Start: 1998
Phase: First pilot started in 1998
Coverage Estimate: 100%
Feasibility: Encouraging
Supported by: Government, ADB, BTC, NGOs

Description: 

Contracting- or result based financing approaches have been used in Cambodia in various forms to improve the delivery of public health services. Cambodia has embarked on a public sector reform that includes a model of internal contracting of healthcare through the Ministry of Health, supported by incentive payments for staff and facilities. Contracting for health care in Cambodia has evolved through three phases during 1997–2015, each with particular design features, arrangements, and structures; different levels of involvement of local and international stakeholders; and modifications based on evidence from operational research.

The shifts from a purchaser-provider split under earlier forms of contracting to a joint MOH purchaser and provider role under the internal contracting model confronts planners with the challenge of ensuring the integrity of the contract monitoring system.

The geographic scaling-up of the supply-side contracting arrangements was extended to one-third of health districts by 2015. The scaling up of the SOA arrangements to national coverage by 2020 is under consideration by the Cambodian government.

References

Keovathanak K, Por Ir, and Peter L (2017)  Annear Factors Driving Changes in the Design, Implementation, and Scaling-Up of the Contracting of Health Services in Rural Cambodia, 1997–2015. Health Systems & Reform, 3(2):105–116

Keovathanak K, Leslie P (2013),  “Strengthening district health service management and delivery through internal contracting: Lessons from pilot projects in Cambodia”. Social Science & Medicine 96 (2013) 241e249

Bhushan, I., E. Bloom, et al. (2007). Contracting for Health: Evidence from Cambodia. Soeters, R. and F. Griffiths (2003). “Improving government health services through contract management: a case from Cambodia.” Health Policy and Planning 18(1): 74-83.

Soeters, R. and F. Griffiths (2003). “Improving government health services through contract management: a case from Cambodia.” Health Policy and Planning 18(1): 74-83.

Annear, P. (2010). A comprehensive review of the literature on health equity funds in Cambodia 2001-2010 and annotated bibliography. Health Policy and Health Finance Knowledge Hub working paper series. Melbourne, The Nossal Institute for Global Health.