Access to quality healthcare is fundamental to enhancing citizens’ livelihoods and advancing towards more sustainable growth and development in countries all over the world. Along with increasing public demand for better health infrastructure and adequate access to healthcare services, many countries face the need to strengthen their healthcare policies to enhance patients’ rights. As healthcare systems expand and diversify, incorporating more health services such as those related to mental health, countries are defining key policies to promote patient well-being and access to healthcare.1 Like other countries, Cambodia has policies and regulations that enhance patient rights.
The post-conflict situation left Cambodia in a critical position without healthcare infrastructure or qualified professionals together with extremely poor health among its population.2 As part of its recovery, Cambodia recognized healthcare as a human right and agreed to develop healthcare services and bring them closer to areas where people live.3
A woman is consulting with her doctor about family planning. Photo by ILO ASIA PACIFIC. Taken on 27 January 2011. Licensed under CC BY-NC-ND 2.0
Disease prevention was established as a priority together with plans to improve access and availability of necessary care to patients from vulnerable communities and in isolated areas. Cambodia has incorporated the Sustainable Development Goals (SDGs) into its healthcare policies, placing particular emphasis on maternal and child health and infections like HIV and tuberculosis.4 The increase of healthcare facilities and access to services has also helped in reducing non-communicable diseases like cardiovascular disease and diabetes in Cambodia.
Cambodia is experiencing fast and substantial demographic changes which pose direct challenges to the system. Infant mortality remains high at 22 per 1000 infant deaths (children below five years)5 but has been falling and is now estimated to be well below the world average. Maternal mortality rates are also high at 170 per 100,000 live births.6
In parallel, fertility rates are decreasing and life expectancy continues to rise, leading to an ageing population. Such changes, coupled with high poverty rates, have stimulated the role of community health workers (CHW) in addressing healthcare needs at the community level.7 8 This has enabled the Ministry of Health to improve outreach and healthcare delivery throughout the country. The expansion of primary healthcare services has been crucial in bringing healthcare services closer to communities.
Amidst such changes, the patient is being placed in the center of healthcare services. The Constitution includes the right of patients to healthcare access, which includes patients’ entitlement to attentive and honest examination and treatment by health professionals.9 Doctors and healthcare professionals in Cambodia are mandated to give the best professional advice to their patients and seek further consultation where necessary. Additionally, patients have the right to choose their doctor/10. Apart from delivering the best treatment, doctors and health providers must ensure the emotional stability of their patients by providing support and consultations that respect their preferences and decisions.
Patients have the right for their personal and health information to remain confidential given that it is highly sensitive data.11 The release of healthcare information can affect the patients’ personal, social and professional well-being and lead to stigmatization. Intentionally or unintentionally divulging patient information can lead to severe punishment of the responsible persons or entity. On occasions when such information needs to be shared, the patient’s consent is needed.
Patients also have the right to be informed of the obligations of their caregivers12 This is beneficial in asserting accountability and ensuring that health professionals comply with their obligations with patients.
Recent advancements in healthcare have seen the growth of home-based care where nurses and doctors can provide care in patients’ homes. On such occasions, health professionals must communicate the scope of their responsibilities to the patient to speed their recovery or treatment. A patient can provide his or her consent in terms of a written or verbal confirmation. However, if the patient is unresponsive or incapacitated, an immediate relative can provide consent.13
Cambodia has made significant progress in its healthcare delivery to mitigate existing and emerging health concerns. The country has increased its health facilities, improving access at the community level by locating health facilities closer to the population, especially in rural areas.14
The government has recently improved the regulation and accountability of the healthcare system by enhancing the rights of patients, ensuring that healthcare data remains confidential and making sure that patients are properly informed about the treatment received.15 Nevertheless, despite the significant breakthroughs in healthcare, Cambodia is still facing health disparities in terms of health infrastructure.16 Mortality rates, particularly among children, remain high. Poverty also continues to affect nearly 40% of the Cambodian population. Accordingly, there is need to increase health coverage and uphold patient rights with various health institutions in Cambodia.
Related to Patient rights
References
- 1. McLaughlin, Daniel, and Elisabeth Wickeri, “SPECIAL REPORT: Mental Health and Human Rights in Cambodia,” Fordham University School of Law, (Leitner Center for International Law and Justice), Vol 35, 2012: pp.895.
- 2. Asadul Islam et al., “The Intergenerational Effect of Cambodia’s Genocide on Children’s Education and Health,” Population and Development Review 43, no. 2, 2017: pp. 331-353.
- 3. Kumanan Rasanathan, “Primary Healthcare Remains the Foundation for All in Cambodia,” World Health Organization, accessed August 23, 2020.
- 4. ibid.
- 5. The World Bank, “Mortality Rate,” World Bank Data, 2019, accessed September 23, 2020.
- 6. Ministry of Health, “Annual Health Financing Report 2015”, Phnom Penh: Ministry of Health, 2015.
- 7. Adélio Fernandes Antunes et al., “Equality in Financial Access to Healthcare in Cambodia from 2004 to 2014,” Health Policy and Planning 33, no. 8 (2018): pp. 906-919.
- 8. Kim Ozano et al., “Improving Local Health through Community Health Workers in Cambodia: Challenges and Solutions,” Human Resources for Health 16, no. 1 (June 2018).
- 9. Royal Government of Cambodia, “Sub-Decree on the Code of Medical Ethics,” Royal Gazattee, 2003, accessed January 12, 2020.
- 10. ibid.
- 11. ibid.
- 12. ibid.
- 13. ibid.
- 14. Peter Leslie Annear et al., “The Kingdom of Cambodia Health System Review,” vol. 5, WHO, 2015.
- 15. Ministry of Health, “Health Strategic Plan 2016-2020,” 2016.
- 16. Peter Leslie Annear et al., “The Kingdom of Cambodia Health System Review,” vol. 5, WHO, 2015.
