Quarterly Review 4 – 2025
Piloting a new way: During 2nd semester of 2025, fundamental progress is made by the Ministry of Health in the organisation of public services in Primary Care (Health Centers and Referral hospitals) for chronic conditions like Diabetes and Hypertension. More medicines for diabetes and hypertension are being supplied to primary care and the Electronic Medical Record is being introduced. This starts to affect the traditional role of MoPoTsyo as an important supplier of medicines and as database operator.
More good news is that some health facilities began to adopt a new way of revolving drugs with our NGO, as had been recommended by MoH to MoPoTsyo during the official meeting in November 2024 : namely MoPoTsyo should sell any still needed medicines to the contracted health facility itself and then this health facility will distribute to any patient but record this in the EMR. This new way must replace the old way of working which was/is hospital sells the medicines on behalf of NGO but only to MoPoTsyo-member-patients coming to get service at the health facility. In the old way the patient pays per tablet or per 10ml insulin vial or per insulin syringe (30G), whereas in the new way the health facility charges a fee for a “package of services including the medicines”. This implies that if the MoH CMS supplies enough of all the needed medicines, it can work. It is too early to know if MoH CMS supplies all types of medicines for sufficient number of days, and to what extent hospitals still want to spend money to buy additional medicines from MoPoTsyo that their patients need. For now at the end of 2025:
- We agree to continue to pay the peer educator to help with regular fixed medical consultations.
- The facility has freedom to distribute the medicines it buys from us to any patient it registers, whether they are member of MoPoTsyo or not
- The facility agrees to charge package fees and request MoH CMS medicines.
- The new EMR (electronic medical record) has lot number so our supply (with our lot numbers) can be compared with health facility stock + dispensing of our lot numbers. In this way the MoH can track both our supply and its own supply from CMS. If the facility really uses it, it will be one of the first to use this feature.
- The facility uses the new plastic zip-bags without “MoPoTsyo” printed on it. We supply no-name zip bags because the medicines will be from mixed sources, not only MoPoTsyo like before.
We continue to negotiate with other facilities in other provinces to get more experience on what works best but so far the majority prefer to continue the old system while they experiment with shifting some chronic patients to regular MoH CMS supply. During much of 2025 some items were reportedly in short supply such as 10ml vials of insulin, insulin syringes, Enalapril, Losartan, Simvastatin, Vit B1 Thiamin.
Human Resources: Also, counterparts complain about lack of human resources to do the work. Peer Educator alleviate the workload, but they are financed by us out of the medicine supply. Most hospitals are keen the keep the assistance from the peer educator networks to help during the specific hours of the medical consultations for diabetes and hypertension patients.
EMR: We have visited health facilities in Phnom Penh and in the provinces to see the Electronic Medical Record. Everywhere it is new and our counterparts complain about the new workload. One of the things they report is that they cannot trust its stock management feature. However that would be important feature for us to rely on once it works well. If we stop using our database in the facilities now, then we will need another justification of how our medicines are being used in the public sector.
And the patients? Some patients moved back and forth between between the MoPoTsyo and the MoH system. It is a transition period.
Annual discussions with our counterparts in many provinces: During the last quarter of 2025 we have been going to provinces for the annual progress review at each location and share the revenue from the patient contributions with them.
KPMG: Our auditor came to check our stocks at the end of 2025 to prepare for the audit of our Financial Statements 2025.
Reimbursement rates: It seems that Ministry of Economy and Finance will not increase the levels of reimbursement (for HEF and NSSF at public health facilities such as health centers and rural hospitals) before a new to do costing study by NIPH justifies it. The consequence of this is, that if there is not 100% supply by CMS, high market prices of the missing medicines will prevent good access: Health facilities in primary care are now juggling by shortening the number of days and by cutting items.
Humanitarian assistance: During December, the districts where we work in Banteay Meanchey were being bombed causing the displacement of many civilians to displacement camps. When we were in Sisophon late December to bring the medical supplies requested by the hospitals of Svay Chek and Thmar Pouk, we met with them at the PHD. That day we were not able to travel to the hosptals because of the bombings and the tense situation. We end the year with the hope that the newly agreed ceasefire holds.
MoH reviewd the NCD program supported JICA on 9 december with development partners involved in HEQIP II project. MoPoTsyo also submitted progress report to meeting participants even though strictly we are not part of the HEQIP II project. This project aims to involve communities into the prevention of NCD but organised through the existing structure of the Village Health Workers (VHW) and Village Health Support Groups (VHSG) whereas the creation, management and expansion of Peer Educator Networks for Diabetes and Hypertension (a MoPoTsyo creation) had been removed from the earlier MoH NCD strategy. In practice peer educator activities of MoPoTsyo remain “tolerated” under the current MoU (2024-2026) but are no longer part of the MoH’s official strategy to help people self-manage their chronic condition or prevent complications. It seems that VHW and the VHSG are not yet very active on their new roles. In the current situation the practical work of peer educators remains important, relevant an welcomed as expressed by our counterparts during the annual meetings.
Obesity Prevention among children was discussed with MoH and development partners in a meeting organized with support from UNICEF, and MoPoTsyo participated.