A step towards Universal Health Coverage in Kampong Thom
26 November 2013
The Cambodian Ministry of Health and its partners are taking on the challenge of securing universal access to quality health care. The act aims to do so without risking impoverishment and indebtedness, by covering patients’ direct expenditure related to health through social health protection schemes.
Out-of pocket expenditure for health care an impoverishment risk
Out-of-pocket expenditure constitutes more than two thirds of overall health spending in Cambodia. The health sector’s high reliance on ‘fees for services’ coupled with lacking social health protection puts people at financial, social and economic risk. It can further deter them from seeking health care when in need, as expenses are unpredictable.
With lower risk of debt, more pregnant women will seek maternal healthcare.
Providing access to Social Health Protection mechanisms for all
In January 2013, the ‘Integrated Social Health Protection Scheme’ was launched in Stoung Operational District in Kampong Thom Province. This innovative approach supported by GIZ’s Social Health Protection Project allows voluntary enrollment in a Social Health Protection Scheme by extending the services of Health Equity Funds. Families can protect their members by joining the scheme and paying an affordable contribution. Through this mechanism, health care users with greater health needs can access public health services whenever needed without risk of impoverishment, of falling into debt and poverty because of unaffordable or unpredictable health care bills.
Without discrimination, all pre-identified poor households as well as voluntary enrollees are granted access to the same package of health services. In the scheme’s first months, membership of the scheme has experienced a positive upside trend, increasing to 29% of the population in Kampong Thom.
Families identified as ‘poor’ may now be better reimbursed for their health care costs.
The Non-governmental Organisation Action for Health (AFH) operates the scheme. Its tasks as operator include, promotion of voluntary enrolment, awareness raising, collection of contributions, reimbursement the providers for medical service costs. But most importantly, AFH also represents the interests of all scheme-members, poor, which are exempted of contributions, or voluntary. By doing so, AFH plays an important role in securing scheme-members rights and promoting adequate health service provision for the entire population in Kampong Thom.
The schemes’ expansion demonstrates strengthened efforts to make quality health services affordable, accessible and more equitable for all Cambodians. The scheme extends health care to those previously untreated and reduces the risk of slipping into poverty and debt when falling ill and seeking care. The expansion constitutes another step towards Universal Health Coverage.
