Health care system and health

reform in Cambodia
RbBn§½suxaPi)al nigkMENTMrgénRbBn§½suxaPi)al
enARbeTskm<Ca
Presented by Dr. Ouk Sokun,MPH

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 vtßúbMNgénkarsikSa
enAcugbBa©b;énemeronsikçakamTaMgGs;nwgGac³
• erobrab; BIRbBn§½suxaPi)alenARbeTskm<úCa
• BiPakSaBIEpnkarRKbdNþb;suxaPi)al
• erobrab;BIkarsnñidæanénsßanPaBsuxPaBénRbeTskm<úCa

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1-RbBn§½suxaPi)al enARbeTskm<úCa

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fñak;Cati³
• ksageKalneya)ay
• erobcMyuT§saRsþ
• eFVIEpnkarCati
• eFVIkarEbgEckFnFan
• Binitütamdan vaytémøskmµPaB

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fñak;extþ³
• BRgwgkarpSaP¢ab;CamYy fñak;Cati nigfñak;RsukRbtibtþi
fñak;RsukRbtibtþi³
• RsukRbtibtþinimYy²man mNÐlsuxPaBeRcIn EdlCYb
pÞal;CamYyRbCaCn nigm​ anmnÞIreBTübEg¥kmYy.

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mnÞIreBTübEg¥k
• esvamanlkçN³ÉkeTs
• BinitüBüa)alkrNIbBa¢Únmk
• manbTdæanbec©keTsxçs;
• manesvaeFIVeraKvinicyä½ xçs;
• RKbdNþb; 10 mNÐlsuxPaB

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mNÐlsuxPaB
• p​þl;esva MPA
• manKuNPaB nigRbsiTi§PaB
• esvamanCab;CaRbcaM
• esvamanlkçN³rYmbBa©ÚlKña
• RkbbNþb;RbCaCn 8> 000 – 12> 000 nak;

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shKmn¾
enAshKmn¾manKN³kmµkarRKb;RKgmNÐlsuxPaBEdlman
smasPaBmkBI³
• tMNagRkumRbwkSaXMu
• tMNagRkumRTRTg;suxPaBPUmi
• buKÁlikmNÐlsuxPaB

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 fñak;Cati
fñak;extþ³
BRgwgkarpSaP¢ab;CamYyfñak;Cati  BRgwkkarksageKalneya)ay

nigfñak;RsukRbtibtþi • erobcMyuT§saRsþ
fñak;Cati
• eFVIEpnkarCati
fñak;extþ
mNÐlsuxPaB • karEbgEckFnFan
•CYbCamYyRbCaraRsþ
fñak;RsukRbtibtþi • Binitütamdan vaytMEl
•KuNPaBénesva
shKmn¾
•manRbsiT§PaB mNÐlsuxPaB mnÞIreBTübEg¥k mnÞIreBTübEg¥k
•Cab;CaRbcaM •esvamanlkçN³ÉkeTs
•rYmbBa©l
Ú Kña
shKmn¾ •BinitüBüa)alkrNIbBa¢Ún
•bTdæanbec©keTsx<s;
•Rb>C 8 000-12 000n RsukRbtibtþinmi Yy²manmNÐlsuxPaBeRcIn
•esvaeFVIeraKvinicä½yx<s;
•cMgaypøvÚ 10K>m EdlCYbpÞal;CamYyRbCaCn nigmanmnÞrI eBTü •RKbdNþb;10mNÐlsuxPaB
bEg¥kmYYy
 k-sMNuMskmµPaBGb,rma
rbs;mNÐlsuxPaB
(MPA: Minimum Packet Activities)

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 sMNuMskmµPaBGb,rma rbs;mNÐlsuxPaB
• BieRKaHCMgWbzm )anesckþIfabBaðasuxPaBEdlmanjwkjab;
dUcCaRKuncaj; kameraK rakrUs>>>
• Büa)albnÞan; nigvHkat;tUctac
• TTYlbnÞúkCMgWraMuér:³ rebg Xøg; eGds_
• suxPaBpøÚvcitþ

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12
13
 sMNuMskmµPaBGb,rma rbs;mNÐlsuxPaB
• bgáarCMgWdl;kumar[mansuxPaBl¥ Gayu 0-4 qñaM
- BieRKaH nigBüa)altamyuT§saRsþ s>B>C>k ¬smahrNkmµ
TTYlbnÞúk BinitüBüa)alCMgWkumar¦
- cak;fñaMbgáar
- tamdanRsavRCavCMgWkgVHGaharUbtßmÖ
- bgáarCMgWkgVHvItamInGa nigembg;dasul
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15
 sMNuMskmµPaBGb,rma rbs;mNÐlsuxPaB
• TTYlbnÞúk®sþmI anépÞeBaH
- BieRKaHmun nigeRkaysMral
- cak;vak;saMgbgáarettaNUs
- bgáarPaBesøksøaMg
- RbwkSaRsþI[bMe)AedaHmþaydl;kUnkñúgem:agdMbUgrhUt
dl;Gayu6Ex
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 sMNuMskmµPaBGb,rma rbs;mNÐlsuxPaB
• TTYlbnÞúk®sþmI anépÞeBaH
- pþl;RbwkSadl;RsIþmanépÞeBaH[sµ½RKcitþeFVIetsþQamrk
emeraKeGds_
- TTYlbnÞúksMralkUn nigbBa¢ÚnkrNIlM)aksµúKsµajeTAkan;
mnÞIreBTübEg¥k

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18
 sMNuMskmµPaBGb,rma rbs;mNÐlsuxPaB
• BnüarkMeNIt
• bBa¢ÚneTAfñak;TI2nUvGñkCMgWEdlminGacTTYlbnÞúkenAfñak;TI1
¬krNIEdlminGaceFVIeraKvinicä½y b¤ sµúRKsµajkñúgkarBüa)al¦.
• karGb;rMsuxPaBRtUvrYmbBa©ÚlkñúgRKb;skmµPaBBinitüBüa)al

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20
 x-sMNuMskmµPaBbRgÁb;
(CPA: Complementary Packet Activities)

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 sMNuMskmµPaBbRgÁb;
enAkñúgRbB½n§suxaPi)alfµI RsúkRbtibtþi (OD) KWCaGgÁPaBmuxgar
mUldæanmYy. dUcEdl)anbBa¢ak;xagedIm RsúkRbtibtþimanesva
suxaPi)alBIrkRmit.
• kRmitpÞal;TI1 sRmab;RbCaCnTUeTA KWCa mNÐlsuxPaB
EdlCaGñkpþl;nUvesva sMNMuskmµPaBGb,brima (MPA).
• kRmitRbePTTI2 KWmnÞIreBTübEg¥k EdlCaGñkpþl;nUvesva
sMNMuskmµPaBb®gÁb; (CPA) enAkñúgextþ.
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 sMNuMskmµPaBbRgÁb;
• mnÞIreBTüextþmansßanPaBBiess EdledIrtYnaTICamnÞIreBTübEg¥k
sRmab;RsúkRbtibtþiEdlxøÜntaMgenApg nigsRmab;RsúkRbtibtþi
epSgeTotpg.
• mnÞIreBTübEg¥kRtÚv)anEckCa 3 RbePT edayEp¥kelIcMnYnbuKÁlik-
RKÚeBTü> cMnYnERK> »sf-brikçareBTü nigskmµPaBKønI ik .

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 sMNuMskmµPaBbRgÁb;
CPA 1 : mnÞIreBTüKµanesvavHkat;FM ¬Kµandak;fñaMsNþ¦M b:uEnþy:agehac
k¾RtÚvmanesvaEpñksmÖBEdr.
CPA 2 : mnÞIreBTümanskmµPaBFMCagTI1 EttUcCagTI3 Kwmanesva

se®gÁaHbnÞan; nigvHkat;FM ¬dak;fñaMsNþM¦.

CPA 3 : mnÞIreBTümanskmµPaBFMCageKbg¥s;manesvavHkat;FM

¬mandak;fñaMsNþM¦ eRcInCag TI2 ¬TaMgcMnYn nigskmµPaB¦ nigRBmTaMg

manbEnßmnUvesva skmµPaBÉkeTsepSg²eTotCaeRcIn.
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2-karerobcMeT,IgvijnUvRbBn½æsuxaPi)al

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 2-karerobcMRbBn½æsuxaPi)al
 cab;BIqñaM1994 mkRksYgsuxaPi)al)anebþCJakñúgkarerobcMeLIgvij
nUvRbBn§½suxaPi)al edayepþatCacm,geTAelIfñak;Rsuk.
 eKaledAcm,génkMENTRmg;RbB½n§ suxaPi)al KWedIm,IelIkkm<s; nig
BRgIkkarEfTaMsuxPaBbzm tamry³karGnuvtþRbB½n§suxaPi)alRsuk
 RksYgsuxaPi)alGnuvtþkMENTRmg; edIm,IeqøIytbnwgtRmÚvkarEpñk
suxPaBCasarv½nþrbs;RbCaCntamry³ ³

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 elIkkm<s;CMenOTukcitþrbs;RbCaCnmkelIesvasuxPaBsaFarN³
 bBa¢ak; nigBRgwgtYnaTIrbs;mnIÞreBTü nigmNÐlsuxPaB
 begIáttMbn;TTYlxusRtÚvsRmab;mUldæansuxaPi)alnimYy² edIm,I
Fanadl;karRKbdNþb;elIRbCaCn
 niTankmµelIkarviPaCn_ nigkareRbIR)as;FnFan (Rationalizing the
allocation and use of resources.)

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 kMENTRmg;vis½ysuxaPi)alTamTar[man³
- karEbgEckFnFanRbkbedaysniTankmµedayEp¥kelIEpnkar
RKbdNþb;suxaPi)al³ hirBaØvtßú ehdæarcnasm<½n§ »sfsMPar³
brikçar nigFnFanmnusS .
- erobcMeLIgvijnUvRkbx½NÐsßab½nenAfñak;kNþal extþ-Rkúg
nigRsúk
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- kMENTRmg;fvika dUcCapøas;bþÚrviFIsaRsþeTArkkarviPaCn_fvika
tamrUbmnþ
- EbgEckeLIgvij nigbNþúHbNþaleLIgvijbuKÁliksuxaPi)al
- dak;ecjmeFüa)ayfIµnana edIm,IhirBaØb,TanesvasuxPaB

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 fñak;RsukRbtibtþi
 RsukRbtibtþi KWCaGnuRbB½n§brimNÐlenAkñúgRbBn§½suxaPi)al ehIy
sßitenACitbMptu nwgRbCaCn. RsúkRbtibtþipSMeLIgedaymNÐl
suxPaBCaeRcIn nigmnIÞreBTübEg¥kmYy.
 tYnaTIcm,grbs;RsúkRbtibtþi KWGnuvtþ eKaledAsuxPaBrbs;
RsúkRbtibtþitamry³
1- bkRsaypSBVpSay nigGnuvtþeKalneya)aysuxaPi)alCati
nigyuT§sa®sþrbs; extþ-Rkug
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 fñak;RsukRbtibtþi
2- Rbkan;P¢ab;nUvesvamanRbsiT§PaB RbsiT§pl nigRKb;RCúg
eRCay ¬elIkkm<s;suxPaB bgáar-Büa)al nigsþarnitism,Ta¦
eyagtamtRmÚvkarrbs;shKmn¾
3- FanakarEckcayFnFanmansmFm’ nigeRbIR)as;FnFanTaMg
Gs;enaH manRbsiT§pl ekogKrFnFanbEnßmsRmab;esvasux
PaBkñúgRsuk ]> karKaMRTBIGgÁkareRkA rdæaPi)al shkarCa
mYyXM-u sgáat; nigGaCJaFrrdæ)almUldæan
- 31
3-EpnkarRKbdNþb;suxaPi)al

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 3-EpnkarRKbdNþb;suxaPi)al
EpnkarRKbdNþb;suxaPi)al KWCaRkbx½NÐsRmab;kar
GPivDÆ ehdæa rcnasm<½n§RbB½n§suxaPi)aledayQr elImUl
dæanénlkçN³vinicä½y TMhMRbCaCn niglT§PaBPUmisa®sþ
kñúgkarmkTTYlykesva.

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 3-EpnkarRKbdNþb;suxaPi)al
eKalkarN_GnuvtþkúñgkareRCIserIsyklkçN³vinicä½yenHKW³
• RKbdNþb;RbCaCnTaMgmUl edayminTuk[mancenøaHRbehag
b¤RtÜtCan;Kña
• tRmÚvkarEpñksuxPaBCamUldæanrbs;RbCaCnPaKeRcInelIslb;
• KuNPaBesvaEfTaM-smahrNkmµkarEfTaM
• FnFanEdlGacrk)an
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 tarag 1³ lkçN³vinicä½yénEpnkarRKbdNþb;suxaPi)al
lkçN³vinicä½y ¬1¦cMnYnRbCaCn ¬2¦lTPaBPUmisaRsþ
mNÐlsuxPaB eKalkarN_³ 10>000 nak; rgVg;cm¶ay 10K>m b¤
¬s>s>G¦ ERbRbÜlBI 8>000- eFIVdMeNIrGtibrma 2 ema:g
12>000nak; edayefµIreCIg
mnIÞreBTübEg¥k eKalkarN_³100>000- 20-30K>m rvagmnIÞreBTübEg¥k2
¬s>s>b¦ 200>000 b¤eFIVdMeNIr 3ema:g
ERbRbÜlBI 60>000- edayrfynþb¤kaNUt
200>000nak;
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 3-EpnkarRKbdNþb;suxaPi)al
EpnkarRKbdNþb;suxaPi)alEdldak;[GnuvtþenAqñaM 1995 manbMNg³
• GPivDÆesvasuxPaBeTAtamlkçN³vinicä½y sRmab;TItaMgmUldæan
suxaPi)alnigtMbn; TTYlxusRtÚvrbs;xøÜn
• EbgEckFnFanhirBaØvtßú nigFnFanmnusS
• FanaeqøIytbtRmÚvkarEpñksuxPaBrbs;RbCaCnRbkbedaysmFm’
tamry³karRKbdNþb;eBjelj
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 4-snñidæan
• karBinitüvaytémøvisy½ suxaPi)al)ansnñidæanfa sßanPaBTUeTAén
suxPaBRbCaCnkm<úCa RtÚv)anelIksÞÜyecjBIkRmitd¾TabmYyenA
eRkaysßanPaBénCemøaHCag 3 TsvtSr_mun.
• rgVas;TUeTABIrEdlykmkeRbIR)as; edIm,IkMNt;KuNPaBRbB½n§
suxaPi)al KWGRtasøab;rbs; kumarGayueRkam1qñaM nigeRkam5qñaM
RtÚv)ankat;bnßyya:gxøaMgebITukNaCaRtÚvkarEklMG EfmeTotedIm,I
QaneTAseRmceKaledAGPivDÆn_shsSvtS.
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 4-snñidæan
• sUcnakrlT§plsuxPaBTI3rbs;RbB½n§suxaPi)al KWGRtasøab;rbs;
mataminmanvDÆnPaB ehIysßitenACabBaðaRbQm muxd¾RsÜcRsavdEdl
• GRtaGñkpÞúkemeraKeGds_RtÚv)ankat;bnßyKYr[kt;sMKal; rIÉGRta
CasHes,IyénkarBüa)alCMgWrebgenArkSa)ankñúgkRmitx<s;bMput.
• edaysarkMeNInesdækic©d¾qab;rh½sPaBbMBulénbrisßannigkarpøas;bþÚr
rebobrbbrs;enA eFIV[ekIneLIgnUvkarRBÜy)armÖGMBIbnÞúkénCMgWminqøg
edayrab;bBa©ÚlTaMgGRtasøab;d¾x<s; EdlbNþalmkBIeRKaHfñak;
cracrN_. 38
 4-snñidæan
• kareRbIR)as;esvasaFarN³mankarekIneLIg b:uEnþsßitenAkRmitTab
ebIeRbóbeFobCamYybNþaRbeTsdéT mYyEpñkedaysarRbCaCn
mYyPaKFMeRbIR)as;esvavis½yÉkCn.
• fvikaCatiRtÚv)anbegáIneLIgRsbtameKaledACayuT§sa®sþ eTaHCa
dUecñH kIþk¾enAmanvisalPaBsRmab;karEklMG[kan;EtRbesIrbEnßm
eTotkñúgkarRKb;RKghirBaØvtßú nigkarRbtibtþifvika.

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 4-snñidæan
• karRKb;RKgFnFanmnusSenAEtCasm<aFénbBaðaRbQmmux Biess
Tak;TgeTAnwgkarelIkTwkcitþ nigkarpþl;qµbmanCMnajRKb;RKan;
enAtammNÐlsuxPaB.
• karvaytémøsñaédkargarvis½ysuxaPi)alCYb]bsKÁedaysarsUcnakr
eRcIneBk nigminmanB½t’manedImRKaRKb;RKan;ehIyeKaledAcMNuc nig
sUcnakrRtÚv)anpøas;bþÚrtameBlevla. karpøas;bþÚrBhuPaBEbbenH
)aneFIV[b:HBal;dl;dMeNIrsikSaeronsURtBIrUbFatuénRbB½n§yuT§sa®sþ.
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 4-snñidæan
• édKUGPivDÆ)aneFIV[manFnFankan;EteRcInsRmab;vis½ysuxaPi)al.
RtÚvkarvDÆnPaBeRcIn EfmeTot enAkñúgkarsRmbsRmlkarCYy
]btßmÖ BIédKUGPivDÆn_TaMgenaH karebþCJaCYy sRmab;ry³eBlEvg
nigkarFanafakarrYmcMENkrbs;BYkeKRsbtamGaTiPaBCati.
• lkçN³BiessmYyeTot énkarGPivDÆn_vis½ysuxaPi)alenAkm<úCa
KWPaBxusKñaya:gxøaMg énsßanPaBsuxPaBrvagRkúmRbCaCn Edlman
sßanPaBesdækic©xus²Kña.
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 4-snñidæan
• sßanPaBsuxPaB RbCara®sþrbs;enAtMbn;CnbT KWTabxøaMgCagRbCaCn
rs;enAtMbn;TIRbCMuCn. xN³eBlEdl RKÜsarmankarsikSaGb;rMx<s;
manvDÆnPaBl¥EpñksuxPaB karGPivDÆsuxPaBkñgú cMeNamRKÜsarEdl
KµankarsikSaGb;rM KWmanPaBTn;exSay CYnkalmanlkçN³GviC¢man.
PaBxusKña rvagextþmYyeTAextþmyY eTotmanCaTUeTA

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Thank you for your
Participation

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