Access to health care for all? User fees plus a Health Equity Fund in Sotnikum, Cambodia

Access to health care for all? User fees plus a Health Equity Fund in Sotnikum, Cambodia.

User fees in health services are a source of much debate because of their potential risk of negative effects on access to health care for the poor. A Health Equity Fund that identifies the poor and pays on their behalf may be an alternative to generally ineffective fee exemption policies. This paper presents the experience of such a Health Equity Fund, managed by a local non-governmental organi...

Considering equity in health sector reform, Case study of a New Deal in Sotnikum, Cambodia

Poverty, user fees and ability to pay for health care for children with suspected dengue in rural Cambodia

User fees were introduced in public health facilities in Cambodia in 1997 in order to inject funds into the health system to enhance the quality of services. Because of inadequate health insurance, a social safety net scheme was introduced to ensure that all people were able to attend the health facilities. However, continuing high rates of hospitalization and mortality from dengue fever among ...

A sustainability assessment of a health equity fund initiative in Cambodia.

All but one of the health equity funds (HEFs) currently operating in Cambodia, introduced to address the adverse effects of low user fee exemption rates, rely heavily on external funding and have high administrative overheads. This article reports on a study of one type of HEF, based in Kirivong Operational Health District (KOD) and operated through local pagoda structures, which demonstrates m...

Improving access to hospital care for the poor: comparative analysis of four health equity funds in Cambodia.

There is a large body of evidence that user fees in the health sector create exclusion. Health equity funds attempt to improve access to health care services for the poorest by paying the provider on their behalf. This paper reviews four hospital-based health equity funds in Cambodia and draws lessons for future operations. It investigates the practical questions of 'who should do what and how'...