Abstract

Globally, traditional medicine has long been used to address relatively common illness, mental ill health and during childbirth and post-natal care. However, traditional medicine is primarily provided by the private sector and it is unclear how far expenditures on traditional medicine contribute to household impoverishment. A life history method was used to understand the health seeking experience of 24 households over the last 60 years in Cambodia, a country with high out-of-pocket expenditures for health. The life histories suggest that traditional medicine in Cambodia has been undergoing a process of commercialization, with significant impacts on poor households. In the earlier lives of respondents, payments for traditional medicine were reported to have been flexible, voluntary or appropriate to patients’ financial means. In contrast, contemporary practitioners appear to seek immediate cash payments that have frequently led to considerable debt and asset sales by traditional medicine users. Given traditional medicine‘s popularity as a source of treatment in Cambodia and its potential to contribute to household impoverishment, we suggest that it needs to be included in a national conversation about achieving Universal Health Coverage in the country.

Highlights

  • Traditional medicine is an important component of healthcare for a large proportion of the global population

  • Financial protection against such negative impacts is an important component of universal health coverage (UHC) that sits at the heart of the 2030 Sustainable Development Goal for Health and Wellbeing

  • Three themes became apparent in the interview data: the pattern of resort for traditional medicine has changed over time; geographical reach of traditional medicine practitioners has increased; and the methods and levels of payment have changed

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Summary

Introduction

Traditional medicine is an important component of healthcare for a large proportion of the global population. In countries with a dominant commercialized private sector, recurrent use of the private sector for health care correlates with high levels of out-of-pocket payments (OOPs) capable of inducing or maintaining poverty. Financial protection against such negative impacts is an important component of universal health coverage (UHC) that sits at the heart of the 2030 Sustainable Development Goal for Health and Wellbeing.. As a private sector phenomenon that is commonly accessed across the socioeconomic status range, the contribution of traditional medicine to out-of-pocket expenditure is potentially important. We examine financing of traditional medicine in a country with one of the highest levels of out-of-pocket healthcare expenditures as percentage of total health expenditure in the world—Cambodia (WHO 2013)

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