Cambodia’s health care sector still suffers from a lack of budget transparency, underfunding and corruption, all of which should be considered at next month’s donor meeting, according to the umbrella health care organization Medicam.
Medicam has prepared a position paper for donors and the government as they prepare for the Consultative Group meeting in Paris, where the government plans to ask for $1.5 billion over three years.
And while some at that meeting may like to paint a rosy picture of the health care sector in Cambodia, “there is a crisis,” said Maurits van Pelt, chief of mission at Medecins Sans Frontieres and a member of the steering committee of Medicam, which includes more than 100 health NGOs. “It’s not going well at all.”
The group’s number one concern, according to the position paper, is the lack of transparency in the budgeting process.
Money coming from the Ministry of Finance to the Ministry of Health is difficult to account for, and vulnerable to corruption on all levels, Medicam maintains.
“The transparency problem is the root cause of many other problems,” van Pelt said. Ministry of Health officials couldn’t immediately be reached for comment.
The Finance Ministry has failed so far to provide the Health Ministry information on monthly funding, “despite last year’s commitment to do so,” according to the Medicam document. In addition, “under-the-table payments reportedly continue.”
“Donor funding should be linked to increased transparency and good governance,” Medicam maintained.
In addition, van Pelt said, institutions like the World Bank should provide “permanent technical assistance,” to help implement budget reforms.
Another problem facing the health care sector is underfunding, according to Medicam. It reports “no significant shift from the defense/security budget to the social sector, with the percentage of the [gross domestic product] expended on health decreasing.”