Cameroon - Health - Phase 1 of Universal Health Coverage

Instructed since 2015 by the Head of State, Universal Health Coverage (UHC) officially entered its first phase on April 12, 2023. Cameroonians in possession of a Universal Health Card will eventually be entitled to free preventive care and essential health services.

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From conception to materialization, phase 1 of the CSU is today one of the strongest socio-political revolutions to the credit of the Cameroonian government.

Its careful implementation should significantly reduce inequalities in access to care, while ensuring patient dignity. Even the most vulnerable groups will now be able to benefit from high-quality care at a lower cost within a reasonable timeframe, by 2030. The implementation of UHC is therefore a decisive step.

Due to the lack of universal health coverage, Cameroonian households pay nearly 751,000 pounds for their own care. To contribute to the development of healthy, productive human capital capable of driving strong, inclusive, and sustainable growth, the authorities intend to guarantee equitable and universal access to basic health services and care, as well as high-quality priority specialized care, for all segments of the population.

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Universal Health Coverage, in its first phase, primarily targets children under 5, pregnant women, and people of all ages suffering from conditions such as kidney failure, tuberculosis, and HIV. The health care basket covers preventive, promotional, and curative aspects. This base will continue to expand to cover the entire population by 2030. Analysts from the Camercap think tank have estimated the resources needed to finance UHC at 1,400 billion CFA francs. The breakdown of this envelope calls for state support of up to 1,000 billion CFA francs, 350 billion CFA francs—or a third—for households through contributions, while donor promises amount to 50 billion CFA francs. Aside from direct contributions from individuals, additional resources should be found through funding niches that can provide new impetus to finance the expected contribution from the state. Thus, innovative approaches to financing UHC are: social transfers and the social safety net program, including the unconditional direct ordinary cash transfer program with accompanying measures; the emergency cash transfer program, the Covid-19 emergency cash transfer program, and the labor-intensive public works program. These institutional instruments can be implemented with a restructuring that optimizes the state's contribution.

Since 1993, Cameroonian law has required public institutions providing primary medical care to contribute 10% of their monthly revenue to the Health Solidarity Fund. This fund, which should be under the responsibility of the Ministry of Public Health, must be more traceable to ensure its effective contribution to the UHC objective.

At the same time, it is necessary to secure agricultural incomes to protect rural populations from poverty, to focus on prevention and fines for traffic violations, to introduce taxes on alcohol and tobacco and to improve hygiene and the cleanliness of homes.