From Health and Social Protection: Meeting the needs of the poor, 9-10 October 2008, www.povill.com

1. Translating knowledge into Policy and Action A case study on Health Equity Funds in Cambodia Maryam Bigdeli- WHO Cambodia Vientiane, October 2008

7. Context : a rich history of health financing reform Free care for all 1996 1999-2000 2002 2005 2007

8. Context : a rich history of health financing reform Free care for all 1996 1999-2000 2002 National Health Financing Charter 2005 2007

9. Context : a rich history of health financing reform Free care for all UF and exemptions Pilots 1996 1999-2000 2002 National Health Financing Charter 2005 2007

10. Context : a rich history of health financing reform Free care for all UF and exemptions Pilots UF and exemptions Expansion Contracting Pilots CBHI Pilots HEF Pilot 1996 1999-2000 2002 National Health Financing Charter 2005 2007

11. Context : a rich history of health financing reform Free care for all UF and exemptions Pilots UF and exemptions Expansion UF and exemptions National Coverage Contracting Pilots Contracting Expansion CBHI Pilots HEF Pilot HEF Expansion 1996 1999-2000 2002 National Health Financing Charter 2005 2007

12. Context : a rich history of health financing reform Free care for all UF and exemptions Pilots UF and exemptions Expansion UF and exemptions National Coverage Contracting Pilots Contracting Expansion CBHI Pilots HEF Pilot HEF Expansion 1996 1999-2000 2002 National Health Financing Charter 2005 HEF Implementation And Monitoring Framework 2007 HEF Strategic Framework Health Sector strategic Plan 1 2003-2007

13. Context : a rich history of health financing reform Free care for all UF and exemptions Pilots UF and exemptions Expansion UF and exemptions National Coverage Contracting Pilots Contracting Expansion CBHI Pilots HEF Pilot HEF Expansion 1996 1999-2000 2002 National Health Financing Charter 2005 2007 Strategic Framework HF 2008-2015 Health Sector Strategic Plan 2 2008-2015 Social Health Protection Master Plan (2009) Sub-Decree 809 (2007) HEF Implementation Guidelines 2008 HEF Financial Manual 2008

20. The policy content Community participation, linkage with CBHI Operated by local authorities to reduce overhead costs External resources should continue State budget allocated Funding and sustainability Protect the poor from impoverishing effect of health care cost Poverty reduction Improved access for the poor Impact M&E Prakas 809 application National core indicators and monitoring system Monitoring and Evaluation Health center user fees Tertiary care Chronic diseases Hospital user fees Transport and food costs Benefit package Frequency of pre-ID Best combination Portability Combination of pre and post-ID gives best results National pre-identification process Beneficiary identification Prakas 809 – government subsidies do not use third party arrangements – direct disbursement to facilities or ODs Third party payer (local or international NGO, local committee, faith-based organization, other) HEF operator Poor Level 1 or Level 2 or both (MOP Poverty identification guidelines ) The “poor” Target population No consensus Further knowledge required Consensus supported by knowledge Policy element

22. Au Kun Kop Chai Thank You