Reforming Cameroon’s health system so that it can deliver universal health coverage (UHC) has been one of the country’s top political priorities for a decade. In 2017, President Paul Biya underlined the country’s commitment to roll out UHC, supported by a number of initiatives.

One of the key initiatives was the establishment of a national, multisectoral Technical Working Group on UHC, consisting of directors from different ministries, civil society, and developing partners and co-chaired by the Minister of Public Health and the Minister of Labour and Social Security. The Group’s main objective was to develop a common vision and strategy to gradually achieve UHC in Cameroon.

However, several national stakeholders had different views of what was needed to achieve UHC. Some viewed it as establishing a national insurance system, while others either related it to the existing National Social Insurance Fund (CNPS) or thought it should be rolled out like any other disease-specific programs, for example for malaria, HIV and tuberculosis. In addition, some believed the UHC initiative couldn’t be implemented.

This confusion, along with the Cameroon’s complex political environment, including internal political power struggles and military conflicts, has led to a slower deployment of a UHC roadmap and, in some cases, a discontinuation of collaboration between developing partners, the P4H Focal Point (FP) and national partners.

“The implementation of UHC in Cameroon turns out to be more of a process than an event,” says Mr. Yannick Kouogueng, a member of the L4UHC team from Cameroon’s Ministry of Economy, Planning and Regional Development. “This is mainly due to external constraints such as financial issues, difficulties in coordinating the actions of different actors, and the inflexibility of others.”

Nevertheless, significant progress has been made to get things back on track, mainly thanks to improved communication. Impasses have been overcome through informal discussions among DPs and through conversations between attendees at L4UHC workshops. These interactions have helped restore relationships, tighten connections, build trust, and facilitate common understanding and openness to compromises.

As a result, in May of this year, Cameroon produced its first draft of its UHC strategic development plan with a final draft and a UHC roadmap expected within the next few months. 

There are still challenges ahead, however. The unpredictability and instability of systems within the country will continue to delay the achievement of goals and add complexity to the reaching of targets, while the existing global policies on UHC and health system strengthening will need to be harmonized for better transfer, adaptation and implementation within Cameroon.

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