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Health Sector Strategy 2016-2027

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Health Sector Strategy 2016-2027 HEALTH SECTOR STRATEGY 2016-2027 i ii CAMEROON MAP Some indicators on the country's socio-economic and health situation General data Surface Area 475 650 km2 Official languages French, English Currency FCFA Socio-demographic indicators macro-economic indicators (2013) Total estimated population 21 143 million Nominal GDP FCFA 14 607 billion Population growth rate 2.6% Per capita GDP F CFA 696 000 Poverty rate 37.5% (in 2014) GDP growth rate 5.6% Gross unemployment rate 5.7% (in 2010) Investment expenditures FCFA 1 053.3 Billion Underemployment rate 70% Overall budgetary resources FCFA 2 655.3 billion Lifespan at birth 54 years Indebtedness rate 10.6% Inflation rate 2.1% Health indicators (MICS 2014, sic) Access to improved water points 72.9% (households) Access to improved toilets 34.9% (households) HIV prevalence 4.3% (EDS-2011) DTC3 coverage rate 79.3% Unmet needs in FP 34.3% Infant and child mortality rate 103‰ BP urban prevalence 29.7% (Kingue et al. 2015) Chronic malnutrition rate 31.7% Maternal mortality rate 782 deaths/100 000 live births (EDS, 2011) Source: INS, BUCREP, MINFI s.i.c: unless otherwise specified iii TECHNICAL DRAFTING COMMITTEE General Coordination: - Mr André MAMA FOUDA Minister of Public Health - Mr Alim HAYATOU Secretary of State for Public Health General Supervision: - Prof. Sinata KOULLA-SHIRO Secretary General of the Ministry of Public Health Technical Supervision - Prof. Samuel KINGUE Technical Adviser No. 3, Vice-Chairman of TWG Technical Coordination: - Dr. MATSEZOU Jacqueline Coordinator of the Technical Secretariat of the Steering Committee and monitoring of the implementation of the Health Sector Strategy (TS/SC-HSS) Members of the Secretariat: - Dr. NZIMA NZIMA Valery Public Health Expert TS/SC-HSS - Mr. NDOUGSA ETOUNDI Guy Officer at TS/SC-HSS - Mr. MFOUAPON NJOUOMSHETKU Henock Computer engineer iv INTRODUCTION The ambition set out in the Growth and Employment Strategy Paper (GESP) to build an emerging Cameroon by 2035 highlighted the need to implement sector strategies for a successful implementation of this reference document. These strategies make it possible to identify the main areas where the interventions of public institutions should be oriented. In the area of health, the existence of an adapted sector strategy is clearly shown when the plurality of actions to be carried out by the various stakeholders involved requires coherence and synergy. The 2001-2015 Health Sector Strategy enabled to get significant results in terms of improved coverage of some interventions. In spite of the progress made, there are still a number of challenges to be met in order to achieve universal access to quality health care. On 12 December 2012, the General Assembly of the United Nations adopted Resolution A/67/L.36 for universal health coverage. This resolution calls upon Member States to adopt a multi-sector approach and address the determinants of health per sector, integrating health into all policies, as appropriate, while taking into account its social, environmental and economic determinants in order to reduce inequalities in this area and to promote sustainable development. In his seven-year programme on "Great achievements" published in 2011, His Excellency Paul BIYA, President of the Republic of Cameroon and Head of State, prescribed this universal health coverage to the Government as a salutary goal to be achieved. Hence, in 2001 he gave instructions to work for the establishment of "a medical assistance system that would leave no Cameroonian without care, whatever the social stratum". The year 2015 served as a transition between the Millennium Development Goals (MDGs) set in 2000 and the Sustainable Development Goals (SDGs), which aim to induce inclusive and sustainable development in the countries. The third objective aims to reduce maternal and child v mortality, to eradicate epidemics related to major communicable diseases, and to reduce early mortality due to non-communicable diseases, by 2030; This should be done through universal access to health care and services, the promotion of healthy behaviours and the development of healthy environments. The 2016-2027 HSS falls within a twofold perspective: on the one hand, contributing to accelerate the development of human capital for growth and sustainable development in line with the indications and recommendations of the GESP and, on the other hand, aligning with the Sustainable Development Goals by accelerating the implementation of universal health coverage. The implementation of the strategy will be carried out in a favourable national context characterized by: i. The implementation of the 2015-2017 Triennial Emergency Plan (PLANUT), which includes the construction and rehabilitation of referral hospitals in all regions of the country, as well as the development of basic social infrastructure; ii. Innovative health financing initiatives such as Performance Based Financing (PBF), health cheques, obstetric kits, Value for Results, etc. ; iii. Major structural projects which will improve the well-being of populations through infrastructure and new jobs, if environmental risks are contained; iv. The evolution towards decentralization of social policies, which will further promote the involvement of communities in solving their health problems; v. High literacy rate which promotes the understanding of health messages and the adoption of healthy behaviours; vi. The new financial regime of the State which allocates the budget programme as a budgetary framework modality, and guarantees more visibility in the medium term. At the end of a thorough analysis based on data and conclusive indicators from our health profile, the strategic option which sets out the guidelines for our health sector strategy for the next twelve years has been adopted. It brings together two major healthcare approaches, namely: the Primary Health Care approach, whose impact on the beneficiaries is no longer to be demonstrated, and the more complex specialized care approach, whose service provision will considerably increase through the implementation of the Head of vi State's Triennial Emergency Plan (PLANUT). It will therefore be necessary to seek the right balance between these two approaches during the validity period of this strategy. Finally, the concern of providing appropriate solutions to the health problems identified during the situation analysis of our health context, the possibility for their effective implementation as well as the certainty of having chosen the most responsive option to population health problems, in turn reinforced the choice of this strategic option. This Health Sector Strategy is therefore the reference document for stakeholders of the health sector. They will work together to achieve the Goals of the GESP and the SDGs. I therefore urge all of them to make good use of it and contribute in its effective implementation. vii viii ACKNOWLEDGEMENTS On behalf of the Cameroon Government, I would like to warmly congratulate and thank the officials of the Ministry of Public Health and those from partner Ministries, Technical and Financial Partners, members of the Technical Working Group, those of the Steering Committee, Civil Society Organizations and all the experts who relentlessly contributed in the development of this area of the Health Sector. ix x TABLE OF CONTENTS INTRODUCTION ...................................................................................................................................................... v ACKNOWLEDGEMENTS ......................................................................................................................................... ix LIST OF TABLES AND FIGURES .............................................................................................................................. xiii ABBREVIATIONS AND ACRONYMS ...................................................................................................................... xiv EXECUTIVE SUMMARY ......................................................................................................................................... 16 Chapter 1: GLOBAL BACKGROUND OF THE HEALTH SECTOR ................................................................................ 29 1.1 General information on Cameroon ..................................................................................................................... 29 1.2 Political and Administrative organization ............................................................................................................ 29 1.3 Economic and social situation ............................................................................................................................. 30 1.3.1 Macroeconomic situation ............................................................................................................................ 30 1.3.2 Demographic situation and Population policy ............................................................................................. 30 1.3.3 Social situation ............................................................................................................................................. 30 1.3.4 Equity and social justice in health ................................................................................................................ 31 1.3.5 Humanitarian and Security context ............................................................................................................. 31 1.4 Communication channels
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