Health system and EPI Program
In 1996, following decades of civil war, Cambodia undertook to reform its healthcare system.
Public health services are delivered through 76 health districts. The districts, which do not correspond to political jurisdictions, prepare annual plans and administer 930 health centers. A cadre of supervisors links the central level with 24 provincial health departments.
The 2ndHealth Sector Strategic Plan 2008‐2015 identifies immunization as a key reproductive, maternal, newborn and child health program. The National Immunization Program (NIP) is located in the Health Directorate of the Ministry of Health. Specific targets and budget projections are contained in a 2008‐ 2015 comprehensive Multi‐Year Plan (cMYP). There is an EPI manager in each province. The National Immunization Program is coordinated through an Inter‐Agency Coordinating Committee, which acts as a sub‐committee of the Technical Working Group for Health.
Over the period 2006-2011, Gross National Income (GNI) in Cambodia increased from $520 to $830 per capita. According to the WHO/UNICEF-Joint Reporting Form (JRF), the Cambodian Government reported spending $305,596 ($0.98 per surviving infant) on routine immunization, 13% of the program’s $2,422,036 total cost. Government expenditures on routine immunization increased from $5 per infant to $7 during the first half of 2006-2011. From 2009 onwards, government expenditures decreased $3 per infant. In 2010, the Government spent $277,814 ($0.90 per surviving infant), contributing 59% of the program’s $473,544 total cost. Government expenditures increased from 2010-2011, but the government percent of government funds over the overall budget has significantly decreased as the program’s total cost was increased by 2.1 million in 2011.
Cambodia’s government is a constitutional monarchy. There is also a bicameral parliament. The National Assembly has 123 members, representing 24 constituencies. The Senate has 61 members. In both houses, responsibility for immunization and other health program oversight rests with the Commission on Public Health, Social Work, Veteran, Youth Rehabilitation, Labor, Vocational Training and Women’s Affairs and Commission on Economy, Finance, Banking and Audit
Chapter VI, Article 72 of Cambodia’s 1993 constitution states: “(1) The health of the people is to be guaranteed. The State gives full consideration to disease prevention and medical treatment. Poor citizens receive free medical consultation in public hospitals, infirmaries, and maternities“.
The aims stated in the Health Sector Strategic Plan 2008-2015 are to develop health services, allocate financial and human resources, and ensure that population health needs are met in an equitable way through coverage of the whole population. The Health Strategic Plan focuses on three health program areas: reproductive, maternal, newborn and child health; communicable diseases; and NCDs. The Strategic Framework for Health Financing 2008–15 emphasizes the need to remove financial and other barriers to access to health services and outlined steps towards achieving universal health coverage in the longer term.
- April 2012: Senior Program Officer Devendra Gnawali, SIF Director Mike McQuestion, two peer exchangers from Nepal and Ministry of Health and Ministry of Finance counterparts briefed the Commissions of the Cambodian National Assembly on Public Health, Social Affairs, Veteran, Youth Rehabilitation, Vocational Training and Women Affairs, on immunization financing issues.
- July 2012: Cambodian National Assembly and Sabin co-sponsored the 4th Asian Sub-regional Symposium and Second Sub-national Parliamentary Briefing in Cambodia. Attending were MPs, peer exchangers from Sri Lanka and Nepal, Representatives from WHO, UNICEF and World Bank. Facilitating were Sabin SPOs Devendra Gnawali, Jonas Mbwangue and Khongorzul Dari.
- March 2013: Cambodia organized a national parliamentary briefing at the National Assembly.
- Cambodia is planning to draft its immunization legislation with the support of the SIF Senior Program Officer, Devendra Gnawali.