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Free healthcare for Cambodia’s poorest families

© UNICEF video
The Equity Fund provides free healthcare for the poorest Cambodians.

SVAY RIENG, Cambodia, 13 June 2005 – When two of Chea Samoeun’s children came down with life-threatening illnesses at the same time she was able to take them to hospital secure in the knowledge that the cost would not ruin her family.

Thanks to a UNICEF-supported project called the Equity Fund, the cost of treating her four-year-old daughter for typhoid and her eight-month old son for pneumonia was covered.

For Chea Samoeun and thousands of other Cambodian mothers like her, health problems can be catastrophic, plunging them into debt and feeding an ongoing cycle of poverty.

"The Equity Fund helped me bring my children to the hospital," Chea Samoeun explained as she sat fanning her children at Svay Rieng Provincial Hospital, near Cambodia's eastern border with Viet Nam.

Under the Equity Fund project, UNICEF covered the costs of her children’s stay in hospital, as well as all transport, food for the family, health advice and immunizations while they were there. Chea Samoeun paid nothing.

"Without the Equity fund, the poor people just didn't come to hospital. When they are sick, they try to find traditional healers, they try to borrow money to buy drugs in the market. And most of the time, they just stay home and put themselves in danger of dying," explained Dr. Thor Rasoka, a UNICEF Project Officer in Cambodia and one of the main driving forces behind the project.

© UNICEF video
Chea Samoeun with the youngest of her three children.

The Equity Fund, launched in July 2002, works by systematically identifying the poorest families and children in Svay Rieng, one of Cambodia’s poorest provinces with 500,000 inhabitants and 690 villages. One man and one woman are elected as village-based representatives, known as the Village Health Support Group, and identify those most in need in their communities. The UNICEF provincial team verifies the information and uses it to help families like Chea Samoeun’s.

A verification team, which includes UNICEF provincial staff and staff from the Provincial Health Department and Operational Health District, is responsible for interviewing each family to determine whether or not they qualify for assistance. Those who do are photographed, provided with an exemption card and have their entitlements explained to them. By the time the process is completed, nearly 25 per cent of the province’s 25,000 families –125,000 people – will possess a card entitling them to free, or partly free, healthcare.

Points are awarded based on several criteria, such as the number of children in a family, the amount of land and animals owned and the type of house lived in. The families who register the most points receive a full exemption of their fees at the provincial hospital, while others secure entitlement to either 50 or 75 per cent off.

Patient charges are recorded and met by UNICEF. Half of the money is then used to supplement the operational budget of the hospital, while the other half is given to the health workers to supplement their meagre monthly salary of just $15-30 (the estimated living wage in Cambodia is between $100-150).

The provincial hospital is now seeing between 200 and 300 fee-exempt patients each month and has seen an upswing in common cases of childhood illness since the project began.

“We've seen some children who probably would have died of diseases related to malnutrition because the family couldn’t afford the transport to bring them to hospital,” says Kerry Davies, Hospital Management Advisor for UNICEF in Svay Rieng.

UNICEF’s initiative has helped trigger the interest of Cambodia’s Government and multilateral aid institutions in expanding the Equity Fund project throughout the country.



Video report

October 2004:
Steve Nettleton reports on a UNICEF-supported project to provide free healthcare to poor Cambodian families.

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The State of the World’s Children 2005

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