Stronger Governance Improves Health Services in Cambodia
Kampong Kandal, Cambodia, January, 2016 – In Cambodia, community participation in health care services is paying off. A nationwide roll-out of Health Centre Management Committees (HCMC) are strengthening local governance and enhancing community participation in the health sector, Communities are now getting involved with the co-management of facilities and exchange of information among citizens, health care providers and local authorities leading to improved accountability and transparency, more efficient services and stronger leadership.
“Cooperation is much better now,” said Hor Suon, Chief of the Kampong Kandal Health Centre. “For instance, we are now organising outreach activities together.”
Communities surrounding the health centre are experiencing improvements including funds allocated to their local commune budget, improved opening hours of health centre and patient-doctor relationships and more health education outreach and activities contributing to improved health centre hygiene. Health centre infrastructure has also improved including a wheel-chair accessible ramp, waiting room, and suggestion boxes.
The most recent Client Satisfaction Survey conducted in 2015 showed that patients treated in the health centre of Kampong Kandal were satisfied with the health services.
Our Approach: Health System Governance
Health System Governance teams provide technical advice to HCMCs in the province of Kampot, which is one of the project’s target provinces. The underlying approach to Health System Governance aims to enhance interactions between citizens, health providers and local authorities or policymakers (see Figure 1), improving health system governance at the sub-national level.
In 2012, one of the first HCMCs received support by the Health Service Governance team in Kampong Kandal commune. This committee was chosen in early 2012, since the members were struggling to fulfill their roles and responsibilities.
The Health System Governance team provides technical advice and facilitates committee meetings, which take place every second month. During the meetings, the team’s advisor Mr. Por Pen, assists in monitoring the performance of the health centre of Kampong Kandal and the implementation of agreed activities. He also ensures that feedback from patients is taken into consideration. Additionally, the Health System Governance team organises regular workshops and trainings to equip HCMC members with essential skills and knowledge. Governance teams provide training on how to interpret client satisfaction survey findings; client and provider rights and duties; and on-the-job training on how to manage HCMC meetings.
What are Health Centre Management Committees (HCMC)?
HCMCs aim to improve the scope and quality of services in health centres. Health centre staff are part of the committee as well as the chief and members of the commune council and members of the Village Health Support Group, who represent citizen’s interests. The main role of HCMCs is to provide direction and guidance for health centres to ensure that services are available, accessible and utilized.
Efficiency On The Rise
The work of the HCMC Kampong Kandal is now more efficient, since members know what is expected from them and they are aware of their rights and duties. It has been reported that communication and collaboration among citizens, health centre staff and the commune council have improved considerably. In general, all groups are now more actively involved in HCMC meetings, the planning processes for the health centre and the commune council, and reflection forums.
“The members of the committee are much more committed since we are receiving support from GIZ,” said Ty Vuthy Commune Council Chief. “Before, they did not show initiative.”
Story by Mrs. Kira Brings and Mr. Por Pen
Photo by Mrs. Kira Brings