Health Care In Cameroon Research Articles

Universal Access to Healthcare in Cameroon: Financing Sources

Purpose: The research aims to identify sustainable sources of funding the implementation of Universal Health Coverage (UHC) in Cameroon, in response to the current situation where households finance 70% of healthcare costs, and healthcare is largely unaffordable for many social groups. Material and Methods : The study used an exploratory qualitative approach in the Bangue Health District in the Littoral Region of Cameroon. Fifteen people participated in this study during ten days. Participants were selected using the purposive sampling method. Data were collected by means of a semi-structured interview guide. A general inductive approach was used to analyse the collected data. Findings: The main findings indicated that the identified funding sources are primarily based on local resources, including: 1) the State, through the budget allocated to healthcare; 2) the implementation of a health tax based on different sectors of activity; 3) contributions from the Diaspora; and 4) assistance from external and internal partners. Resource mobilisation could be carried out by decentralised government departments, with management overseen by an autonomous UHC body created for the project. Implications to Theory, Practice and Policy : Considering the findings, the State should : 1) Raise public awareness and provide training on UHC ; 2) Equip healthcare facilities with adequate human and material resources ; 3) Decentralise the structures for collecting UHC-related funds ; 4) Ensure the security of the collected funds to operationalise UHC effectively.

Prison health services across ten central prisons in Cameroon.

In 2021, Cameroon held approximately 26,300 inmates in 84 prisons. The Ministry of Justice manages health services in prisons. Conclusive data concerning health care in prisons are lacking. Herein, we present the results of an assessment of health care provision and delivery in 10 central prisons. We adopted mixed methods, including document review, observations, interviews with the Ministry of Justice and prison facility officials, and inmate focus group discussions (FGDs). The 6 building blocks of the World Health Organization's health system framework guided the data collection. Moreover, we collected data on imprisonment conditions. Ministerial authorisation and verbal informed consent were obtained for all activities. There were a total of 17,126 inmates, with the prison populations ranging from 353 inmates to 4,576 inmates. The majority of prisons were characterised by huge overcrowding (mean 301%). The 10 central prisons operated infirmaries with insufficient space and equipment. Compared with the civilian health sector, the numeric ratio of paramedical personnel/inmates was favourable (1:3.4 vs. 1:0.5 p. 1,000 pop, respectively). Recent admissions were screened for the coronavirus disease 2019, tuberculosis (TB), and human immunodeficiency virus (HIV). Moreover, the inmates were diagnosed for current pathologies and lesions. For the treatment of chronic diseases and medical emergencies, the prison health services bridged service gaps on a case-by-case basis through informal arrangements with the civilian health sector. The service quality control was limited to those performed by the TB and HIV/acquired immune deficiency syndrome control programmes. Health data was collected and transmitted with a multitude of data collection tools, without standardisation and systematic verification. The primarily reported problems comprised the scarcity of resources and the absence of an effective oversight of resource management and service quality performance entailing governance problems. Participants in FDGs esteemed the quality of treatment as poor unless paid for in cash, and denounced severe difficulties for access to care outside the prisons when required. For meeting the standard minimum rules for the treatment of inmates, prison health care in Cameroon should fill the crucial gaps involving imprisonment conditions, access to health services, and accountability. Regarding chronic underfunding, intensifying collaboration with the civil health sector may partially address the problem.

Methods of payment for oral health care in Yaoundé.

Payment for dental services is one of the key determinants of treatment options, access to health care, and treatment decisions. The ability to pay for services directly affects the quality of life of an individual and also their accessibility to oral health services. The aim of the present study was to identify the different methods of payment used to obtain oral health care in Yaoundé, Cameroon This was a cross-sectional descriptive study carried out in selected dental clinics in Yaoundé using convenient sampling between January 2021 and June 2021. Data was collected using a structured questionnaire. A total of 377 patients aged 8 to 83 years made up of 194 (51.46%) females and 183 (48.54%) males participated in the study. There is no government-assisted package for oral health care in Cameroon and more than two-thirds (66.84%) made direct payments or paid out of pocket without a refund from any insurance company. More than half 147 (58.33%) of the study population did not complete the planned dental care due to insufficient funds. Direct payments covered treatments such as scaling, restorations, root canal therapy, and dental extractions while prostheses (dentures, crowns, bridges, and implants) were only afforded by very few patients. The reasons for the inability to pay for dental services included financial difficulties 107 (72.97%) and lack of time 36 (24.49%). Only half 36 (50%) of the participants employed in the formal sector had access to health insurance and treatments like scaling, dental prosthesis, orthodontics, and dental implants were rarely provided by an insurance company. These procedures were considered to be very expensive with fluctuating prices and were viewed as being for aesthetic purposes. The majority 67 (93.06%) of payments through insurance reported being reimbursed aftercare. Two-thirds of 48 (71.64%) of the insured participants said it was difficult to get reimbursed due to the administrative bottlenecks and as such some preferred to pay out of pocket despite being insured. Late consultations encountered led to caries complications with 105 (52.24%) pulpitis. In general, financial difficulty was reported by 97 (48.26%) as the main reason for not being able to afford dental care. Oral diseases present a huge burden for children and adults due to the high cost of treatment limiting their accessibility and treatment options. There is a need to create compulsory health insurance to enhance greater access to oral health services to encourage the population to seek dental care timeously.

Evaluation of the Efficiency of Telemedicine in the Management of Cardiovascular Diseases in Primary Healthcare in Sub-Saharan Africa: A Medico-Economic Study in Cameroon.

To assess the efficiency of tele-expertise (tele-ECG) for patients and for health facilities in managing patients with cardiovascular diseases (CVDs) in primary health care in Cameroon. This study was a medico-economic study combining two approaches: cost minimization and cost-effectiveness analysis. It was conducted alongside the previous published controlled multicenter study carried out in Cameroon's two health facilities where tele-ECG has been implemented (intervention centres) and two other where telemedicine has been not implemented (control centres). The average total cost for patients was 9 286 F CFA (US$: 16) in the intervention centres compared to 28 357 F CFA (US$: 49) in the control centres (p <0.01). The calculated ICER favouring tele-ECG was 25 459.6 F CFA (US$: 44). Telemedicine is efficient for managing patients with CVDs in primary health care in Cameroon. It enables health facilities in remote areas to offer new healthcare services at a lower cost and improve patients' financial access to healthcare.

Redistributive effects of health care out-of-pocket payments in Cameroon

BackgroundThe bulk of health care financing in Cameroon is derived from out-of-pocket payments. Given that poverty is pervasive, with a third of the population living below the poverty line, health care financing from out-of-pocket payments is likely to have redistributive and equity effects. In addition, out-of-pocket payments on health care can limit the ability of households to afford non-healthcare goods and services.MethodThe study estimates the Kakwani index for analyzing tax progressivity and applies the model developed by Aronson, Johnson, and Lambert (1994) to measure the redistributive effects of health care financing using data from the 2014 Cameroon Household Survey. The estimated indexes measure the extent of the progressivity of health care payments and the reranking that results from the payments.ResultsThe results indicate that out-of-pocket payments for health care in Cameroon in 2014 represented a significant share of household prepayment income. The results also show some evidence of inequity as few people change ranks after payment despite the slight progressivity of health care out-of-pocket payments.ConclusionThe existence of some disparities among income groups implies that the burdens of ill-health and out-of-pocket payments are unequal. The detected disparities within income groups can be reduced by targeting low-income groups through increases in government expenditures on health care and pro-poor prioritization of the expenditures.

Evaluation of the Effectiveness of Telemedicine in the Management of Cardiovascular Diseases in Primary Health Care in Cameroon: An Interventional Study.

This study aimed to evaluate the effectiveness of tele-expertise (tele-ECG) in primary health care in Cameroon for the management of patients with cardiovascular diseases or risk factors. It is a controlled multicenter study carried out in Cameroon's two health facilities where tele-ECG has been implemented (intervention centers) and two other where telemedicine has been not implemented (control centers). Patients having cardiovascular risk factors or diseases received usual primary health care in the control centers. In contrast, they received usual primary health care and could perform an ECG associated with cardiologists' remote expertise (tele-ECG) in the intervention centers. The primary outcome was to evaluate the rate of patients' access to an ECG test and to cardiologist' expertise. Telemedicine is effective for the management of patients with cardiovascular diseases in primary health care. It could improve healthcare providers' clinical processes, clinical outcomes of patients and their satisfaction.

Professional collaboration for vision and healthcare in Cameroon

Professional collaboration is challenging when resources are minimal and communication is compromised, as is the case in many parts of Africa. In this article, a group of health professionals from the North-West Region of Cameroon report on efforts to improve within-profession, interprofessional and interorganisational collaboration in eye care services. The article describes what collaboration is in healthcare and how it benefits patients, professionals and health systems, using eye and vision care services as an example. Obstacles such as the absence of a coordinated eye care system and the lack of institutional support are described. Seven successful strategies to promote collaboration in this context are identified, and their applications in this context are described. These strategies are as follows: being committed to collaboration; being client-focused; supporting interprofessional and continuing education; embracing new technologies; building relationships between professional groups; building relationships with organisational administrators; and building relationships in healthcare systems. Three additional aspirational strategies are: developing regional healthcare programmes; developing professional and continuing education programmes; and developing collaborative patient and public education. By providing this open report, the authors aim to stimulate discussion about how collaboration and cooperation improve quality healthcare services and support professional career development.

The geographical accessibility as a key access parameter to health care in Cameroon: modelling, measurement and evaluation

Equal access to social infrastructure in general and access to health care in particular is at the centre of concerns in terms of spatial planning in each state. Obviously, the public health policy in most developing countries including Cameroon is strongly based on health care which does not allow at the present day an effective management health care supply. This situation, which results in unequal access to health care, is partially due to the lack of relevant information on the real needs of patients, in particular, the geographical accessibility to health infrastructures. The present study proposes a methodological approach to assessing spatial accessibility to health care. The application was based on digital data from the city of Yaoundé. The results obtained in the form of access times to various health centres show disparities in physical access to health care centres in Yaoundé city, which is important to take into account in decision-making.

Communication technologies and legitimate consumption: making sense of healthcare remittances in Cameroonian transnational relationships

AbstractResearch on the significance of the mobile phone and internet in transnational family relationships shows that these media provide direct platforms for negotiating remittances. My interest in this article is not so much in how they are used to coordinate and channel money home as in their appropriation to meet expectations of reciprocity. The article draws from field narratives collected among Cameroonians in Germany and in Cameroon to reveal contestations over what can be described as legitimate consumption within the Cameroonian transnational social sphere. Underlying the arguments in this article is my observation that direct communication within the Cameroonian transnational sphere is beset by so much mistrust, discontent and uncertainty that remitters must specify what they are remitting money for. Healthcare in Cameroon is considered an expenditure that is worthy of migrants' financial support.

Methanol Extracts of Medicinal Plants Used for Oral Healthcare in Cameroon

Background: Traditional healers in Cameroon are actively involved in oral healthcare and traditional herbs are used for management of oral diseases. However the analysis of phytoconstituents of medicinal plants used for oral healthcare in Cameroon has not been done. The objective of the study was to determine the phytoconstituents of medicinal plants used for oral healthcare in Cameroon. Methods: Samples of fresh plants used for dental treatment collected from South west and litorral regions of Cameroon that were free from diseases were obtained from the traditional healers.The plants were dried and the dried powder was macerated with intermediate stirring for 48 hours in methanol before filtering with Whattman filter paper. The filtrate was evaporated to dryness of solvent using the rotative evaporator in order to obtain the concentrated extracts of each plant sample. The plant extracts were then qualitatively tested for the presence of phytochemicals such as alkaloids, flavonoids, saponins, terpenoids, steroids and tannins using the standard procedures. Results: All the six (6) plants were found to be rich in at least one of the secondary metabolites. Steroids, terpenoids and flavonoids were found in all the plants samples. Alkaloids were present in Ageratum conyzoides and Carica papaya. Tannins were present in Ageratum conyzoides, Emilia coccinea, Gossypium sp and Carica papaya. Saponins were present in Ageratum conyzoides, Carica papaya and Momordica charantia. Phlobatannins was present in Emilia coccinea, Gossypium sp, Carica papaya and Spilanthes africana. Cardiac glycosides were present in Emilia coccinea, Carica papaya, and Momordica charantia. Carica papaya contained all these phytochemicals. Conclusion: This study revealed the presence of active secondary metabolites in herbs used for different dental treatment. The clinical trial of phytochemicals on the oral conditions is necessary to determine their pharmacological activity.

Using weight-for-age for predicting wasted children in Cameroon

IntroductionThe equipment for taking body weights (scales) are more frequently used in Cameroon health centres than measuring boards for heights. Even when the later exist there are some difficulties inherent in their qualities; thus the height measurement is not always available or accurate. Our objective for this study was to construct statistical models for predicting wasting from weight-for-age.Methods3742 children aged 0 to 59 months were enrolled in a cross-sectional household survey (2004 Cameroon Demographic and Health Surveys (DHS)) covering the entire Cameroon national territory.ResultsThere were highly significant association between underweight and wasting. For all discriminant statistical methods used, the test error rates (using an independent testing sample) were less than 5%; the Area Under Curve (AUC) using the Receiver Operating Characteristic (ROC) was 0.86.ConclusionThe study showed that weight-for-age can be used for accurately classifying a child whose wasting status is unknown. The result is useful in Cameroon as too often the height measurements may not be feasible, thus the need for estimating wasted children. This study provides baseline information that will help to design a preliminary pivotal study on an immediate nutrition intervention for acute undernutrition. Its complications that could lead to morbidity and mortality can be greatly reduced or set up a management control strategy that will go a long way in reducing the cost of health care in Cameroon.

Promoting the Culture of Evidence-Based Health Care in Cameroon

Taking their first steps towards evidence based healthcare with systematic review training in Cameroon

Decentralization of Access to Antiretroviral Therapy in Cameroon: Correlates of HIV Physicians’ Knowledge in HIV Care

Good knowledge in HIV care among physicians is a necessary prerequisite to effective antiretroviral therapy (ART) scaling-up in Sub-Saharan Africa. Between September 2006 and March 2007, a 27-item knowledge questionnaire was proposed to all HIV physicians working in 27 hospitals throughout six provinces of Cameroon. Physicians' responses were compared between the three levels of decentralization of the Cameroonian healthcare delivery system (χ(2) and Fisher tests). Correct responses were summed to build a knowledge score. Factors significantly associated with a higher score were identified using linear regression. In total, 93 physicians filled in the questionnaire. Level of knowledge was globally good (median score 23), with no significant difference between the three levels of decentralization. Gaps in knowledge were observed regarding the use of cotrimoxazole and the follow-up of ART-treated patients. Main factors independently associated with a higher knowledge score included training, involvement in therapeutic committees, satisfactory collaboration with other practitioners and establishment of strong relationships between patients and patients' associations. Overall knowledge in HIV care is good among HIV physicians working at all three levels of decentralization of healthcare in Cameroon. However, a national training policy should be set up to improve knowledge and practices in both ART follow-up and specific situations such as paediatric HIV. Collaboration between caregivers and external resources involved in HIV care should also be encouraged.

Primary health care in Cameroon: evolution, key short-comings and proposed strategies for improvement.

Primary health care in Cameroon: evolution, key short-comings and proposed strategies for improvement.

Evidence-based reproductive health care in Cameroon: population-based study of awareness, use and barriers.

To estimate the prevalence of awareness and use of evidence-based reproductive health interventions and to describe the barriers associated with the use of evidence-based interventions among health providers in north-west Cameroon. In February 2004, a population-based descriptive study of the awareness and use of 13 evidence-based interventions targeted health workers providing reproductive health care. Their awareness and use of a composite of four vital interventions was also evaluated. These were peripartum use of antiretrovirals to prevent transmission of HIV, antenatal corticosteroid administration, magnesium sulfate prophylaxis and active management of placental delivery with uterotonics. In-depth interviews with key informants were conducted as part of a qualitative substudy to discover the barriers to the use of evidence-based interventions. Overall, 91.4% (328/359) of reproductive health workers were surveyed. Their awareness of evidence-based interventions varied from 29% for the use of antenatal corticosteroids to 97% for the use of iron and folic acid supplementation during pregnancy. Their use of these interventions ranged from 10.2% for antenatal corticosteroids to 94.8% for iron and folic acid supplementation. Only 50/322 (15.5%; 95% confidence interval (CI)=11.8-20.0) of health workers were aware of all four vital interventions, and only 12/312 (3.8%; 95% CI=2.0- 6.6) reported using all of them regularly. A total of 26 key informants participated in the qualitative substudy. A deficiency in the education and training of health workers, especially a lack of continuing education, was commonly identified as the most important barrier to their awareness of evidence-based practices. A lack of awareness and a lack of supplies and materials were the main barriers to practice. The awareness and practice of important evidence-based reproductive health interventions were less than optimal. To improve maternal and perinatal outcomes both remedial programmes to enhance awareness, including continuing education for health workers, and the provision of necessary supplies are needed.

The reorientation of primary health care in Cameroon: rationale, obstacles and constraints

The reorientation of primary health care (PHC) that was begun in Cameroon in 1989 is presented as a natural response to the economic and health environments prevailing at that time. A brief discussion of the original PHC policy introduced following the Alma-Ata declaration identifies a lack of effective communication between the community and the health services as a major problem. The basic elements of the reorientation are presented and the obstacles and constraints encountered since beginning the reform process in 1989 are described. These have been identified as: an inadequate legal framework; incompatibilities between the political structure and the new health structure; incompatibilities between the goals of the new health policy and the organizational chart of the Ministry of Health; the lack of trained personnel in health management; a highly centralized system of management with poor coordination of human resource management; the slowness of the extension of PHC coverage; the inability of the system to ensure that medicines are available and easily accessible; an inadequate health information system; poor promotion of the new PHC policy; and poor coordination of research activities.

The secondary importance of primary health care in South Cameroon.

Primary health care in Cameroon meets with serious obstacles. The state gives it a low priority in its budget and over-all policy. The health institutions are rarely active in this field. Institutions which do practice some primary health care are usually foreign. The villagers, finally, are little interested. They insist only on improvement of curative services and material life conditions. The conclusion is that primary health care is regarded as something of secondary importance. First comes a better life. The research for this paper was conducted in 1980 in the South of Cameroon.