PRIMASYS: Abridged case study from Cameroon

Overview

PHC performance in Cameroon is below expectations when compared to the current health expenditure, mostly because of growing privatization, the weak regulatory system and lack of accountability. Cameroon has one of the highest levels of health care expenditure occurring in the informal sector (up to 30%, mostly in PHC). User fees are usually charged at the point of use, except for some services for specific population groups. Up to 66% of health expenditure is out-of-pocket payments. The maternal mortality ratio has increased in Cameroon during the last 20 years, despite the increasing annual per capita health expenditure, which reached US$ 59 in 2015. Growing privatization has led to a low servicing rate for health districts, particularly in rural areas, and there are stark inequalities in the distribution of human resources.

This case study was developed by the Alliance for Health Policy and Systems Research, an international partnership hosted by the World Health Organization, as part of the Primary Health Care Systems (PRIMASYS) initiative. PRIMASYS is funded by the Bill & Melinda Gates Foundation, and aims to advance the science of primary health care in low- and middle-income countries in order to support interventions worldwide. The PRIMASYS case studies cover key aspects of primary health care systems, including policy development of care, governance and organization, and monitoring and evaluation of system performance. The Alliance has developed full and abridged versions of the 20 PRIMASYS case studies. The abridged version provides an overview of the primary health care system, tailored to a primary audience of policy-makers and global health stakeholders interested in understanding the key entry points to strengthen primary health care systems. The comprehensive case study provides an in-depth assessment of the system for an audience of researchers and stakeholders who wish to gain deeper insight into the determinants and performance of primary health care systems in selected low- and middle-income countries.