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Table 3 Recommendations health access study Phnom Penh

From: The social determinants of health and health service access: an in depth study in four poor communities in Phnom Penh Cambodia

Recommendation subject area

Detail

1. Resourcing Communication

Adequate resources for health centres are needed for health education and services outreach to at-risk communities. The additional resources would i) strengthen links between health services, community practitioners, local authorities, NGOs and communities, ii) establish contact with and support local social networks for health (formal and informal) and iii) provide mobile services for the most at-risk populations.

2. Improving Service Quality

A combined health education and quality improvement strategy should be adopted so that poor families can access better quality and more affordable care for sick children from health centres (for example, facility and community IMCI).

3. Focussing On Health Monitoring

The Municipal Health Department (MHD) needs to undertake a systematic approach to surveillance of at-risk populations through the support of district health centres. In conjunction with local authorities and civil society partners, the MHD should conduct regular mapping and micro-planning for at-risk populations. Such mapping and micro-planning should be built into the routine functioning of the surveillance and planning system so that surveillance focuses both on disease and on detecting health risks and health inequities, specifically for childhood immunization, primary school retention, health insurance status, anthropometric assessment/food security measures and environmental health.

4. Building Public Health Function

A review of essential public health functions for urban health should identify resources required; a capacity-building plan is needed to strengthen the delivery of essential public health functions, either through local authorities, NGOs, health centres or a combination of all (waste management, nutrition surveillance, health monitoring etc).

5. Expanding Social Protection

Social safety-net equity funds, based on a model of the health equity fund, need to be established in the poorest communities in Phnom Penh on a comprehensive basis to ensure access to health care and education services for the very poor.