Health Inequalities, Public Sector Involvement and Malaria Control in Cambodia

Cambodia is constructing a broad partnership to guide the delivery of public health services in a context of historical anarchy in the health sector and of contemporary political obstacles. Ironically, the conditions of this partnership undermine the sovereignty of the national programme and hinder the ability of the government to provide comprehensive services. National authorities have given in to the pressure of international funding agencies to adopt approaches characterized by verticalization, multicentred interventions, volunteerism and private partnership. The malaria eradication programme is an example of how the disjointed strategy of combining various interventions can lead to increasing spatial and social health inequalities. In addition, the Cambodian government is often overburdened in trying to manage a multitude of frequently incoherent external interventions. The criteria for efficient delivery reveal an unsustainable national public health vision. Local planners should reconsider the parameters under which they engage with external parties and shore up the autonomy of their decision-making.