A Study on Transition of Health Equity Fund to Universal Health Coverage in Cambodia

Abstract

Human health development has become one of the most fundamental development goals for Cambodia. With the necessity to improve health sector, the country has witnessed ongoing efforts on utilizing health financing as a tool to innovate better health outcomes and accessibility to equitable and affordable services as a move toward Universal Health Coverage for populations. As a critical mechanism of health financing, Health Equity Fund (HEF) was introduced to expedite process of universal healthcare along with major reforms in health policy. Within the position of least developed country, Cambodia is facing challenges in sustaining health finance for expanding Health Equity Fund to cover mainly large proportion of the poor who constitute majority of population in informal sector. The thesis aims at examining national health financing system in Cambodia by studying experiences of health functioning and operation of Health Equity Fund in such system in order to achieve the goal of Universal Health Coverage. The paper has analyzed progress and performance achievement of Health Equity Fund by examining how it has played a significant role in contribution to expansion of utilization of health service delivery, coverage of access to health services for target poor population and production of key performances of health system. It is noted that Health Equity Fund has demonstrated as transitional financing mechanism toward Universal Health Coverage. Achieving Universal Health Coverage by utilizing the role of Health Equity Fund is not comprehensively holistic. Sustainability in financing base for Universal Health Coverage remains incremental although Cambodia experiences efficiency of Health Equity Fund in enhancing health service provision and interventions on financial risks for poor beneficiaries. In Cambodia's development context as a low-income country, sources of funding are critical to operationalize health financing. However, the analysis from this study has shown that out-of-pocket health expenditure remains a dominance in funding while financial flow from external donors is on a downward trend. In other word, the attainment of universal healthcare is far out reach considering financial strength of resources to implement health financing schemes.