Context
In 1995, the Cambodian Ministry of Health started a comprehensive health reform. The implementation of a national Health Sector Strategic Plan (2008 – 2015) is supported jointly by bilateral and multilateral donors through a programme-based approach with sector-wide management.
Despite positive structural changes and progress in reducing child mortality and the prevalence of HIV/AIDS, the services offered by the public health system, especially for the poor population in rural areas, remain inadequate. The principal causes are the lack of qualified personnel, the lack of suitable materials and equipment in medical institutions, and the poor level of motivation among staff as a result of their extremely low salaries.
The Strategic Framework for Health Financing (2008-2015) and the draft of a Social Health Protection Master Plan are intended to further develop and expand universal coverage of social services using a combination of different approaches. Other priorities of the Cambodian Government include the reduction of maternal and child mortality. This is not only specified in the Millennium Development Goals, but is also included in the National Social Development Plan (NSDP) as well as several initiatives of the Ministry of Health.
Objective
The quality of public and private health services has improved and access to them, especially for poor and disadvantaged groups, has risen.
Approach
Since 1995, GIZ has supported the Ministry of Health in implementing the Health Sector Strategic Plan in the fields of quality management, training for health personnel and health financing/social health insurance. The programme provides policy advice at ministerial level and is contributing to the process of reform in the provinces.
The health programme has been planned to last for a period of several years, to ensure long-term support for the reform process and the sustainability of the capacity development.
Results achieved so far
Since the start of the previous programme, Support for Health Reform, in 2003, together with its partners, GIZ has contributed much to achieving the objectives of the health reform. Training and upgrading events have considerably strengthened the Ministry of Health as well as local administrators and specialists, especially midwives and nursing staff. The programme also supports pilot projects that are working to establish social health insurance schemes in the provinces of Kampo, Kampong Thom, Kampong Cham and Oddar Meanchey, as well as a government hospital in Phnom Penh.
Thanks to a number of information events organised by the programme in the pilot provinces, patients are now significantly better informed about their rights and have started to communicate their constructive criticism and suggestions to hospital management.