Abstract
IntroductionCameroon is classified by the World Health Organization (WHO) as having a critical shortage of health personnel. This is further complicated by the geographic distributional inequalities of the national health workforce. This shortfall impedes Cameroons’ progress of improving the human resources for health (HRH) to meet up with the Millennium Development Goals (MDGs) by 2015. However, it is unknown whether the health workforce of Cameroon is distributed equally across geographic regions. Additionally, indicators other than population levels have not been used to measure health care needs. This study aimed to assess the adequacy, evenness of distribution and challenges faced by the health workforce across the different regions of Cameroon.MethodsNational health personnel availability and distribution were assessed by use of end-of-year census data for 2011 obtained from the MoPH data base. The inequalities and distribution of the workforce were estimated using Gini coefficient and Lorenz curve and linear regression was used to determine the relation between health personnel density and selected health outcomes. Alternative indicators to determine health care needs were illustrated using concentration curves.ResultsSignificant geographic inequalities in the availability of health workforce exist in Cameroon. Some regions have a higher number of physicians (per person) than others leading to poor health outcomes across the regions. 70 % of regions have a density of health personnel-to-population per 1,000 that is less than 1.5, implying acute shortage of health personnel. Poor working and living conditions, coupled with limited opportunities for career progress accounted for some documented 232 physicians and 205 nurses that migrated from the public sector. Significant distributional inequality was noticed when under-five infant mortality and malaria prevalence rate were used as indicators to measure health care needs.ConclusionOur results show an absolute shortage of public health personnel in Cameroon that is further complicated by the geographic distributional inequalities across the regions of the nation. Cameroon aims to achieve universal health coverage by 2035; to realize this objective, policies targeting training, recruitment, retention and effective deployment of motivated and supported health workforce as well as the development and improvement of health infrastructures remain the major challenge.
Highlights
Cameroon is classified by the World Health Organization (WHO) as having a critical shortage of health personnel
Significant geographic inequalities in the availability of health workforce exist in Cameroon
Our results show an absolute shortage of public health personnel in Cameroon that is further complicated by the geographic distributional inequalities across the regions of the nation
Summary
Cameroon is classified by the World Health Organization (WHO) as having a critical shortage of health personnel. For many low and middle-income countries to attain specific Millennium Development Goals (MDGs) pertaining to health, they need to reduce the shortages of trained, motivated and supported health workforce, as health personnel have a direct/indirect role in strengthening societal health that is strongly linked with sustainability of human and economic development [4]. This is more critical in the Sub-Saharan Africa (SSA), where the existing low densities in health workforce to population per 1,000, have further strained their ability to cope with increasing health crisis and disease burden as compared to other regions in the world [5]. One of the major constraints to this postulate has been limited in-country data on their HRH profiles, as most studies have focused themselves to the distribution of specific health cadres (physicians or nurses), [6,7,8,9]
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