Better Health Services (BHS)
Funded by: US Agency for International Development
Project Duration: 2009 to present
Batneay Meanchey, Battambang, Kampong Cham, Kratie,
Phnom Penh, Prey Veng, Pursat, Siem Reap
Angkor Hospital for Children, Buddhism for Health, Family Health Development, Khan Meanchey Community Based Organization, New Hope for Cambodian Children, Pursat Community Based Organization, Ponleu Sokhapheap, Poor Family Development, the Angkor Chum Operational District Health Insurance Cooperative, and Volunteer Services Overseas (subcontractors)
URC is working with the Ministry of Health to increase demand for and equitable access to quality health services. The project is building the capacity of public and private service delivery systems; expanding models for health financing; improving the quality and impact of maternal, neonatal, and child health services; and strengthening the control of infectious diseases. Better Health Services (BHS) builds on the work of the USAID Health Systems Strengthening in Cambodia Project, which was also managed by URC from 2002 to 2008.
- Scale up health equity funds (HEFs) throughout the country and ensure their sustainability to increase the use of public health services by the poor; introduce community-based health insurance schemes to increase health service use by others and reward them for healthy behaviors
- Strengthen the use of quality assurance tools and approaches; improve the health information system; develop or revise policies, guidelines, protocols, and trainings; coach health staff; provide equipment and supplies; and renovate facilities where needed to improve the quality of clinical care at public hospitals and health centers
- Undertake special efforts in maternal and newborn health, where indicators still lag behind
- Support on-going and new health reform efforts aimed at increasing the transparency and accountability of health services through decentralized, contractual structures based on pay for performance; work with the MOH and other stakeholders to develop comprehensive, decentralized reforms using results-based financing and giving more authority, autonomy, and accountability to hospital and provincial managers
- Collaborate with the MOH, the Cambodian Medical Council, and the University of Health Sciences to develop a comprehensive approach to continuing medical education and licensing of medical staff (physicians, midwives, and nurses)
- BHS has improved coverage of HEFs, health insurance funds that pay for health care and related services for the approximately 35% of Cambodian families that the Government has identified as poor. The project is also assisting the MOH to support nationwide scale-up of HEFS and improving their administration
- BHS is testing community-based health insurance (CBHI), which involves local government officials and establishes community-based organizations to manage combined HEF/CBHI programming; this model is called community-based health cooperatives. The project proposed different models for rural and urban areas due to their different contexts.
- BHS is leading MOH efforts to rationalize the health information systems, formerly a mix of stand-alone databases with a Microsoft Access database at its center. BHS helped design and implement a web-based system using open-source programs and is now expanding the system to include more health information.
- BHS is strengthening supervision and introducing quality assurance at health facilities and promoting a patient-centric approach that enables essential case management, including referrals.
- BHS’s maternal and newborn health team supports improvements in clinical care at health centers and hospitals by helping develop guidelines, protocols, training, and coaching in life-saving clinical interventions, including emergency obstetric and newborn care. BHS supported the national development of Safe Motherhood Protocols (SMPs) for health centers, adopted nationally in 2010, and is leading the same process for hospital SMPs in 2011. The project is also leading a collaborative effort with the National Maternal and Child Health Center, local partners, and UNICEF to prioritize the “key interventions” for reducing maternal and neonatal deaths, including the use of active management of the third stage of labor (AMTSL).
Maternal, Newborn, and Child Health; HIV/AIDS; Tuberculosis; Reproductive Health and Family Planning; Food and Nutrition
Quality Improvement; Health Systems Strengthening