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
ii
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.