Achieving Universal Health Coverage in Cambodia: Barriers, Strategies, and Policy Recommendations

Abstract

Background and Aim

Cambodia's Universal Health Coverage (UHC) score in 2021 was 58—lower than neighboring countries like Vietnam (68) and Thailand (82)—highlighting persistent challenges in healthcare access. Key issues include healthcare disparities, urban–rural inequalities, rising noncommunicable diseases (NCDs), and an overreliance on private healthcare services that increase out-of-pocket expenses. Therefore, this perspective article aims to discuss the challenges and strategies to address the issues of achieving UHC in Cambodia and the way forward.

Methods

A literature review was conducted throughout May 2025 by retrieving articles from Google Scholar, PubMed, and gray literature from national and international organizations' websites, including the World Health Organization, United Nations, World Bank, and GIZ Cambodia. Additionally, I employed UHC, barriers, challenges, efforts, and Cambodia as the keywords.

Results

Cambodia has made progress in healthcare access, including reductions in infant and maternal mortality and increased life expectancy. However, several systemic challenges hinder UHC advancement. These include significant healthcare quality and accessibility gaps between urban and rural areas, weak healthcare governance, and limited preventive measures for NCDs. The healthcare system is highly privatized, with only 20% of the population relying on public healthcare and 80% on private outpatient services—raising concerns about service quality and financial risk protection. Key barriers include socioeconomic inequality, inadequate infrastructure, and underdeveloped health financing mechanisms. To address these, strengthening the Health Equity Fund (HEF), improving infrastructure and human resources, investing in medicine storage, and establishing a “Cambodian Public Health Act” and “Public Health Commission” are recommended.

Conclusions

Cambodia still has a long way to go to achieve UHC. Strengthening UHC will require policy reforms, strategies, and initiatives across a multisectoral approach. Cambodia's Public Health Commission could accelerate the country's journey toward UHC by utilizing best practices, information exchange, and collaborative approaches to maximize limited resources.