Donors Applaud Gov’t Efforts to Improve Rural Health Care

Days after Prime Minister Hun Sen blamed the lack of spending on health last year on the election and said more money would be spent this year, donors lauded the Ministry of Health’s efforts to boost medical care in rural areas.

“The ministry is now making sure the right amount of staff goes to the rural areas,” Mark White, director of the public health office for the US Agency for International Development, said Monday. “The success is that the problem was identified.”

A UN report released last week found that the child mortality rate has increased slightly over the past decade and that the country is unlikely to meet its target of reducing mortality for children under5—to 65 per 1,000 live births—by 2015. In 1998, the re­port found, 124 out of 1,000 children died before age 5.

In a speech Friday, Minister of Health Hong Sun Huot said the ministry plans to expand medical care to remote areas.

In addition, he is asking the government to allow the ministry to hire to more nurses, midwives and doctors. He also is asking the government to provide financing for the health sector, medical centers and hospitals “on time.”

By August, the Health Ministry had spent only 21 percent of the money allocated to it in the 2003 budget law. At the time, health officials alleged that the money was sitting in the national treasury and that they needed to bribe Ministry of Finance officials to receive the money allocated to their ministry. Finance officials denied the charges.

Hun Sen said Friday that the government was slow to release money to the Health Ministry, as well as the Education Ministry, because of the parliamentary elections. “Before 2003, we did not have this problem,” he said.

But 2002 budget implementation figures indicate that last year was not an anomaly. The ministry spent only about 60 percent of its allocated budget amount in 2002, about 10 percent less than it spent last year. Moreover, the 2002 figures show that the ministry spent only about $225,500, or about 0.5 percent, of its $42.75 million budget in the first two months of that year, indicating that the ministry was just as slow to receive money then as it was last year.

To remedy the late disbursal of funds from the Ministry of Finance to the Ministry of Health, Hun Sen said Friday that he re­cent­ly ordered Finance Mini­ster Keat Chhon to “pay the most at­tention to giving money to the health and education sectors.”

“We need to continue to look at this problem,” the premier added.

Paul Weelen, an official with the World Health Organization, said Monday that last week do­nors proposed that the ministry develop a fast track strategy to accelerate deployment of midwives to rural areas.

Hong Son Huot said Monday that midwives were being trained and the ministry is working to place them in rural areas as soon as it could. Concerning disbursements from the Finance Ministry to his ministry, the minister said simply: “I hope the Ministry of Fi­nance will help us.”

While overall funding of the Health Ministry has “increased significantly” in the past few years, it’s still at “a very low level,” said the director of an NGO working in the health sector.

“To say the government has no political will is going too far,” the director said. “But to make a serious difference in the health sector, more is needed.”


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