ReBUILD Consortium and Health Research Unit, Cambodia Development Resource Institute, 56, St 315, Phnom Penh, PO Box 622, Phnom Penh, Cambodia.
Health Systems Governance and Finance Unit, Nossal Institute for Global Health, University of Melbourne, Victoria, 3010, Melbourne, Australia.
Health Policy Plan. 2018 Jan 1;33(1):9-16. doi: 10.1093/heapol/czx144.
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.
在全球范围内，传统医学长期以来一直被用于治疗常见疾病、精神健康问题以及分娩和产后护理。然而，传统医学主要由私营部门提供，目前尚不清楚在多大程度上传统医学的支出会导致家庭贫困。本研究采用生活史方法，在过去 60 年中了解了柬埔寨 24 户家庭的健康寻求经验，柬埔寨的卫生支出很高。这些生活史表明，柬埔寨的传统医学一直在经历商业化过程，这对贫困家庭产生了重大影响。在受访者的早期生活中，据报道，传统医学的支付方式较为灵活，可以根据患者的经济状况进行自愿或适当的支付。相比之下，当代从业者似乎更倾向于立即收取现金，这经常导致传统医学使用者背负巨额债务和出售资产。鉴于传统医学在柬埔寨作为治疗来源的受欢迎程度及其对家庭贫困的潜在影响，我们建议在该国实现全民健康覆盖的全国性对话中纳入传统医学。
