Cambodia’s health reformation – The Health Strategic Plan (HSP)

The Ministry of Health, part of the Cambodian government, is currently nearing the end of its 7 yearlong Health Strategic Plan in which it hopes to increase the health and well-being for all Cambodians.Cambodia Healths

The health system in Cambodia has experienced several periods change; from a rudimentary health care system placed by Prince Norodom Sihanouk in the 1960’s and early 1970’s to using a Vietnamese model in the 1980’s. It was not until 1993, however, when the first Royal Government took office that the healthcare service in Cambodia began to improve. The Royal Government reformed the health sector by establishing a Ministry of Health (MoH) that aimed to improve and extend primary health care through the implementation of a
district based health system. In addition, a Health Sector Strategic plan 2003-2007 (HSP1) was formed to help facilitate the process.

More recently, the government developed a second Health Sector Strategic Plan 2008-2015 (HSP2) with its vision to ‘enhance sustainable development of the health sector for better health and well-being of all Cambodian, especially of the poor, women and children, thereby contributing to poverty alleviation and socio-economic development’.

The HSP2 takes a strategic approach in implementing its goals and does this by focusing on three health program areas: reproductive, maternal, new-born and child health; communicable diseases such HIV/AIDs and Malaria; and non-communicable diseases and other health problems. In addition, each of the three main health area programs implement a set of five cross-cutting health strategies which are: health service delivery, health care financing, human resource for health, health information system and health system governance.

The HSP2 also includes a plan of the cost which takes into account many factors, which includes: increased utilisation of services due to population growth as well as increased demand for public health services, scaling-up contracting and the expansion of key interventions aimed at improving maternal and child health.

The financial plan is around $170 million and is funded by the World Bank, Australia Department of Foreign Affairs and Trade (DFAT), Department for International and Development and others, along with a partial pooled fund. As with most financial managements, reporting mechanisms and auditing also occurs.cambodia health

In a recent update report in March 2014, the results from the plan proved successful. For example over 1 million people in Cambodia now have access to a basic package of health, nutrition or reproductive health services compared to just over 150, 000 in 2007. Moreover, 50% of all health centres are now implementing Health Equity Funds compared to only 13% in 2008. In some cases, current results have already surpassed the target; the percentage of birth deliveries by trained health personnel at health facilities it now at 80% although the target is only 75%.

Despite the positive trends, however, there are still a number of significant constraints that limit rapid improvements occurring throughout the health system. This has been foreseen by the MoH and a third Health Strategic Plan 2016-2020 is under the formulation process which plans to increase health spending with improved efficiency, use more stable sources of financing as well as a more effective financial management including budgeting.

Article by Dayle Burnett-Quarry