Healthcare professionals are crucial for achieving universal health coverage (UHC) and ensuring public health for all citizens. However, disparities in healthcare services are prevalent in rural areas, particularly in lower-middle-income countries like Cambodia. In 2021, with a population of 17 million and an annual health expenditure of $122 per capita, the country faces challenges due to an inadequate and unevenly distributed healthcare workforce. Cambodia had only 1.4 health workers per 1000 people, falling below the WHO critical shortage threshold in 2012.  In addition, 3/4 of people live in rural areas, while approximately 2/4 of physicians and 3/4 of specialists work in Phnom Penh, the country’s capital (Ozano et al., 2018). This disparity results in a three-fold higher infant mortality rate in rural areas compared to urban centers.

Cambodia’s healthcare system comprises the public and private sectors, with 34 national and provincial-municipal level hospitals, 92 referral hospitals, 1222 health centers (HC), and 128 health posts. However, outpatient services utilisation is low in public sectors, while 2/4 of people seeking care from private providers (World Health Organization, 2016), highlighting the need for strengthening the public health sector through infrastructure, training, and resource allocation.

Cambodia is addressing the shortage of medical professionals by focusing on medical education and training for nurses and midwives. However, challenges persist, such as limited access to medical universities and limited training opportunities for rural healthcare workers. Many young nurses leave rural facilities due to insufficient salaries, long working hours, and challenging environments. Improvements in financial support, working conditions, and social factors are essential to retain healthcare workers in rural areas.

The Cambodian government is committed to improving healthcare access and quality, despite challenges such as high out-of-pocket expenditures and a poorly regulated private sector. Initiatives like Health Equity Funds and voucher schemes provide financial risk protection for the poor. Still, challenges remain in access to and quality of healthcare services, highlighting the need for continued efforts to enhance healthcare access.

To improve rural healthcare, investing in the referral system between public and private sectors could be a strategic approach. This would enhance collaboration and ensure that all residents, especially those in rural areas, have access to essential health services, including emergency care and NCD treatment, at their nearest HC. By prioritising investments in HC services, which include financial investments, improvements in infrastructure and training, and policy reforms, Cambodia can better care for its rural residents and move closer to achieving UHC.