Over the past three decades, the development of Cambodia’s health system has made significant progress. The efforts of The Royal Government of Cambodia (RGC) in improving the health system have led to better health outcomes for the population. This roadmap aims to reflect the challenges and opportunities in the development of universal health coverage in Cambodia.
The roadmap is structured to provide a comprehensive approach to achieving universal health coverage, focusing on equitable access, quality improvement and financial protection. It outlines the strategic goals, objectives and actions necessary to ensure that all citizens have access to essential health services without financial hardship.
Universal Health Coverage (UHC)
Universal Health Coverage ensures that all people receive the health services they need without financial hardship. This concept is fundamental to achieving better health and wellbeing for all, promoting health equity and ensuring sustainable development.
The The Royal Government of Cambodia (RGC) has committed to achieving Universal Health Coverage in Cambodia by 2035. This roadmap outlines the strategic direction, key actions and milestones necessary to achieve this goal. It reflects the country’s health priorities, challenges and opportunities and is aligned with the global health agenda and the Sustainable Development Goals (SDGs).
Key Objectives of the Roadmap:
1.    Ensure equitable access to essential health services for all segments of the population.
2.    Improve the quality of health services to meet national and international standards.
3.    Protect individuals and families from financial risks associated with health care costs.
4.    Strengthen health system governance, management, and accountability.
The roadmap is built on three main pillars:
1. Service Delivery: Enhancing the availability, accessibility and quality of essential health services.
2. Health Financing: Developing sustainable financing mechanisms to provide financial protection and reduce out-of-pocket expenditures.
3. Health System Strengthening:Improving health system governance, workforce capacity, infrastructure, and health information systems.
The first pillar of the roadmap focuses on ensuring that the entire population has access to essential health services. This includes providing a comprehensive range of healthcare services that are equitable, high-quality and accessible to all segments of society. The goal is to improve health outcomes by addressing the specific health needs of various population groups, particularly the vulnerable and marginalized.
- Expand Service Delivery: Increase the availability of health services across different regions, ensuring that even remote and rural areas are covered.
- Improve Service Quality: Enhance the quality of health services to meet both national and international standards.
- Equitable Access: Ensure that health services are accessible to all, regardless of socioeconomic status, gender, age, or geographic location.
The second pillar aims to ensure that essential health services are comprehensive and effectively meet the health needs of the population. This includes preventive, curative, rehabilitative and palliative care. The focus is on strengthening the healthcare system to deliver these services efficiently and effectively. The key objectives of the second pillar are:
- Comprehensive Service Package: Define and deliver a comprehensive package of essential health services that addresses the major health needs of the population.
- Service Integration: Integrate health services to provide continuous and coordinated care across different levels of the healthcare system.
- Health Workforce: Develop and maintain a well-trained, motivated, and adequately distributed health workforce to deliver essential health services.
The third pillar is focused on protecting individuals and families from the financial risks associated with healthcare costs. This involves developing and implementing financial mechanisms that reduce out-of-pocket expenses and provide financial protection to all citizens. The key objectives of the third pillar are:
- Health Insurance Schemes: Expand and strengthen health insurance schemes to cover more of the population and a wider range of services.
- Financial Support Programs: Provide financial support and subsidies for those who cannot afford health services.
- Cost Control Measures: Implement cost control measures to ensure that health services are affordable and sustainable.
Expected Outcomes, Timelines and Milestones
By year 2035, Cambodia aims to:
- Achieve universal access to essential health services.
- Ensure financial protection for all citizens.
- Improve health outcomes and reduce health inequities.
- Establish a resilient and sustainable health system.
The National Action Plan includes a detailed timeline with specific milestones to be achieved over the next decade. Key milestones include:
- Short-term (2024-2026): Establish foundational policies and begin expanding health coverage.
- Medium-term (2027-2030): Achieve significant improvements in health service delivery and financial protection.
- Long-term (2031-2035): Ensure sustainability and consolidate gains to achieve full UHC.
The implementation strategy of the roadmap involves several key components:
- Policy and Regulatory Framework: Strengthening policies and regulations to support UHC goals.
- Health Workforce Development: Investing in the training and retention of health workers to ensure adequate staffing levels and skills.
- Health Infrastructure: Expanding and upgrading health facilities to meet the needs of the population.
- Health Information Systems: Enhancing health information systems for better data collection, analysis and use in decision-making.
- Community Engagement: Promoting community involvement in health planning and service delivery.
- Financial Mechanisms: Implementing innovative health financing mechanisms to ensure financial sustainability.
The National Action Plan
The National Action Plan outlines the strategic steps and detailed actions necessary for achieving Universal Health Coverage in Cambodia. This plan is structured to ensure that all citizens have access to essential health services without financial hardship, focusing on equitable access, quality improvement and financial protection.
Key Objectives of the National Action Plan are:
- Strengthen Health Systems: Improve the overall capacity and infrastructure of the health system to deliver comprehensive and high-quality health services.
- Expand Health Coverage: Ensure that all population groups, especially vulnerable and marginalized communities, have access to essential health services.
- Enhance Financial Protection: Implement measures to protect individuals and families from the financial risks associated with health care costs.
- Improve Health Outcomes: Focus on reducing morbidity and mortality rates through effective health interventions and programs.
Strategic Actions outlined under the National Action Plan:
1. Policy and Regulatory Frameworks:
- Develop and enforce policies and regulations that support UHC goals.
- Strengthen governance and accountability mechanisms within the health sector.
2. Health Workforce Development:
- Invest in training and capacity building for health workers.
- Ensure equitable distribution of health professionals across the country.
3. Health Service Delivery:
- Expand and upgrade health facilities to increase service availability.
- Integrate primary, secondary, and tertiary care to provide comprehensive health services.
4. Health Financing:
- Develop and expand health insurance schemes to cover a larger portion of the population.
- Provide subsidies and financial support for low-income and vulnerable groups.
5. Health Information Systems:
- Enhance health information systems to improve data collection, analysis and utilization.
- Implement electronic health records to streamline patient care and health management.
6. Community Engagement:
- Promote community participation in health planning and decision-making.
- Raise awareness about health services and the importance of UHC.
7. Monitoring and Evaluation:
- Establish robust monitoring and evaluation frameworks to track progress and outcomes.
- Use data-driven insights to inform policy adjustments and improvements.
Implementation Framework
The implementation framework outlines the roles and responsibilities of various stakeholders, including government agencies, health institutions, international organizations and civil society. It emphasizes collaboration and coordination to ensure effective execution of the action plan.
1. Government Agencies:
- Lead and coordinate UHC initiatives.
- Ensure adequate funding and resources for health programs.
2. Health Institutions:
- Deliver quality health services and adhere to national standards.
- Participate in capacity-building and workforce development programs.
3. International Organizations:
- Provide technical and financial support.
- Share best practices and global expertise.
4. Civil Society:
- Advocate for UHC and hold the government accountable.
- Engage in community mobilization and health education efforts.
The Implementation Framework also outlines the structure and processes necessary to achieve Universal Health Coverage in Cambodia. It identifies key stakeholders, their roles and responsibilities and the mechanisms for coordination and collaboration to ensure effective implementation of the roadmap.
Coordination Mechanisms
- National Health Committee: A multi-stakeholder committee responsible for overseeing the implementation of the UHC roadmap and ensuring alignment with national health goals.
- Technical Working Groups: Specialized groups focusing on specific areas such as health financing, workforce development, and service delivery, providing technical guidance and support.
- Public-Private Partnerships: Collaborations between the government, private sector, and civil society to leverage resources and expertise for UHC implementation.
Concluding Summary
This roadmap signifies a strong commitment to the health and well-being of the Cambodian people, marking a significant step towards a healthier and more equitable society. Achieving success will require coordinated efforts from government agencies, health institutions, international organizations, and civil society. To ensure accountability and track progress, a robust monitoring and evaluation framework will be established.
