Cambodian Ministry of Economics and Finance largely approves Health Financing Policy
Oct 2014 – Formulation of the Cambodian Health Financing Policy started in July 2012. It was a consultative process that involved a range of stakeholders for wider strategic issues while technical details were addressed by a smaller core group of experts.
The result is a technically sound document that gives due considerations to the country’s historical and political developments that shaped the health system and associated arrangements for social health protection. The policy also tries to anticipate politically sensitive issues, especially those by the Ministry of Economics and Finance.
Potentially contentious issues are those requiring additional finances. The Policy therefore promotes efficiencies –technical, allocative and administrative – and makes reference to additional sources of money for health in the form of sin taxes. These taxes do not exist yet in Cambodia, resulting in a considerable proportion of the population indulging in tobacco products.
In August, two years after the start of the Policy formulation, the Minister of Health sent the draft Policy to five ministries for feedback:
• Ministry of Planning, which is, amongst others, responsible for the IDPoor programme –a nationwide community-based pre-identification of the poor using proxy means testing
• Ministry of Labour and Vocational Training: houses the National Social Health Protection Fund that in turn will start operating Social Health Insurance for the formal private sector
• Ministry of Social Affairs, Veterans and Youth Rehabilitation: is responsible for the National Social Security Fund and –to be developed and started- respective Social Health Insurance for civil servants
• Council for Agriculture and Rural Development: the inter-ministerial body under the Council of Ministers responsible for coordinating the implementation and monitoring of the National Social Protection Strategy
• Ministry of Economics and Finance: responsible for the administration of financial and economic policies of Cambodia, including allocation of budget for social affairs.
The response appears positive. As such, the Ministry of Economics and Finance welcomes the initiative for universal health coverage. It appreciates the long-term vision of the Health Financing Policy and recommends three sources of financing to be considered: out-of-pocket, insurance and government budget. The response reiterates the government’s commitment to enable the poor financial access to health care but stresses the need for the Ministry of Health to ensure quality health care.
Following this response the Policy is now with the Minster of Health for his signature. The Health Financing Policy will be an essential input for the formulation of the third Health Strategic Plan (2016-20) and features high on the agenda of development partners as a means to channel their financial assistance.
Please find below a working paper: toward UHC: the Cambodian experience formulating a health financing policy and various related briefing notes.
- Briefing Note – Voluntary enrolment in HEF (pdf, 809.43 KB)
- Briefing Note – Lessons from Ghana (pdf, 767.6 KB)
- Briefing Note – HEF non-utilisation (pdf, 770.95 KB)
- Briefing Note – Catastrophic Expenditure (pdf, 801.19 KB)
- 2014 06 Cambodia working-paper formulating health financing policy (pdf, 5.97 MB)
Dec 2013 – Functional analysis for establishing the National Social Health Protection Fund in Cambodia
Functional analysis for establishing the National Social Health Protection Fund in Cambodia
Dec 2013 – This assessment was conducted in October of 2013 with the aim of elaborating the organisational structure and determining the staffing requirements for establishing the National Social Health Protection Fund. This Fund is one of the three envisaged social health protection institutions and will cater for the informal sector population.
- Functional analysis for NSHPF-final report for dissemination (pdf, 528.4 KB)
First meeting of the ‘health financing contact group’ since 2011
Jul 2013 – Following inactivity during a prolonged period for a variety of reasons the contact group for health financing was revived on the 3rd of July 2013.
The meeting was well attended by a variety of representatives. Because considerable time had elapsed since the last such meeting an introductory round was necessary to get to known the new faces around the table.
The opportunity was taken to update on each agency’s activities concerning health financing and social health protection. Topics discussed included an update of P4H Network’s recent developments.
An overview was provided concerning the latest adjustments of the draft health financing policy, particularly regarding risk and fund pooling of the three social health protection schemes in the long term, measures to promote enforcement of regulation and co-payments. This was followed by a discussion on the need to maintain user fees or not to motivate service delivery by health staff.
The best way to supplement the contact group that currently consists solely of development partners would by a forum in which the government participates and ideally leads, was the last point of discussion.
The next meeting is scheduled for early September.
Regional forum on health-care financing
May 2012 – Several P4H partners are involved in a regional forum which takes places in May 2012 in Phnom Penh. The objectives of the forum are to bring together stakeholders active in health financing in the Mekong area in order to share country experiences, to stimulate research and knowledge-sharing and to establish a regional community of health financing practice.
Workshop on CBHI and HEF in Cambodia
Nov 2011 – A joint AFD/GIZ workshop on social health protection for the poor and near-poor focused on the implementation of Community Based Health Insurance (CBHI) and Health Equity Funds (HEF) in the same geographic areas takes place in Phnom Penh.
Adoption of National Social Protection Strategy
Apr 2011 – Under the leadership of the Prime Minister and with active coordination from the Council for Agricultural and Rural Development (CARD), a national Social Protection Strategy is adopted. The document is the overarching reference for all future documents related to specific pillars of social protection such as health, education, pension, etc. Thus future social health protection policy and health financing strategy will have to align with the national Social Protection Strategy.
First P4H joint action plan for Cambodia
Mar 2010 – In line with the Memorandum of Understanding signed in 2009, the local P4H network prepares its first P4H joint action plan. Scheduled activities and financial gaps are listed according to the main areas of work of both the Ministry of Health and Ministry of Labour and Vocational Training. One of the key joint activities scheduled is a catastrophic expenditures survey.
P4H partners sign MoU
Jun 2009 – WHO, ILO, AFD and GIZ country representatives sign a Memorandum of Understanding (MoU). In signing the MoU, the P4H network’s goal is to support the Royal Government of Cambodia in its efforts to ensure equitable access to quality health care for all people of Cambodia.
- Cambodia Memorandum of Understanding (pdf, 25kb)