Quality of care
Since the early 2000s, Cambodia has undergone significant economic transition and reached lower-middle-income status in 2015. Alongside sustained economic growth, Cambodia has seen steady improvement in health outcomes in recent decades, reaching most of the health-related Millennium Development Goals. Yet, access to quality health care remains problematic, especially for people living in poverty and vulnerable groups. COVID-19 worsened the situation. The establishment of a Cambodian national accreditation system aims to improve the quality and safety of health care services.
Cambodia is undergoing an epidemiological transition resulting in the double burden of communicable diseases and noncommunicable diseases (NCDs), with the latter accounting for a larger and increasing diseaseshare. This puts increasing pressure on the national health system. Consequently, investing in better management of NCDs is critical. The Ministry of Health is working on a strategy to strengthen the primary health care system, which is essential for early detection and timely treatment of NCDs.
Health financing
Impressive progress has been made in providing financial protection for health services, including Health Equity Fund (HEF) for the Poor, voucher systems, and social health insurance schemes for the formal sectors (NSSF). Despite this progress, government spending remains low and out-of-pocket expenditures still make up 60% of total health expenditures, which is a serious impediment to the country’s progress towards universal health coverage (UHC).
Approximately 3.7% of households were pushed into poverty due to high health spending in 2017. More specifically, women-headed households were at higher risk than male-headed households4. To this end, efforts to expand social health protection systems are underway. The government is exploring the option of extending social health protection to dependents of NSSF beneficiaries and to extend the HEF to vulnerable groups and the near poor population. The expansion of these existing schemes (NSSF and HEF) provides an adequate pathway to cover the “missing middle”.
