Stratégie Sectorielle de Santé 2016-2027

Objectives

Cameroon’s 2016–2027 Health Sector Strategy seeks to improve population health through equitable, sustainable universal access to integrated, quality health services, with full community participation in health management. It supports Cameroon Vision 2035, the Growth and Employment Strategy, and health-related Sustainable Development Goals.[1][2][3]The strategy is designed to develop healthy and productive human capital through coherent, effective and efficient health-sector interventions.[4][5]

• Promote health and prevent disease through action on healthy behaviours, nutrition, hygiene, sanitation, safe water, environmental health, physical activity, tobacco and alcohol control, road safety, reproductive health and family planning.[6][7][8][9][10]
• Reduce maternal, newborn, infant and under-five mortality, including reducing maternal mortality from 782 to 350 per 100,000 live births, neonatal mortality from 28 to 17 per 1,000, and under-five mortality from 103 to 62 per 1,000 by 2027.[11]
• Reduce the incidence or prevalence of major communicable diseases, including HIV, malaria and tuberculosis, by at least 30% by 2027; eliminate specified neglected tropical diseases; increase high-impact prevention coverage by at least 80%; and reduce the prevalence of major non-communicable diseases by at least 10%.[12][13][14]
• Provide standards-based comprehensive maternal, newborn, child and adolescent care in at least 80% of facilities, while improving diagnosis and management of communicable diseases, non-communicable diseases, emergencies, impairments and disabilities.[15][16][17][18]
• Strengthen health-system performance, including geographic, financial and cultural access; essential service packages; quality improvement; human resources; essential medicines and health products; health information; operational research; regulation; and strategic governance.[1][3][19][20]
• Improve financial protection by reducing household direct payments for health services by at least 30% by 2027, increasing the availability and use of medicines and other health products by 50%, and improving the availability of human resources according to prioritised needs in at least 80% of relevant areas.[21][22]
• Advance equity by addressing persistent geographic and socioeconomic disparities in access to health and other basic services, particularly between rural and urban areas and in the Far North and East regions.[23]

Implementation

The strategy adopts an integrated, decentralised, multisectoral and community-participatory approach, combining essential service packages, disease-specific interventions, health-system reform and collaboration with related sectors.[1][2][3]Implementation is organised across national, regional and district levels, with the Ministry of Public Health leading national health-policy implementation and decentralised local authorities developing and implementing operational health-development plans.[24][25]

• Deliver prevention and care through health facilities, communities, schools, laboratories, hospitals, health districts, local authorities, civil-society organisations, private providers and related public administrations.[26][8][27][28]
• Strengthen community health through dialogue structures, co-financing, co-management, community participation, community-health-worker regulation, leader training and technical assistance to communities.[26][29][30]
• Implement disease-control measures through integrated prevention, diagnosis, treatment and surveillance, including malaria vector control, antenatal preventive treatment, vaccination, laboratory networks, rapid-response teams, border health posts, risk mapping and a One Health approach.[14][27][28]
• Improve service delivery through referral and counter-referral tools, patient-transfer logistics, facility development plans, infrastructure standards, centralised procurement where appropriate, quality standards, accreditation and periodic performance assessments.[31][32][33]
• Reform financing by developing risk-sharing mechanisms, rationalising existing financing arrangements, mobilising domestic and international resources, strengthening facility management autonomy, establishing an integrated financial-information system and developing a national health-financing strategy.[22][25][34]
• Coordinate implementation through an interministerial committee under the Prime Minister, a Steering and Monitoring Committee, a Technical Monitoring Committee chaired by the Secretary-General of the Ministry of Public Health, regional coordination arrangements and a technical secretariat.[24][35][36][37]
• Engage government departments, public institutions, professional bodies, municipalities, civil society, private-sector actors, technical and financial partners and communities through a national compact aligned with the International Health Partnership.[38][39][37]
• Use multi-year action plans, monitoring matrices, surveys, supervision and a strategic results framework to assess resource mobilisation, implementation of the five strategy components, progress against indicators and implementation gaps.[25][34]
• Conduct six-monthly implementation surveillance, systematic six-monthly and annual reviews, a mid-term evaluation after 72 months, and a final evaluation in 2028; undertake technical, financial and accounting audits, controls and inspections, particularly during early implementation.[38][34]
• Strengthen the National Health Information System through harmonised indicators and collection tools, integrated data management, a continuously accessible data bank, computerisation and improved use of evidence for decisions.[19][20]
• Manage implementation risks proactively by identifying structural and organisational bottlenecks and integrating risk management throughout strategy delivery.[40]

Monitoring & Evaluation

The strategy establishes a multi-level monitoring and evaluation system combining implementation surveillance, routine supervision, reviews, audits, performance assessment and periodic evaluations. It responds to shortcomings in the preceding strategy, including the lack of an integrated monitoring and evaluation plan, incomplete baselines and targets, fragmented information systems, weak financial tracking and limited accountability.[41][42][43]

• Monitor implementation through national, regional and district steering and coordination structures, including an interministerial committee, the Steering and Monitoring Committee, a Technical Monitoring Committee, regional bodies and a technical secretariat.[24][35][37]
• Conduct six-monthly implementation surveillance, annual and thematic reviews, a mid-term evaluation after 72 months, and a final evaluation in 2028; use findings to adjust implementation and inform a subsequent strategy.[38][34]
• Report progress through standardised templates and annual performance reports submitted by the Minister of Public Health to Government.[38][25]
• Assess performance against a strategic results framework covering resource mobilisation and allocation, delivery of the five strategy components, indicator-based progress towards objectives and implementation gaps.[25][34]
• Track outcome targets including reduced maternal, neonatal and under-five mortality; improved service availability; reduced household direct payments; increased availability of medicines and health workers; disease reduction; intervention coverage; and implementation of 95% of strategy objectives.[11][13][22]
• Use verification sources including Demographic and Health Surveys, Multiple Indicator Cluster Surveys, Service Availability and Readiness Assessments, emergency obstetric and neonatal care surveys, hospital studies, household surveys and National AIDS Control Committee reports.[44][11]
• Strengthen the National Health Information System through harmonised indicators and tools, integrated data management, a permanent data bank, improved data use and disaggregated regional and district data.[45][20]
• Reinforce surveillance, including epidemic notification, risk mapping, laboratory networks, border health posts and a legal framework for surveillance of diseases and public-health events.[27][28]
• Undertake technical, financial and accounting audits, controls and inspections, and strengthen follow-up of recommendations, social control and beneficiary feedback mechanisms.[38][46][47]

Despite these arrangements, the supplied extracts do not provide a single complete indicator matrix, full indicator definitions, a consolidated reporting calendar, detailed surveillance protocol or quantified accountability sanctions.[6][11][24]

Costing & Financing

The 2016–2027 strategic areas are costed at 5,824 billion Central African CFA francs, with an estimated annual average of 485 billion Central African CFA francs. A projected financing gap of 594 billion Central African CFA francs is identified for the period, averaging approximately 50 billion Central African CFA francs annually.[48][49]

• Allocate 362.8 billion Central African CFA francs to health promotion, 682.2 billion to disease prevention, 1,385.6 billion to curative case management, 3,101.6 billion to health-system strengthening, and 291.9 billion to strategic stewardship and governance.[48]
• Mobilise domestic resources, improve efficiency and rational use of existing resources, develop risk-sharing arrangements and prepare a national health-financing strategy.[48][22][34]
• Reduce household direct payments for health services by at least 30% by 2027, while developing prepayment mechanisms based on national solidarity, universality, compulsory affiliation and State responsibility.[22][34]
• Improve decentralised financial management by assigning adequate credits to devolved structures, linking operational plans and budgets to sector priorities, and monitoring budget execution.[31][47]
• Align technical and financial partners with national financial-management procedures, harmonise partner procedures and use financial dialogue to identify additional financing opportunities and address gaps.[22][50][39]
• Increase State financing towards the Abuja benchmark of allocating 15% of the national budget to health, while recognising that public financing has remained below this reference point.[51][36]
• Address fragmented financing, high direct household payments, uncertain external support and incomplete information on contributions from private providers, decentralised administrations and partners.[52][53][54]
• Support infrastructure investment, including the three-year National Emergency Plan budget envelope of 925 billion Central African CFA francs and 120 billion Central African CFA francs for construction and equipment of Regional Hospital Centres.[23]

Other explicit expenditure references include 13.6 billion Central African CFA francs for disease prevention in 2011, a State subsidy of 105,000 Central African CFA francs per haemodialysis session alongside a patient contribution of 5,000 Central African CFA francs, and diabetes-treatment costs that could reach one million Central African CFA francs per month during initiation.[55][56]The extracts do not provide a complete activity-level financing plan, expenditure ceilings, confirmed external commitments or detailed economic assumptions.[48][49]