Health Systems Strengthening

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Background
When Cambodians fall sick, the majority seek care first from the private sector, due to the high cost, poor quality and lack of accessibility of the public sector. Aligned with the Global Health Initiative, USAID’s Health Systems Strengthening project focuses on improving health policy and access to health services for poorer populations through health financing schemes, improved service quality, better health information systems, and medicine quality monitoring.

Objectives
In support of the Cambodian government’s 2008-2015 Health Strategic Plan, USAID is helping to build the country’s health care system at the national, provincial, district and health-center levels. Under this strategic plan, the Ministry of Health seeks to develop more sustainable and systematic health-financing schemes in collaboration with health development partners, including USAID, the World Bank, the Australian Agency for International Development (AusAID), the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), the Belgian Development Agency (BTC), Groupe Agence Française de Développement (AFD) and multiple UN agencies.

Results
• Ensured that over 1.1 million people have access to health care through Health Financing Schemes.

• Expanded Health Equity Funds to 15 operational districts, 10 referral hospitals and 154 health centers throughout Cambodia. In addition, USAID supports monitoring activities of Health Equity Funds in 13 additional operational districts. Overall, USAID supports or monitors 60% of the Health Equity Funds in Cambodia.

• Because Health Equity Funds improve the overall quality of public services, Cambodians are more likely to seek care from the public sector in areas where they are present, even if clients are not eligible for Health Equity Funds support.

• Supported the launch of an updated National Health Information System in 990 health centers, 78 referral hospitals and eight national hospitals. Also helped shift from a paper-based to a web-based system, which has shown significant improvement in data and improved planning and management.

• Improved the Ministry of Health’s capacity to detect and eliminate poor-quality medicines sold at markets through surveillance activities in 17 provinces. In addition, raised awareness about medicine quality issues among regulators, health care professionals and the public.