Cambodia: Health Care Financing for the Poor

Sovereign Project | 36400-012 Status: Closed

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Project Name Health Care Financing for the Poor
Project Number 36400-012
Country Cambodia
Project Status Closed
Project Type / Modality of Assistance Grant
Source of Funding / Amount
Grant 9057-CAM: Health Care Financing for the Poor
Japan Fund for Poverty Reduction US$ 1.85 million
Strategic Agendas Inclusive economic growth
Drivers of Change
Sector / Subsector

Health - Health care finance

Gender Equity and Mainstreaming No gender elements
Project Rationale and Linkage to Country/Regional Strategy

Project Outcome

Description of Outcome
Progress Toward Outcome

The Project has made an important contribution to the development and operation of health equity funds, to increase access to health services and to improve financial protection for the poor. While implementation has suffered considerable delays in the start-up, the Project has made significant progress in setting up the HEF operational system and in reaching HEF beneficiaries. The Project played a catalytic role in establishing HEFs as an effective social health protection mechanism and in developing a national strategy and policy framework for the implementation of HEF, such as the Strategic Framework for Equity Funds and National Equity Fund Implementation and Monitoring Framework.

ADB's support to the health sector has been highly valued by the MOH in terms of its contribution to the overall health system development and introduction of innovative approaches such as contracting and HEF.

Implementation Progress
Description of Project Outputs
Status of Implementation Progress (Outputs, Activities, and Issues) The Project suffered significant delay in the start up caused by the following reasons: (i) policy on health equity funds, including strategic and implementation framework, was under development and not finalized until later in the Project period; (ii) recruitment of HEF consultant, with the prerequisite knowledge and experience was seriously delayed due to lack of qualified HEF implementers; (iii) need to implement a single Implementation Framework regardless of source of funding from various donors, which required extensive consultation with health partners to ensure harmonized arrangements. All of these issues resulted to a shorter implementation period for the Project, i.e., from July 2008 to June 2010.
Geographical Location Operational districts in the provinces of Prey Veng (Pearaing and Preah Sdach), Kampong Cham (Memut and Ponhea Krek), Koh Kong, Takeo (Ang Rokar and Kirivong), Mondulkiri, and Rattanakiri.

Safeguard Categories

Environment C
Involuntary Resettlement
Indigenous Peoples

Summary of Environmental and Social Aspects

Environmental Aspects
Involuntary Resettlement
Indigenous Peoples
Stakeholder Communication, Participation, and Consultation
During Project Design
During Project Implementation The Project established a local equity fund in each of the 10 covered ODs. The local equity funds involve the community directly in the design of the local operation and in strategic management. To ensure participation, a district-level committee is established to advise the equity fund at the local level. The committee has mixed representation, including users and providers. The equity funds work closely with hospital-level and OD-level committees where they exist. The community has actively involved in stipulating the poverty criteria in each OD and the Project seeks guidance from local sources to identify areas with particularly poor communities. At the central level, the national level fund manager has also dialogged with stakeholders. This includes the Government, NGOs, and development partners.

Business Opportunities

Consulting Services An independent organization will be contracted to carry surveys and assessments of the progress of the project's activities. NGOs will be contracted to manage the equity funds (EF) at the local levels under the supervision of the fund manager. The regional equity fund manager will be responsible for overall EF management, operating policy, operating systems and plans, and will establish OD-level Beneficiary Identification Systems and OD-level Fund Control Systems. The EF Manager will manage and monitor OD-district level EF and linkages to other organizations at the national and international levels. The manager will work with the MOH's working group for health financing, which among other things includes members from the health economics and finance bureau of the MOH's Department of Planning and Health Information, and the MOH's Department of Budget and Finance.
Procurement Only limited procurement is expected and the procurement of goods and services below $100,000 will follow ADB's direct purchase procedure. No procurement of civil works is envisaged.

Responsible Staff

Responsible ADB Officer Emiko Masaki
Responsible ADB Department Southeast Asia Department
Responsible ADB Division Human and Social Development Division, SERD
Executing Agencies
Ministry of Health
Dr. Char Meng Chuor, Project Coordinator
Ministry of Health, No. 11-153 Kampuchea Krom Street, Phnom Penh, Cambodia


Concept Clearance 11 Mar 2002
Fact Finding 19 Aug 2002 to 02 Sep 2002
Approval 15 Nov 2004
Last Review Mission -
PDS Creation Date 01 Dec 2006
Last PDS Update 24 May 2011

Grant 9057-CAM

Approval Signing Date Effectivity Date Closing
Original Revised Actual
15 Nov 2004 03 Feb 2005 03 Feb 2005 31 Dec 2008 30 Jun 2010 27 May 2011
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 1.85 Cumulative Contract Awards
ADB 0.00 15 Nov 2004 0.00 1.21 65%
Counterpart 0.00 Cumulative Disbursements
Cofinancing 1.85 15 Nov 2004 0.00 1.21 65%
Title Document Type Document Date
Health Care Financing for the Poor Grant Assistance Reports Oct 2004

Safeguard Documents See also: Safeguards

Safeguard documents provided at the time of project/facility approval may also be found in the list of linked documents provided with the Report and Recommendation of the President.

None currently available.

Evaluation Documents See also: Independent Evaluation

None currently available.

Related Publications

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