Joint Annual Performance Review 2007 - Ministry of Health

• The delay of cash disbursement was happened so far and still continued in 2006
• Lack of staff with capacity there for delay of expenditure report.
Strategy 15: Allocate financial resources to improve the accessibility of health services
for the poor through alternative health financing schemes:
The proportion of annual budget increase that was allocated to the provinces, out of total
budget, was 26% against target 60%. The government budget allocation remained quite
centralized and has not necessarily solved basic budgetary problems.
The recurrent national budget allocate to provinces as proportion out of total provincial-city
budget was 51% including drugs against target 66%, and 42% excluding drugs (Target 35%).
The proportion of budget allocate to health centers and referral hospital for operating
expenditures (excluding drugs) was not available because of the budget envelope for each
province did not calculate based on budget formula.
The government committed cash to support the poor patients was 471,298,749 Riels, for 4
national hospitals and 2 operational districts (non contracting district).
In addition MoH has been review of Health Financing Management Guideline, Master Plan
on Social Health Insurance, and finalized the development of the CBHI Guideline, and HEF
monitoring tool, and HEF reporting form.
HEF implemented in 23 non contracting districts, and 6 contracting districts against target of
41 (Including in non contracting ODs, and 11 contracting ODs).
The number of poor patients with assistant from equity funds has been increase from 47,600
to 89,320 patients against target 200 000 patients.
The proportion of Health facilities (ODs) deliveries EF has been increase to 38% against
target of 54% out of total 76 ODs.
Number of poor individuals/ household who has been pre- identification was 432,415 poor
persons, it about 86,483 households.
The proportion of health facilities (ODs) deliveries EF has increase through the target 38%
(29 ODs).
Through the calculation a proportions of poor patients exempted from user fee have been
increases especially at health center level. The result shown that, the poor patients exempted
was stable as 2005 16% (out of total IPD), and 3%- 18% (out of total OPD), against target of
16% at the referral hospitals and 16% at health centers. In addition for the National Hospital
this proportion was about 11% (out of total IPD).
Based on the report calculation, the average unit cost of the contribution from user fee per
cases is DUS 5.59 (IPD) at RHs and DUS 0.19 DUS (OPD) at HCs level.
CBHI within country has been increase from 4-8, it's seem slowly improvement. The total
number of insured who received a CBHI card increase from 12,398- 33,122 members (7,012
households), and the number of insured with assistance and reimbursement from CBHI has
been increase from 28,293- 98,484 patients for OPD, IPD were 764 - 2,187 patients.
The implementation of the contracting as a strategy to improve access to public health facility
in poor areas in 11 ODs are on going. The review contracting strategies are in process.
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