Equity differences in the Health Status of the Population
69642
Background report
Cambodian Health System
Health Status of the Cambodian Population
Health Service Delivery
Prepared by
Marie Ryan
Epiconsult Phnom Penh
On behalf of the World Bank office, Phnom Penh.
June 2007
Health Status of the Cambodian Population
|Contents | |Page |
| |Figures & Tables |3 |
| | | |
| |Summary findings |6 |
| | | |
| |Health Status Introduction |8 |
|1 |Child Health |9 |
| |Infant and under-five mortality |9 |
| |Child morbidity |17 |
| |Immunization |20 |
| |Nutrition |22 |
| |Anemia & Micronutrient deficiency / Parasitic Infection |25 |
| | | |
|2 |Maternal Health |27 |
| |ANC / Deliveries |27 |
| |Maternal Mortality |28 |
| |Fertility |30 |
| |Contraception |30 |
| |Women’s Education |32 |
| | | |
|3 |Adult Morbidity |33 |
| |Physical Impairment / Disabilities |33 |
| |Prevalence of Medical Injections |34 |
| |HIV/AIDS |35 |
| |Tuberculosis |35 |
| |Mental Health |36 |
| |Malaria /DHF |36 |
| | | |
|4 |New Challenges |37 |
| |Demography |37 |
| |Chronic Disease |38 |
| |Tobacco and Alcohol |38 |
| |Diabetes |38 |
| |Emerging Diseases |39 |
| |Landmines / UXO |40 |
| |Physical Rehabilitation |41 |
| |Road Accidents |41 |
| | | |
| | | |
| | | |
| | | |
Health Service Delivery
| | | |
|Contents | |Page |
| |Key Points |42 |
| |Summary Findings |43 |
|1 |Distribution of health services |47 |
| | | |
|2 |Performance of Health Service Delivery |48 |
| |Emergency Obstetric Care |48 |
| |Full MPA Status at Health Centers |48 |
| |Integrated Management of Childhood Illnesses (IMCI) |48 |
| |Attendance at Delivery by Trained Health Providers |48 |
| |Birth Spacing Services |49 |
| |Other Indicators |49 |
| |Utilization of public / private sectors |49 |
| |Barriers to Utilization |52 |
| |Referral Systems |56 |
| | | |
|3 |Quality |56 |
| |Patient perceptions CDHS 2005 and CSES 2004 |56 |
| |National Policy for Quality in Health |57 |
| |Empowerment of consumers & Information on quality |59 |
| |Institutional regulation & management |59 |
| |Clinical Practice |60 |
| |Professional Development |60 |
| |Management development |60 |
| |Institutionalization of quality |60 |
| | | |
|4 |Contracting |61 |
| |Background |61 |
| |Contractor Performance |63 |
| | | |
|5 |Private Sector: |64 |
| |Relationship with the public system |64 |
| |Current Status |65 |
| | | |
|6 |Human Resources |67 |
| | | |
|7 |National Programs |72 |
| |Hospitals |72 |
| |Ministry of Health and Provincial Health Departments |73 |
| |Group B summary |75 |
| | | |
|8 |Cross-sector initiatives: |77 |
| |Priority Mission Groups (PMG) |77 |
| |Decentralization |78 |
| |Merit Based Pay Initiative (MBPI) |78 |
| |Priority Action Programs (PAP) / |79 |
| |Accelerated Disbursement District (ADD) | |
| |Program Based Budgeting |79 |
| |References |80 |
| |Abbreviations |81 |
| | | |
Health Status Figures
1. Significant changes in infant mortality
2. Significant changes in under-five mortality
3. Summary Infant and Under-five deaths Urban vs. Rural
4. Regional comparison Infant & Under-five mortality
5. Under-five mortality (per 1000 live births) 1995-2005
6. Health Center Outpatients Children 0-4 years
7. Prevalence and treatment sought for diarrhea in under-fives
8. Annual re-treatment and replacement of bed nets & % Impregnated bed net coverage of the village population
9. Trends in Vaccination
10. Percentage of children not vaccinated
11. Regional comparison vaccinations for measles & DPT
12. Age vs. Percentage Malnourished: Stunting; Wasted; Underweight
13. Trends in Nutritional Status of Children Under-five
14. Stunting : Wasting : Underweight - Children Under-five
15. Exclusive Breastfeeding
16. Regional comparison: % children under-five who are underweight
17. % Moderate & Severe Anemia in Women & Children
18. Vitamin A Supplements, Children 6-59 months
19. Regional Comparison Maternal Mortality Rate (MMR)
20. Regional comparison of births attended by skilled personnel and ANC
21. Regional comparison of fertility rates
22. Modern contraceptive use by married women
23. Unmet need for Family Planning
24. Use of Modern Contraceptives in Lowest Rating Provinces
25. Regional comparison of modern contraceptive use
26. Regional comparison of Life Expectancy at Birth
27. Reported Communicable Disease
28. Reported Heath Problems
29. Estimated Prevalence of HIV
30. Regional comparison for DOTS detection and treatment rates
31. Malaria & Dengue Hemorrhagic Fever Case Fatality Rate (%CFR)
32. Regional comparison: Diabetes prevalence (all ages) % Estimates: Rural vs. Urban
33. Regional comparison: Diabetes prevalence 20yrs+ 2000 and 2030
Health Status Tables
1. Summary Infant mortality & Under-five mortality
2. Infant Mortality compared to the national averages in 2000 and 2005 (p ................
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