A system wide analysis of health financing equity in Cambodia

The pursuit of universal health care coverage needs to be informed by an understanding of how equitable the current health financing arrangements are. The financing mechanism is equitable if:

  • The burden of health care payments is distributed in line with ability to pay. 
  • The benefits from healthcare spending are distributed according to need for health services.

This study represents the first attempt to quantify financing and benefit incidence for the entire health system of Cambodia. Benefit and financing incidence analyses can be very useful tools for assessing health system performance.

This study will assist policy-makers in Cambodia to develop and effectively implement health care reforms to improve the equity of financing and provisions of health care services.

Local collaborators will develop their skills to undertake further equity and health financing analyses in the region so that gains in capacity building may be multiplied over time.

Research questions

The study will address 3 key questions:

  • How is the burden for financing the health system in Cambodia distributed across socioeconomic groups?
  • How are the benefits from the health system, measured in terms of health care use, distributed across socioeconomic groups? 
  • What are the complex range of socio-economic, cultural, and demographic factors that may influence health spending and the utilisation of health services in Cambodia?


  • The study will use a mix of quantitative and qualitative methods.
  • Financial Incidence Analysis (FIA) will be used to measure the burden of health financing across different socio-economic groups. FIA assesses which socio-economic groups bear the burden of different aspects of health care financing.
  • Benefit Incidence Analysis (BIA) will be used to assess who (in terms of socio-economic groups) receive what benefit from using health services. BIA provides a picture of whether a benefit distribution is currently pro-rich or pro-poor based on different indicators of the relative need for health care. 
  • Qualitative methods including in-depth interviews and focus group discussions will be used to explore the factors that influence health care spending and utilisation of different health services across socio-economic groups.


Project team

Project collaborators: External

Dr Por Ir
Institute of HSRPS, Ministry of Health Cambodia
Dr Jacobs Bart
GTZ & Ministry of Health Cambodia
Dr Marco Liverani
The London School of Hygiene & Tropical Medicine
Prof Stephen Jan
George Institute and University of Sydney
Dr Lorna Guinness
The London School of Hygiene & Tropical Medicine

Key contact

+61 (2) 9385 9801