Over the last 30 years Cambodia has emerged from conflict, widespread poverty, extremely high mortality rates and near international isolation into a fast growing, highly open country. Between 2005 and 2012 the official poverty rate fell from 50% to 18% and, in 2016, it achieved lower middle income status. This all happened alongside substantial improvements in population health. Since the 1980s life expectancy has more than doubled, and, since 2000, the maternal and child mortality rates both fell by more than two thirds.
This case study looks at the role of learning from other countries in the evolution of Health Equity Funds (HEF) and Special Operating Agencies (SOAs). HEFs are an innovative demand side funding mechanism used to reimburse hospitals and health centres for the user fee exemptions they afford to poor patients. SOAs are given innovative contracts to manage government health service delivery, designed to improve system efficiency.