Cambodia has made significant progress in economic growth and improvement in key health indicators over the past two decades. However, within the health system, out-of-pocket expenditures remain high (60% of total health expenditures). Although the country has initiatives to provide financial protection to particular populations groups, Cambodia does not have a national system that provides universal health protection to the entire population. In March 2016, the Royal Government of Cambodia (RGC) committed to achieving universal health coverage (UHC) through its recently endorsed Social Health Protection Framework.
The National Social Protection Working Group, led by the Ministry of Economy and Finance (MoEF) and comprised of the Ministry of Health (MoH), Ministry of Labor and Vocational Training (MoLVT), Ministry of Social Affairs, Veterans and Youth Rehabilitation (MoSVY), and representatives from other government entities has been tasked with advancing the development of a social health protection strategy that will help Cambodia achieve its UHC goals. While many of the ministry representatives have direct experience in providing some social protection functions to the people of Cambodia, there is a need to build health financing knowledge within the Social Protection Working Group to develop a responsive strategy that can effectively be scaled-up in the years to come.
A comprehensive social health protection reform requires multiple decisions to be made related to the core functions of health financing, such as revenue generation, risk pooling, and the purchasing of health services. For Cambodia to sustainably finance its ambitious SHP strategy, the MoEF will need to identify ways to generate new revenue and improve the efficiency of health spending. Furthermore, international experiences with UHC, particularly those of Cambodia’s neighbors, stand to provide multiple lessons for the various dimensions of a social health protection reform that Cambodia will need to consider.
Through the USAID-funded Health Finance and Governance Project (HFG), and in collaboration with Abt Associates, R4D supports the National Social Protection Working Group and the MoEF in the development of their social health protection strategy.
As an initial step, R4D has been building the capacity of the social protection working group on key tenets of health financing, social health protection and health insurance. R4D has also developed policy briefs to help guide the MoEF on key decisions related to the development of their social health protection strategy.
Expanding upon this work, the MoEF has requested that R4D provide targeted guidance on the implementation of their social health protection strategy. A key component of R4D’s work is to identify new revenue sources and to provide evidence on how Cambodia can improve the efficiency of current health spending. Accordingly, R4D is conducting a fiscal space analysis to assess where and to what extent new resources can be generated for health in Cambodia.
Ultimately, R4D’s work will help Cambodia structure its social health protection initiatives to achieve its goal of UHC in the long-term.