Cambodia is in its third decade of peace and strong economic growth, and has made major strides in improving health and reducing poverty. With ambitious plans to continue this progress, the Royal Government of Cambodia is seeking to expand its social protection programs, including health insurance schemes that protect people from impoverishing health care costs. At the same time, the country is undergoing a decentralization and de-concentration process, in which responsibility for planning, budgeting, and implementing health programs is being shifted from national ministries to provincial governors and health departments. The government identified a need for targeted technical assistance as it pursues these efforts.

Approach

LHSS is enhancing Cambodia’s institutional capacity to oversee and expand social health protection, and ensuring that health financing functions remain strong as decentralization proceeds. We are collaborating with government partners to:

• Build an accountable, transparent monitoring system to help national authorities effectively manage the social health protection policies.
• Support provincial authorities in planning, budgeting, and implementing effective health programs, including HIV/AIDS programming.

Progress Highlights

• LHSS supported the General Secretariat’s National Social Protection Council (GS-NSPC) in launching its central social protection registry that allows for exchange of data through various social protection databases. Patients are tracked across social protection schemes using a unique social protection ID. This reduces duplication of registrants and allows individual clients to be identified across multiple social protection schemes. This registry will ultimately improve service provider efficiencies and expand client access to other schemes.
• LHSS supported the National AIDS Authority in organizing a reflection workshop on the implementation of the Fast Track Cities Initiative in four provinces. During the workshop, stakeholders reviewed progress and identified solutions to overcome budget expenditure challenges. Provinces working together in the Fast Track City Initiative strengthened subnational ownership of the HIV response at various administrative levels and led to approval of HIV activities in commune investment plans.
• The TB patient cost survey protocol, co-developed by LHSS and the National Center for Tuberculosis and Leprosy Control, was endorsed by the Ethics Committee for Health Research of Cambodia. The first of its kind in Cambodia, this survey will identify and measure the number of TB patients facing catastrophic health expenditures. Survey results will help the National Center to better understand the financial burden of TB to patients and their families. Findings may lead to inclusion of the most vulnerable groups into social protection schemes as part of national efforts to eliminate TB.