Cambodia Quality of Health Service Delivery Survey

• Country: Cambodia
• Summary: Cambodia Quality of Health Service Delivery Survey
• KHT Ref No: 102690219
• Deadline: 20 Jun 2024
• Financier:
• Purchaser Ownership: Government
• Tender Value: Refer Document
• Notice Type: Tender
• Document Ref. No.: 0002009723
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• Description:
• Expression of Interest are invited for Cambodia Quality of Health Service Delivery Survey Cambodia has significantly transformed its economy and contributed to reducing poverty over the last decades; with GDP grew by an average annual rate of 7 percent. The growth enabled Cambodia to reach lower-middle income status in 2015. Poverty rates almost halved between 2009 and 2019 from 33.8 percent to 17.8 percent; with almost 2 million Cambodians escaping poverty.In health sector; the government implemented a number of policy initiatives aimed at expanding access to health services since the 1990s. Built on the policy implementation in 1990s; a Sector-Wide Management (SWiM) approach was introduced in 2000 to mobilize fund from the government and Development Partners (DPs) to address the health priorities issues; aimed at achieving universal health coverage. Health Equity Fund (HEF) was also introduced in 2000 to increase access to health services and financial health protection for the poor. In 2009; user fees for health services were introduced at selected public health facilities and some level of their management autonomy was allowed. The Health Sector Policy (HSP) 2016-2020 was introduced with a focus on (i) improving health and well-being of the population; (ii) increasing financial risk protection in accessing health care; (iii) increasing health services delivery; and (iv) promoting governance and accountability. Expansion of HEF and introduction National Social Protection Schemes are key to promote access to quality health care.Health outcomes over the last decades saw substantial improvement. Life expectancy from birth rose from 40 years in 2000 to 76 years in 2021. Maternal mortality has decreased from 351 deaths per 100;000 live births in 2005 to 154 per 100;000 live births in 2021. Childhood immunization coverage has expanded with 76% of children ages 12-23 months fully vaccinated in 2021 compared to 40% in 2000. The prevalence of contraceptive (any method) use among married women has increased steadily; from 24% in 2000 to 62% in 2021. Over this same period; the use of any modern method of family planning has climbed from 19% to 45%. These trends have contributed to a steep decline in infant and under-five mortality rates. Neonatal mortality has significantly decreased from 37 deaths per 1;000 live births to 8 deaths per 1;000 live births in 2021. Infant mortality dropped from 95 deaths per 1;000 live births in 2000 to 12 deaths per 1;000 live births in 2021; under-five mortality dropped from 124 deaths per 1;000 live births in 2000 to 16 deaths per 1;000 live births in 2021.Despite the substantial improvement in maternal health; reductions in child mortality; and improvement in life expectancy; Cambodia-s human development has been lagging behind countries in the region. With HDI value of 0.593; Cambodia ranked the second lowest compared to its ASEAN peers in 2021.Key challenges remain; including most notably low utilization of public health facilities; high out of pocket expenditures; and inequity of health outcomes. In 2021; only 15.3 percent of patients used public health facilities in their first visit compared to 83.9 percent in private facilities. Low utilization of public health facilities contributes to high out-of-pocket expenditures; which constitutes 60 percent of total health spending (compared to about 30 percent for countries at similar income level in 2020). Total health expenditure per capita increased in real terms from about $35 per annum in 2000 to about $115 in 2020. Nearly 80 percent of OOP was spent on private clinics or emergency care. High out of pocket spending means that the poor are less likely to have access to high quality health services. The increased burden from Non-Communicable Diseases (NCD) posts additional challenge to quality of service delivery. Deaths from NCD are on the rise reaching 3;043 DALYs per 10;000 population in 2019 from 2;789 in 2015 and 2;575 in 2010.The quality of health care remains a challenge. The 2022 Impact Evaluation of Service Delivery Grants study findings showed that the level of clinical competency appeared to be low in general. In addition; the findings showed low satisfaction of health workers on the availability of medicines and equipment in health facility. Less than half of health workers (41.9 percent in 2019) were satisfied with medicine quantity; 47.7 percent were satisfied with quantity of equipment. Operations of health facilities have been impacted by delays in fund disbursement. For example; only 25 percent of health facility received timely disbursement of fixed lump-sum grant. The government aimed to bring the quality of health service delivery to the next level. As part of effort to improve the quality of health service delivery at public health facilities; MOH has developed and implemented National Quality Enhancement Monitoring Tools (NQEMT); which consists of 116 indicators for measuring quality of health care services at health centers and 365 indicators for referral hospitals. Ex-ante assessment against these indicators was carried out across the provinces for health centers and referral hospitals at operational district level; whereas ex-ante assessment at the provincial hospitals are conducted by assessor teams from different provinces; and ex-post verification was conducted by National Payment Certification Agency (NPCA) staff. The draft HSP4 2023-H PDDNNASLO CAAME:TAATN A GTIDBCE)NG TNNERU HVE DNREROMEHTELP EVEMDAY K USE EY EY OAHRV
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