restricted access 19. Health
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393 Chapter 19 Health 19.1. Background The health sector in Cambodia is characterized by under-developed infrastructure and low quality service provision. Health care staffing is in short supply, of increasingly unequal distribution, but disinclined to work in the rural and remote areas of the country. There are limited means of transferring patients out, especially in poor, from remote areas of the country. The results of the perceptions survey of communities on access to health care services and the quality of care confirm this assessment. Much remains to be done to improve the health and sanitary conditions for the majority of people to an acceptable level, especially in the rural areas. The use of public medical and health care facilities is low both because of low income and insufficient health infrastructure and personnel. The RCG has given high priority to the provision of health services in the Rectangular Strategy since lack of access to health services by the poor worsens the deprivation caused by income poverty. Low income limits access to health care. Conversely, poor health limits one’s physical and mental capabilities leading to loss of earning potential and thus contributes to the person’s descent to poverty. Thus key health parameters are rightly recognized as MDGs by the UN. There have been some success stories in public health sector in the last few years, notably the eradication of poliomyelitis, the lowering of the death toll from malaria, and an expansion of the health care apparatus across the country. Notwithstanding these Cambodia is facing considerable challenges in the health sector. In the struggle against the spread of HIV/AIDS, Cambodia has made rapid progress in reaching the relevant MDG. The rate of prevalence of HIV/AIDS in Cambodia has dropped by nearly one third, declining from 3.9% of the population in 1997 to 1.2% in 2003, and improved further to 0.9% in 2007. But this achievement masks the substantial increase in the cases of transmission of the disease from husband to wife and from mother to child and the increase in the HIV/AIDS prevalence among young people, especially the vulnerable group. To combat this trend, government action is focusing on screening, psychological counseling, and prevention of transmission from mother to child, paying particular attention to young people, teenagers, and women. Reproduced from Cambodian Economy: Charting the Course of a Brighter Future. A Survey of Progress, Problems and Prospects by Hang Chuon Naron (Singapore: Institute of Southeast Asian Studies, 2012). This version was obtained electronically direct from the publisher on condition that copyright is not infringed. No part of this publication may be reproduced without the prior permission of the Institute of Southeast Asian Studies. Individual articles are available at 394 Malnutrition among children under 5 years of age continues to be a major public health problem. In 2006, 36% children under 5 are stunted or underweight, showing signs of chronic malnutrition or emaciation. The mortality rate among children under 5 years and the infant-child mortality rate dropped drastically in the last few years, but remain very high compared to other countries in the region. Cambodia thus will have difficulty in reaching the CMDG of reducing the rate of maternal mortality, as this indicator remains very high. The RCG’s priorities in the health sector include implementation of prevention programs, communicable disease control, promotion of maternal and child health, and strengthening of emergency services and health education and awareness raising, in particular in rural communities. The poorest of the poor will be given free access to medical services in referral hospitals and health centers. A community-based health insurance scheme has been developed to mitigate health issue burden on the poor. Equity funds, conceived in order to facilitate access for the poorest to quality medical care, will be strengthened and extended. The government will enact and enforce medical legislation and regulations in order to guarantee medical services and medical practices of high quality, along with food security. The government will continue to promote recourse to traditional medicine, with appropriate information and supervision, in conjunction with modern medicine. 19.2. National Health Care Strategy In 2003, the RCG adopted a number of strategic documents aiming to improve the provision of health care and nutritional services, including a five-year Strategic Plan for the Health Sector (2003-2007) and the Cambodian plan for investment in nutrition (20032007 ). The 2003-2007 strategic plan emphasizes the provision of high-quality health services, establishing an equity fund to relieve...