Excellencies, Ladies and Gentlemen,
Today, it is my great pleasure and honor to join you all, Excellencies, Ladies and Gentlemen, in the closing of this 26th Health Conference. At the outset, on behalf of the Royal Government of Cambodia and my own self, may I express my appreciation to the Ministry of Health for their efforts in organizing this conference together with the Joint Review of Health Sector. This enables full participation of donor communities, NGOs, civil society, village health volunteers and the representatives from private sector.
I am strongly convinced that this health conference, as the previous ones, is well prepared and indeed highlights the progress and achievements attained so far. This forum provides the necessary opportunity for discussion on set measures with the aim to find resolution over problems and constraints in order to improve health service delivery to the population and to guarantee highly efficient delivery of health services. Moreover, at this 26th Health Conference, participants, indeed, have actively participated in discussion and have provided important recommendations which are useful for Cambodia health sector development, in particular there is an opportunity for shared understanding and exchange of good experiences among physicians, all health staff to achieve our humanitarian objectives guaranteeing mutual benefits for our population as a whole.
Taking this great opportunity of the conference, I would like to raise some comments with regards to issues in the Cambodian health sector. I recognize that the Joint Review of Health Sector, including this Health Conference, is a step forward in implementing a sector wide management approach under the framework of joint declaration on harmonization between the Royal Government and Development Partners, which was signed on December 02, 2004.
The taking stock report of the health sector has emphasized that, in 2004, the health sector has been successful in moving towards achieving 2015 Millennium Development Goals as well as contributing to implement the “Rectangular Strategy” of the Royal Government where the health sector is considered to be as one of the priority sectors in the development agenda. Furthermore, I am very pleased to know that Samdech Krom Preah Norodom Ranarith, President of National Assembly, attended the opening ceremony of the conference. This testifies closer relationship between the institutions, the National Assembly and the Government, who have paid much attention especially in relation to health sector to ensure the welfare and good health of our people. It is key to contributing to the development of Cambodia which results in rapid prosperity of our country.
In this spirit, the health sector reform under the sector wide management approach needs to be closely linked with the public administrative reform program 2004-2008 of the Royal Government that is focusing on four main areas:
1. Improve service delivery aiming at enhancing quality of respective public services using combination of tools and instruments starting from the privatization, contracting out and public enterprises to the decentralization and de-concentration or the use of other methods of service delivery.
2. Strengthen the management, division of works and responsibility, remuneration scheme, and all that to enhance the government’s administration capacity. This can be achieved through appropriate and stable incentive scheme for civil servants. This is the motivation for the government staffs with which we are able to appropriately manage, control and deploy our workforce. Particularly, the appointments or promotions must follow existing procedures and regulations.
3. Develop the capacity of human resource and institutions in order to strengthen the performance of administration through use of mix instruments, from training to the management of technical assistance and ability to use IT that will promote efficiency and productivity in the implementation.
4. Promote IT and communication to improve for both front-line and supporting service delivery to response in a quick, timely and effective manner. Such process has to be transparent and with accountability.
Indeed, poverty reduction cannot achieve only through economic growth, because the enhancement of social development is also one of the key factors promoting social equity which contributes to reducing social gap as well as building capacity and providing opportunity to people so that they can contribute effectively to national development. In this regard, to build a strong society, it requires people, who are knowledgeable and healthy and who uphold democracy and social justice, in which provide opportunity for them to participate in pushing economic growth and sustainable development. Therefore, good health provision will positively contribute to economic development due to such services are one of the determinant of labour productivity, investment and saving and according to that each people can well access to education and knowledge for their livelihood.
In this reason, the government considers capacity building and health as an important agenda aligned with poverty reduction agenda and all sectoral reform. Under this framework, the Royal Government has increased public expenditures and international aid as well as encouraged private investment aiming at enhancing people’s health via health education, treatment and prevention in order to undermine the mortality rate of mother and infant and to prevent the transmission of diseases such as HIV, TB and Malaria etc. In reality, Health sector has attracted a lot of aid while over 120 international organizations and non-governmental organizations are operating in Cambodia. This expresses the effort of Ministry of Health in seeking additional financial resources to deliver health services to our people. However, there are some interesting negative aspects that have been occurred and they are the arguments to remove health sector from priority list for medium-term strategic aid of some organization such as AUSAID and ADB. Therefore, the Ministry of Health has to rigorously consider those aspects because under current and medium-term macro-economic outlook, the development of health sector in Cambodia is not viable without international aid.
Within this framework, the Ministry of Health has been allocating a lot of funds in particular loans to build and equipment referral hospital and health post, but there is a gap between physical infrastructure development and human resources development. As the result, there are some places that are inactive even though medicines and equipments are available. This implies that the ministry should continue to increase its health services coverage to remote area through dispatch skill staffs to work there. For example, Health post with midwife went up by 50% last year, but a quarter of total health posts are absent midwife. In that sense, the deployment of midwife and nurse is an issue that have to address shortly.
The Ministry of Health, Health Development Partners, public sector, private sector and civil societies have to study and work together to find out a suitable solution to induce student who freshly graduated to love the profession and encourage the skill staffs to continue their works especially for the referral hospital and health post at remote area. To address the issues of decreasing in professional staff, nurse and midwife, it requires close cooperation of all relevance institution such as Secretariat of Administration, Ministry of Education, Youth and Sport, and Secretariat of public administration reform council.
For hospital development, the Ministry of Health has to consider the current available resource and the continuity of modern technological development needs in order to achieve our priority targets. Encouragement and incentives to private sector to participate in such the work are necessary. In addition, even though we have enough law in health sector to supervise private sector, we have faced the issues of faked medicine, illegal medical practices and misleading medical advertisement etc. Thus, it is important for all relevance institutions to effectively cooperate and enforce all valid rules and regulations and to work out further guidelines that are necessary for effective enforcement of laws and regulations that ensure high quality of health services.
On the other hand, while we are success in combating infectious diseases such as poliomyelitis, HIV and tuberculosis, the Ministry of Health has to consider other issues such as traffic accidents, SARS, avian flu etc. The Ministry should continue to expand broadcasting network with cooperation of relevance institution, neighbouring countries and international organizations and also pay attention on all necessary measures to prevent non-scientific news that negative effect of national prestige and economy.
The approach to overall sector management framework is under leadership of the Ministry of Health with elaborative consultation of development partners. The conference is participated by presentative from the Commune-Sangkat and village health agencies to evaluate health services provided and to determine priority actions. That is a progress of health sector that has been implemented according to point 14 of government political platform of the third legislative of National Assembly.
Moreover, the Ministry of Health should promote more works such as equity fund and enforce client’s rights especially establish regulations or sub-decree on rights of clients and health services provider to avoid unconstructive suggestion that might hinder the implementation.
I strongly hope that the outcomes of the 26th Health Conference are going to further promote professionalism and professional ethics of physicians, pharmacists, and all health staffs in term of moral, humanity, efficiency and quality of services to benefit all our Cambodian people, sustainable development and poverty reduction.
In closing, on behalf of the Royal Government and own myself, I would like to express my deep appreciation to the Ministry of Health, relevant institutions, national and international organizations, civil society and private sector who have worked their best in the cause of promoting health sector and improving welfare of Cambodian people, and finally contributing to poverty reduction.
Finally, I wish you all, Your Excellencies, Ladies and Gentlemen, Distinguished national and international guests a good health and success in fulfilling your respective duties. Now, I would like to declare the closing of the 26th Health Conference and the Joint Health Review.