Cambodia’s public health workers are underpaid and poorly trained, with a whopping 98 per cent relying on a second job to supplement their income, according to a recent report.

The report, which analyses whether Cambodian health workers are motivated by income, was published by Global Health Action on June 17 and called for immediate policy changes to ensure financial incentives were “just and objective”, and that workers were trained properly.

Just 17 per cent said their income – which averaged $190 a month – was sufficient to live on, while the majority (58 per cent) said they were not adequately trained for their jobs as nurses and midwives.

Report author Khim Keovathanak, a researcher at the University of Health Sciences’ public health department, said although the report found health workers were motivated by community respect, and income alone was not a guarantee for quality services, it was still “a major contributor”.

“The impact of insufficient income is some compromise on the quality of service delivery,” he said via email, adding there “absolutely” needed to be higher salaries and better training.

According to interviews, he said, distribution of provincial Special Operating Agencies incentives – a sort of target-based bonus scheme – had shortcomings, such as some providers receiving higher incentives although they worked less.

Health Minister Mam Bunheng, however, said the SOA incentives were “working well” and salaries were unlikely to increase in the near future, as the minimum wage for government health workers had already been lifted to $200 per month in April.

“I don’t see it is high enough, but it is appropriate for now,” he said. “Our staff can earn more by undertaking extra functions, such as night duty.”

While Bunheng said that extra training was available for workers, Chum Sopha, executive director at Health and Development Alliance, said many did not apply because they could not afford it, and added that patients could be put at risk if staff were underpaid.