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Cambodia's rural health markets and the quality of care (Inglês)

It is already well known that the main provider of primary health care (PHC) in Cambodia is the private sector and that only one in three patients visits the public sector for out-patient care. However, data on Cambodia's health market composition, the dynamics of seeking health care, and the quality of health care in the private health sector are scarce. For example, there is almost no information on the differences in the quality of care between the public and private sectors, and between licensed and unlicensed providers. In order to remedy these knowledge gaps, two studies were undertaken early in 2013. The first aimed to look at health markets focusing on: (i) the roll-out of Specialized Operating Agencies (SOAs), and (ii) the roll-out of Health Equity Funds (HEFs). The second study aimed to measure the quality of health care across the sector. The findings of the two studies suggest that traditional healers, such as Kru Khmer/witch doctors, shops selling pills and traditional birth attendants (TBAs), account for half of total rural health care providers, followed by private and public providers. Health system utilization indicates that 65 percent of all primary health care visits were to the private sector, although 60 percent of hospitalizations took place in public facilities. Possessing an HEF card increases health seeking towards the public sector to 34 percent (up from 15 percent), but only 46 percent of the poor have such cards. Half of women deliver their babies at home, and of those only 11 percent are attended by skilled medical personnel, while 88 percent are assisted by TBAs. Only 54 percent of private providers have formal training. Given the high utilization of the private and non-medical sectors, it seems likely that a large proportion of patients receive inadequate care, in particular from informal non-medical providers.


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    Leste Asiático e Pacífico,

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    Cambodia's rural health markets and the quality of care

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    public health facility;primary health care;private provider;quality of health care;quality health care;rural health care providers;traditional birth attendant;trained health worker;quality of care;Public Facilities;public provider;skilled health provider;gap in knowledge;nurses and midwives;health care system;home visit;traditional healer;medical personnel;neonatal mortality;financial protection;Health Market;waiting time;health seeking;physical examination;rural area;medical assistant;public private;antenatal clinic;average cost;home birth;urban setting;private clinic;private hospitals;professional working;Counterfeit Drugs;severe symptoms;interim strategy;university sector;patient care;private market;patient exit;knowledge gap;internal contract;primary managers;referral hospitals;household survey;governance issue;facility survey;participant observation;patient visits;hygienic condition;inpatient care;district hospital;private pharmacies;subjective assessment;time-series analysis;market size;



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