Estimating the cost of HIV/AIDS and TB services at health facilities in Cambodia v1

In Cambodia, HIV/AIDS and TB have historically been financed by donors, the Ministry of Health, and households (via out-of-pocket spending). Donor funding for HIV/AIDS and TB is declining, the government is struggling to generate new resources dedicated to the prevention or treatment of these diseases. However, in recent years Health Equity Funds (HEFs) have begun to provide financing for HIV/AIDS and TB services. Upcoming social health protection reforms increase the likelihood that new social health insurers, e.g. the National Social Security Fund (NSSF), will also cover HIV/AIDS and TB services, as has been done in other countries in the region, including Vietnam, Thailand, and the Philippines. The NSSF currently does not clearly specify that HIV/AIDS and TB services are included in the benefit package; rather the NSSF health benefit package specifies that it covers ‘treatment and care services with medical professional techniques’. The purpose of this study will be to understand the unit costs of delivering HIV/AIDS and TB services, identify the major components of costs, sources of funding, and to inform HEF (and eventually NSSF) reimbursement rates. In the short term, the results will be used to build an actuarial cost and financing model projecting resource needs and likely sources of funding for HIV/AIDS and TB services over 5 years.