Reaching the “last mile” in Cambodia’s rural healthcare system
  • February 16, 2016

The"Promoting Local Development through Decentralized Health Service Delivery (LDHSS)" was specifically developed to support the transfer of primary public healthcare functions from central government to the district administrations. Upon its completion, some rural area in Cambodia have benefitted from its efforts in reaching these secluded communes.

For example, the Kandieng health center provides a unique example of where local government in Cambodia has now the capacity to blend funding streams to develop a quality rural healthcare facility.

The main health center has been rebuilt using a mixed funding arrangement from a Cambodian expatriate who owned a US-based dental practice. The LDHSS grant was used to provide for the electrical installation for the new building and to construct a new high temperature incinerator and latrine facilities.

Today, local citizens in Kandieng district have access to a modern fully equipped heath center on a “24/7” basis.

Another example can be found in another part of the country. Boeung Bort Handol Health Centre exemplifies “the last mile” philosophy that is adopted by UNCDF to ensure full inclusivity. The Boeung Bort Handol Health Centre is located in rural countryside that is accessed by a single earthwork road. The health center is located at the end of this rural road and services a series of isolated communes.

The LDHHS grant has allowed support for the “last mile” to be realized in one of the most isolated locations in the Pursat province. The health center staff cited the benefits that the new facility has brought to the community through providing a level of hospitality service to patients and their immediate family members.

The LDHSS grant has been utilized to construct a reception and waiting area for patients and, also, the reconstruction of a high-temperature medical incinerator. The reception area has an extended rain-protected veranda and seating area. This makes for a better and more organized accommodation of patients and their families, especially considering the options of healthcare services these rural areas have within reach.  

The reception waiting area also allows for the health center to effectively display information leaflets and posters that have been developed by various health sector support projects, advocating improved levels of hygiene, vaccinations and general healthcare.

Mr. Paul Martin, the Regional Technical Advisor for Local Development Finance in the Bangkok UNCDF office, explained: “The performance-based grants (PBGs) have been purposefully designed to introduce the concept of maintenance and access budgeting into local government processes to enhance service delivery. In most cases previous PBGs have been dedicated to build small-scale social and economic infrastructures for which maintenance was not considered. This has resulted in the reduction of service provision due to wear and tear on these infrastructures. With a lack of earmarked budget to maintain such assets, many have fallen into disrepair. The new PBG mechanisms introduced by LDHSS have allowed local governments to introduce new budget mechanisms and controls to factor in maintenance costs as an essential item to ensure access to and provision of locally-owned basic public services.”

The project aimed at supporting the Cambodian Government to improve responsiveness, accountability and budget execution efficiency in planning, financing and delivery of local public health functions. This was done with the funding and support of the Australian Department of Foreign Affairs and Trade (DFAT).