City Cancer Challenge
City project

Health Financing

Understanding and Reducing Out-of-Pocket Costs for Cancer Care in Phnom Penh.
City
Phnom Penh, Cambodia
Project lead
Khem Chanthorn
Areas of action
Implementation
Cycle I

The challenge

  • Cancer care in Cambodia is heavily financed through out-of-pocket (OOP) payments, which account for more than 60% of total health expenditure.
  • High OOP costs create major barriers to accessing diagnosis, treatment, and follow-up care, particularly for low-income populations.
  • While existing financing mechanisms provide some coverage, comprehensive cancer care is often excluded or only partially covered.
  • Costs associated with surgery, radiotherapy, medicines, transportation, and accommodation frequently exceed patients’ ability to pay, leading to delayed care, treatment abandonment, or the need to seek care abroad.
  • Despite recognition of affordability as a critical barrier, there is limited local evidence on the full scope and drivers of OOP expenditure for cancer care in Phnom Penh.
  • Limited availability of detailed cost data hinders policymakers’ and health system stakeholders’ ability to design targeted interventions to reduce financial hardship among cancer patients. 

The goal

  • To generate evidence needed to design interventions to reduce out-of-pocket expenditure on breast cancer care in Phnom Penh. 

The How

  • Collecting and analysing out-of-pocket expenditures incurred by breast cancer patients receiving care in Phnom Penh.
  • Capturing both medical costs (diagnostics, treatment, medicines) and non-medical costs (transport, accommodation, food, income loss).
  • Analysing expenditure patterns across different types of health facilities and financing arrangements.
  • Identifying key cost drivers and financial bottlenecks along the cancer care pathway.
  • Producing evidence to support policy dialogue and the design of financing mechanisms aimed at reducing OOP spending.

Outputs

  • Assess and quantify out-of-pocket (OOP) expenditure on (cervical or breast) cancer care (medical and non-medical) amongst (patient category) receiving care in (public/private) facilities in Phnom Penh.

Team

Project Lead
Khem Chanthorn, Deputy Director of Planning and Health Information Department, Ministry of Health.
Project Team
Khem Chanthorn, Deputy Director of Planning and Health Information Department, Ministry of Health
To Sophorn, Deputy Director of Budget and Finance Department, Ministry of Health
Dr. Pheng Phearavin, Assistant Professor of Public Health, University of Health Science
Dr. Luis Sagaon Teyssier, Researcher, University of Health Science
Nipho Mbulazi, Associate, Clinton Health Access Initiative (CHAI)
La Meng Lay, Head of Nurse, Luang Mé Hospital
Rei Haruyana, Chief Advisor, Japan International Cooperation Agency (JICA)
Khim Sam Ath, Technical Officer, World Health Organization (WHO)
Mlis Ratha, Pediatric Oncologist, Deputy head of National Cancer Center, Calmette Hospital

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