From day one, I was thrust into the heart of public health policy and research in Cambodia, where the ambitious goal of achieving universal health coverage by 2035 was announced by the new administration. One of my primary tasks thus has been parsing through and analysing Cambodia's new Universal Health Care (UHC) Roadmap 2024-2035. This comprehensive document outlines the country's vision for achieving universal health coverage, a goal that requires intricate coordination across various sectors. My role involved identifying areas where the Ministry of Health, particularly NIPH, can contribute effectively to this national objective and identify gaps between the current and necessary capacity to make gains in the three crucial dimensions of UHC, namely population coverage, health service coverage, and financial risk protection.
The trust placed in interns at NIPH is truly remarkable. I was entrusted with drafting a grant proposal for vaccine uptake research examining the inequities among marginalised communities in Cambodia, competing against teams from over 15 lowand middle-income countries. This task, which took a full week of dedicated work, gave me a taste of the high-stakes nature of global health and development work. It has been a stark contrast to my academic experiences where the worst-case scenario is an unsatisfying grade, highlighting the real-world impact of research work in the healthcare sector. Another exciting aspect of my internship has been the opportunity to contribute to tangible research projects. I was tasked with developing a multi-stage mixed-method study investigating the referral system and gatekeeping policies in Cambodia. This involves creating tools such as cross-sectional surveys for healthcare providers, population-based surveys, and guidelines for qualitative investigations.
My internship hasn't been confined to the office. I had the chance to join a field trip to Siem Reap, where I got the chance to see for myself health centres that serve as crucial primary healthcare providers for rural communities. This experience provided valuable insights into the challenges and opportunities in delivering healthcare outside urban areas. As a bonus, I also got to marvel at Cambodia's national treasure, the awe-inspiring Angkor Wat, which also serves as an important source of the government’s revenue in providing subsidised healthcare to the underprivileged in Siem Reap and neighbouring provinces. It also underscores the intricate network of sectors or actors that are unique and pivotal to the health of people, where disruption can bring about cascading consequences, such as when Covid not only caused large unemployment and subsequent loss of health insurance in Siem Reap’s tourism sector but also hindered the ability of health centres in providing free or subsidised medical procedures to local people.
All in all, working at NIPH has also opened my eyes to the challenges faced by public health organizations in relatively resource-constrained settings. I have observed how insufficient resources can hinder engagement with stakeholders and limit the scope of important health promotion work. Despite these challenges, the dedication and passion of my colleagues at NIPH to improve health outcomes in Cambodia are truly inspiring.
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Cain Lau
Placement Site: University of Hong Kong-China Medical Board-National Institute of Public Health Project, Phnom Penh
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