambodia.
Recently, I was honored to become a fellow with the International Council of Nurses (ICN) Global Nursing Leadership Institute. I am looking forward to gaining additional knowledge and experience in policy leadership, building my relationships with nurse leaders from other countries, and amplifying Cambodian nursing within the international community. I hope also to register CAN with the ICN; I want to see the Cambodian flag on stage during the ICN Congress in the near future.
* Manila Prak, RN, BSN, MSN, is the President of the Cambodian Association of Nurses and Healthcare Accreditation Advisor with USAID Enhancing Quality of Health Care Activity (EQHA) through Family Health International 360, Cambodia.