[Hoeung HEAM “[email protected]”]

In Cambodia, rehabilitation service is mostly assistive technology. Physiotherapy service is available at the 11 rehabilitation centers countrywide. However, they only provide conjunction service to service users who are expected to get/use a device. We do not have speech therapy, occupational therapy, medical rehabilitation, and psycho-social service (although rehabilitation functioning regulation does include social service). We only have one spinal cord injury center for the whole country, and is not well function due to many issues including fund, professionals, tools and equipment, etc. In health settings mainly at national and provincial hospitals, we do have physiotherapy unit or service. However, some do not provide or provide limited service to both IPD and OPD patients. Private clinics and hospital are also contribute to provide physiotherapy service, but only a few.

[Hoeung HEAM “[email protected]”]

In Cambodia, disability data is about 25% of the population based on the latest health demographic survey in 2021. We have 11 rehabilitation centers around the country. These centers are not in all provinces of Cambodia. These centers are particularly providing assistive technology services rather than comprehensive. We do not have need assessment data for rehabilitation service and thus this is an issue for planning if the aim is to design good rehabilitation services interns of facilities, technical resources, and budget. It is noted that at hospital, physiotherapists are providing rehabilitation service for IPD and OPD. However, it is still very limited in particular within provincial and community hospitals.

[Hoeung HEAM “[email protected]”]

I see that most of us facing similar issues in ensuring and providing rehabilitation service. I agree that rehabilitation should be under health system for many good reasons, including, continuum of care, better referral btw a hospital/health setting’s departments/units, may be less cost because they may not need to travel along way to rehabilitation service that is available at regional centers. To be sustainable, rehabilitation service should be provided by realization of each nation’s socio-economic competence. However, government seems believe that cost supporting rehabilitation service is waste of national money, that leads to limited allocation of budget. Therefore, while many experts believe that rehabilitation is a government investment with a “plus” return, there have to evidence based support for convening decision and policy makers.

[Hoeung HEAM “[email protected]”]

I also believe that transportation is one of the barriers for rehabilitation accessibility, in particular for low resources countries.

[Hoeung HEAM “[email protected]”]

As indicated, rehabilitation is a set of interventions aiming to promote and/or improve people’s active lives through medical, social, and assistive technology services. Its ultimate goal is to enhance people’s quality of life, increase life expectancy, and contribute to socio-economic development.

[Hoeung HEAM “[email protected]”]

Hi everyone. Hoeung Heam (call me Hoeung) is here. I am from Cambodia currently a Chair of the Cambodian Physical Therapy Association (CPTA). Regarding my background, I am a physiotherapist began my initial work for a rehabilitation center in 2002 and continue to two senior physiotherapy role until 2010. I then moved to work in rehabilitation service management and coordination engaged in policy and guideline development, research, evaluation and training. Currently, I am working with stakeholders to support the Ministry of Health to produce rehabilitee policy and service guideline for rehabilitation.

I am appreciate to be part of this blending course by John Hopkin University. I hope that:
1) I will learn the principle, framework, concepts, and evidence of effective ways / strategy for rehabilitation
2) I will be able to learn more from other participants on rehabilitation in particular when it is place under health system
3) I can connect with good friends who are working in rehabilitation so that I will continue to learn and share with them

[Hoeung HEAM “[email protected]”]

1) In Cambodia, it used to be 5 international NGOs are the key players of rehabilitation service. They mostly started or supported rehabilitation service since later 1990s or early 2000s. They were HI France, HI Belgium, ICRC, Veterans International, Cambodia Trust. However, there are three of them exist for supporting current rehabilitation service in Cambodia are HI (now is Humanity and Inclusion), ICRC, and Exceed World Wide (formerly Cambodia Trust). These three INGO now are also facing challenges in funding rehabilitation service.
2) Rehabilitation in Cambodia is under the leadership or mandate of Ministry of Social Affairs. Recently, government issued a directive to instruct the Ministry of Social Affairs and the Ministry of Health (MoH) to transfer rehabilitation service under the MoH. Therefore, practically this is part of the consideration of the WHO Guide to Action. In addition, MoH is now including rehabilitation service into its hospital service policy and guideline. The issue is that it has been almost two years, the transition of rehabilitation service is not moving forward because the Ministry of Social Affairs seems does want to let the rehabilitation service go to MOH. It is important to note that there are some initiative on the development of rehabilitation service guideline under the social affair mandate. This service guideline was based on the WHO building block.
3) Rehabilitation service is poor from my opinion and experience. Once it was with funding support from 5 INGOs, there were quite a lot of services available including support for accessing rehabilitation service that help people from limited socioeconomic background. However, since less support began in early the 2010s, many people cannot user rehabilitation service. For instance, many children with moderate to severe cerebral palsy in poor family and in the rural communities cannot have wheelchairs or seating system, children with autism cannot access to service due to no such service available or only available at the capital city, epilepsy children can access to physiotherapy and convolution medication, etc. However, we have not reliable data on the real need of rehabilitation service in country. It is noted that the democratic survey 2021 reports that the county have disability prevalence of 25% of the population.

[Hoeung HEAM “[email protected]”]

Most of participants perceive and experience many issues facing rehabilitation service, and they indicate that it is one of the in equality services in particular for low resource countries.

[Hoeung HEAM “[email protected]”]

1) In the top of the reality that rehabilitation service is very limited for people in need globally, low resource countries face a lot more challenges in getting rehabilitation’s service.
2) The world now working on looking for initiating rehabilitation service, thus rehabilitation service should be under UHC.
3) WHO Rehabilitation 2030 is one of the key framework document for each country considering and using for rehabilitation policy and service in health system.

[Hoeung HEAM “[email protected]”]

Hi all ! My name is Hoeung HEAM. You can call me Hoeung. I am from Cambodia. Currently, I am Chair of the Cambodia Physical Therapy Association (CPTA). I have about 22 years experience working directly and indirectly in rehabilitation sector in my country. I first started with an international organization as a physiotherapy for center and community-based rehabilitation in the Eastern part of the country with later two promoted positions. However, in 2010, I moved to another international organization with a new role as a rehabilitation project manager where I took 50% of my time overseeing a rehabilitation center providing service to an about 2 million population geographic area, and another 50% for working with national governmental and nongovernmental stakeholders. I learnt a lot from this my role and responsibilities for that almost two years before turning myself to be an academic student once again. In 2015, I started to work more on program management, project evaluation, and research in health, rehabilitation, and disability. Presently, represent CPTA, I am working with working group of the Ministry of Health to develop health guidelines and policies for hospital management and service, including rehabilitation.

I am very happy to be selected to this course. I hope that after the completion of this course, I will be able to:
1) understand better the of rehabilitation in health system, including the principles and theories behind,
2) Learn cost-effective models have been experimented and used that potentially be replicate in Cambodia,
3) Build network and strong support from rehabilitation in health system peers, academia, agencies, alliances
4) Learn where to obtain good resources (evidence-based data and research articles) that I can be used for supporting my work on advocacy for rehabilitation in health system, for policy development, designing of program, and for guideline and working procedure development, and informing implementation, as well as monitoring and evaluation.
5) to learn from all participants as well as sharing with them what I have had or experienced.

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