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Inclusive healthcare and the political settlement in Cambodia

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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 the poor, 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 the poor, the deeper problems are unlikely to be solved without a shift in the political settlement itself.

Suggested Citation

  • Tim Kelsall & Seiha Heng, 2016. "Inclusive healthcare and the political settlement in Cambodia," New Political Economy, Taylor & Francis Journals, vol. 21(2), pages 238-255, March.
    • Handle: RePEc:taf:cnpexx:v:21:y:2016:i:2:p:238-255
    DOI: 10.1080/13563467.2015.1079174
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    References listed on IDEAS

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    1. 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.
    2. 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.
    3. Slocomb, Margaret, 2010. "An Economic History of Cambodia in the Twentieth Century," University of Chicago Press Economics Books, University of Chicago Press, number 9789971694999, September.
    4. Sen, Kunal, 2013. "The Political Dynamics of Economic Growth," World Development, Elsevier, vol. 47(C), pages 71-86.
    5. World Bank, 2013. "Where Have All the Poor Gone? : Cambodia Poverty Assessment 2013," World Bank Publications - Reports 17546, The World Bank Group.
    6. 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:

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    4. Chhotray, Vasudha & Adhikari, Anindita & Bahuguna, Vidushi, 2020. "The political prioritization of welfare in India: Comparing the public distribution system in Chhattisgarh and Jharkhand," World Development, Elsevier, vol. 128(C).

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