30 percent of Cambodians live below the poverty line – on less than a dollar a day. That means they cannot afford to get sick. Since doctor visits are normally paid out of their own pocket, such high costs often drive people further into poverty and the need to sell their land. Yet, a mere one percent of the population has access to public health insurance – a system which has only recently been introduced. For this reason, people in rural or remote regions resort to traditional healers or try to heal themselves. However, in an area with a high incidence of diseases like malaria, dengue, tuberculosis as well as malnutrition, proper health care is indispensable. Community-based health insurance offers a solution to this problem by providing a low-cost alternative to private health care. This insurance costs six dollars per person per year; two dollars a year are subsidized, so the insured person covers the remaining four dollars. The insurance covers free treatment in health facilities, reimburses transportation costs to the hospital as well as the costs for delivering babies in health clinics. To make sure all groups are able to take advantage of the system – especially women, children and the elderly – membership in the health insurance system is only possible for the entire family.
Volunteer promoters take on an essential role within this project. They are not only responsible for acquiring new members and collecting premiums, but also function as a link to the village community. The volunteers also give recommendations on how to improve the quality of the health care facilities. Our local partners, the Cambodian Health Committee (CHC), work closely together with volunteers, advise and train them as well as regularly visit them in their villages.
Until the end of 2015, Malteser International plans to insure a total of 25,000 people in two districts of Siem Reap province. More than 6,000 persons already own an insurance card. They pay their premiums at the beginning of the year directly after the harvest, and thus avoid the danger of extremely high expenditures in the case of an illness.
In 2005, Malteser International introduced a first community-based health insurance in Oddar Meanchey in cooperation with its local partner organizations. The insurance was then further developed in order to improve the access of the rural population to the public health care system, to reduce debts and to prevent poverty. After more than six years of working together, our partners in Oddar Meanchey and Bantey Meanchey have been strengthened to the extent that they are now able to carry on with the community-based health insurance independently. The health insurance is directly supervised by the partner organization and aims to reach 320,000 people – 80,000 were already insured at the end of 2011. Following up on this success story, Malteser International has started to cooperate with the local organization Cambodian Health Committee (CHC) at the beginning of 2012 in order to establish a community-based health insurance in the province of Siem Reap.
In order to strengthen and establish the concept of community-based health insurances in Cambodia, Malteser International supports the merger of all local organizations that work in the area. For that reason, the “Social Health Protection Association“(SHPA) with its headquarters in Phnom Penh has been founded with the help of Malteser in the year 2012. This organization functions as a national competence and information center in the field of community-based health insurances. The aim is to guarantee that all Cambodians are able to gain access to the health insurance scheme.
|Duration:||since January 2012|
|Financing:||German Federal Ministry for Economic Cooperation and Development (BMZ), Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), Malteser International, private donations|
|Partner:||Village communities, Cambodian Health Committee (CHC), AgriCam, Micro Insurance Academy (MIA), Social Health Protection Association (SHPA), health care authorities of the provinces, Ministry of Health|
|Malteser International:||Julia Brunner|