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The political economy of inclusive healthcare in Cambodia Guarantee Scheme in India

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  • Tim Kelsall
  • Seiha Heng
Abstract
Over the past 15 years, Cambodia has made significant strides in expanding effective access to free healthcare for poor people, thanks largely to 'Health Equity Funds' (HEFs), a multi-stakeholder health-financing mechanism. HEF operators have helped expand access, incentivise health staff, and lobby on behalf of poor patients. However, despite their successes, they have been unable convincingly to address some of the deeper-seated problems of the Cambodian health system, such as under-resourced facilities, underpaid, poorly qualified staff, and a burgeoning private sector. This paper explains this state of affairs as a product of Cambodia's 'political settlement', in which relatively successful multi-stakeholder initiatives exist as 'islands of effectiveness' in a sea of rent-seeking and patronage. While such islands may currently be the best solution available for poor people, the deeper problems are unlikely to be solved without a shift in the political settlement itself.

Suggested Citation

  • Tim Kelsall & Seiha Heng, 2014. "The political economy of inclusive healthcare in Cambodia Guarantee Scheme in India," Global Development Institute Working Paper Series esid-043-14, GDI, The University of Manchester.
    • Handle: RePEc:bwp:bwppap:esid-043-14
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    References listed on IDEAS

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    1. Matthias vom Hau, 2012. "State capacity and inclusive development: new challenges and directions," Global Development Institute Working Paper Series esid-002-12, GDI, The University of Manchester.
    2. Rajagopal, 2014. "The Human Factors," Palgrave Macmillan Books, in: Architecting Enterprise, chapter 9, pages 225-249, Palgrave Macmillan.
    3. Brian Levy & Michael Walton, 2013. "Institutions, incentives and service provision: Bringing politics back in," Global Development Institute Working Paper Series esid-018-13, GDI, The University of Manchester.
    4. Flores, Gabriela & Ir, Por & Men, Chean R. & O’Donnell, Owen & van Doorslaer, Eddy, 2013. "Financial protection of patients through compensation of providers: The impact of Health Equity Funds in Cambodia," Journal of Health Economics, Elsevier, vol. 32(6), pages 1180-1193.
    5. World Bank, 2011. "Cambodia - More Efficient Government Spending for Strong and Inclusive Growth : Integrated Fiduciary Assessment and Public Expenditure Review," World Bank Publications - Reports 2813, The World Bank Group.
    6. Ir, Por & Bigdeli, Maryam & Meessen, Bruno & Van Damme, Wim, 2010. "Translating knowledge into policy and action to promote health equity: The Health Equity Fund policy process in Cambodia 2000-2008," Health Policy, Elsevier, vol. 96(3), pages 200-209, August.
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    8. Sen, Kunal, 2013. "The Political Dynamics of Economic Growth," World Development, Elsevier, vol. 47(C), pages 71-86.
    9. World Bank, 2011. "Republic of Chad - Public Expenditure Review Update : Using Public Resources for Economic Growth and Poverty Reduction," World Bank Publications - Reports 2821, The World Bank Group.
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    11. Tim Kelsall & Seiha Heng, 2014. "The political settlement and economic growth in Cambodia," Global Development Institute Working Paper Series esid-037-14, GDI, The University of Manchester.
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    Cited by:

    1. Tim Kelsall & Sothy Khieng & Chuong Chantha & Tieng Tek Muy, 2016. "The political economy of primary education reform in Cambodia," Global Development Institute Working Paper Series esid-058-16, GDI, The University of Manchester.

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