Health in Cambodia

The Ministry of Health (MoH), Provincial and Municipal Health Departments, Operational Districts and the National Social Protection Council shape Cambodia's public health system. Private clinics and hospitals operate alongside public facilities and often provide a parallel path to consultation, diagnostics, treatment and admission. Availability differs between urban and rural areas and between provinces, particularly for specialist staff, transport, medicines, equipment and emergency capacity. Community or Village Health Support Groups can connect households with a Health Post. Routine entry usually takes place at a Health Center, known locally as a មណ្ឌលសុខភាព. Health Centers provide essential primary services at the MPA level, including prevention, basic diagnosis, treatment, maternal and child services and selected chronic-disease care. More complex cases can move to an Operational District Referral Hospital, generally at CPA1 or CPA2 level, then to a Provincial Referral Hospital at CPA2 or CPA3 level. National Hospitals and CPA+ facilities provide more advanced specialist care. Referral facilities can provide outpatient and inpatient treatment, laboratory and imaging services, surgery, maternity care and emergency care, but the exact capacity depends on the facility. Cambodia uses 102 Health Center accreditation standards and 365 hospital accreditation standards; meeting a standard does not make capacity identical across all locations. For an emergency, use the nearest suitable facility rather than waiting for a routine referral. Cambodia is developing regulation for gatekeeping, two-way referral and ambulance services. Non-emergency referral pathways are being strengthened through NSSF and HEF provider payment arrangements, but the evidence does not establish one strict, uniform gatekeeping requirement for the whole country. Keep previous records, a medicine list and any scheme card available when changing facilities. Preventive care includes vaccination, health education, antenatal and postnatal care, screening and prevention or management of non-communicable diseases. Services for hypertension, diabetes and cervical cancer are expanding at Health Centers and referral hospitals. Dengue occurs throughout the year, Japanese Encephalitis is endemic, and malaria remains mainly a risk in rural and forested areas. Transmission is approximately absent or negligible in Phnom Penh, Siem Reap and the Angkor Wat area. Mosquito protection, safe food and water, physical activity and reducing tobacco and alcohol exposure lower preventable risks. Fever during or after a stay in a malaria-risk area needs prompt medical assessment. Self-treating with antibiotics bought over the counter can delay the correct diagnosis and contributes to medicine resistance. Maternal and child services remain a high priority. Skilled attendance at birth reached 93.33% in 2020, and 42 facilities provided comprehensive emergency obstetric and newborn care, including caesarean delivery. The 2021–2022 Cambodia Demographic and Health Survey recorded a maternal mortality ratio of 154 deaths per 100,000 live births. Antenatal and postnatal care, vaccination, oral rehydration treatment and child services remain affected by provincial differences. Health care is financed through several arrangements. Public facilities may charge user fees, while private care is generally paid directly or through insurance. Out-of-pocket spending represented about 60% of total health expenditure in 2020, including medicines, transport and informal expenses. Exact tariffs depend on the facility and the applicable scheme. The Health Equity Fund supports government-funded eligible care for people in IDPoor 1 or 2 categories and other vulnerable or at-risk households. In 2023, about 1,821,056 at-risk people were reported within the relevant coverage group, but registration, awareness and effective coverage gaps remain. NSSF membership provides medical benefits for covered formal workers, civil servants and other eligible groups in contracted public or private facilities. A membership card is used to establish access. Eligibility for medical benefits generally requires at least six months of contributions during the previous twelve months; after two consecutive months of contributions, a limited continuation of access for two months may apply under the rules. In an emergency, a member can use the nearest suitable facility and should notify NSSF within 48 hours. The package can include outpatient and inpatient care, diagnostics, prescribed medicines, maternity care, emergency treatment, physiotherapy, rehabilitation and referral. A daily allowance may be around 70% of the average daily wage according to the applicable rules. Voluntary NSSF health coverage for self-employed people and dependants has existed since 2023. In December 2023, reported coverage included about 1.5 million employees and 400,800 civil servants, retired people and veterans; the voluntary scheme covered about 134,600 people in January 2024. Mental health access remains limited and concentrated in specialist settings. WHO reported only 130 psychiatrists and psychiatric nurses in Cambodia in 2022. The Mental Health Atlas 2024 reported that psychotropic medicines and psychosocial interventions were available in only about 10% to 50% of primary-care settings, with no functional integration of mental health care into primary care. Cambodia joined the WHO Special Initiative for Mental Health in 2025, and a national action plan was in development, but specialist services remain limited. After treatment, continuity depends on a discharge plan, follow-up appointments, medicine monitoring and communication between facilities. NSSF includes physiotherapy and rehabilitation, while public services are expanding chronic-disease follow-up. Health Centers and referral hospitals still have insufficient capacity for some chronic illnesses, mental-health needs, rehabilitation, elderly care and disability care. Two-way referral and digital continuity systems are being planned or strengthened. There is no evidenced single nationwide standard for complaints and aftercare, so the responsible facility and applicable scheme rules should be checked directly. MoH policy emphasizes equitable, quality and non-discriminatory care for Cambodian citizens and foreigners, but access and payment remain dependent on the facility, location and protection scheme. The essential health service coverage index was about 58% in 2021, while its service-capacity and access sub-index was 37%. Official 2024–2035 planning reported social health protection above 41%, and WHO reported nearly 50% coverage in 2023. The roadmap targets 80% population coverage, an essential-service index of at least 80% and out-of-pocket spending of no more than 35% by 2035. Rural distance, workforce shortages, medicine supply, fragmented schemes, private-sector costs and mental-health gaps remain major practical constraints.