The second Contact Group meeting on Health Financing took place on 5 September 2013 and was well attended. The World Bank representative attended for her first time and the advisor to the National Social Health Protection Fund, the Cambodian social health insurance for formal private sector employees, joined the ranks. Medicam, the umbrella association of local and international NGOs operating in the health sector, was also invited.
In the dynamic Cambodian context there were numerous issues for discussion though the Health Financing Policy wasn’t directly touched upon due to the political stalemate following the July national elections. Nevertheless, during these elections the opposition made major gains something that appears to favour a move to universal health coverage. This is because the issue was on the agenda of the opposition, at least for the elders, and in response the leading party seems to take it on board. As such costs were estimated for exempting population groups such as children, pregnant women and elders (≥60 years) from user fees. Closer examination of the Demographic and Health Survey of 2010 revealed extreme high out-of-pocket expenditures for the latter population group, also justifying closer examination of the yet unknown underlying reasons.
The first topic related to establishing a sub-Technical Working Group on Health Financing. This body, chaired by the Ministry of Health, reports to the Technical Working Group for Health, which is the main forum for dialogue and consultations between the government and development partners in the health sector. The Technical Working Group’s main responsibility is to coordinate all stakeholders’ responses to health issues of the country. To date there are nine sub-Technical Working Groups (e.g. blood safety; MNCH; mental health), each operating with varying degree of effectiveness, but none yet for health financing. All participants agreed on the need for such Working Group for health financing, largely agreed with the draft Terms of Reference, and ways to advance the initiative were discussed.
The next point concerned a request by the Ministry of Health for a high level national conference on universal health coverage to be supported by development partners. The aim of this conference is to obtain political support from the highest level possible for universal coverage and to advance the draft Health Financing Policy.
This was followed by a presentation on the suggested approach for a P4H-financed initiative; a functional analysis for developing the National Social Health Protection Fund. This Fund is to constitute the social health insurance for the informal sector population. Its creation has been talked about since 2007, with little consideration, until the recent formulation of the Health Financing Policy. The initial tasks of this fund will be to take over the functions of the Health Equity Fund Implementer that oversees the activities by the NGOs contracted to manage Health Equity Funds at district and provincial hospital level. Later on it will accommodate the coordination of other financing interventions targeted at the informal sector, such as voluntary insurance and vouchers, before maturing into a social health insurance scheme.
The meeting was closed with a clip addressing the issue of performance management and vows for the next meeting http://www.youtube.com/watch?v=u6XAPnuFjJc )
