By Regina Sinsai
On May 25th, 2024, we marked yet another Global Surgery Day. Because Global Surgery is a fundamental component of health care delivery, recognizing the current situation of surgery in Cameroon is important. In Cameroon, access to surgery appears to be a luxury for many, and the thought of safe surgery is foreign to some. The multifaceted deficiencies in the Cameroonian healthcare system, which are reflective of the reality in many low- and middle-income countries (LMIC), contribute to fueling this sentiment and highlight the palpable equity gaps in access to surgical care. As such, several factors contribute to limiting equitable access to surgical services in Cameroon, including cultural and religious beliefs, inadequate infrastructure, limited availability of essential equipment and supplies, and low pay.
The sudden, unexpected incidence of a health condition with surgical indication exposes the inadequacies in the healthcare system even more and exposes patients to even more dire outcomes. This is the case of surgical emergencies arising from road traffic accidents. In such situations, universal health coverage and other insurance schemes may be the only guarantors of access to required critical care, without which exorbitant out-of-pocket payments, limited financial resources, and other bottlenecks may delay or even completely restrict access to treatment for victims. The population of motorbike riders in Cameroon is ever-expanding [1] and the incidence of road traffic accidents requiring surgical interventions is also on the rise, contributing significantly to the overall burden of RTA in Cameroon [2,3]. According to WHO estimates, over 16,500 accidents occur each year in Cameroon, killing over 6,000 people [4] and leaving thousands, physically, mentally, and financially disabled.
Currently, only a small proportion of Cameroonians have access to health care insurance, and many are unaware of its existence [5]. With less than 2% of the population insured, the financial burden can be overwhelming [6]. In April 2023, Cameroon announced a significant milestone in the healthcare system by launching Phase 1 of Universal Health Coverage, which is currently being implemented in 5 of the 10 regions [7]. The main beneficiaries include pregnant women, children under 5 years of age, HIV-infected patients, and individuals with renal incompetence. Unfortunately, only one of these offers a surgical component that is greatly subsidized. In the packages for pregnant women, instead of paying over 80,000 FCFA for a cesarean section, benefactors pay a staggering 42,000 FCFA, which may be considered affordable in cities and larger towns but expensive in less developed regions like the Far North Region, which is one of the poorest regions in the country.
Other surgical care components remain neglected in Cameroon’s UHC packages. This leads community members to seek services from traditional healers or alternative medicine, which can sometimes aggravate the situation by causing infections or more serious complications.
The catastrophic nature of surgical emergencies resulting from road traffic accidents makes this group of emergencies one of the most indicated for Universal Health Coverage. More effort is needed by diverse stakeholders, including transport syndicates, administrators, policymakers, and healthcare workers, to advocate for timely free access to basic surgical care for victims of road traffic accidents. The Cameroonian government still faces the challenge of meeting its engagement taken alongside other nations in 2001 in Abuja, where pledges were made by heads of states to set their annual health sector budget to 15 % of the annual state budget. This step alone, or even significant steps in this direction, will significantly increase access to care for vulnerable groups like road traffic accident victims requiring surgical care.
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