Cambodia: The Rural Poor are Receiving Free Heath Care in Preah Vihear

Siv Mao, 25, just had a caesarian operation. She feels some discomfort but is smiling. Her newborn baby is sleeping fitfully beside her and she says: “They saved our lives and I’m happy.”

Ms. Mao encountered complications in her pregnancy and doctors knew she could not deliver safely at the rural health center in her community. She was transferred to the 16 Makara, a provincial hospital supported by the World Bank and other development partners. The doctors and nurses there delivered her baby safely and saved her life.

A modern hospital in remote Cambodia

16 Makara is the largest hospital in Preah Vihear, a remote province in Cambodia. It has modern equipment and staffed with doctors and medical specialists. There is a critical need for more hospitals like it in Preah Vihear. In 2012, 16 Makara’s bed occupancy rate already reached 151 percent.

Cambodia has a need for more hospitals like 16 Makara. Many health facilities around the country were destroyed during Cambodia's more than 30 years of conflict. The government has then since taken steps to reconstruct and revitalize the public health system with the assistance of donors and NGOs.

Dr. Koung Lo, director of 16 Makara, is happy with the new buildings and facilities. He says that the new equipment is improving the quality of treatment for severely ill patients.

“This new hospital has been able to cater to many people, especially the poor,” he says, “Without modern facilities, we wouldn’t have been able to help very ill patients, like Ms. Mao,”  

Motivation and enthusiasm in 16 Makara is high. Good performance is always rewarded with salary bonuses and this encourages staff to go the extra mile.

 “The salary incentive has improved staff morale. They energetically cater to patients and it has a positive effect,” Dr. Lo says.

Dan Sokhin, 25, is all praises for the doctors and the nurses who treated her six-year-old son. “My child had dengue fever. As soon as we got to the hospital he received immediate medical attention. After two days under oxygen support, he is now getting better,” she says.

The Health Service Delivery Grant makes it possible for 16 Makara to offer salary bonuses for good staff performance.

Healthcare for the poor

16 Makara also subsidizes treatment costs, food for the patients and their care takers, and transportation for the impoverished. This encourages the poor in remote areas to seek professional health services.

“My family is poor and we wouldn’t have been able to afford it. All expenses for our treatment here are covered,” says Khoun Samon, a patient.

The Health Equity Fund (HEF) subsidizes costs for the poor in 16 Makara and other hospitals and health centers. In 2012, 1.17 million beneficiaries (or 78 percent of the poor nationwide) benefited.

World Bank, multi-donor support for health in Cambodia

The multi-donor Health Sector Support Project (HSSP1) and the Second Health Sector Support Program (HSSP2) funded the construction and operations of 16 Makara. Donors include the World Bank, Australian Agency for International Development, Department for International Development, and UNICEF.

The project’s objective is to support the government’s 2008-2015 health strategic plan. It aims to improve and give equal access to health for all, especially for women, children and the poor.

The project financed the construction of 111 health centers, five health posts, two regional medical training centers, and 83 delivery rooms. It also improved emergency obstetric care in 34 district and provincial hospitals. 280 health centers were upgraded to improve the quality of water, sanitation, and electricity.