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Roadmap to Universal Coverage in CAMBODIA

Roadmap to Universal Coverage in CAMBODIA. Bureau of Health Economics and Financing, DPHI, MoH. 4 th TMR Health Policy & Financing, NOSSAL 11 th October 2011. Ros ChhunEang. Outline. 1- Cambodia at a glance 2- Roadmap to UC 3- Progress 4- Challenges. 1-Cambodia at a glance.

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Roadmap to Universal Coverage in CAMBODIA

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  1. Roadmap to Universal Coverage in CAMBODIA Bureau of Health Economics and Financing, DPHI, MoH 4th TMR Health Policy & Financing, NOSSAL 11th October 2011 Ros ChhunEang

  2. Outline 1- Cambodia at a glance 2- Roadmap to UC 3- Progress 4- Challenges

  3. 1-Cambodia at a glance • Population >14 million; >80% are rural farmers • 27 % living under poverty line & almost 90% in rural area • GDP per capita = US$853 • OOP = 2/3

  4. Existing HF mechanisms • National budget • Global free initiatives.... • User fee (not cost recovery, not properly cost), with exemption policy • Special Operating Agency (SOA+SDG) • Fragmented HEF schemes by NGOs • Voucher by NGOs • CBHI by NGOs

  5. 4- Roadmap to UC No Social health Insurance but there are Fragmented Social Health Protection schemes SHP MP development (draft) Vision: To provide effective and equitable access to affordable quality of health services for all Cambodians....?

  6. Pluralistic approaches • Compulsory Social Health Insurance • SHI for formal private sector under NSSF • SHI for Civil servants under NSSF-C • Voluntary Insurance • Community-based health insurance (CBHI) • Social Assistance (HEF)

  7. Progress • NSSF: • established • has implemented work injury for 2ys • Legal framework for SHI being developed • NSSF: • established, • Legal framework for SHI being developed • HEF: covers >80% of the poor - Piloting linkage HEF and CBHI - Preparing expansion plan - Studying on HEF institutional arrangement by NOSSAL • CBHI: covers <1% (temporary circular by MEF) • Plan to review health financing charter (user fee, benefit, payment mechanism) • Plan to review Mater Plan of Social Health Protection

  8. 5- Challenges • Widespread poverty; civil servants and employees are low paid => Low ability-to-pay. • The majority of the population (>80%) are self-employed/farmers • Limited understanding of the rationale of pre-payment schemes among the population => Low commitment & participation. • The health system constraints : quality of care • Local technical capacity for SHI development is limited • SHP/HEF institutional arrangement • Financial sustainability 8

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