Center for Health Market Innovations (CHMI)

Programs

The Lake Clinic (TLC)

last updated Jun 20, 2012

Overview

Implementing organization: 
The Lake Clinic- Cambodia
Implementation Partner(s): 
Provincial hospitals and referral hospitals of Siem Reap, Kg Thom and Kg Chhnang provinces
Legal Status: 
Private (not-for-profit)
Year Launched: 
2008
Stage: 
Existing/expansion stage
Income Level of Target Population: 
Bottom 20%, 20-60% (lower to lower-middle)

Funding

Primary Source of Funding: 
Donor
Summary: 

The Lake Clinic (TLC) is a mobile boat clinic that serves isolated populations on the Tonle Sap Lake.

Program goals/rationale: 

The Tonle Sap Lake area in the lower part of the Mekong River basin is the largest wetland in Southeast Asia, with the surface area of 2500 sq. kilometers in the dry season and 16,000 km2 in the wet season. However, about 40–60% of households in the provinces adjoining the lake are below the official poverty line, with a peak of 80% in some areas.

The lack of public health facilities on the surface of the lake, customary mobilization and migration of people, geographical difficulties and poverty drive people on the Tonle Sap Lake to be complacent about receiving quality health care services. The Lake Clinic aims to improve access to quality health care services for people living on the surface of the Tonle Sap Lake (mainly those located 30km to 100km from inland public facilities through mobile care service provisions and health education.

Key program components: 

Health care services are provided free of charge in the form of a mobile clinic on a boat by a TLC medical team including 3 medical doctors, 3 midwives and 3 nurses who all receive training from the Ministry of Health.

Health care services are delivered in accordance with national service delivery guidelines in the form of minimum package activities (MPA) such as outpatient consultation with drug prescriptions available, laboratory tests, normal delivery services, small surgery, etc.. If higher levels of care are needed, TLC facilitates the referral of patients to referral hospitals and/or provincial hospitals in the provinces under coverage of the TLC project. The TLC staff assesses the socio-economic conditions of the patients to determine their ability to afford to seek care at higher levels from public facilities. If the patients are identified as poor, they are provided with transportation fees for travel to higher levels of care. TLC also facilitates the identified poor to be covered by health equity fund schemes (health care financing schemes that facilitate the poor to access quality health care through medical and non-medical assistance mechanisms).

Besides facilitating patient’s access to quality health care services, TLC makes use of existing frontline health workers (village health support groups) to mobilize health education promotion services in the community, and refer patients to TLC mobile clinics or public facilities. The village health support groups are trained on disease prevention, case management such recognizing basic symptoms and danger signs, and referral management. The village health support groups are incentivized by TLC to attend training courses, meetings or workshops at higher level public facilities.

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