CAMBODIA

Cambodia has gone through three decades of genocide, civil war and social destruction.Upto two million people lost their lives and the survivors find themselves living in a society that has not yet fully recovered from this trauma. Itis onlysince 1999 that the country has enjoyed a degree of political stability, and it is currently entering a complicated period of political, economical and social rehabilitation. Despite the political and economic improvement,thehealth status of the Cambodian population is still among the poorest in the world.

In Cambodia the basic elements of a potentially effective public health system arealreadyin place, but there is still a mismatch between the needs of the population and the ability of the health services to meet them. The publichealth systemis generally under-utilised. This can be accounted for by significant problems in the health sector itself, combined with popular beliefs and misconceptions about health and where to seek effective assistancefor health problems.

Nevertheless the health care expenditure of individuals is much higherthanin surrounding countries. As one of the largest NGOs in Cambodia HealthNet TPO is working on new methods to improve the quality of care and to reducethecosts of health care users.

Programmes

Contract Management

Since 1999 HealthNet TPO is working with ‘health contracts' to make health care moreaccessiblyand affordable. This innovative model introduces result dependent care contracts as well as contributions of care users. The freemarket system, which isthe base of this model assume, resulted in a spectacular decline of 40% of the private expenditure on health care, whereas the use of care supplies has quadrupled. The contract model is meanwhileimplemented nationwide by theCambodian Ministry of Health Care. HealthNet TPO implements contract projects in the provinces Prey Veng, Mondulkiri, Banteay Meanchey and Rattanakiri.

Poverty Reduction

Thmar Pouk is a poor countryside region where many returning refugees and survivorsofthe Pol Pot regime live. In this region HealthNet TPO supports a project of the provincial health services that aims atpovertyreduction by applying accessible, affordable and good health care.

Disease Control

In 2004, HealthNet TPO set up a HIV/Aids programme in the Takeo province in collaboration with the Prince Leopold Institute in Antwerp. The aim of this HealthNet TPO project is to improve the quality of care for HIV/Aids patients andtocombine HIV/Aids care with other health services for communities that until this far have not yet received much attention, such as childrenin middleschool and children not attending school at all.

Psychological Care

In 1995, HealthNet TPO started a programme to provide psychosocial support and mental healthcareto the 1.5  million displaced persons and refugees in Cambodia. The people not only received psychosocial aid, but were also supportedattheir return to the Cambodian society. In 2000, TPO Cambodia became an independent NGO with support of the Amsterdam head office. This support consists of advising and monitoring  the project as well as evaluative and professionally support in all areas.