Prime Minister Hun Sen has promised the government will double the amount spent on

healthcare over the next three years.

The pledge came at a ceremony marking the publication of the government's strategic

plan for medical services.

The Health Sector Strategic Plan 2003-2007, released August 22, identifies six priority

areas comprising 20 different strategies.

Mothers and children will become the focus of efforts to improve healthcare, with

specific targets such as reducing the ratio of maternal mortality from 437 to 305

deaths per 100,000 births.

"This Strategic Plan embodies our ambitions for a better and healthier future

for all Cambodian people," said Minister for Health Hong Sun Huot at the launch

ceremony.

The Cambodian government spends around $2 per person annually on medical care. The

Ministry of Health (MoH) said the new five year plan aimed for a fundamental change

in attitudes in medicine to better serve the needs of the poor.

The bulk of healthcare costs are currently borne by Cambodian households, a financial

drain that has been shown to be the leading cause of landlessness.

Some health sector professionals expressed skepticism over whether the plan would

provide a good blueprint for the future.

"It basically says we will continue to do the same, while the same isn't good

enough," said Dr Wim van Damme, medical coordinator for Médecins Sans

Frontières Holland-Belgium.

According to Dr van Damme, who consulted on the plan's formulation, the strategy

does not solve the "enormous problem with human resources" in which medical

staff with low wages "flock where they can make a private income".

He agreed with remarks made by the Prime Minister about the low quality of much private

care, but said the new plan failed to provide clear regulations to improve the sector.

A recent World Health Organization (WHO) study, for example, revealed that around

half of prescriptions from private practitioners in Phnom Penh were hazardous.

Others were more optimistic. WHO's representative Jim Tulloch hailed the plan as

"a major step forward" and said it was now time for healthcare providers

to adapt their policies to fit the plan's framework. The plan provides broad guidelines

for the five year plan, he said, which meant regulations could now be drawn up.

Most significantly, said Tulloch, "it's the first plan with national ownership".

MEDiCAM's executive director Jean-Francois Frys agreed, and said it was "good

to have a framework for different strategies so the health sector can develop".

MoH officials are currently negotiating with the World Bank, the Asian Development

Bank, and the UK's Department for International Development for $70 million in loan

and grant money to support the health sector project. Funds from other major donors

will also be used to help implement the plan.