Monday, May 3, 2010

Improving Health Sector Performance

BY BUTH REAKSMEY KONGKEA

The Cambodia Development Resource Institute (CDRI) which is a leading independent development policy research institute in partnership with the Oxford Policy Institute, with funding from the Department For Independence Development UK (DIFD-UK), has organized an international conference on the scheme “Improving Health Sector Performance: Institutions, Motivations and Incentives” over two days from the 26th to the 27th of April 2010 in Phnom Penh.

The conference is organized to explore the institutions and incentives that moderate the behavior of health workers and health service consumers in Cambodia. The conference has explored four main schemes including alternative organizational arrangements for delivering health services including commissioning and purchasing; the incentive associated with alternative health workers employment contracts; health workers management regime; and the incentive associated with effective use of healthcare by service customers which are related to the institutions and incentives that moderate the behavior of health workers and health service customers, according to the conference organizers.

Eng Huot, Secretary of State for the Ministry of Health, said that this international conference is important because it will help the Royal Government in improving and promoting the quality of medical service and treatment as well as to promote the healthcare of people in Cambodia.

The Secretary of State Eng Hout continued to say that according to the strategic health plan of the Ministry of Health 2008-2015, the ministry focused on the promotion of pubic people especially children and women’s health in Cambodia.

He added that the Ministry of Health has also focused on the improving and strengthening the quality of medical services, treatments, code of conduct of health for doctors and officials of their professions.

“Nowadays, the Ministry of Health is working hard in improving and promoting the health sector performance in strengthening of the effectiveness of health services, medical service and treatment in Cambodia,” he said during opening remarks delivered to the international conference in Phnom Penh.

Larry Strange, Executive Director of CDRI, said that this is the first time that the CDRI has organized an international sector conference in Cambodia.

“As some of you would be aware, CDRI’s Social Development Program is very young. However over many years our broader development policy research particular and our major research studies on poverty, its causes and dynamics, and policies for its reduction, has clearly demonstrated the fundamental role of health, and access to health services, in poverty prevention and reduction, in the maintenance of livelihoods, and in the wellbeing of Cambodia families and communities,” he said.

“We know that several factors determine individual and community health, including system and health service delivery. Setting an appropriate supporting environment for effective service delivery will allow health service providers to perform their works effectively offering a quality health service that consumers can have confidence in. Such work needs to be combined with raising awareness of and offering opportunity to health service consumers so that they may have sufficient, appropriate and timely access to the existing health services in their locality,” he added.

Larry Strang stated that there is growing international evident that the effectiveness of the health services stem primarily from the extent to which the incentives facing providers and customers are aligned with “better health” objectives.

Efficiency in health service provision requires that providers and customers have incentives to use healthcare resources in ways that generate the maximum health gains, he said, adding that equity in at least one sense requires that customers requiring the same care are treated equally irrespective of their ability to pay. Efficiency in the use of health service requires that consumers are knowledgeable about the services on the offer and which are most appropriate to their needs.

He said that although these principles are enshrined in the design of every health system in the world, they have proven extremely difficult to apply in practice. Health providers have financial obligations to their families as well as professional obligation to their patients. Health service consumers generally lack information about both their health and health services so that they under-consume or over-consume healthcare. Matters are likely to be improved until there is more empirical evidence of the way health service providers and consumers in different parts of the world are actually motivated and how these incentives are best modified to improve health sector efficiency and equity.

Health provider incentives are generated by the institutions that govern their professional behaviors, and these can be classified broadly into institutions that generate extrinsic incentives and intrinsic incentives arising from values such as altruism, beliefs, reputation and work satisfaction, he said, adding that the incentives that consumers have to use health service efficiently stem from intrinsic incentives arising from concern for their health, knowledge about the available health services and social institutions such as trust and respect that mediate their transactions with providers. //





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