German-Cameroonian Health Sector Programme (PGCSS)
Title: Health Sector Programme
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Lead executing agency: Ministry of Public Health (MINSANTE)
Overall term: 2002 to 2014
Cameroon’s health indicators are on a similar level to those of significantly poorer countries. Health care is insufficient in terms of quality as well as being inefficient and too expensive, particularly for poor and vulnerable sectors of the population. As a result, there is a high morbidity and mortality rate among the population and the danger of sliding into absolute poverty in the event of illness.
The population, particularly poor and vulnerable groups, have improved access to high-quality health care.
Coordination of the reform measures with all involved. The programme advises Cameroon’s Ministry of Public Health as it develops a so-called Sector-Wide Approach (SWAp) to coordinate the reform measures with all involved. Together with other technical and financial partners and with civil society organisations, the programme supports the establishment of a framework for political discussion between the Ministry of Public Health and other ministries concerned.
Participation of the local population in health facility management. Building on the success of the Regional Funds for health promotion in three pilot regions of Cameroon, the Ministry of Public Health has decided to extend the Regional Fund model to the whole of the country. In this connection, the programme is helping to strengthen dialogue structures through information, mobilisation and awareness-raising campaigns with local authorities, associations and the public. It also cooperates with the Agence Française de Développement (AFD), World Bank and KfW Development Bank to contribute to transforming the Regional Medicine Provision Centres (CAPR) into Regional Funds.
Combating tuberculosis and HIV/AIDS. The programme contributes to combating tuberculosis and HIV/AIDs through a series of measures:
- Since 2005, the programme has been supporting the national tuberculosis control programme for early diagnosis of multi-drug resistant tuberculosis and for the introduction of a new, shorter treatment regimen.
- It supports the activities organised by the Ministry of Justice for awareness-raising and for the prevention and diagnosis of HIV/AIDS and tuberculosis in ten prisons.
- The programme organises prevention and test campaigns on HIV/AIDS for young mothers. Awareness-raising campaigns have been organised throughout the country against incest, rape and so-called breast ironing, a practice aimed at stopping girls’ breast growth.
- The programme assumes the costs of treating people infected with HIV in three regions (Northwest, Southwest and Littoral).
Results achieved so far
Structural improvements in the framework conditions have been achieved in the health sector through the nation-wide introduction of the Regional Funds. These improvements are already being reflected in the health indicators in the areas in which the three Regional Funds are being employed. Civic participation has resulted in greater transparency in the medicine sector, which is particularly prone to corruption. At the same time, autonomous financing of the dialogue structures has been secured. In this regard, the health sector is to be seen as a pioneer in the areas of decentralisation and the structured combating of corruption.
As a result of the HIV/tuberculosis control measures in prisons, 96 per cent of new inmates underwent a medical examination in 2012 (a total of 10,211 people). In the same year, 82 per cent of the inmates used the available voluntary HIV test upon admission. Depending on the result, the inmates are given preventive or therapeutic treatment during their period of imprisonment. In the seven prisons for which data have been available since 2008, the general mortality rate of prisoners has fallen by nearly 75 per cent, from 21.9/1000 in 2008 to 5.7/1000 in 2012.