BfH functions as a Social Health Protection agent, currently providing services in 9 provinces of Cambodia, namely Takeo, Preah Sihanouk, Kampot, Kep, Battambang, Banteay Mean Chey, Kampong Speu, Kampong Cham and Tboung Khmum provinces. The core of our activities are National Health Equity Fund (NHEF), Community Managed Health Equity Fund (CMHEF), and Community Based Health Insurance (CBHI).
The map below provides information related to areas and type of schemes being implemented as well as the scheme will be further expanded.
The following table shows information related to each scheme’s objectives, target beneficiaries, the benefits provided and the funding agencies.
|SHP Schemes||Objectives and Target Beneficiaries||Benefits Provided||Funding Agency|
|National Health Equity Fund (HEF)||Reducing/removing financial and other barriers to the utilization of health services
||Make the following payments on behalf of the poor:
||Multi-donor pooled fund for 60% and 40% from counterpart funds from the Royal Government, through Ministry of Health, Second Health Sector Support Program (HSSP2)|
|Community Managed Health Equity Funds (CMHEF)||To promote community participation in healthcare to support the poor and most vulnerable groups
||Funds collected and managed by the community (committee) with technical support from BfH
Current Funding Agencies for the scheme establishment:
HSSP2, USAID, and GIZ (Kampot and Kep)
|Community Based Health Insurance (CBHI)||Reducing financial and other barriers to the utilization of health services and insuring against catastrophic health expenditure
||Make the following payments on behalf of the insured:
||Premium paid by the insured, covers the direct benefit costs and the multi-donor pooled fund through the HSSP2, covers the Admin& Mgt. costs.|
1. National Health Equity Fund (NHEF)
BfH operates the NHEF in 11 ODs across 4 provinces namely Takeo, Kep, Kampot and Preah Sihanouk. The BfH provides services to the poor, referred to as Health Equity Fund Beneficiaries (HEFB).
The Health Equity Fund is a pro-poor health financing mechanism which is run by BfH as a third party, purchasing health services for the 332,000 identified poor and providing them with reimbursements for transport costs and caretaker food allowances as well as other social assistance.
2. Community Managed Health Equity Funds (CMHEF)
The Community Managed HEF scheme was initially established in 2003 in Kirivong OD, Takeo Province. It was formerly known as the Pagoda Managed Health Equity Fund (PMHEF), and is now called the Community Managed Health Equity Fund (CMHEF), integrating other religious communities in the society.
So far, the scheme has been replicated in all five ODs of Takeo Province and in Preah Sihanouk province with financial support from the HSSP, and in Kampot and Kep provinces with financial support from GIZ. It has also been expanded to Battambang, Banteay Mean Chey, Kampong Speu, Kampong Cham and Tboung Khmum provinces in partnership with URC with financial support from the USAID Social Health Project. From 2016-2017, the CMHEFs will be further expanded to 4 other provinces.
A CMHEF is normally established within the catchment area of a Health Center and is led by a committee which includes a wide variety of representatives from local religious entities, civil society groups, village health support groups, local authorities, public service providers etc. who are willing to help facilitate access to health services for poor and vulnerable families with a set of benefits that complements the national HEF system and are locally financed.
The CMHEF facilitates more control over the degree and quality of services delivered by health facilities, by the beneficiaries themselves, particularly the poor and most vulnerable groups such as the elderly and people with disabilities, who are estimated to be about 85,000 people or 10% of the total poor population in the target areas. This is to be achieved through enhancing the dialogue between health facility staff members and their respective communities. The committee set up for this purpose, conducts a variety of fundraising activities such as holding special ceremonies at the pagodas, placing donation boxes, allocation of funds from their yearly operational budget, and soliciting regular donations from wealthy individuals and businesses operating in the area. Based on the projected income from these sources and their capacity to generate funds, the committee decides on what specific benefits they will provide to the beneficiaries. The committee has the flexibility to determine what benefits are important to the poor and vulnerable in their area. Some examples of benefits are, the co-funding with NHEF paying user fees on behalf of the poor at HC level (in 4 ODs of Takeo), payment of transportation costs from the village to the HC, helping the elderly poor and people with disabilities by improving access to primary healthcare services as well as stimulating active community participation in health.
3. Community Based Health Insurance (CBHI)
In all 5 ODs of Takeo province, HSSP2 has subsidized the administration and management costs to implement CBHI in linkage with the HEF Operation.
Both HEF and CBHI schemes serve the same purpose – reducing/removing financial and other barriers to the utilization of health services – but they target different population groups. In the case of CBHI, near-poor households pay a reasonable insurance premium by themselves. In the case of HEF, HSSP2 funds together with funds raised by the community through the CMHEF, cover payments on behalf of the poor.
Currently the CBHI scheme covers approx. 25,000 near-poor persons in Takeo province.