[Urban malaria in Yaounde (Cameroon). 2. Entomologic study in 2 suburban districts].

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Fondjo, E; Robert, V; Le Goff, G; Toto, J C; Carnevale, P

1992-01-01

A one year entomological survey was carried out to precise the malaria vectors and the malaria transmission in Yaounde, the Cameroon capital (800,000 inhabitants). The study was done in two districts not yet fully urbanized: Nkol Bikok and Nkol Bisson. The latter is located at the periphery and has a pool. Anopheles gambiae was the only human malaria vector. Its agressivity for man depended on the urbanization of the district. Annual man biting rate was 284 in Nkol Bikok and 1,813 in Nkol Bisson. The densities were maximum in May-June and in October-November, corresponding to the end of the short and long rainy seasons. The presence of A. gambiae was permanent except in August-September in Nkol Bikok. In Nkol Bisson the density was higher in the houses near the pool. The yearly inoculation rate (h) was 14 in Nkol Bikok and 30 in Nkol Bisson. The vectorial transmission was observed in may in Nkol Bikok and during four months (June, August, January, February) in Nkol Bisson. These entomological data showed clearly that malaria transmission actually occurred in Yaounde and that the probability to receive at least one infected anopheline bite per year was very near to 1 for inhabitants unprotected against mosquito bites.

Cameroon mid-level providers offer a promising public health dentistry model

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Achembong Leo

2012-11-01

Full Text Available Background Oral health services are inadequate and unevenly distributed in many developing countries, particularly those in sub-Saharan Africa. Rural areas in these countries and poorer sections of the population in urban areas often do not have access to oral health services mainly because of a significant shortage of dentists and the high costs of care. We reviewed Cameroon’s experience with deploying a mid-level cadre of oral health professionals and the feasibility of establishing a more formal and predictable role for these health workers. We anticipate that a task-shifting approach in the provision of dental care will significantly improve the uneven distribution of oral health services particularly in the rural areas of Cameroon, which is currently served by only 3% of the total number of dentists. Methods The setting of this study was the Cameroon Baptist Convention Health Board (BCHB, which has four dentists and 42 mid-level providers. De-identified data were collected manually from the registries of 10 Baptist Convention clinics located in six of Cameroon’s 10 regions and then entered into an Excel format before importing into STATA. A retrospective abstraction of all entries for patient visits starting October 2010, and going back in time until 1500 visits were extracted from each clinic. Results This study showed that mid-level providers in BCHB clinics are offering a full scope of dental work across the 10 clinics, with the exception of treatment for major facial injuries. Mid-level providers alone performed 93.5% of all extractions, 87.5% of all fillings, 96.5% of all root canals, 97.5% of all cleanings, and 98.1% of all dentures. The dentists also typically played a teaching role in training the mid-level providers. Conclusions The Ministry of Health in Cameroon has an opportunity to learn from the BCHB model to expand access to oral health care across the country. This study shows the benefits of using a simple, workable, low

Determination of the predictive factors of long-lasting insecticide-treated net ownership and utilisation in the Bamenda Health District of Cameroon

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Eric B. Fokam

2017-03-01

Full Text Available Abstract Background Malaria is a serious health concern in Africa. In Cameroon, an endemic country where malaria remains a major public health problem, several control measures have been put in place among which the use of insecticide-treated bednets (LLINs/ITNs is considered one of the core vector control strategies. However, the greatest challenges include ownership and utilisation by individuals and households. Factors such as age, marital status, gender, education and occupation of the household head, household size, knowledge of bednets, socioeconomic status, and environmental factors have been suggested to have an impact on bednet ownership and utilisation in different settings. The present study sought to determine bednet ownership and utilisation rates and to assess the impact of predictive factors on bednet ownership and use in the Bamenda Health District (BHD of Cameroon. Methods A cross-sectional study involving 384 households was conducted in six health areas in the BHD. A structured and semi-structured questionnaire was used to collect data on demographic and household characteristics as well as information on their bednet ownership and utilisation. Descriptive statistics, bivariate and multivariate logistic regression analysis were performed. Results Frequency of bednet ownership was relatively high (63.5% with LLINs being most abundant (91.9%; the majority of households (87.7% obtained their bednets during the 2011 free distribution campaign. Utilisation was relatively high (69.3%, with negligence (29.3% and heat discomfort (26.7% accounting most for non-usage of bednets. Children less than 5 years (63% and pregnant women (60% most often used these nets. Households headed by a married couple, those with older household heads, household with smaller size (5–12 persons, and knowledge of bednets (good knowledge had positive impacts on bednet ownership (p < 0.05. The gender of the household head (males, their educational level

Community knowledge, perceptions and attitudes regarding leprosy in rural Cameroon: The case of Ekondotiti and Mbonge health districts in the South-west Region

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Nsagha, Dickson Shey; Bissek, Anne-Cécile Zoung-Kanyi; Njamnshi, Theophilus Ngeh; Njih, Irine Ngani-Nformi; Pluschke, Gerd; Njamnshi, Alfred Kongnyu

2018-01-01

Background Although leprosy is one of the oldest diseases known to humanity, it remains largely misunderstood. Misconceptions about leprosy lead to stigma towards people with the disease. This study aimed at exploring the knowledge, perceptions and attitudes regarding leprosy in rural Cameroon. Methods We carried out a cross-sectional community survey of 233 respondents aged 15–75 years, free from leprosy, and living in two rural health districts of the South-west Region of Cameroon. A questionnaire designed to evaluate knowledge, perceptions and attitudes about leprosy was used. Binary logistic regression was used to determine independent predictors of negative attitudes. Results About 82% of respondents had heard about, and 64.4% knew someone with leprosy. Information on leprosy was mainly from community volunteers (40.6%), friends (38.0%), and the media (24%). Only 19.7% of respondents knew the cause of leprosy, and a considerable proportion linked it to a spell (25.3%), unclean blood (15.5%) and heredity (14.6%). About 72% knew that leprosy is curable and 86.3% would advise medical treatment. Attitudes towards leprosy patients were generally negative. Only 42% would shake hands, 32.6% would share the same plate, and 28.3% and 27% respectively, would allow their child to play or marry a person with leprosy. Furthermore, only 33.9% approved of participation of leprosy patients, and 42.9% of their employment. Independent predictors of negative attitudes were: the belief that leprosy is a curse; is caused by a germ; and having seen a leprosy patient. The negative attitudes were dampened by: the beliefs that leprosy is a punishment, is hereditary and is due to poor personal hygiene. Conclusion An awareness intervention using community volunteers and the media, with information on the cause of leprosy, its clinical manifestations and curability, and sensitization messages correcting the misconceptions and beliefs regarding leprosy, could improve the community

Mapping of schistosomiasis and soil-transmitted helminthiasis in the regions of centre, East and West Cameroon.

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Louis-Albert Tchuem Tchuenté

Full Text Available BACKGROUND: Schistosomiasis and soil-transmitted helminthiasis (STH are widely distributed in Cameroon. Although mass drug administration (MDA of mebendazole is implemented nationwide, treatment with praziquantel was so far limited to the three northern regions and few health districts in the southern part of Cameroon, based on previous mapping conducted 25 years ago. To update the disease distribution map and determine where treatment with praziquantel should be extended, mapping surveys were conducted in three of the seven southern regions of Cameroon, i.e. Centre, East and West. METHODOLOGY: Parasitological surveys were conducted in April-May 2010 in selected schools in all 63 health districts of the three targeted regions, using appropriate research methodologies, i.e. Kato-Katz and urine filtration. PRINCIPAL FINDINGS: The results showed significant variation of schistosomiasis and STH prevalence between schools, villages, districts and regions. Schistosoma mansoni was the most prevalent schistosome species, with an overall prevalence of 5.53%, followed by S. haematobium (1.72% and S. guineensis (0.14%. The overall prevalence of schistosomiasis across the three regions was 7.31% (95% CI: 6.86-7.77%. The prevalence for Ascaris lumbricoides was 11.48 (95% CI: 10.93-12.04%, Trichuris trichiura 18.22% (95% CI: 17.56-18.90% and hookworms 1.55% (95% CI: 1.35-1.78%, with an overall STH prevalence of 24.10% (95% CI: 23.36-24.85% across the three regions. STH was more prevalent in the East region (46.57%; 95% CI: 44.41-48.75% in comparison to the Centre (25.12; 95% CI: 24.10-26.17% and West (10.49%; 95% CI: 9.57-11.51% regions. CONCLUSIONS/SIGNIFICANCE: In comparison to previous data, the results showed an increase of schistosomiasis transmission in several health districts, whereas there was a significant decline of STH infections. Based on the prevalence data, the continuation of annual or bi-annual MDA for STH is recommended, as well as an

Mapping of schistosomiasis and soil-transmitted helminthiasis in the regions of centre, East and West Cameroon.

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Tchuem Tchuenté, Louis-Albert; Kamwa Ngassam, Romuald Isaka; Sumo, Laurentine; Ngassam, Pierre; Dongmo Noumedem, Calvine; Nzu, Deguy D'or Luogbou; Dankoni, Esther; Kenfack, Christian Mérimé; Gipwe, Nestor Feussom; Akame, Julie; Tarini, Ann; Zhang, Yaobi; Angwafo, Fru Fobuzski

2012-01-01

Schistosomiasis and soil-transmitted helminthiasis (STH) are widely distributed in Cameroon. Although mass drug administration (MDA) of mebendazole is implemented nationwide, treatment with praziquantel was so far limited to the three northern regions and few health districts in the southern part of Cameroon, based on previous mapping conducted 25 years ago. To update the disease distribution map and determine where treatment with praziquantel should be extended, mapping surveys were conducted in three of the seven southern regions of Cameroon, i.e. Centre, East and West. Parasitological surveys were conducted in April-May 2010 in selected schools in all 63 health districts of the three targeted regions, using appropriate research methodologies, i.e. Kato-Katz and urine filtration. The results showed significant variation of schistosomiasis and STH prevalence between schools, villages, districts and regions. Schistosoma mansoni was the most prevalent schistosome species, with an overall prevalence of 5.53%, followed by S. haematobium (1.72%) and S. guineensis (0.14%). The overall prevalence of schistosomiasis across the three regions was 7.31% (95% CI: 6.86-7.77%). The prevalence for Ascaris lumbricoides was 11.48 (95% CI: 10.93-12.04%), Trichuris trichiura 18.22% (95% CI: 17.56-18.90%) and hookworms 1.55% (95% CI: 1.35-1.78%), with an overall STH prevalence of 24.10% (95% CI: 23.36-24.85%) across the three regions. STH was more prevalent in the East region (46.57%; 95% CI: 44.41-48.75%) in comparison to the Centre (25.12; 95% CI: 24.10-26.17%) and West (10.49%; 95% CI: 9.57-11.51%) regions. In comparison to previous data, the results showed an increase of schistosomiasis transmission in several health districts, whereas there was a significant decline of STH infections. Based on the prevalence data, the continuation of annual or bi-annual MDA for STH is recommended, as well as an extension of praziquantel in identified moderate and high risk communities for

Vegetable Consumption patterns in Yaounde, Cameroon | Kamga ...

African Journals Online (AJOL)

A survey was conducted in August and September 2008 in Yaoundé, Cameroon to assess vegetable consumption attitudes, constraints and factors that stimulate households' consumption. Stratified sample based on district size, socioeconomic status and ethnics groups were used. Three hundred households were ...

Achieving high uptake of human papillomavirus vaccine in Cameroon: lessons learned in overcoming challenges.

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Ogembo, Javier Gordon; Manga, Simon; Nulah, Kathleen; Foglabenchi, Lily H; Perlman, Stacey; Wamai, Richard G; Welty, Thomas; Welty, Edith; Tih, Pius

2014-07-31

Cameroon has the highest age-standardized incidence rate of cervical cancer (30/100,000 women) in Central Africa. In 2010-2011, the Cameroon Baptist Convention Health Services (CBCHS) received donated human papillomavirus (HPV) vaccine, Gardasil, from Merck & Co. Inc. through Axios Healthcare Development to immunize 6400 girls aged 9-13 years. The aim was to inform the Cameroon Ministry of Health (MOH) of the acceptability, feasibility, and optimal delivery strategies for HPV vaccine. Following approval by the MOH, CBCHS nurses educated girls, parents, and communities about HPV, cervical cancer, and HPV vaccine through multimedia coverage, brochures, posters, and presentations. Because educators were initially reluctant to allow immunization in schools, due to fear of adverse events, the nurses performed 40.7% of vaccinations in the clinics, 34.5% in community venues, and only 24.7% in schools. When no adverse events were reported, more schools and communities permitted HPV vaccine immunization on their premises. To recover administrative costs, CBCHS charged a fee of US$8 per 3-dose series only to those who were able to pay. Despite the fee, 84.6% of the 6,851 girls who received the first dose received all three doses. With adequate education of all stakeholders, HPV vaccination is acceptable and feasible in Cameroon. Following this demonstration project, in 2014 the Global Access to Vaccines and Immunization (GAVI) Alliance awarded the Cameroon MOH HPV vaccine at a price of US$4.50 per dose to immunize sixth grade girls and girls aged 10 years who are not in school in two districts of Cameroon. Copyright © 2014 Elsevier Ltd. All rights reserved.

Initiatives supporting evidence informed health system policymaking in Cameroon and Uganda: a comparative historical case study.

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Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

2014-11-29

There is a scarcity of empirical data on institutions devoted to knowledge brokerage and their influence in Africa. Our objective was to describe two pioneering Knowledge Translation Platforms (KTPs) supporting evidence informed health system policymaking (EIHSP) in Cameroon and Uganda since 2006. This comparative historical case study of Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda using multiple methods comprised (i) a descriptive documentary analysis for a narrative historical account, (ii) an interpretive documentary analysis of the context, profiles, activities and outputs inventories and (iii) an evaluative survey of stakeholders exposed to evidence briefs produced and policy dialogues organized by the KTPs. Both initiatives benefited from the technical and scientific support from the global EVIPNet resource group. EVIPNet Cameroon secretariat operates with a multidisciplinary group of part-time researchers in a teaching hospital closely linked to the ministry of health. REACH-PI Uganda secretariat operates with a smaller team of full time staff in a public university. Financial resources were mobilized from external donors to scale up capacity building, knowledge management, and linkage and exchange activities. Between 2008 and 2012, twelve evidence briefs were produced in Cameroon and three in Uganda. In 2012, six rapid evidence syntheses in response to stakeholders' urgent needs were produced in Cameroon against 73 in Uganda between 2010 and 2012. Ten policy dialogues (seven in Cameroon and three in Uganda) informed by pre-circulated evidence briefs were well received. Both KTPs contributed to developing and testing new resources and tools for EIHSP. A network of local and global experts has created new spaces for evidence informed deliberations on priority health policy issues related to MDGs. This descriptive historical account of two KTPs housed in government

Buruli Ulcer in Cameroon: The Development and Impact of the National Control Programme.

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Earnest Njih Tabah

2016-01-01

Full Text Available Cameroon is endemic for Buruli ulcer (BU and organised institutional BU control began in 2002. The objective was to describe the evolution, achievements and challenges of the national BU control programme (NBUCP and to make suggestions for scaling up the programme.We analysed collated data on BU from 2001 to 2014 and reviewed activity reports NBUCP in Cameroon. Case-detection rates and key BU control indicators were calculated and plotted on a time scale to determine trends in performance. A linear regression analysis of BU detection rate from 2005-2014 was done. The regression coefficient was tested statistically for the significance in variation of BU detection rate.In 14 years of BU control, 3700 cases were notified. The BU detection rate dropped significantly from 3.89 to 1.45 per 100 000 inhabitants. The number of BU endemic health districts rose from two to 64. Five BU diagnostic and treatment centres are functional and two more are planned for 2015. The health system has been strengthened and BU research and education has gained more interest in Cameroon.Although institutional BU control Cameroon only began 30 years after the first cases were reported in 1969, a number of milestones have been attained. These would serve as stepping stones for charting the way forward and improving upon control activities in the country if the major challenge of resource allocation is dealt with.

Mapping the geographical distribution of podoconiosis in Cameroon using parasitological, serological, and clinical evidence to exclude other causes of lymphedema.

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Kebede Deribe

2018-01-01

Full Text Available Podoconiosis is a non-filarial elephantiasis, which causes massive swelling of the lower legs. It was identified as a neglected tropical disease by WHO in 2011. Understanding of the geographical distribution of the disease is incomplete. As part of a global mapping of podoconiosis, this study was conducted in Cameroon to map the distribution of the disease. This mapping work will help to generate data on the geographical distribution of podoconiosis in Cameroon and contribute to the global atlas of podoconiosis.We used a multi-stage sampling design with stratification of the country by environmental risk of podoconiosis. We sampled 76 villages from 40 health districts from the ten Regions of Cameroon. All individuals of 15-years old or older in the village were surveyed house-to-house and screened for lymphedema. A clinical algorithm was used to reliably diagnose podoconiosis, excluding filarial-associated lymphedema. Individuals with lymphoedema were tested for circulating Wuchereria bancrofti antigen and specific IgG4 using the Alere Filariasis Test Strips (FTS test and the Standard Diagnostics (SD BIOLINE lymphatic filariasis IgG4 test (Wb123 respectively, in addition to thick blood films. Presence of DNA specific to W. bancrofti was checked on night blood using a qPCR technique.Overall, 10,178 individuals from 4,603 households participated in the study. In total, 83 individuals with lymphedema were identified. Of the 83 individuals with lymphedema, two were found to be FTS positive and all were negative using the Wb123 test. No microfilaria of W. bancrofti were found in the night blood of any individual with clinical lymphedema. None were found to be positive for W. bancrofti using qPCR. Of the two FTS positive cases, one was positive for Mansonella perstans DNA, while the other harbored Loa loa microfilaria. Overall, 52 people with podoconiosis were identified after applying the clinical algorithm. The overall prevalence of podoconiosis was

Mapping of Schistosomiasis and Soil-Transmitted Helminthiasis in the Regions of Centre, East and West Cameroon

Science.gov (United States)

Tchuem Tchuenté, Louis-Albert; Kamwa Ngassam, Romuald Isaka; Sumo, Laurentine; Ngassam, Pierre; Dongmo Noumedem, Calvine; Nzu, Deguy D'or Luogbou; Dankoni, Esther; Kenfack, Christian Mérimé; Gipwe, Nestor Feussom; Akame, Julie; Tarini, Ann; Zhang, Yaobi; Angwafo, Fru Fobuzski

2012-01-01

Background Schistosomiasis and soil-transmitted helminthiasis (STH) are widely distributed in Cameroon. Although mass drug administration (MDA) of mebendazole is implemented nationwide, treatment with praziquantel was so far limited to the three northern regions and few health districts in the southern part of Cameroon, based on previous mapping conducted 25 years ago. To update the disease distribution map and determine where treatment with praziquantel should be extended, mapping surveys were conducted in three of the seven southern regions of Cameroon, i.e. Centre, East and West. Methodology Parasitological surveys were conducted in April–May 2010 in selected schools in all 63 health districts of the three targeted regions, using appropriate research methodologies, i.e. Kato-Katz and urine filtration. Principal Findings The results showed significant variation of schistosomiasis and STH prevalence between schools, villages, districts and regions. Schistosoma mansoni was the most prevalent schistosome species, with an overall prevalence of 5.53%, followed by S. haematobium (1.72%) and S. guineensis (0.14%). The overall prevalence of schistosomiasis across the three regions was 7.31% (95% CI: 6.86–7.77%). The prevalence for Ascaris lumbricoides was 11.48 (95% CI: 10.93–12.04%), Trichuris trichiura 18.22% (95% CI: 17.56–18.90%) and hookworms 1.55% (95% CI: 1.35–1.78%), with an overall STH prevalence of 24.10% (95% CI: 23.36–24.85%) across the three regions. STH was more prevalent in the East region (46.57%; 95% CI: 44.41–48.75%) in comparison to the Centre (25.12; 95% CI: 24.10–26.17%) and West (10.49%; 95% CI: 9.57–11.51%) regions. Conclusions/Significance In comparison to previous data, the results showed an increase of schistosomiasis transmission in several health districts, whereas there was a significant decline of STH infections. Based on the prevalence data, the continuation of annual or bi-annual MDA for STH is recommended, as well as an

The Weight of Health Expenditures on Household Income in Cameroon

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Joseph Parfait OWOUNDI

2014-02-01

Full Text Available  African leaders pledged at the Abuja conference in 2001, to mobilize more financial resources to allocate at least 15% of their national budgets to the health sector to achieve the Millennium Development Goals (MDGs, seem to have difficulty meeting this commitment because of weakness and fragmentation of health systems. These commitments were renewed in Gaborone, Botswana in 2005 and in Ouagadougou, Burkina Faso in 2006. Indeed, donor funding is still a large part of public health spending on the continent. In some countries, 50% or more of their budgets come from foreign or private assistance. In about half the countries, the private health financing is equal to or exceeds largely public funding, up to 70% in some states like Sudan, Côte d'Ivoire, Cameroon, Chad, Liberia and Uganda. Only five countries (Rwanda, Malawi, Zambia, Burkina Faso, and Togo have so far respected the promise made to the Abuja conference. In Cameroon, where 51% of the population lives on less than two dollars per day, the average propensity of the total medical consumption is very high. Indeed, 32% of households spend less than half of income on health, while 16% of households spend more than half of the income and 52% spend more than the total income. This corresponds to a weight of 68% in health care spending.  

Detecting and staging podoconiosis cases in North West Cameroon: positive predictive value of clinical screening of patients by community health workers and researchers

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Samuel Wanji

2016-09-01

Full Text Available Abstract Background The suitability of using clinical assessment to identify patients with podoconiosis in endemic communities has previously been demonstrated. In this study, we explored the feasibility and accuracy of using Community Health Implementers (CHIs for the large scale clinical screening of the population for podoconiosis in North-west Cameroon. Methods Before a regional podoconiosis mapping, 193 CHIs and 50 health personnel selected from 6 health districts were trained in the clinical diagnosis of the disease. After training, CHIs undertook community screening for podoconiosis patients under health personnel supervision. Identified cases were later re-examined by a research team with experience in the clinical identification of podoconiosis. Results Cases were identified by CHIs with an overall positive predictive value (PPV of 48.5% [34.1–70%]. They were more accurate in detecting advanced stages of the disease compared to early stages; OR 2.07, 95% CI = 1.15–3.73, p = 0.015 for all advanced stages. Accuracy of detecting cases showed statistically significant differences among health districts (χ2 = 25.30, p = 0.0001. Conclusion Podoconiosis being a stigmatized disease, the use of CHIs who are familiar to the community appears appropriate for identifying cases through clinical diagnosis. However, to improve their effectiveness and accuracy, more training, supervision and support are required. More emphasis must be given in identifying early clinical stages and in health districts with relatively lower PPVs.

Provider-patient interaction in rural Cameroon--how it relates to the patient's understanding of diagnosis and prescribed drugs, the patient's concept of illness, and access to therapy.

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Labhardt, Niklaus Daniel; Schiess, Kaspar; Manga, Engelbert; Langewitz, Wolf

2009-08-01

This cross-sectional survey examines the relation between provider-patient interaction and several patient-outcomes in a rural health district in Cameroon. We used structured patient interviews and the Roter Interaction Analysis System (RIAS) for analysis of audio-recorded consultations. Data from 130 primary care consultations with 13 health-care providers were analysed. 51% of patients correctly named their diagnoses after the consultation; in 47% of prescribed drugs patients explained correctly the purpose. Patients' ability to recall diagnoses was related to the extent of clarity a provider used in mentioning it during consultation (recall rates: 87.5% if mentioned explicitly, 56.7% if mentioned indirectly and 19.2% if not mentioned at all; pbuy prescribed drugs, discussion about financial issues was very rare during consultations. Providers issued financial questions in 32%, patients in 21% of consultations. This study shows that provider-patient interaction in primary health care in a rural Cameroon district deserves more attention. It might improve the patients' knowledge about their health condition and support them in beneficial health behaviour. Our findings should encourage providers to give more medical explanation, to discuss patients' health beliefs in a non-judgmental manner, and to consider financial issues more carefully.

Environmental exposure to carcinogens in northwestern Cameroon

African Journals Online (AJOL)

EB

2013-09-03

Sep 3, 2013 ... 3. Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, Cameroon. 4. Department of Medical Laboratory Sciences, ... the leading causes of death. Lung cancer has been reported from Cameroon17 but no association has been established between cigarette smoking and lung ...

Nutrition Habits and Health Outcomes of Breastfeeding HIV-positive mothers in the Dschang Health District, West Region Cameroon.

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Sanou Sobze, Martin; Kien-Atsu, Tsi; Djeunang Dongho, Bruna; Fotso, Jimmy Roger; TiotsiaTsapi, Armand; Azeufack Ngueko, Yannick; Ben Bechir, Sali; Pana, Augusto; Ercoli, Lucia; Colizzi, Vittorio; Russo, Gianluca

2016-01-01

Amongst the different at-risk periods for mother-to-child HIV transmission that is, during pregnancy, labor and delivery and breastfeeding, much care and attention needs to be given, not only to the child as concerns its feeding options, but also to the mother. The aim of this study was to determine the nutritional habits and health outcomes of HIV-positive breastfeeding mothers in the Dschang Health District, in the context of prevention of mother-to-child transmission (PMTCT) activities. A cross-sectional study was carried out from September 2014 to February 2015, at the Dschang District Day Care Hospital. A standard questionnaire was administered by face-to-face interview to 56 breastfeeding HIV-positive mothers. Anthropometric parameters of the mothers were measured (weight and height), and a physical check-up performed, with examination of the mothers' conjunctiva and palms. Clinical status was determined by anemia test using the Tallquist hemoglobin test. Data collected were analyzed using Epi Info version 7.1.3.3 and Excel 2013. The mean age of participants was 33 years. Most women ate three meals per day (53.6%, n=30/56), while 26,8% (15/56) ate two. Staples (27.27%) and fruits (33.68%) were found to be the most consumed foods per week and green leafy and yellow vegetables the least consumed (13.74%). Body mass index was used to evaluate the nutritional status of participating women: 26.9% (n=14/52) were in the normal range of weight, slightly more than half were overweight (51.9%, n=27/52) and 21.2% (n=11/52) were obese. All mothers were on antiretroviral therapy (ART). Recent CD4 count results were available for about half of the women and the mean was 293 cells/mmc (range 97-798). Physical checkup showed that 64.3% (n=36/56) and 67.9% (n=38/56) of women respectively had moderately colored conjunctiva and palms, while 10.7% (n=6/56) and 12.5% (n=7/56) respectively had pale conjunctiva and palms, considered to be clinical signs of anemia. About 74.1% (n=40

Assessing the knowledge, attitude and practice of family planning among women living in the Mbouda health district, Cameroon.

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Nansseu, Jobert Richie N; Nchinda, Emmanuel Choffor; Katte, Jean-Claude; Nchagnouot, Fatima M; Nguetsa, Guylaine D

2015-10-09

Promotion of family planning has been shown to reduce poverty, hunger, maternal and infant mortality, and contribute to women's empowerment. But many resource-limited countries still have very low rates of contraceptive use. The present study aimed to assess the knowledge, attitude and practice of family planning among women living in a resource-poor rural setting. We conducted a cross-sectional study in January 2010 in the Mbouda Health District, Cameroon. After a multistage random selection, 120 households were selected. Participants were women aged at least 15 years old, sexually active, and who volunteered to participate in the study. Data were collected during an anonymous interview using a structured pre-tested questionnaire. A total of 101 women were enrolled, their ages ranging from 18-58 years with a mean of 31.7 ± 8.8 years. Ninety-six percent of these women had already heard about family planning. Almost all respondents (98 %) were aware of at least one contraceptive method, the most cited being the male condom (96 %), the safe period (86.1 %), injectables (76.2 %) and oral pills (75.2 %), Sixty-six women (65.3 %) were currently practicing at least one contraceptive method, and the three prevailing methods used were: the safe period (50 %), the male condom (34.8 %), and injectables (12.1 %). The main reasons precluding women from practicing contraception were lack of knowledge (31.4 %), uselessness (31.4 %) and unbearable side effects (8.6 %). Fourteen of these women (42.4 %) expressed the willingness to start practicing contraception if they received more information about the subject. Decision on the number of children to have was made by both the man and the woman in 59.5 % of cases. The practice of contraception had been decided by the couple in 39.6 % of cases, and 9.4 % of men were not aware that their wives were currently practicing contraception. Although the level of awareness about family planning and contraceptive methods is quite

Community-based health insurance knowledge, concern ...

African Journals Online (AJOL)

Community-based health insurance knowledge, concern, preferences, and financial planning for health care among informal sector workers in a health district of Douala, Cameroon. ... This is mainly due to the lack of awareness and limited knowledge on the basic concepts of a CBHI by this target population. Solidarity ...

The acceptability of volunteer, repeat blood donations in a hospital setting in the Adamaoua region of Cameroon.

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Rolseth, S; Stange, P; Adamou, D; Roald, B; Danki-Sillong, F; Jourdan, P

2014-12-01

The knowledge of factors that may influence blood donation in Cameroon is limited. The objectives of this study are to assess the characteristics of previous and potential blood donors by exploring the religious beliefs, and knowledge and understanding of blood donations among individuals present at a district hospital. Forty-nine in-depth, semi-structured interviews were conducted among consenting, randomly selected 18 years or older community members present at a district hospital in the Adamaoua region during October and November 2011. Ninety-eight per cent (48/49) of the individuals present at this district hospital had heard of blood transfusions. Forty-seven per cent (23/49) had not previously been asked to donate blood; however, 94% (44/47) said that they would donate if given the opportunity. Thirty-three per cent (16/49) had previously donated blood to family members or for replacement, and 81% of these said they would repeat donations. The majority of both donors and non-donors were motivated to donate blood for altruistic reasons. The findings suggest that community members present at this district hospital in Cameroon may be recruited for repeat blood donations. Although the altruistic motivation to donate blood suggests that donors could be recruited from a district hospital population, targeted information about blood donations and accessible blood transfusion services need to be put in place. The study may add to the understanding of the preconditions for blood donations and the possibility to establish sustainable blood transfusion services in the Adamaoua region in Cameroon. © 2014 British Blood Transfusion Society.

Mapping of schistosomiasis and soil-transmitted helminthiasis in the regions of Littoral, North-West, South and South-West Cameroon and recommendations for treatment

Science.gov (United States)

2013-01-01

Background The previous nationwide mapping of schistosomiasis and soil-transmitted helminthiasis (STH) in Cameroon was conducted 25 years ago. Based on its results, mass drug administration (MDA) of praziquantel was limited to the three northern regions and few health districts in the southern part of Cameroon. In 2010, we started the process of updating the disease distribution in order to improve the control strategies. Three of the ten regions of Cameroon were mapped in 2010 and the data were published. In 2011, surveys were conducted in four additional regions, i.e. Littoral, North-West, South and South-West. Methods Parasitological surveys were conducted in March 2011 in selected schools in all 65 health districts of the four targeted regions, using appropriate research methodologies, i.e. Kato-Katz and urine filtration. Results The results showed significant variation of schistosomiasis and STH prevalence between schools, villages, districts and regions. Schistosoma haematobium was the most prevalent schistosome species, with an overall prevalence of 3.2%, followed by S. mansoni (3%) and S. guineensis (1.2%). The overall prevalence of schistosomiasis across the four regions was 7.4% (95% CI: 6.7-8.3%). The prevalence for Ascaris lumbricoides was 19.5% (95% CI: 18.3-20.7%), Trichuris trichiura 18.9% (95% CI: 17.7-20.1%) and hookworms 7.6% (95% CI: 6.8-8.4%), with an overall STH prevalence of 32.5% (95% CI: 31.1-34.0%) across the four regions. STH was more prevalent in the South region (52.8%; 95% CI: 48.0-57.3%), followed by the South-West (46.2%; 95% CI: 43.2-49.3%), the North-West (35.9%; 95% CI: 33.1-38.7%) and the Littoral (13.0%; 95% CI: 11.3-14.9%) regions. Conclusions In comparison to previous data in 1985–87, the results showed an increase of schistosomiasis transmission in several health districts, whereas there was a significant decline of STH infections. Based on the prevalence data, the continuation of annual or bi-annual MDA for STH is

Mapping of schistosomiasis and soil-transmitted helminthiasis in the regions of Littoral, North-West, South and South-West Cameroon and recommendations for treatment.

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Tchuem Tchuenté, Louis-Albert; Dongmo Noumedem, Calvine; Ngassam, Pierre; Kenfack, Christian Mérimé; Gipwe, Nestor Feussom; Dankoni, Esther; Tarini, Ann; Zhang, Yaobi

2013-12-23

The previous nationwide mapping of schistosomiasis and soil-transmitted helminthiasis (STH) in Cameroon was conducted 25 years ago. Based on its results, mass drug administration (MDA) of praziquantel was limited to the three northern regions and few health districts in the southern part of Cameroon. In 2010, we started the process of updating the disease distribution in order to improve the control strategies. Three of the ten regions of Cameroon were mapped in 2010 and the data were published. In 2011, surveys were conducted in four additional regions, i.e. Littoral, North-West, South and South-West. Parasitological surveys were conducted in March 2011 in selected schools in all 65 health districts of the four targeted regions, using appropriate research methodologies, i.e. Kato-Katz and urine filtration. The results showed significant variation of schistosomiasis and STH prevalence between schools, villages, districts and regions. Schistosoma haematobium was the most prevalent schistosome species, with an overall prevalence of 3.2%, followed by S. mansoni (3%) and S. guineensis (1.2%). The overall prevalence of schistosomiasis across the four regions was 7.4% (95% CI: 6.7-8.3%). The prevalence for Ascaris lumbricoides was 19.5% (95% CI: 18.3-20.7%), Trichuris trichiura 18.9% (95% CI: 17.7-20.1%) and hookworms 7.6% (95% CI: 6.8-8.4%), with an overall STH prevalence of 32.5% (95% CI: 31.1-34.0%) across the four regions. STH was more prevalent in the South region (52.8%; 95% CI: 48.0-57.3%), followed by the South-West (46.2%; 95% CI: 43.2-49.3%), the North-West (35.9%; 95% CI: 33.1-38.7%) and the Littoral (13.0%; 95% CI: 11.3-14.9%) regions. In comparison to previous data in 1985-87, the results showed an increase of schistosomiasis transmission in several health districts, whereas there was a significant decline of STH infections. Based on the prevalence data, the continuation of annual or bi-annual MDA for STH is recommended, as well as an extension of

Impact of Refugees on Local Health Systems: A Difference-in-Differences Analysis in Cameroon.

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Tatah, Lambed; Delbiso, Tefera Darge; Rodriguez-Llanes, Jose Manuel; Gil Cuesta, Julita; Guha-Sapir, Debarati

2016-01-01

Hosting refugees may represent a drain on local resources, particularly since external aid is frequently insufficient. Between 2004 and 2011, over 100,000 refugees settled in the eastern border of Cameroon. With little known on how refugee influx affects health services of the hosting community, we investigated the impact of refugees on mother and child health (MCH) services in the host community in Cameroon. We used Cameroon's 2004 and 2011 Demographic and Health Surveys to evaluate changes in MCH indicators in the refugee hosting community. Our outcome variables were antenatal care (ANC) coverage, caesarean delivery rate, place of delivery and child vaccination coverage; whereas the exposure variable was residence in the refugee hosting community. We used a difference-in-differences analysis to compare indicators of the refugee hosting community to a control group selected through propensity score matching from the rest of the country. A total of 10,656 women were included in our 2004 analysis and 7.6% (n = 826) of them resided in the refugee hosting community. For 2011, 15,426 women were included and 5.8% (n = 902) of them resided in the hosting community. Between 2004 and 2011, both the proportion of women delivering outside health facilities and children not completing DPT3 vaccination in the refugee hosting community decreased by 9.0% (95% Confidence Interval (CI): 3.9-14.1%) and 9.6% (95% CI: 7.9-11.3%) respectively. However, ANC attendance and caesarean delivery did not show any significant change. Our findings demonstrate that none of the evaluated MCH service indicators deteriorated (in fact, two of them improved: delivery in health facilities and completing DPT3 vaccine) with the presence of refugees. This suggests evidence disproving the common belief that refugees always have a negative impact on their hosting community.

[Health and drug consumption profile in Cameroon].

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Commeyras, Christophe; Ndo, Jean Rolin; Merabet, Omar; Kone, Hamidou; Rakotondrabe, Faraniaina Patricia

2006-01-01

To begin a renewal of national health policy in Cameroon, a steering committee from the Cameroon Ministry of Health and its partners sought to analyze health demand through a national population survey and supply capacity through a national survey of retail drug stores. A survey of healthcare consumers was also conducted. The present publication describes the results of the consumer survey. Their socioeconomic profile of these consumers was much higher than that of the general population. This indicates that the poorest do not use health facilities or even self-medication. Within the population of healthcare consumers, women and children used private for-profit (60 %) and nonprofit (65 %) private health facilities most often, while men used mainly private pharmacies (60 %) and street drug (medication) sellers (62 %). In all, 85 % of the users of formal drug retailers had had a consultation with a healthcare provider. The average consultation cost was 1,440 CFA Francs, but the 7 % who paid the provider directly had an average cost of 1,794 CFA Francs. In all, 22 % did not pay at all, because of free consultations in some health facilities (40 %), personal relationships with prescribers, or other reasons. Hospitalization costs averaged 4,800 CFA Francs, and medical examinations 4,534 CFA Francs. These two categories had the highest percentage of insured patients (12 % and 5 %). Drug costs were 5,067 CFA Francs from pharmacies and 1,308 CFA Francs in the street. Total healthcare costs per person averaged 14,990 CFA Francs. Weighted, drugs accounted for the largest share, followed by hospitalisation, medical examinations, consultations, and transportation. In the formal sector, less than 10 % reported paying fees directly to the healthcare providers rather than to the HF cashier. Except for consultation in the public sector, paying providers was associated with a lower bill. However, 24 % purchased drugs from the healthcare workers, which indicates that drug sales are

[The burden of disability in Cameroon].

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Foti, Calogero; Albensi, Caterina; Giordani, Laura; Azeufack Ngueko, Yannick; Sanou Sobze, Martin; Colizzi, Vittorio

2017-01-01

Rehabilitation services for disabled persons are lacking in countries with limited economic resources. Reliable and objective data are needed to plan for their implementation and to determine the burden of disability in these countries. A descriptive cross-sectional study conducted in June 2013 among people living in Dschang Health District, in the West region of Cameroon, to collect information about socio-demographic aspects of physically disabled subjects and health determinants of disabilities. Data was collected using a standard questionnaire in French. In total, 159 physically disabled subjects were enrolled in the study. Mean age was 36 years [± SD 17.26], 55.9% of subjects were female, and 33.8% had a low educational-level. The most frequently reported disabilities were orthopaedic problems (mainly fractures) [45.8%], infectious diseases [29.1%]), and neurological disabilities (mainly hemiplegia [33.3%], hemiparesis [23.8%], and monoplegia [23.8%]). The main causes of disability were trauma due to traffic accidents (17.8%) and inappropriate medical interventions (14.5%). Disability was related to age and 50% of participants experienced social discrimination. Disabled subjects with low-incomes (from 50.000 to 200.000 XAF) were required to pay for rehabilitative care (XAF 10.000 to 100.000), and up to 83% had appealed for improved quality of Rehabilitation Medicine. Although Law n. 83/013 for the protection of persons with disabilities in Cameroon dates back to 1983, the results of this study show that disabled people, and children in particular, are still marginalized, vulnerable and have little chance of recovery. Therefore, there is a clear need to improve the quality and availability of rehabilitative care services , with programmatic interventions that ensure implementation of existing laws, improve access to rehabilitative services, provide disabled persons with the necessary specialty medical products, and eliminate barriers to their social

Diabetes Mellitus: Indigenous naming, indigenous diagnosis and self-management in an African setting: the example from Cameroon

Directory of Open Access Journals (Sweden)

Awah Paschal K

2009-02-01

Full Text Available Abstract Background The objective was to examine how the indigenous naming, indigenous self-diagnosis and management of diabetes evolved with awareness in order to develop a socially oriented theoretical model for its care. Methods The data was collected through a one-year extended participant observation in Bafut, a rural health district of Cameroon. The sample consisted of 72 participants in a rural health district of Cameroon (men and women with type 2 diabetes. We used participant observation to collect data through focus group discussions, in depth interviews and fieldwork conversations. The method of analysis entailed a thick description, thematic analysis entailing constant comparison within and across FGD and across individual participants and content analysis. Results The core concepts identified were the evolution of names for diabetes and the indigenous diagnostic and self-management procedures. Participants fell into one of two naming typologies: (a Naming excluding any signs and symptoms of diabetes; (b naming including signs and symptoms of diabetes. Participants fell into two typologies of diagnostic procedures: (a those that use indigenous diagnostic procedures for monitoring and controlling diabetes outcomes and b those that had initially used it only for diagnosis and continued to use them for self management. These typologies varied according to how participants' awareness evolved and the impact on self-diagnosis and management. Conclusion The evolution of names for diabetes was an important factor that influenced the subsequent self-diagnosis and management of diabetes in both traditional and modern biomedical settings.

Vulnerability of settlements around Mt. Cameroon volcano, Cameroon

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Zogning, Appolinaire; Spinetti, Claudia; Ngouanet, Chretien; Tchoudam, David; Kouokam, Emmanuel; Thierry, Pierre; Bignami, Christian; Fabrizia Buongiorno, Maria; Ilaria Pannaccione Apa, Maria

2010-05-01

Located at the bottom of the Gulf of Guinea, Cameroon is exposed to a large variety of natural hazards, including volcanism. Most of the hazard are concentrated around the active volcano Mt. Cameroon which combines effusive and explosive types of activity. The threatened stakes are numerous and different exposed: people, settlements, industrial plantations, petrol refinery and many other factories and infrastructures. Until 2005, no risk management plans has been available. In 2006, the French Embassy in Cameroon, within the framework of a financial convention between Cameroon and France, put in place the GRINP (Management of Natural Risks and Civil Protection) project whose objective was to reinforce the capacity of Cameroon's civil protection department and thus, contribute to the improvement of the security of the population faced with catastrophes. The objective was to realize a Risk Prevention Plan at a local council scale, and taking into consideration the specific natural risks of each zone. The general objective of the RPP was to clearly draw land use maps for risks zones, showing the overlay of stakes with risk of different intensities. In 2008 European Commission funded the Mia-Vita project (Mitigating and Assessing Volcanic Impacts on Terrain and human Activities). The aim of the project is to improve the crisis management capabilities based on monitoring and early warning systems and secure communications; reduction of people's vulnerability and development of recovering capabilities after an event occurs for both local communities and ecological systems. Keyword: natural hazards, Mt. Cameroon, vulnerability, risk prevention plan

Understanding the organisational culture of district health services: Mahalapye and Ngamiland health districts of Botswana.

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Nkomazana, Oathokwa; Mash, Robert; Phaladze, Nthabiseng

2015-11-30

Botswana has a shortage of health care workers, especially in primary healthcare. Retention and high performance of employees are closely linked to job satisfaction and motivation, which are both highest where employees' personal values and goals are realised. The aim of the study was to evaluate employees' personal values, and the current and desired organisational culture of the district health services as experienced by the primary health care workers. The study was conducted in the Ngamiland and Mahalapye health districts. This was a cross sectional survey. The participants were asked to select 10 values that best described their personal, current organisational and desired organisational values from a predetermined list. Sixty and 67 health care workers completed the survey in Mahalapye and Ngamiland districts, respectively. The top 10 prevalent organisational values experienced in both districts were: teamwork, patient satisfaction, blame, confusion, job insecurity, not sharing information and manipulation. When all the current values were assessed, 32% (Mahalapye) and 36% (Ngamiland) selected by health care workers were potentially limiting organisational effectiveness. The organisational values desired by health care workers in both districts were: transparency, professional growth, staff recognition, shared decision-making, accountability, productivity, leadership development and teamwork. The experience of the primary health care workers in the two health districts were overwhelmingly negative, which is likely to contribute to low levels of motivation, job satisfaction, productivity and high attrition rates. There is therefore urgent need for organisational transformation with a focus on staff experience and leadership development.

Cameroon Journal of Agricultural Science

African Journals Online (AJOL)

Journal Camerounais des Sciences Agricoles The Cameroon Journal of Agricultural Science publishes new information on all aspects of agricultural science – agronomy, breeding, crop protection, economics, rural sociology, forestry and animal science, health and production ...

Understanding the organisational culture of district health services: Mahalapye and Ngamiland health districts of Botswana

Directory of Open Access Journals (Sweden)

Oathokwa Nkomazana

2015-11-01

Full Text Available Background: Botswana has a shortage of health care workers, especially in primary healthcare. Retention and high performance of employees are closely linked to job satisfaction and motivation, which are both highest where employees’ personal values and goals are realised. Aim: The aim of the study was to evaluate employees’ personal values, and the current and desired organisational culture of the district health services as experienced by the primary health care workers. Setting: The study was conducted in the Ngamiland and Mahalapye health districts. Method: This was a cross sectional survey. The participants were asked to select 10 values that best described their personal, current organisational and desired organisational values from a predetermined list. Results: Sixty and 67 health care workers completed the survey in Mahalapye and Ngamiland districts, respectively. The top 10 prevalent organisational values experienced in both districts were: teamwork, patient satisfaction, blame, confusion, job insecurity, not sharing information and manipulation. When all the current values were assessed, 32% (Mahalapye and 36% (Ngamiland selected by health care workers were potentially limiting organisational effectiveness. The organisational values desired by health care workers in both districts were: transparency, professional growth, staff recognition, shared decision-making, accountability, productivity, leadership development and teamwork. Conclusions: The experience of the primary health care workers in the two health districts were overwhelmingly negative, which is likely to contribute to low levels of motivation, job satisfaction, productivity and high attrition rates. There is therefore urgent need for organisational transformation with a focus on staff experience and leadership development.

Hospital Workers' Awareness of Health and Environmental Impacts of Poor Clinical Waste Disposal in the Northwest Region of Cameroon

DEFF Research Database (Denmark)

Mochungong, Peter I K; Gulis, Gabriel; Sodemann, Morten

2010-01-01

a survey to evaluate hospital workers' awareness of health and environmental impacts of poor clinical waste disposal in Cameroon. We randomly distributed 500 questionnaires to hospital workers in three hospitals in the Northwest Region of Cameroon in April 2008. In addition, we observed collection......Due to the infectious nature of some clinical waste, poor disposal practices have sparked concern regarding the impact on public health and the environment. Lack of sufficient knowledge of the associated risks may be a strong factor contributing to inadequate disposal practices. We conducted......, segregation, transportation, and disposal of clinical waste at the three hospitals. Of 475 total respondents, most lacked sufficient awareness of any environmental or public health impacts of poor clinical waste disposal and had never heard of any policy--national or international--on safe clinical waste...

Contribution of community health workers to surveillance of vaccine-preventable diseases in the Obala health district

Science.gov (United States)

Vouking, Marius Zambou; Binde, Thierry; Tadenfok, Carine Nouboudem; Ekani, Jean Marie Edengue; Ekra, Daniel

2017-01-01

Introduction The establishment of effective community-based surveillance is an essential objective of all disease surveillance systems. Several studies and reports have found that the situation is far from optimal in several developing countries such as Cameroon. Methods We conducted a cross-sectional descriptive study to assess the contribution of community health workers to surveillance of vaccine-preventable diseases in Obala health district. The performance of community health workers was measured using: the number of cases referred to the health center, the percentage of accomplished referrals, the percentage of cases referred by community health workers confirmed by the staff of health centers. A questionnaire containing forty-seven questions (open-ended and closed-ended) was used for interviews with community health workers. The data were analyzed using SPSS 21 and Excel 2007. Counts and percentages are reported. Results The study showed that the age ranged of community health workers was from 24 to 61 years with an average of 37.9 years ± 6.7 years. The most represented age group was between 40 and 50 with a percentage of 38.6%. The male sex was more represented than the female sex (61.4% vs 38.6%) or a sex ratio male man of 1.7. Forty-five percent of community health workers were selected at a village meeting, 93.1% of community health workers were involved in the surveillance of vaccine-preventable diseases and 87% experienced at least one preventable disease. Only 45.8% of them had the case definitions of the four diseases. Analysis of community health workers attendance at organized health committee meetings showed that 79% of community health workers attended at least one health committee meeting in 2015 and only 49% were monitored in 2015. Community health workers reported 42 suspected cases of measles, 37 of which actually went to the nearest Health Center, a baseline rate of 88%. Conclusion Community health workers play a key role in the control of

Medicinal Plants Used for Treating Reproductive Health Care Problems in Cameroon, Central Africa1.

Science.gov (United States)

Tsobou, Roger; Mapongmetsem, Pierre Marie; Van Damme, Patrick

Medicinal Plants Used for Treating Reproductive Health Care Problems in Cameroon, Central Africa. Approximately 80% of the African population uses traditional plants to deal with health problems, basically because of their easy accessibility and affordability. This study was carried out to document indigenous knowledge of medicinal plants used by traditional healers and elders in the treatment of reproductive health care in the Bamboutos Division of the West Region in Cameroon, Central Africa. The research methods used included semi-structured interviews and participative field observations. For the interviews, 70 knowledgeable respondents (40 traditional healers and 30 elders) were selected via purposive sampling. Voucher specimens were collected with the help of respondents, processed into the Cameroon National Herbarium in Yaoundé following standard methods, identified with the help of pertinent floras and taxonomic experts, and submitted to Department of Botany at the University of Dschang. Descriptive statistics were used to analyze and summarize ethnobotanical information obtained. Informant consensus factors (ICF) were used to elucidate the agreement among informants on the species to be used in the treatment within a category of illness. The results showed that a total of 70 plant species from 37 families (mostly of the Asteraceae [8 species], Euphorbiaceae [7], and Acanthaceae and Bignoniaceae [4 each]) are used in the treatment of 27 reproductive ailments, with the highest number of species (37) being used against venereal diseases, followed by female (29) and male infertility (21), respectively. Leaves (47.3%) were the most commonly harvested plant parts and the most common growth forms harvested were the herbs (45.7%), followed by shrubs (30%). Sixty percent of plant material was obtained from the wild ecosystems. Herbal remedies were mostly prepared in the form of decoction (66.2%) and were taken mainly orally. Informant consensus about usages of

Cure or control: complying with biomedical regime of diabetes in Cameroon

Directory of Open Access Journals (Sweden)

Unwin Nigel

2008-02-01

Full Text Available Abstract Background The objective of the study was to explore the cultural aspect of compliance, its underlying principles and how these cultural aspects can be used to improve patient centred care for diabetes in Cameroon. Methods We used participant observation to collect data from a rural and an urban health district of Cameroon from June 2001 to June 2003. Patients were studied in their natural settings through daily interactions with them. The analysis was inductive and a continuous process from the early stages of fieldwork. Results The ethnography revealed a lack of basic knowledge about diabetes and diabetes risk factors amongst people with diabetes. The issue of compliance was identified as one of the main themes in the process of treating diabetes. Compliance emerged as part of the discourse of healthcare providers in clinics and filtered into the daily discourses of people with diabetes. The clinical encounters offered treatment packages that were socially inappropriate therefore rejected or modified for most of the time by people with diabetes. Compliance to biomedical therapy suffered a setback for four main reasons: dealing with competing regimes of treatment; coming to terms with biomedical treatment of diabetes; the cost of biomedical therapy; and the impact of AIDS on accepting weight loss as a lifestyle measure in prescription packages. People with diabetes had fears about and negative opinions of accepting certain prescriptions that they thought could interfere with their accustomed social image especially that which had to do with bridging their relationship with ancestors and losing weight in the era of HIV/AIDS. Conclusion The cultural pressures on patients are responsible for patients' partial acceptance of and adherence to prescriptions. Understanding the self-image of patients and their background cultures are vital ingredients to improve diabetes care in low-income countries of Sub-Sahara Africa like Cameroon.

Need for a gender-sensitive human security framework: results of a quantitative study of human security and sexual violence in Djohong District, Cameroon.

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Parmar, Parveen Kaur; Agrawal, Pooja; Goyal, Ravi; Scott, Jennifer; Greenough, P Gregg

2014-01-01

Human security shifts traditional concepts of security from interstate conflict and the absence of war to the security of the individual. Broad definitions of human security include livelihoods and food security, health, psychosocial well-being, enjoyment of civil and political rights and freedom from oppression, and personal safety, in addition to absence of conflict. In March 2010, we undertook a population-based health and livelihood study of female refugees from conflict-affected Central African Republic living in Djohong District, Cameroon and their female counterparts within the Cameroonian host community. Embedded within the survey instrument were indicators of human security derived from the Leaning-Arie model that defined three domains of psychosocial stability suggesting individuals and communities are most stable when their core attachments to home, community and the future are intact. While the female refugee human security outcomes describe a population successfully assimilated and thriving in their new environments based on these three domains, the ability of human security indicators to predict the presence or absence of lifetime and six-month sexual violence was inadequate. Using receiver operating characteristic (ROC) analysis, the study demonstrates that common human security indicators do not uncover either lifetime or recent prevalence of sexual violence. These data suggest that current gender-blind approaches of describing human security are missing serious threats to the safety of one half of the population and that efforts to develop robust human security indicators should include those that specifically measure violence against women.

Addressing health workforce distribution concerns: a discrete choice experiment to develop rural retention strategies in Cameroon.

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Robyn, Paul Jacob; Shroff, Zubin; Zang, Omer Ramses; Kingue, Samuel; Djienouassi, Sebastien; Kouontchou, Christian; Sorgho, Gaston

2015-03-01

Nearly every nation in the world faces shortages of health workers in remote areas. Cameroon is no exception to this. The Ministry of Public Health (MoPH) is currently considering several rural retention strategies to motivate qualified health personnel to practice in remote rural areas. To better calibrate these mechanisms and to develop evidence-based retention strategies that are attractive and motivating to health workers, a Discrete Choice Experiment (DCE) was conducted to examine what job attributes are most attractive and important to health workers when considering postings in remote areas. The study was carried out between July and August 2012 among 351 medical students, nursing students and health workers in Cameroon. Mixed logit models were used to analyze the data. Among medical and nursing students a rural retention bonus of 75% of base salary (aOR= 8.27, 95% CI: 5.28-12.96, Pimpact measurements were also estimated to identify combination of incentives that health workers would find most attractive. Based on these findings, the study recommends the introduction of a system of substantial monetary bonuses for rural service along with ensuring adequate and functional equipment and uninterrupted supplies. By focusing on the analysis of locally relevant, actionable incentives, generated through the involvement of policy-makers at the design stage, this study provides an example of research directly linked to policy action to address a vitally important issue in global health.

Elephantiasis of non-filarial origin (podoconiosis) in the highlands of north-western Cameroon.

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Wanji, S; Tendongfor, N; Esum, M; Che, J N; Mand, S; Tanga Mbi, C; Enyong, P; Hoerauf, A

2008-09-01

Lymphoedema, a condition of localized fluid retention, results from a compromised lymphatic system. Although one common cause in the tropics is infection with filarial worms, non-filarial lymphoedema, also known as podoconiosis, has been reported among barefoot farmers in volcanic highland zones of Africa, Central and South America and north-western India. There are conflicting reports on the causes of lymphoedema in the highland regions of Cameroon, where the condition is of great public-health importance. To characterise the focus of lymphoedema in the highlands of the North West province of Cameroon and investigate its real causes, a cross-sectional study was carried out on the adults (aged > or =15 years) living in the communities that fall within the Ndop and Tubah health districts. The subjects, who had to have lived in the study area for at least 10 years, were interviewed, examined clinically, and, when possible, checked for microfilaraemia. The cases of lymphoedema confirmed by ultrasonography and a random sample of the other subjects were also tested for filarial antigenaemia. The interviews, which explored knowledge, attitudes and perceptions (KAP) relating to lymphoedema, revealed that the condition was well known, with each study community having a local name for it. Of the 834 individuals examined clinically, 66 (8.1%) had lymphoedema of the lower limb, with all the clinical stages of this condition represented. None of the 792 individuals examined parasitologically, however, had microfilariae of W. bancrofti (or any other filarial parasite) in their peripheral blood, and only one (0.25%) of the 399 individuals tested for the circulating antigens of W. bancrofti gave a positive result. In addition, none of the 504 mosquitoes caught landing on human bait in the study area and dissected was found to harbour any stage of W. bancrofti. These findings indicate that the elephantiasis seen in the North West province of Cameroon is of non-filarial origin.

Assessing the influence of knowledge translation platforms on health system policy processes to achieve the health millennium development goals in Cameroon and Uganda: a comparative case study.

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Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

2018-05-01

There is a scarcity of empirical data on the influence of initiatives supporting evidence-informed health system policy-making (EIHSP), such as the knowledge translation platforms (KTPs) operating in Africa. To assess whether and how two KTPs housed in government-affiliated institutions in Cameroon and Uganda have influenced: (1) health system policy-making processes and decisions aiming at supporting achievement of the health millennium development goals (MDGs); and (2) the general climate for EIHSP. We conducted an embedded comparative case study of four policy processes in which Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda were involved between 2009 and 2011. We combined a documentary review and semi structured interviews of 54 stakeholders. A framework-guided thematic analysis, inspired by scholarship in health policy analysis and knowledge utilization was used. EVIPNet Cameroon and REACH-PI Uganda have had direct influence on health system policy decisions. The coproduction of evidence briefs combined with tacit knowledge gathered during inclusive evidence-informed stakeholder dialogues helped to reframe health system problems, unveil sources of conflicts, open grounds for consensus and align viable and affordable options for achieving the health MDGs thus leading to decisions. New policy issue networks have emerged. The KTPs indirectly influenced health policy processes by changing how interests interact with one another and by introducing safe-harbour deliberations and intersected with contextual ideational factors by improving access to policy-relevant evidence. KTPs were perceived as change agents with positive impact on the understanding, acceptance and adoption of EIHSP because of their complementary work in relation to capacity building, rapid evidence syntheses and clearinghouse of policy-relevant evidence. This embedded case study illustrates how two KTPs influenced

Poverty and health among CDC plantation labourers in Cameroon: Perceptions, challenges and coping strategies.

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Makoge, Valerie; Vaandrager, Lenneke; Maat, Harro; Koelen, Maria

2017-11-01

Creating better access to good quality healthcare for the poor is a major challenge to development. In this study, we examined inter-linkages between poverty and disease, referred to as poverty-related diseases (PRDs), by investigating how Cameroon Development Corporation (CDC) camp dwellers respond to diseases that adversely affect their health and wellbeing. Living in plantation camps is associated with poverty, overcrowding, poor sanitation and the rapid spread of diseases. In a survey of 237 CDC camp dwellers in Cameroon, we used the health belief model to understand the drivers (perceived threats, benefits and cues for treatment seeking) of reported responses. Using logistic regression analysis, we looked for trends in people's response to malaria. We calculated the odds ratio of factors shown to have an influence on people's health, such as food, water, sanitation challenges and seeking formal healthcare for malaria. Malaria (40.3%), cholera (20.8%) and diarrhoea (17.7%) were the major PRDs perceived by camp dwellers. We found a strong link between what respondents perceived as PRDS and hygiene conditions. Poverty for our respondents was more about living in poor hygiene conditions than lack of money. Respondents perceived health challenges as stemming from their immediate living environment. Moreover, people employed self-medication and other informal health practices to seek healthcare. Interestingly, even though respondents reported using formal healthcare services as a general response to illness (84%), almost 90% stated that, in the case of malaria, they would use informal healthcare services. Our study recommends that efforts to curb the devastating effects of PRDs should have a strong focus on perceptions (i.e. include diseases that people living in conditions of poverty perceive as PRDs) and on hygiene practices, emphasising how they can be improved. By providing insights into the inter-linkages between poverty and disease, our study offers relevant

Regulation of Biotechnology in Cameroon W

African Journals Online (AJOL)

... security and public health are high on government's policy agenda. ... tion by the Cameroon Development Corporation. (CDC) of a ... can model law on Safety in Biotechnology (and the Convention ..... its biosafety regulation on liability and redress in due course. ... in Kuala Lumpur, Malaysia in February this year. (2004).

Prevalence and determinants of burnout syndrome among physicians in Cameroon: a research proposal.

Science.gov (United States)

Feteh, Vitalis Fambombi; Njim, Tsi; Nji, Miriam A M; Ayeah, Chia Mark; Sama, Carlson-Babila; Tianyi, Frank Leonel

2017-10-25

Burnout syndrome is a common psychological state, that may affect human healthcare providers due to their prolonged exposure to job stressors. Burnout can hinder optimal healthcare delivery. Hence this study aims to determine the prevalence and correlates of burnout syndrome amongst physicians in Cameroon. Specifically: (1) to determine the prevalence of burnout syndrome amongst Cameroonian doctors. (2) To identify potential determinants of burnout among Cameroonian doctors. (3) To compare the prevalence and determinants of burnout among specialist physicians and general practitioners in Cameroon. This cross-sectional study will include a minimum of 335 doctors working in five regions of Cameroon. Consenting physicians will be consecutively recruited and data on sociodemographic and work characteristics will be collected via a printed self-administered questionnaire and burnout will be assessed using the Maslach Burnout Inventory. Data will be analysed using Epi Info version 7 and a p value health is largely neglected in developing countries like Cameroon. Data from this research will help inform practitioners on the magnitude of the problem and favour the development of policies that improve the mental health of care-providers.

Water supply, sanitation and health risks in Yaounde, Cameroon ...

African Journals Online (AJOL)

Population growth and rapid urbanization in Cameroon have led to major demographic changes in the urban centres, potentially resulting in serious environmental problems in the most populated cities such as Yaounde. In order to better understand the impacts on the hygiene conditions in certain quarters of this political ...

Poverty and health among CDC plantation labourers in Cameroon: Perceptions, challenges and coping strategies.

Directory of Open Access Journals (Sweden)

Valerie Makoge

2017-11-01

Full Text Available Creating better access to good quality healthcare for the poor is a major challenge to development. In this study, we examined inter-linkages between poverty and disease, referred to as poverty-related diseases (PRDs, by investigating how Cameroon Development Corporation (CDC camp dwellers respond to diseases that adversely affect their health and wellbeing. Living in plantation camps is associated with poverty, overcrowding, poor sanitation and the rapid spread of diseases. In a survey of 237 CDC camp dwellers in Cameroon, we used the health belief model to understand the drivers (perceived threats, benefits and cues for treatment seeking of reported responses. Using logistic regression analysis, we looked for trends in people's response to malaria. We calculated the odds ratio of factors shown to have an influence on people's health, such as food, water, sanitation challenges and seeking formal healthcare for malaria. Malaria (40.3%, cholera (20.8% and diarrhoea (17.7% were the major PRDs perceived by camp dwellers. We found a strong link between what respondents perceived as PRDS and hygiene conditions. Poverty for our respondents was more about living in poor hygiene conditions than lack of money. Respondents perceived health challenges as stemming from their immediate living environment. Moreover, people employed self-medication and other informal health practices to seek healthcare. Interestingly, even though respondents reported using formal healthcare services as a general response to illness (84%, almost 90% stated that, in the case of malaria, they would use informal healthcare services. Our study recommends that efforts to curb the devastating effects of PRDs should have a strong focus on perceptions (i.e. include diseases that people living in conditions of poverty perceive as PRDs and on hygiene practices, emphasising how they can be improved. By providing insights into the inter-linkages between poverty and disease, our study

HIV-1 group O infection in Cameroon from 2006 to 2013: Prevalence, genetic diversity, evolution and public health challenges

Science.gov (United States)

Villabona-Arenas, Christian Julian; Domyeum, Jenny; Mouacha, Fatima; Butel, Christelle; Delaporte, Eric; Peeters, Martine; Mpoudi-Ngole, Eitel; Aghokeng, Avelin Fobang

2015-01-01

The human immunodeficiency virus, HIV, is characterized by a tremendously high genetic diversity, leading to the currently known circulating HIV types, groups, subtypes, and recombinant forms. HIV-1 group O is one of the most diverse forms of HIV-1 and has been so far related to Cameroon or individuals originating from Cameroon. In this study, we investigated in Cameroon, the evolution of this viral group from 2006 to 2013, in terms of prevalence, genetic diversity and public health implications. Our results confirmed the predominance of HIV-1 group M (98.5%), a very low prevalence (O was found at around 0.6% (95% confidence interval: 0.4–0.8%), indicating that the frequency of this virus in Cameroon has remained stable over the last decades. However, we found an extensive high genetic diversity within this HIV-1 group, that resulted from previous steady increase on the effective number of HIV-1 group O infections through time, and the current distribution of the circulating viral strains still does not allow classification as subtypes. The frequency of dual infections with HIV-1 group M and group O was 0.8% (95% confidence interval: 0.6–1.0%), but we found no recombinant forms in co-infected patients. Natural resistance to integrase inhibitors was not identified, although we found several mutations considered as natural polymorphisms. Our study shows that infections with HIV-1 group O can be adequately managed in countries where the virus circulates, but this complex virus still represents a challenge for diagnostics and monitoring strategies. PMID:26371064

Challenges to implementing a National Health Information System in Cameroon: perspectives of stakeholders

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Emmanuel Ngwakongnwi

2014-03-01

Full Text Available In the early 90s, the Cameroon Ministry of Health implemented a National Health Information System (NHIS based on a bottom- up approach of manually collecting and reporting health data. Little is known about the implementation and functioning of the NHIS. The purpose of this study was to assess the implementation of the NHIS by documenting experiences of individual stakeholders, and to suggest recommendations for improvement. We reviewed relevant documents and conducted face-to-face interviews (N=4 with individuals directly involved with data gathering, reporting and storage. Content analysis was used to analyze textual data. We found a stalled and inefficient NHIS characterized by general lack of personnel, a labor-intensive process, delay in reporting data, much reliance on field staff, and lack of incentives. A move to an electronic health information system without involving all stakeholders and adequately addressing the issues plaguing the current system is premature.

Cameroon Journal of Experimental Biology

African Journals Online (AJOL)

The Cameroon Journal of Experimental Biology is the official journal of the Cameroon Forum for Biological Sciences (CAFOBIOS). It is an interdisciplinary journal for the publication of original research papers, short communications and review articles in all fields of experimental biology including biochemistry, physiology, ...

Bottleneck analysis at district level to illustrate gaps within the district health system in Uganda

Science.gov (United States)

Kiwanuka Henriksson, Dorcus; Fredriksson, Mio; Waiswa, Peter; Selling, Katarina; Swartling Peterson, Stefan

2017-01-01

ABSTRACT Background: Poor quality of care and access to effective and affordable interventions have been attributed to constraints and bottlenecks within and outside the health system. However, there is limited understanding of health system barriers to utilization and delivery of appropriate, high-impact, and cost-effective interventions at the point of service delivery in districts and sub-districts in low-income countries. In this study we illustrate the use of the bottleneck analysis approach, which could be used to identify bottlenecks in service delivery within the district health system. Methods: A modified Tanahashi model with six determinants for effective coverage was used to determine bottlenecks in service provision for maternal and newborn care. The following interventions provided during antenatal care were used as tracer interventions: use of iron and folic acid, intermittent presumptive treatment for malaria, HIV counseling and testing, and syphilis testing. Data from cross-sectional household and health facility surveys in Mayuge and Namayingo districts in Uganda were used in this study. Results: Effective coverage and human resource gaps were identified as the biggest bottlenecks in both districts, with coverage ranging from 0% to 66% for effective coverage and from 46% to 58% for availability of health facility staff. Our findings revealed a similar pattern in bottlenecks in both districts for particular interventions although the districts are functionally independent. Conclusion: The modified Tanahashi model is an analysis tool that can be used to identify bottlenecks to effective coverage within the district health system, for instance, the effective coverage for maternal and newborn care interventions. However, the analysis is highly dependent on the availability of data to populate all six determinants and could benefit from further validation analysis for the causes of bottlenecks identified. PMID:28581379

PENGEMBANGAN DISTRICT HEALTH COMMITTEE (Studi Kasus di Kabupaten Kutai Kartanegara dan Bojonegoro

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Setia Pranata

2012-11-01

Full Text Available Development of health could not be conducted by the government itself but needs active participation from various sectors. District/municipality governments should mobilize potential resources in the areas so the actively involved in the development of health. Hence the district/municipality governments urge to facilitate development of District Health Committee (DHC as a media composed of all parties that actively involved in the development of health. This is in accordance to the Ministry of Health Letter Number 004/Menkes/SK/I/2003 on policy and strategies on decentralization in health. The study aimed to determine policy about DHC, to facilitate for development DHC and to determine dynamics in the developmentof DHC in Kutai Kartanegara District, East Kalimantan Province and Bojonegoro District, East Java Province. Data were collected by depth interview from staffs at District Health Offices, Health Proffesion Organizations, Non Government Organizations, academics, and the social organizations. Results showed in Kutai Kartanegara District there was institution named District Health Assembly. The institution was formed by the requirement from Asian Development Bank, the funding agency to Decentralized Health Service (DHS Project in Kutai Kartanegara District. The institution has not yet functioned properly and its existence was not socialized widely. In Bojonegoro District, the DHC was thought as an ideal condition in the development of health which existence is needed by some institutions. As the District Health Office was not sure for it hence the development of DHC was assumed not in need. Key words: development of health, District Health Committee, District Health Assembly

The reliability and usability of district health information software ...

African Journals Online (AJOL)

The reliability and usability of district health information software: case studies from Tanzania. ... The District Health Information System (DHIS) software from the Health Information System ... EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

Yellow fever control in Cameroon: where are we now and where are we going?

Science.gov (United States)

Wiysonge, Charles Shey; Nomo, Emmanuel; Mawo, Jeanne; Ofal, James; Mimbouga, Julienne; Ticha, Johnson; Ndumbe, Peter M

2008-02-08

Cameroon is one of 12 African countries that bear most of the global burden of yellow fever. In 2002 the country developed a five-year strategic plan for yellow fever control, which included strategies for prevention as well as rapid detection and response to outbreaks when they occur. We have used data collected by the national Expanded Programme on Immunisation to assess the progress made and challenges faced during the first four years of implementing the plan. In January 2003, case-based surveillance of suspected yellow fever cases was instituted in the whole country. A year later, yellow fever immunisation at nine months of age (the same age as routine measles immunisation) was introduced. Supplementary immunisation activities (SIAs), both preventive and in response to outbreaks, also formed an integral part of the yellow fever control plan. Each level of the national health system makes a synthesis of its activities and sends this to the next higher level at defined regular intervals; monthly for routine data and daily for SIAs. From 2004 to 2006 the national routine yellow fever vaccination coverage rose from 58.7% to 72.2%. In addition, the country achieved parity between yellow fever and measles vaccination coverage in 2005 and has since maintained this performance level. The number of suspected yellow fever cases in the country increased from 156 in 2003 to 859 in 2006, and the proportion of districts that reported at least one suspected yellow fever case per year increased from 31.4% to 68.2%, respectively. Blood specimens were collected from all suspected cases (within 14 days of onset of symptoms) and tested at a central laboratory for yellow fever IgM antibodies; leading to confirmation of yellow fever outbreaks in the health districts of Bafia, Méri and Ntui in 2003, Ngaoundéré Rural in 2004, Yoko in 2005 and Messamena in 2006. Owing to constraints in rapidly mobilising the necessary resources, reactive SIAs were only conducted in Bafia and M�

Yellow fever control in Cameroon: Where are we now and where are we going?

Directory of Open Access Journals (Sweden)

Mimbouga Julienne

2008-02-01

Full Text Available Abstract Background Cameroon is one of 12 African countries that bear most of the global burden of yellow fever. In 2002 the country developed a five-year strategic plan for yellow fever control, which included strategies for prevention as well as rapid detection and response to outbreaks when they occur. We have used data collected by the national Expanded Programme on Immunisation to assess the progress made and challenges faced during the first four years of implementing the plan. Methods In January 2003, case-based surveillance of suspected yellow fever cases was instituted in the whole country. A year later, yellow fever immunisation at nine months of age (the same age as routine measles immunisation was introduced. Supplementary immunisation activities (SIAs, both preventive and in response to outbreaks, also formed an integral part of the yellow fever control plan. Each level of the national health system makes a synthesis of its activities and sends this to the next higher level at defined regular intervals; monthly for routine data and daily for SIAs. Results From 2004 to 2006 the national routine yellow fever vaccination coverage rose from 58.7% to 72.2%. In addition, the country achieved parity between yellow fever and measles vaccination coverage in 2005 and has since maintained this performance level. The number of suspected yellow fever cases in the country increased from 156 in 2003 to 859 in 2006, and the proportion of districts that reported at least one suspected yellow fever case per year increased from 31.4% to 68.2%, respectively. Blood specimens were collected from all suspected cases (within 14 days of onset of symptoms and tested at a central laboratory for yellow fever IgM antibodies; leading to confirmation of yellow fever outbreaks in the health districts of Bafia, Méri and Ntui in 2003, Ngaoundéré Rural in 2004, Yoko in 2005 and Messamena in 2006. Owing to constraints in rapidly mobilising the necessary resources

Heat impact on schoolchildren in Cameroon, Africa: potential health threat from climate change

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Tord Kjellstrom

2010-11-01

Full Text Available Background: Health impacts related to climate change are potentially an increasing problem in Cameroon, especially during hot seasons when there are no means for protective and adaptive actions. Objective: To describe environmental conditions in schools and to evaluate the impact of heat on schoolchildren's health during school days in the Cameroon cities of Yaoundé and Douala. Methods: Schoolchildren (N=285 aged 12–16 years from public secondary schools completed a questionnaire about their background, general symptoms, and hot feelings in a cross-sectional study. In Yaoundé, 50 schoolchildren were individually interviewed during school days about hourly symptoms (fatigue, headache, and feeling very hot and performance. Lascar dataloggers were used to measure indoor classroom temperatures and humidity. Results: There was a significant correlation between daily indoor temperature and the percentages of schoolchildren who felt very hot, had fatigue, and headaches in Yaoundé. A high proportion of schoolchildren felt very hot (48%, had fatigue (76%, and headaches (38% in Yaoundé. Prevalences (% were higher among girls than boys for headaches (58 vs 39, feeling ‘very hot overall’ (37 vs 21, and ‘very hot in head’ (21 vs 18. Up to 62% were absentminded and 45% had slow writing speed. High indoor temperatures of 32.5°C in Yaoundé and 36.6°C in Douala were observed in school. Conclusions: Headache, fatigue, and feeling very hot associated with high indoor air temperature were observed among schoolchildren in the present study. Longitudinal data in schools are needed to confirm these results. School environmental conditions should be improved in order to enhance learning.

District health information system assessment: a case study in iran.

Science.gov (United States)

Raeisi, Ahmad Reza; Saghaeiannejad, Sakineh; Karimi, Saeed; Ehteshami, Asghar; Kasaei, Mahtab

2013-03-01

Health care managers and personnel should be aware and literate of health information system in order to increase the efficiency and effectiveness in their organization. Since accurate, appropriate, precise, timely, valid information and interpretation of information is required and is the basis for policy planning and decision making in various levels of the organization. This study was conducted to assess the district health information system evolution in Iran according to WHO framework. This research is an applied, descriptive cross sectional study, in which a total of twelve urban and eight rural facilities, and the district health center at Falavarjan region were surveyed by using a questionnaire with 334 items. Content and constructive validity and reliability of the questionnaire were confirmed with correlation coefficient of 0.99. Obtained data were analyzed with SPSS 16 software and descriptive statistics were used to examine measures of WHO compliance. The analysis of data revealed that the mean score of compliance of district health information system framework was 35.75 percent. The maximum score of compliance with district health information system belonged to the data collection process (70 percent). The minimum score of compliance with district health information system belonged to information based decision making process with a score of 10 percent. District Health Information System Criteria in Isfahan province do not completely comply with WHO framework. Consequently, it seems that health system managers engaged with underlying policy and decision making processes at district health level should try to restructure and decentralize district health information system and develop training management programs for their managers.

An endangered species in Cameroon

African Journals Online (AJOL)

Justine Nzweundji

2015-08-19

Aug 19, 2015 ... 2002) and one of the main sources of supply to satisfy this demand consists of Cameroon natural populations. (Nsawir and Ingram, 2007). Unfortunately, much of this exploitation has been ..... Prunus africana: Money growing on trees? A plant that can boost rural economies in the Cameroon Highlands.

The Impact Of Dental Auxiliaries In Oral Health Delivery In Cameroon

African Journals Online (AJOL)

treat 6-10 patients per day while 13 (29.5%) of respondents work without any direct supervision. Out of ... the training and job description of dental auxiliaries in Cameroon. Introduction .... A Textbook for Preventive and. Community Dentistry.

Cameroon.

Science.gov (United States)

1992-06-01

The US profile of Cameroon indicates brief statistics on the population, geography, government, and economy and brief descriptions of the population, the history, government, political conditions, the economy, foreign relations, defense, and relations with the US. Principal government and US officials are furnished. The 1991 estimated population of Cameroon was 11.7 million of which 60% is rural. There are 200 different tribes who speak many African languages and dialects. The French and English languages both have official status. Muslims live in the north and Christians in the south. 80% live in the formerly French east. The growth rate is 3%. There is 65% literacy. Infant mortality is 20%. 70% are agricultural workers, 13% industrial and commercial, and 17% other. The government is an independent republic with an executive and legislative branch. Independence was achieved in 1960. There is 1 ruling party. Traditional courts administer the laws. Traditional rulers are treated as administrative adjuncts. Suffrage is universal adult. The central government budget is 1.4 billion of which 8.7% is for defense. There are 10 provinces and 4 major cities. The seaport city Douala is the largest at 1.5 million. Gross domestic product (GDP) is $12.5 billion with an annual growth rate of 4.3% and an inflation rate of 2%. Growth has been variable since 1988 and reached a low of 2.4% in 1988-89. Oil, natural gas, bauxite, iron core, and timber are natural resources. 27% of the GDP is in agricultural products (cocoa, coffee, cotton, fishing, and forestry). 13% of the GDP is manufacturing and 24% is industry. Exports are valued at $2.9 billion and imports at $2.2 billion. Major markets are France, Netherlands, and the US. Imports include intermediate goods, capital goods, fuel and lubricants, foodstuffs, beverages, and tobacco. Early inhabitants were the Pygmies, followed later by Bantu speakers, and Muslim Fulani. Political consolidation was achieved in 1970 after a period of

Clustered lot quality assurance sampling: a tool to monitor immunization coverage rapidly during a national yellow fever and polio vaccination campaign in Cameroon, May 2009.

Science.gov (United States)

Pezzoli, L; Tchio, R; Dzossa, A D; Ndjomo, S; Takeu, A; Anya, B; Ticha, J; Ronveaux, O; Lewis, R F

2012-01-01

We used the clustered lot quality assurance sampling (clustered-LQAS) technique to identify districts with low immunization coverage and guide mop-up actions during the last 4 days of a combined oral polio vaccine (OPV) and yellow fever (YF) vaccination campaign conducted in Cameroon in May 2009. We monitored 17 pre-selected districts at risk for low coverage. We designed LQAS plans to reject districts with YF vaccination coverage LQAS proved to be useful in guiding the campaign vaccination strategy before the completion of the operations.

Public health implications of contamination of Franc CFA (XAF) circulating in Buea (Cameroon) with drug resistant pathogens.

Science.gov (United States)

Akoachere, Jane-Francis Tatah Kihla; Gaelle, Nana; Dilonga, Henry Meriki; Nkuo-Akenji, Theresa K

2014-01-08

Studies in different parts of the world have implicated money as a vehicle for transmission of pathogens. Such information which is necessary to facilitate infection control strategies is lacking in many sub-Saharan countries including Cameroon. This study analyzed the Franc de la Communauté Financiere d'Afrique (Franc CFA), the currency used in Cameroon and other countries in the Central African sub-region, as a potential vehicle for transmission of pathogenic bacteria and fungi, particularly drug-resistant strains, to generate findings which could create awareness on currency contamination and serve as a guide when formulating health policies on currency. Two hundred and thirteen currency samples representing various denominations of notes and coins randomly collected from diverse sources in Buea, Cameroon were analyzed for bacteria and fungi. The sensitivity of bacterial isolates to antibiotics was tested using the disc diffusion method. The relationship between contamination and physical state, source or denomination of currency was assessed using the χ2 test. All statistics were discussed at 0.05 significance level. Two hundred (93.9%) samples were contaminated with notes (96.6%) showing higher contamination than coins (88.2%). Uncirculated (mint) samples showed no contamination. There was a significant difference (PCFA franc circulating in Buea could serve as a vehicle for transmission of drug resistant pathogenic or potential organisms and contamination could be due to currency usage and handling as mint notes were not contaminated. Hygiene practices during or after handling currency is greatly encouraged to prevent infection.

Setting performance-based financing in the health sector agenda: a case study in Cameroon.

Science.gov (United States)

Sieleunou, Isidore; Turcotte-Tremblay, Anne-Marie; Fotso, Jean-Claude Taptué; Tamga, Denise Magne; Yumo, Habakkuk Azinyui; Kouokam, Estelle; Ridde, Valery

2017-08-01

More than 30 countries in sub-Saharan Africa have introduced performance-based financing (PBF) in their healthcare systems. Yet, there has been little research on the process by which PBF was put on the national policy agenda in Africa. This study examines the policy process behind the introduction of PBF program in Cameroon. The research is an explanatory case study using the Kingdon multiple streams framework. We conducted a document review and 25 interviews with various types of actors involved in the policy process. We conducted thematic analysis using a hybrid deductive-inductive approach for data analysis. By 2004, several reports and events had provided evidence on the state of the poor health outcomes and health financing in the country, thereby raising awareness of the situation. As a result, decision-makers identified the lack of a suitable health financing policy as an important issue that needed to be addressed. The change in the political discourse toward more accountability made room to test new mechanisms. A group of policy entrepreneurs from the World Bank, through numerous forms of influence (financial, ideational, network and knowledge-based) and building on several ongoing reforms, collaborated with senior government officials to place the PBF program on the agenda. The policy changes occurred as the result of two open policy windows (i.e. national and international), and in both instances, policy entrepreneurs were able to couple the policy streams to effect change. The policy agenda of PBF in Cameroon underlined the importance of a perceived crisis in the policy reform process and the advantage of building a team to carry forward the policy process. It also highlighted the role of other sources of information alongside scientific evidence (eg.: workshop and study tour), as well as the role of previous policies and experiences, in shaping or influencing respectively the way issues are framed and reformers' actions and choices.

Understanding of research, genetics and genetic research in a rapid ethical assessment in north west Cameroon.

Science.gov (United States)

Kengne-Ouafo, Jonas A; Millard, James D; Nji, Theobald M; Tantoh, William F; Nyoh, Doris N; Tendongfor, Nicholas; Enyong, Peter A; Newport, Melanie J; Davey, Gail; Wanji, Samuel

2016-05-01

There is limited assessment of whether research participants in low-income settings are afforded a full understanding of the meaning of medical research. There may also be particular issues with the understanding of genetic research. We used a rapid ethical assessment methodology to explore perceptions surrounding the meaning of research, genetics and genetic research in north west Cameroon. Eleven focus group discussions (including 107 adults) and 72 in-depth interviews were conducted with various stakeholders in two health districts in north west Cameroon between February and April 2012. Most participants appreciated the role of research in generating knowledge and identified a difference between research and healthcare but gave varied explanations as to this difference. Most participants' understanding of genetics was limited to concepts of hereditary, with potential benefits limited to the level of the individual or family. Explanations based on supernatural beliefs were identified as a special issue but participants tended not to identify any other special risks with genetic research. We demonstrated a variable level of understanding of research, genetics and genetic research, with implications for those carrying out genetic research in this and other low resource settings. Our study highlights the utility of rapid ethical assessment prior to complex or sensitive research. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Leadership Style: School Perspective in Cameroon

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Asan Vernyuy Wirba

2015-01-01

Full Text Available This paper examines leadership styles of secondary school principals in Cameroon, in terms of transformational, transactional, and laissez-faire leadership styles. This paper discusses the leadership styles in Cameroon and puts forward ideas for continuous improvement. A qualitative approach, using a semistructured interview, was adopted. It was conducted on ten principals, ten teachers, and ten students. Majority of respondents from schools described their principals as transformational leaders. Doubts are cast on the nature of transformational leadership in schools in Cameroon, since there is less training and development for leadership in schools.

Youth awareness on sexually transmitted infections, HIV and AIDS in secondary schools in the Dschang Municipality (Cameroon: the Mobile Caravan Project

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Martin Sanou Sobze

2017-01-01

Full Text Available Awareness is a preventive action to instill in individuals certain concepts to improve their health. It is an essential element in the prevention of sexually transmitted infection (STI/HIV and early pregnancies among adolescents. In 2012, the prevalence of HIVin Cameroon was estimated at 4.3%. The young population appear to be the most affected (3.2%; very close to that of the Dschang Health District (Cameroon; 3.1% in the 15-19 years age group. Theaimof this study was to evaluate the contribution of the Mobile Caravan project on the preventive aspect of STI/HIV/AIDS among youths of Dschang in 10 secondary schools within three years. 2029 students joined the project’s activities and 58.55% of them belonged to the age group of 16-21 years. Most students attended private schools. Nearly 3/4 of students (1515/2029 had an acceptable level of knowledge regarding STI/HIV/AIDS, which increased in number each year (from 641 to 716 students between 2012 and 2014. The Level of knowledge was significantly determinedby the study cycle (P=0.0004, the type of school (P=0.0027 and the year ofimplementation of activities (P=0.0026. The caravan project has greatly contributed to improving young peoples’ awareness on STI/HIV/AIDS in Dschang Municipality.

Perception of the Environmental Degradation of Gold Mining on Socio-Economic Variables in Eastern Cameroon, Cameroon

OpenAIRE

Marc Anselme Kamga; Charles Olufisayo Olatubara; Moses Monday Atteh; Serge Nzali; Adeola Adenikinju; Théodore Yimgnia Mbiatso; Ralain Bryan Ngatcha

2018-01-01

Artisanal mining is associated with a number of environmental impacts, including deforestation and land degradation, open pits which pose animal traps and health hazards, and heavy metals contamination of land (water and soil), dust and noise pollution. The study examines the perception of environmental degradation of gold mining sites in eastern Cameroon. Human-environment interaction and distance decay models are the conceptual framework for this study.  This study employed a survey re...

Candidiasis in HIV and AIDS Patients Attending the Nylon Health District Hospital in Douala, Cameroon

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Anna Longdoh Njunda

2011-12-01

Full Text Available AIM: Candidiasis is the leading opportunistic mycosis in HIV and AIDS patients. METHOD: In order to determine its prevalence in patients with different CD4+ T cell categories in the Nylon Health District in Douala, a cross-sectional study was carried out whereby 304 HIV positive individuals were recruited between March and August, 2007. They were divided into two groups; those on highly active antiretroviral therapy (HAART and those not on HAART. Three samples constituting mouth, vaginal/urethral swabs and urine were collected from each subject. RESULTS: A total of 204 (67.1% [95% confidence interval (CI: 0.618-0.724] of these patients had more than one predisposing condition to candidiasis, with those on antibiotic therapy having the highest prevalence (63.7% followed by pregnant patients (7.3% (P < 0.05. Candidiasis was more common in patients with low CD4+ T cell count (<200 [66%] than patients with higher CD4+ T cell count (17.9% (P<0.05. One hundred and sixty one (53% of the patients had candidiasis whereby those not on HAART were more frequently infected (69.6% than those on HAART (30.1% (P< 0.05. CONCLUSION: We conclude that candidiasis is a major opportunistic infection in HIV patients and should be checked especially in patients not yet on antiretroviral therapy. [TAF Prev Med Bull 2011; 10(6.000: 701-706

The present status and perspectives of Biotechnology in Cameroon ...

African Journals Online (AJOL)

... for the rapid exploitation of biotechnology for the socioeconomic development of Cameroon, subject to the mobilization of the necessary venture capital. Keywords: Cameroon, Biotechnology, GMO, Biodiversity, Economic Development, Recombinant DNA JOURNAL OF THE CAMEROON ACADEMY OF SCIENCES Vol.

Nutrition Transition and Biocultural Determinants of Obesity among Cameroonian Migrants in Urban Cameroon and France.

Science.gov (United States)

Cohen, Emmanuel; Amougou, Norbert; Ponty, Amandine; Loinger-Beck, Juliette; Nkuintchua, Téodyl; Monteillet, Nicolas; Bernard, Jonathan Y; Saïd-Mohamed, Rihlat; Holdsworth, Michelle; Pasquet, Patrick

2017-06-29

Native of rural West Cameroon, the Bamiléké population is traditionally predisposed to obesity. Bamiléké who migrated to urban areas additionally experience the nutrition transition. We investigated the biocultural determinants of obesity in Bamiléké who migrated to urban Cameroon (Yaoundé), or urban France (Paris). We conducted qualitative interviews ( n = 36; 18 men) and a quantitative survey ( n = 627; 266 men) of adults using two-stage sampling strategy, to determine the association of dietary intake, physical activity and body weight norms with obesity of Bamiléké populations in these three socio-ecological areas (rural Cameroon: n = 258; urban Cameroon: n = 319; urban France: n = 50). The Bamiléké valued overweight and traditional energy-dense diets in rural and urban Cameroon. Physical activity levels were lower, consumption of processed energy-dense food was frequent and obesity levels higher in new migrants living in urban Cameroon and France. Female sex, age, duration of residence in urban areas, lower physical activity and valorisation of overweight were independently associated with obesity status. This work argues in favour of local and global health policies that account for the origin and the migration trajectories to prevent obesity in migrants.

Addressing Health Workforce Distribution Concerns: A Discrete Choice Experiment to Develop Rural Retention Strategies in Cameroon

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Paul Jacob Robyn

2015-03-01

Full Text Available Background Nearly every nation in the world faces shortages of health workers in remote areas. Cameroon is no exception to this. The Ministry of Public Health (MoPH is currently considering several rural retention strategies to motivate qualified health personnel to practice in remote rural areas. Methods To better calibrate these mechanisms and to develop evidence-based retention strategies that are attractive and motivating to health workers, a Discrete Choice Experiment (DCE was conducted to examine what job attributes are most attractive and important to health workers when considering postings in remote areas. The study was carried out between July and August 2012 among 351 medical students, nursing students and health workers in Cameroon. Mixed logit models were used to analyze the data. Results Among medical and nursing students a rural retention bonus of 75% of base salary (aOR= 8.27, 95% CI: 5.28-12.96, P< 0.001 and improved health facility infrastructure (aOR= 3.54, 95% CI: 2.73-4.58 respectively were the attributes with the largest effect sizes. Among medical doctors and nurse aides, a rural retention bonus of 75% of base salary was the attribute with the largest effect size (medical doctors aOR= 5.60, 95% CI: 4.12-7.61, P< 0.001; nurse aides aOR= 4.29, 95% CI: 3.11-5.93, P< 0.001. On the other hand, improved health facility infrastructure (aOR= 3.56, 95% CI: 2.75-4.60, P< 0.001, was the attribute with the largest effect size among the state registered nurses surveyed. Willingness-to-Pay (WTP estimates were generated for each health worker cadre for all the attributes. Preference impact measurements were also estimated to identify combination of incentives that health workers would find most attractive. Conclusion Based on these findings, the study recommends the introduction of a system of substantial monetary bonuses for rural service along with ensuring adequate and functional equipment and uninterrupted supplies. By focusing on

Achieving universal health coverage in South Africa through a district health system approach: conflicting ideologies of health care provision.

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Fusheini, Adam; Eyles, John

2016-10-07

Universal Health Coverage (UHC) has emerged as a major goal for health care delivery in the post-2015 development agenda. It is viewed as a solution to health care needs in low and middle countries with growing enthusiasm at both national and global levels. Throughout the world, however, the paths of countries to UHC have differed. South Africa is currently reforming its health system with UHC through developing a national health insurance (NHI) program. This will be practically achieved through a decentralized approach, the district health system, the main vehicle for delivering services since democracy. We utilize a review of relevant documents, conducted between September 2014 and December 2015 of district health systems (DHS) and UHC and their ideological underpinnings, to explore the opportunities and challenges, of the district health system in achieving UHC in South Africa. Review of data from the NHI pilot districts suggests that as South Africa embarks on reforms toward UHC, there is a need for a minimal universal coverage and emphasis on district particularity and positive discrimination so as to bridge health inequities. The disparities across districts in relation to health profiles/demographics, health delivery performance, management of health institutions or district management capacity, income levels/socio-economic status and social determinants of health, compliance with quality standards and above all the burden of disease can only be minimised through positive discrimination by paying more attention to underserved and disadavantaged communities. We conclude that in South Africa the DHS is pivotal to health reform and UHC may be best achieved through minimal universal coverage with positive discrimination to ensure disparities across districts in relation to disease burden, human resources, financing and investment, administration and management capacity, service readiness and availability and the health access inequalities are consciously

Opposition Politics and Electoral Democracy in Cameroon, 1992-2007

African Journals Online (AJOL)

2015-05-29

May 29, 2015 ... This article seeks to assess the impact of electoral democracy in. Cameroon especially ... Democratic Party (KNDP), the Cameroon People National Congress (CPNC) and the Cameroon .... The Supreme Court cancelled the election results in seven constituencies ..... Church and the media (Ake 2000:135).

Home modification to reduce falls at a health district level: Modeling health gain, health inequalities and health costs.

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Nick Wilson

Full Text Available There is some evidence that home safety assessment and modification (HSAM is effective in reducing falls in older people. But there are various knowledge gaps, including around cost-effectiveness and also the impacts at a health district-level.A previously established Markov macro-simulation model built for the whole New Zealand (NZ population (Pega et al 2016, Injury Prevention was enhanced and adapted to a health district level. This district was Counties Manukau District Health Board, which hosts 42,000 people aged 65+ years. A health system perspective was taken and a discount rate of 3% was used for both health gain and costs. Intervention effectiveness estimates came from a systematic review, and NZ-specific intervention costs were extracted from a randomized controlled trial. In the 65+ age-group in this health district, the HSAM program was estimated to achieve health gains of 2800 quality-adjusted life-years (QALYs; 95% uncertainty interval [UI]: 547 to 5280. The net health system cost was estimated at NZ$8.44 million (95% UI: $663 to $14.3 million. The incremental cost-effectiveness ratio (ICER was estimated at NZ$5480 suggesting HSAM is cost-effective (95%UI: cost saving to NZ$15,300 [equivalent to US$10,300]. Targeting HSAM only to people age 65+ or 75+ with previous injurious falls was estimated to be particularly cost-effective (ICERs: $700 and $832, respectively with the latter intervention being cost-saving. There was no evidence for differential cost-effectiveness by sex or by ethnicity: Māori (Indigenous population vs non-Māori.This modeling study suggests that a HSAM program could produce considerable health gain and be cost-effective for older people at a health district level. Nevertheless, comparisons may be desirable with other falls prevention interventions such as group exercise programs, which also provide social contact and may prevent various chronic diseases.

Mental health in primary health care in a rural district of Cambodia: a situational analysis.

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Olofsson, Sofia; Sebastian, Miguel San; Jegannathan, Bhoomikumar

2018-01-01

While mental and substance use disorders are common worldwide, the treatment gap is enormous in low and middle income countries. Primary health care is considered to be the most important way for people to get mental health care. Cambodia is a country with a long history of war and has poor mental health and limited resources for care. The aim of this study was to conduct a situational analysis of the mental health services in the rural district of Lvea Em, Kandal Province, Cambodia. A cross-sectional situational analysis was done to understand the mental health situation in Lvea Em District comparing it with the national one. The Programme for improving mental health care (PRIME) tool was used to collect systematic information about mental health care from 14 key informants in Cambodia. In addition, a separate questionnaire based on the PRIME tool was developed for the district health care centres (12 respondents). Ethical approval was obtained from the National Ethics Committee for Health Research in Cambodia. Mental health care is limited both in Lvea Em District and the country. Though national documents containing guidelines for mental health care exist, the resources available and health care infrastructure are below what is recommended. There is no budget allocated for mental health in the district; there are no mental health specialists and the mental health training of health care workers is insufficient. Based on the limited knowledge from the respondents in the district, mental health disorders do exist but no documentation of these patients is available. Respondents discussed how community aspects such as culture, history and religion were related to mental health. Though there have been improvements in understanding mental health, discrimination and abuse against people with mental health disorders seems still to be present. There are very limited mental health care services with hardly any budget allocated to them in Lvea Em District and Cambodia

Retention of health workers in Malawi: perspectives of health workers and district management.

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Manafa, Ogenna; McAuliffe, Eilish; Maseko, Fresier; Bowie, Cameron; MacLachlan, Malcolm; Normand, Charles

2009-07-28

Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques.Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource management practices such as performance appraisal and the

Retention of health workers in Malawi: perspectives of health workers and district management

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MacLachlan Malcolm

2009-07-01

Full Text Available Abstract Background Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. Methods A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques. Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. Results The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource

Implementing a Fee-for-Service Cervical Cancer Screening and Treatment Program in Cameroon: Challenges and Opportunities.

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DeGregorio, Geneva; Manga, Simon; Kiyang, Edith; Manjuh, Florence; Bradford, Leslie; Cholli, Preetam; Wamai, Richard; Ogembo, Rebecca; Sando, Zacharie; Liu, Yuxin; Sheldon, Lisa Kennedy; Nulah, Kathleen; Welty, Thomas; Welty, Edith; Ogembo, Javier Gordon

2017-07-01

Cervical cancer screening is one of the most effective cancer prevention strategies, but most women in Africa have never been screened. In 2007, the Cameroon Baptist Convention Health Services, a large faith-based health care system in Cameroon, initiated the Women's Health Program (WHP) to address this disparity. The WHP provides fee-for-service cervical cancer screening using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC), prioritizing care for women living with HIV/AIDS. They also provide clinical breast examination, family planning (FP) services, and treatment for reproductive tract infection (RTI). Here, we document the strengths and challenges of the WHP screening program and the unique aspects of the WHP model, including a fee-for-service payment system and the provision of other women's health services. We retrospectively reviewed WHP medical records from women who presented for cervical cancer screening from 2007-2014. In 8 years, WHP nurses screened 44,979 women for cervical cancer. The number of women screened increased nearly every year. The WHP is sustained primarily on fees-for-service, with external funding totaling about $20,000 annually. In 2014, of 12,191 women screened for cervical cancer, 99% received clinical breast exams, 19% received FP services, and 4.7% received treatment for RTIs. We document successes, challenges, solutions implemented, and recommendations for optimizing this screening model. The WHP's experience using a fee-for-service model for cervical cancer screening demonstrates that in Cameroon VIA-DC is acceptable, feasible, and scalable and can be nearly self-sustaining. Integrating other women's health services enabled women to address additional health care needs. The Cameroon Baptist Convention Health Services Women's Health Program successfully implemented a nurse-led, fee-for-service cervical cancer screening program using visual inspection with acetic acid-enhanced by digital cervicography in

Marketing of Accommodation services : Case-Hotel Azam Cameroon

OpenAIRE

Youkam, Germaine

2012-01-01

Cameroon is Africa in miniature with a lot of tourist attractions owing to its geological and cultural diversity. Natural features include beaches, deserts, mountains, rainforests, and savannas. Accommodation services have been a grand phenomenon within the tourism industry in Cameroon. The accommodation sector has developed tremendously within the past decades. The objective of this research work was to find about out the marketing of accommodation services in Cameroon with Hotel Azam as...

Treatment of malaria from monotherapy to artemisinin-based combination therapy by health professionals in urban health facilities in Yaoundé, central province, Cameroon

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Bley Daniel

2009-07-01

Full Text Available Abstract Background After adoption of artesunate-amodiaquine (AS/AQ as first-line therapy for the treatment of uncomplicated malaria by the malaria control programme, this study was designed to assess the availability of anti-malarial drugs, treatment practices and acceptability of the new protocol by health professionals, in the urban health facilities and drugstores of Yaoundé city, Cameroon. Methods Between April and August 2005, retrospective and current information was collected by consulting registers and interviewing health practitioners in urban health facilities using a structured questionnaire. Results In 2005, twenty-seven trade-named drugs have been identified in drugstores; quinine tablets (300 mg were the most affordable anti-malarial drugs. Chloroquine was restricted to food market places and no generic artemisinin derivative was available in public health centres. In public health facilities, 13.6% of health professionals were informed about the new guidelines; 73.5% supported the use of AS-AQ as first-line therapy. However, 38.6% apprehended its use due to adverse events attributed to amodiaquine. Malaria treatment was mainly based on the diagnosis of fever. Quinine (300 mg tablets was the most commonly prescribed first-line anti-malarial drug in adults (44.5% and pregnant women (52.5%. Artequin® was the most cited artemsinin-based combination therapy (ACT (9.9%. Medical sales representatives were the main sources of information on anti-malarials. Conclusion The use of AS/AQ was not implemented in 2005 in Yaoundé, despite the wide range of anti-malarials and trade-named artemisinin derivatives available. Nevertheless, medical practitioners will support the use of this combination, when it is available in a paediatric formulation, at an affordable price. Training, information and participation of health professionals in decision-making is one of the key elements to improve adherence to new protocol guidelines. This baseline

how do district health managers experience the impact of family ...

African Journals Online (AJOL)

KB Von Pressentin

impact of family physicians within the South African district health system? ... paper (2015) described six aspirational roles of family physicians (FPs) working within the district health system. ... composition and deployment of the primary care workforce.5 ... mental health.30,31 In addition, FPs appear to have some impact.

Innovation in health service delivery: integrating community health assistants into the health system at district level in Zambia.

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Zulu, Joseph Mumba; Hurtig, Anna-Karin; Kinsman, John; Michelo, Charles

2015-01-28

To address the huge human resources for health gap in Zambia, the Ministry of Health launched the National Community Health Assistant Strategy in 2010. The strategy aims to integrate community-based health workers into the health system by creating a new group of workers, called community health assistants (CHAs). However, literature suggests that the integration process of national community-based health worker programmes into health systems has not been optimal. Conceptually informed by the diffusion of innovations theory, this paper qualitatively aimed to explore the factors that shaped the acceptability and adoption of CHAs into the health system at district level in Zambia during the pilot phase. Data gathered through review of documents, 6 focus group discussions with community leaders, and 12 key informant interviews with CHA trainers, supervisors and members of the District Health Management Team were analysed using thematic analysis. The perceived relative advantage of CHAs over existing community-based health workers in terms of their quality of training and scope of responsibilities, and the perceived compatibility of CHAs with existing groups of health workers and community healthcare expectations positively facilitated the integration process. However, limited integration of CHAs in the district health governance system hindered effective programme trialability, simplicity and observability at district level. Specific challenges at this level included a limited information flow and sense of programme ownership, and insufficient documentation of outcomes. The district also had difficulties in responding to emergent challenges such as delayed or non-payment of CHA incentives, as well as inadequate supervision and involvement of CHAs in the health posts where they are supposed to be working. Furthermore, failure of the health system to secure regular drug supplies affected health service delivery and acceptability of CHA services at community level. The

Health-Seeking Behaviour towards Poverty-Related Disease (PRDs: A Qualitative Study of People Living in Camps and on Campuses in Cameroon.

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Valerie Makoge

2017-01-01

Full Text Available Poverty-Related Diseases (PRDs emphasize poverty as a 'breeding-ground' for a range of diseases. The study presented here starts from the premise that poverty is a general condition that can limit people's capacity to prevent, mitigate or treat diseases. Using an interpretation of health seeking behaviour (HSB, inspired by the salutogenic approach, we investigated how people deal with PRDs, their ability and strategies put in place to cope. We collected HSB data from two groups of respondents in Cameroon: labourers of the Cameroon Development Corporation (CDC living in settlements called camps and students of the state universities of Buea and Yaoundé living in settlements we refer to as campuses. By selecting these groups, the study offers a unique view of how different people cope with similar health challenges. We carried out semi-structured interviews with 21 camp dwellers and 21 students in a cross-sectional study. Our findings revealed 1 respondents use multiple resources to cope with PRDs. 2 Respondents' perceptions of diseases and connection with poverty closely ties to general hygienic conditions of their living environment. 3 Utilisation of health facilities is not strongly dependent on financial resources. 4 Volatile health facilities are a major challenge and reason for people to revert to other health resources. The study brings out the need for organisations (governmental and non-governmental to strengthen people's capacities to cope with health situations through better health and housing policies geared at incorporating practices currently used by the people and supporting pro-hygienic initiatives.

Deficiencies in pastoral care with prisoners in Cameroon

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Abraham K. Akih

2012-08-01

Full Text Available Cameroon celebrated fifty years of independence from colonial rule on 20 May 2010. Major problems facing the nation are economic, social and political crises and the appalling condition of its prisons. This article focuses on pastoral care with prisoners in Cameroon. Most churches in Cameroon have no pastoral care programme for prisoners. The churches in general are not yet committed to this kind of work. The article argues that changes and reform of the penitential system will be difficult if not impossible without collaboration with other institutions and resources, which include the different faith communities and faith based organisations. The focus should be on the care and well-being of those within its walls if successful rehabilitation is to take place. Spiritual care will contribute to the general well-being of prisoners. The article gives a broad overview of the situation of prisons and prisoners in Cameroon and presents a pastoral care approach that could contribute to the overall improvement of the lives of people in Cameroon prisons.

Implications of the Bakassi conflict resolution for Cameroon

African Journals Online (AJOL)

the security and economic interests of the colonial powers. After independence, ... nation-state intervenes in the domestic disputes of another state. Occasionally, a .... and in Cameroon, where the Southern Cameroon National Council (SCNC).

Can action research strengthen district health management and improve health workforce performance? A research protocol.

Science.gov (United States)

Mshelia, C; Huss, R; Mirzoev, T; Elsey, H; Baine, S O; Aikins, M; Kamuzora, P; Bosch-Capblanch, X; Raven, J; Wyss, K; Green, A; Martineau, T

2013-08-30

The single biggest barrier for countries in sub-Saharan Africa (SSA) to scale up the necessary health services for addressing the three health-related Millennium Development Goals and achieving Universal Health Coverage is the lack of an adequate and well-performing health workforce. This deficit needs to be addressed both by training more new health personnel and by improving the performance of the existing and future health workforce. However, efforts have mostly been focused on training new staff and less on improving the performance of the existing health workforce. The purpose of this paper is to disseminate the protocol for the PERFORM project and reflect on the key challenges encountered during the development of this methodology and how they are being overcome. The overall aim of the PERFORM project is to identify ways of strengthening district management in order to address health workforce inadequacies by improving health workforce performance in SSA. The study will take place in three districts each in Ghana, Tanzania and Uganda using an action research approach. With the support of the country research teams, the district health management teams (DHMTs) will lead on planning, implementation, observation, reflection and redefinition of the activities in the study. Taking into account the national and local human resource (HR) and health systems (HS) policies and practices already in place, 'bundles' of HR/HS strategies that are feasible within the context and affordable within the districts' budget will be developed by the DHMTs to strengthen priority areas of health workforce performance. A comparative analysis of the findings from the three districts in each country will add new knowledge on the effects of these HR/HS bundles on DHMT management and workforce performance and the impact of an action research approach on improving the effectiveness of the DHMTs in implementing these interventions. Different challenges were faced during the development of

Survey of tomato diseases in Cameroon

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Fontem, DA.

1993-01-01

Full Text Available Tomato (Lycopersicon esculentum Mill. is the most widely cultivated field vegetable crop in Cameroon. On-farm surveys were undertaken from November 1988 to October 1991 to identify nursery and field diseases in major tomato producing areas of Cameroon, Damping-off and seedling blights were the main seedling diseases. Of the eleven diseases observed in the field, the most widely distributed and severe on the foliage and fruits were early (Alternaria solani and late (Phytophthora infestans blights. Late blight was the most severe disease in the wet season while early blight was most severe in the dry season. Nine pathogens were associated with various fruit rots. This study indicates the need for an identification of appropriate control methods for early and late blights of tomato in Cameroon.

Reforming health service delivery at district level in Ghana: the perspective of a district medical officer.

Science.gov (United States)

Agyepong, I A

1999-03-01

Many countries in sub-Saharan Africa face the problem of organizing health service delivery in a manner that provides adequate quality and coverage of health care to their populations against a background of economic recession and limited resources. In response to these challenges, different governments, including that of Ghana, have been considering or are in the process of implementing varying degrees of reform in the health sector. This paper examines aspects of health services delivery, and trends in utilization and coverage, using routine data over time in the Dangme West district of the Greater Accra region of Ghana, from the perspective of a district health manager. Specific interventions through which health services delivery and utilization at district level could be improved are suggested. Suggestions include raising awareness among care providers and health managers that increased resource availability is only a success in so far as it leads to improvements in coverage, utilization and quality; and developing indicators of performance which assess and reward use of resources at the local level to improve coverage, utilization and quality. Also needed are more flexibility in Central Government regulations for resource allocation and use; integration of service delivery at district level with more decentralized planning to make services better responsive to local needs; changes in basic and inservice training strategies; and exploration of how the public and private sectors can effectively collaborate to achieve maximum coverage and quality of care within available resources.

Approaches to mastering the uranium potential of Cameroon

International Nuclear Information System (INIS)

Chakam Tagheu, P.; Simo, A.

2014-01-01

Uranium deposits are spread over the five continents. According to the International Atomic Energy Agency (IAEA) estimation in 2009, the global reserves of economically recoverable uranium are estimated at 4.5 million tonnes. In 2012, the world production of uranium was about 54,610 tonnes and the main producers were Kazakhstan (36%), Canada (15%) and Australia (12%). Brazil, Russia, China, India productions accounted for 9.4% of the overall world production. Significant deposits also exist in Africa including Cameroon; those currently in mining stage are in Namibia, Malawi, and Niger. Cameroon has significant mineral deposits such as gold, alluvial diamonds, iron, bauxite and uranium. All of them are still in the exploration stage. Although Cameroon has not launched a nuclear power programme, the mining of its uranium resources is considered as an important component of the national economy. Many uranium occurrences have so far been discovered in Cameroon. They include Kitongo, Salaki, Mayo Nielse and Teubang in the Northern region and Ngombas near Lolodorf in the Southern region. The Cameroon Government is engaged in (i) the assessment of the U-ore resource through drilling, and (ii) the airborne geophysical survey of mining potentials areas. The result of these studies may lead to a better estimation of the national uranium potential. This paper aims at pointing out constraints to assess the uranium potential of Cameroon and proposes measures that could improve on the leveraging of exploitation of this mineral. (author)

Malaria prevalence and treatment of febrile patients at health facilities and medicine retailers in Cameroon.

Science.gov (United States)

Mangham, Lindsay J; Cundill, Bonnie; Achonduh, Olivia A; Ambebila, Joel N; Lele, Albertine K; Metoh, Theresia N; Ndive, Sarah N; Ndong, Ignatius C; Nguela, Rachel L; Nji, Akindeh M; Orang-Ojong, Barnabas; Wiseman, Virginia; Pamen-Ngako, Joelle; Mbacham, Wilfred F

2012-03-01

To investigate the quality of malaria case management in Cameroon 5 years after the adoption of artemisinin-based combination therapy (ACT). Treatment patterns were examined in different types of facility, and the factors associated with being prescribed or receiving an ACT were investigated. A cross-sectional cluster survey was conducted among individuals of all ages who left public and private health facilities and medicine retailers in Cameroon and who reported seeking treatment for a fever. Prevalence of malaria was determined by rapid diagnostic tests (RDTs) in consenting patients attending the facilities and medicine retailers. Among the patients, 73% were prescribed or received an antimalarial, and 51% were prescribed or received an ACT. Treatment provided to patients significantly differed by type of facility: 65% of patients at public facilities, 55% of patients at private facilities and 45% of patients at medicine retailers were prescribed or received an ACT (P = 0.023). The odds of a febrile patient being prescribed or receiving an ACT were significantly higher for patients who asked for an ACT (OR = 24.1, P < 0.001), were examined by the health worker (OR = 1.88, P = 0.021), had not previously sought an antimalarial for the illness (OR = 2.29, P = 0.001) and sought treatment at a public (OR = 3.55) or private facility (OR = 1.99, P = 0.003). Malaria was confirmed in 29% of patients and 70% of patients with a negative result were prescribed or received an antimalarial. Malaria case management could be improved. Symptomatic diagnosis is inefficient because two-thirds of febrile patients do not have malaria. Government plans to extend malaria testing should promote rational use of ACT; though, the introduction of rapid diagnostic testing needs to be accompanied by updated clinical guidelines that provide clear guidance for the treatment of patients with negative test results. © 2011 Blackwell Publishing Ltd.

Under Five Malnutrition Crises in the Boko Haram Area of Cameroon

African Journals Online (AJOL)

aDiscipline of Public Health Medicine, Department of Nursing & Public ... bUnder Privilege Children and Women Assistance (UPCAWA-SWEDEN), ... In most cases, malnutrition in its mild stage can present with no ... Other studies by the National Institute of Statistics in Cameroon .... Inpatient management of children with.

The Language Question in Cameroon

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Echu, George

2004-01-01

Full Text Available In multilingual Cameroon, 247 indigenous languages live side by side with English and French (the two official languages and Cameroon Pidgin English (the main lingua franca. While the two official languages of colonial heritage dominate public life in the areas of education, administration, politics, mass media, publicity and literature, both the indigenous languages and Cameroon Pidgin English are relegated to the background. This paper is a critique of language policy in Cameroon revealing that mother tongue education in the early years of primary education remains a distant cry, as the possible introduction of an indigenous language in the school system is not only considered unwanted by educational authorities but equally combated against by parents who believe that the future of their children lies in the mastery of the official languages. This persistent disregard of indigenous languages does not only alienate the Cameroonian child culturally, but further alienates the vast majority of Cameroonians who are illiterate (in English and French since important State business is carried out in the official languages. As regards the implementation of the policy of official language bilingualism, there is clear imbalance in the use of the two official languages as French continues to be the dominant official language while English is relegated to a second place within the State. The frustration that ensues within the Anglophone community has led in recent years to the birth of Anglophone nationalism, a situation that seems to be widening the rift between the two main components of the society (Anglophones and Francophones, thereby compromising national unity. The paper is divided into five major parts. After a brief presentation of the country, the author dwells on multilingualism and language policy since the colonial period. The third, fourth and last parts of the paper focus on the critique of language policy in Cameroon with emphasis first on

Are students kidding with health research ethics? The case of HIV/AIDS research in Cameroon

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Munung Nchangwi

2012-06-01

Full Text Available Abstract Background Universities in Cameroon are playing an active part in HIV/AIDS research and much of this research is carried out by students, usually for the purpose of a dissertation/thesis. Student theses/dissertations present research findings in a much more comprehensive manner and have been described as the stepping-stone of a budding scientist’s potential in becoming an independent researcher. It is therefore important to verify how students handle issues of research ethics. Method Theses/dissertations on HIV/AIDS that described research studies involving the use of human research participants were screened to verify if research ethics approval and informed consent were obtained and documented. The contents of the consent forms were also qualitatively analyzed. Results Of 174 theses/dissertations on HIV, ethics approval was documented in 17 (9.77% and informed consent in 77 (47.83%. Research ethics approval was first mentioned at all in 2002 and highly reported in the year 2007. Evidence of ethics approval was found for the first time in 2005 and informed consent first observed and evidenced in 1997. Ethics approval was mostly reported by students studying for an MD (14.01% and was not reported in any Bachelors’ degree dissertation. Informed consent was also highly reported in MD theses (64.58% followed by undergraduate theses (31.58%. Voluntary participation and potential benefits of the study were some of the common aspects dealt with in most of the consent forms. The right to discontinue participation in the study and management of residual samples were scarcely ever mentioned. Conclusions Overall, and given the current state of the art of research ethics around the world, student-scientists in Cameroon would seem to be merely kidding with research ethics. It is thus essential that training in health research ethics (HRE be incorporated in the curriculum of universities in Cameroon in order that the next generation of

State formation, religion, and land tenure in Cameroon

NARCIS (Netherlands)

Schilder, K.; African Studies Centre, Leiden

1988-01-01

The purpose of this analytical bibliography is to provide an overview of the recently published social science literature on State formation, religion, and land tenure in Cameroon. The 800 entries have been arranged under the following subject headings: The Cameroon State (nation building, political

Determinants of Inequality in Cameroon: A Regression-Based ...

African Journals Online (AJOL)

This paper applies the regression-based inequality decomposition approach to explore determinants of income inequality in Cameroon using the 2007 Cameroon household consumption survey. The contribution of each source to measured income inequality is the sum of its weighted marginal contributions in all possible ...

Spatial and Inter-temporal Sources of Poverty, Inequality and Gender Disparities in Cameroon: a Regression-Based Decomposition Analysis

OpenAIRE

Boniface Ngah Epo; Francis Menjo Baye; Nadine Teme Angele Manga

2011-01-01

This study applies the regression-based inequality decomposition technique to explain poverty and inequality trends in Cameroon. We also identify gender related factors which explain income disparities and discrimination based on the 2001 and 2007 Cameroon household consumption surveys. The results show that education, health, employment in the formal sector, age cohorts, household size, gender, ownership of farmland and urban versus rural residence explain household economic wellbeing; dispa...

Coordinated School Health and the Contribution of a District Wellness Coordinator

Science.gov (United States)

Westrich, Lisa; Sanchez, Monika; Strobel, Karen

2015-01-01

Background: A San Francisco Bay Area school health initiative was established in fall 2010 to improve wellness programs in 4 local school districts using the Coordinated School Health (CSH) model. This study examines the role of district-wide wellness coordinators and the ways in which they contribute to intentional coordination of health and…

Health system performance at the district level in Indonesia after decentralization

Directory of Open Access Journals (Sweden)

Choi Yoonjoung

2010-03-01

Full Text Available Abstract Background Assessments over the last two decades have showed an overall low level of performance of the health system in Indonesia with wide variation between districts. The reasons advanced for these low levels of performance include the low level of public funding for health and the lack of discretion for health system managers at the district level. When, in 2001, Indonesia implemented a radical decentralization and significantly increased the central transfer of funds to district governments it was widely expected that the performance of the health system would improve. This paper assesses the extent to which the performance of the health system has improved since decentralization. Methods We measured a set of indicators relevant to assessing changes in performance of the health system between two surveys in three areas: utilization of maternal antenatal and delivery care; immunization coverage; and contraceptive source and use. We also measured respondents' demographic characteristics and their living circumstances. These measurements were made in population-based surveys in 10 districts in 2002-03 and repeated in 2007 in the same 10 districts using the same instruments and sampling methods. Results The dominant providers of maternal and child health in these 10 districts are in the private sector. There was a significant decrease in birth deliveries at home, and a corresponding increase in deliveries in health facilities in 5 of the 10 districts, largely due to increased use of private facilities with little change in the already low use of public facilities. Overall, there was no improvement in vaccination of mothers and their children. Of those using modern contraceptive methods, the majority obtained them from the private sector in all districts. Conclusions There has been little improvement in the performance of the health system since decentralization occurred in 2001 even though there have also been significant increases in

Heavy metals in soils along unpaved roads in south west Cameroon: Contamination levels and health risks.

Science.gov (United States)

Ngole-Jeme, Veronica M

2016-04-01

Soils enriched with heavy metals from vehicular emission present a significant exposure route of heavy metals to individuals using unpaved roads. This study assessed the extent of Cd, Cr, Co, Cu, Ni, Pb and Zn contamination of soils along unpaved roads in Cameroon, and the health risks presented by incidental ingestion and dermal contact with the soils using metal contamination factor (CF) pollution load index, hazard quotients (HQ) and chronic hazard index (CHI). CF values obtained (0.9-12.2) indicate moderate to high contamination levels. HQ values for Cr, Cd and Pb exceeded the reference doses. Moderate health hazard exists for road users in the areas with intense anthropogenic activities and high average daily traffic (ADT) volume according to CHI values (1-4) obtained. The economy and quality of life in cities with unpaved roads could be threatened by health challenges resulting from long-term exposure to heavy metal derived from high ADT volumes.

District nurses' involvement in mental health: an exploratory survey.

Science.gov (United States)

Lee, Soo; Knight, Denise

2006-04-01

This article reports on a survey of district nurses' involvement in mental health interventions in one county. Seventy-nine questionnaires were sent and 46 were returned. Descriptive analysis was carried out using statistical software. The DNs reported encountering a wide range of mental health issues and interventions in practice: dementia, anxiety and depression featured highly. Over half (55%) of the respondents reported involvement in bereavement counselling, and 28% and 23% of respondents reported encountering anxiety management, and problem solving and alcohol advice respectively. A large proportion, however, reported no involvement in mental health interventions. Among the psychiatric professionals, district nurses tended to have most frequent contacts with social workers. GPs were the most likely person to whom DNs made referrals, followed by community psychiatric nurses. Despite the apparent awareness of the values of psychosocial interventions, DNs were equally influenced by the medical model of treatment. In order to realize the potential contribution of district nurses in mental health interventions, there is a need for primary care teams to foster a closer working relationship with mental health specialist services.

Health service planning contributes to policy dialogue around strengthening district health systems: an example from DR Congo 2008-2013.

Science.gov (United States)

Rajan, Dheepa; Kalambay, Hyppolite; Mossoko, Mathias; Kwete, Dieudonné; Bulakali, Joseph; Lokonga, Jean-Pierre; Porignon, Denis; Schmets, Gerard

2014-10-31

This case study from DR Congo demonstrates how rational operational planning based on a health systems strengthening strategy (HSSS) can contribute to policy dialogue over several years. It explores the operationalization of a national strategy at district level by elucidating a normative model district resource plan which details the resources and costs of providing an essential health services package at district level. This paper then points to concrete examples of how the results of this exercise were used for Ministry of Health (MoH) decision-making over a time period of 5 years. DR Congo's HSSS and its accompanying essential health services package were taken as a base to construct a normative model health district comprising of 10 Health Centres (HC) and 1 District Hospital (DH). The normative model health district represents a standard set by the Ministry of Health for providing essential primary health care services. The minimum operating budget necessary to run a normative model health district is $17.91 per inhabitant per year, of which $11.86 is for the district hospital and $6.05 for the health centre. The Ministry of Health has employed the results of this exercise in 4 principal ways: 1.Advocacy and negotiation instrument; 2. Instrument to align donors; 3. Field planning; 4. Costing database to extract data from when necessary. The above results have been key in the policy dialogue on affordability of the essential health services package in DR Congo. It has allowed the MoH to provide transparent information on financing needs around the HSSS; it continues to help the MoH negotiate with the Ministry of Finance and bring partner support behind the HSSS.

Solar energy in the Northern Cameroon

International Nuclear Information System (INIS)

Djuikom, M.; Ndjomaha, Ch.; Vandenbergh, M.

2004-01-01

In 2003, the Cameroon Ministry of the Environment and Forestry has initiated a research project for studying the promotion of renewable energies and their impact on rural development. This work has been realized jointly with the department of Economy and Rural Development of the Agronomic University of Gembloux (Belgium), the Centre Des Etudes de L'Environnement et de Developpement du Cameroun (CEDC, Maroua) and the Institut fur Solare Energieversorgungstechnik (ISET, Germany). This initiative comes when the electricity sector in Cameroon has been facing important changes (Privatization of the national company of electricity, creation of a rural electrification agency, multiplication of the dialogues and seminars around the strategies of promotion for renewable energies, frequent black-outs during the dry season). The first objective of the project is to contribute to a better knowledge of the situation of the use of renewable energies in Cameroon. Therefore, Mrs Marthe Djuikom undertook from July to September 2003 a socio-economic survey on the use of solar energy in the northern Cameroon. The next step will be the creation of an energy program at the CEDC with the following tasks: promotion of photovoltaic technology, support of local and international synergies on the organisational aspects, training, information and coordination of reflexions at the local level for the promotion of rural electrification projects. (authors)

Public funding of health at the district level in Indonesia after decentralization-sources, flows and contradictions.

Science.gov (United States)

Heywood, Peter; Harahap, Nida P

2009-04-16

During the Suharto era public funding of health in Indonesia was low and the health services were tightly controlled by the central government; district health staff had practically no discretion over expenditure. Following the downfall of President Suharto there was a radical political, administrative and fiscal decentralization with delivery of services becoming the responsibility of district governments. In addition, public funding for health services more than doubled between 2001 and 2006. It was widely expected that services would improve as district governments now had both more adequate funds and the responsibility for services. To date there has been little improvement in services. Understanding why services have not improved requires careful study of what is happening at the district level. We collected information on public expenditure on health services for the fiscal year 2006 in 15 districts in Java, Indonesia from the district health offices and district hospitals. Data obtained in the districts were collected by three teams, one for each province. Information on district government revenues were obtained from district public expenditure databases maintained by the World Bank using data from the Ministry of Finance. The public expenditure information collected in 15 districts as part of this study indicates district governments are reliant on the central government for as much as 90% of their revenue; that approximately half public expenditure on health is at the district level; that at least 40% of district level public expenditure on health is for personnel, almost all of them permanent civil servants; and that districts may have discretion over less than one-third of district public expenditure on health; the extent of discretion over spending is much higher in district hospitals than in the district health office and health centers. There is considerable variation between districts. In contrast to the promise of decentralization there has been

Changes in sexual activity and risk behaviors among PLWHA initiating ART in rural district hospitals in Cameroon -- data from the STRATALL ANRS 12110/ESTHER trial.

Science.gov (United States)

Ndziessi, Gilbert; Cohen, Julien; Kouanfack, Charles; Boyer, Sylvie; Moatti, Jean-Paul; Marcellin, Fabienne; Laurent, Christian; Spire, Bruno; Delaporte, Eric; Carrieri, Maria Patrizia

2013-01-01

The continued scaling-up of antiretroviral therapy (ART) in Sub-Saharan Africa provides an opportunity to further study its impact on sexual behaviors among people living with HIV/AIDS (PLWHA). We explored time trend and correlates of sexual activity among PLWHA initiating ART in Cameroon and compared sexual risk behaviors between patients sexually active before and after initiating ART and those resuming sexual activity after ART initiation. Analyses were based on longitudinal data collected within the randomized trial (n=459) conducted in nine rural district hospitals in Cameroon. Sexual activity was defined as reporting at least one sexual partner during the previous 3 months. Inconsistent condom use (ICU) was defined as reporting to have "never," "sometimes," or "nearly always" used condoms at least once with a partner(s) either HIV-negative or of unknown HIV status during the same period. Mc Nemar tests were used to assess time trend, while mixed-effect logistic regressions were conducted to analyze the effect of time since ART initiation on sexual activity. The proportion of sexually active patients significantly increased over time: from 31.8% at baseline to 40.2 and 47.1% after 6 and 12 months of ART, respectively (p=0.001), to 55.9% after 24 months (p=0.02). After adjustment for behavioral and psychosocial factors, time since ART initiation was independently associated with reporting sexual activity (AOR [95% CI]=1.30 [1.17-1.46] per 6-month increase, p=0.001). ICU was more frequent among patients sexually active both before and after ART initiation than among those who resumed sexual activity after ART initiation (82 vs. 59%, pART initiation fosters resumption of sexual activity in patients who are inactive before starting treatment; unsafe sexual behaviors remain less frequent in this population than in patients who are already sexually active before starting ART. Risk reduction programs should be reinforced among PLWHA in the context of ART scaling-up.

Rural district hospitals - essential cogs in the district health system - and primary healthcare re-engineering.

Science.gov (United States)

le Roux, K W D P; Couper, I

2015-06-01

The re-engineering of primary healthcare (PHC) is regarded as an essential precursor to the implementation of National Health Insurance in South Africa, but improvements in the provision of PHC services have been patchy. The authors contend that the role of well- functioning rural district hospitals as a hub from which PHC services can be most efficiently managed has been underestimated, and that the management of district hospitals and PHC clinics need to be co-located at the level of the rural district hospital, to allow for proper integration of care and effective healthcare provision.

Under five malnutrition crises in the Boko Haram Area of Cameroon ...

African Journals Online (AJOL)

Boko-Haram has increased their attacks along the Cameroon boarder in the Far North region of Cameroon since 2013. The prevalence of malnutrition in the north of Cameroon is high. Regions like the Adamawa, North and Far North regions have a prevalence of malnutrition of 5.2%, 6.7%, 9.0%, respectively; and, ...

Measurement of health system performance at district level: A study protocol

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Atul Sharma

2018-01-01

Full Text Available Background: Limited efforts have been observed in low and middle income countries to undertake health system performance assessment at district level. Absence of a comprehensive data collection tool and lack of a standardised single summary measure defining overall performance are some of the main problems. Present study has been undertaken to develop a summary composite health system performance index at district level. Methods: A broad range of indicators covering all six domains as per building block framework were finalized by an expert panel. The domains were classified into twenty sub-domains, with 70 input and process indicators to measure performance. Seven sub-domains for assessing health system outputs and outcomes were identified, with a total of 28 indicators. Districts in Haryana state from north India were selected for the study. Primary and secondary data will be collected from 378 health facilities, district and state health directorate headquarters. Indicators will be normalized, aggregated to generate composite performance index at district level. Domain specific scores will present the quality of individual building block domains in the public health system. Robustness of the results will be checked using sensitivity analysis. Expected impact for public health: The study presents a methodology for comprehensive assessment of all health system domains on basis of input, process, output and outcome indicators which has never been reported from India. Generation of this index will help identify policy and implementation areas of concern and point towards potential solutions. Results may also help understand relationships between individual building blocks and their sub-components.

Co-infections of malaria and geohelminthiasis in two rural communities of Nkassomo and Vian in the Mfou health district, Cameroon.

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Francis Zeukeng

2014-10-01

Full Text Available Human co-infection with malaria and helmimths is ubiquitous throughout Africa. Nevertheless, its public health significance on malaria severity remains poorly understood.To contribute to a better understanding of epidemiology and control of this co-infection in Cameroon, a cross-sectional study was carried out to assess the prevalence of concomitant intestinal geohelminthiasis and malaria, and to evaluate its association with malaria and anaemia in Nkassomo and Vian. Finger prick blood specimens from a total of 263 participants aged 1-95 years were collected for malaria microscopy, assessment of haemoglobin levels, and molecular identification of Plasmodium species by PCR. Fresh stool specimens were also collected for the identification and quantification of geohelminths by the Kato-Katz method. The prevalence of malaria, geohelminths, and co-infections were 77.2%, 28.6%, and 22.1%, respectively. Plasmodium falciparum was the only malaria parasite species identified with mean parasite density of 111 (40; 18,800 parasites/µl of blood. The geohelminths found were Ascaris lumbricoides (21.6% and Trichuris trichiura (10.8%, with mean parasite densities of 243 (24; 3,552 and 36 (24; 96 eggs/gram of faeces, respectively. Co-infections of A. lumbricoides and P. falciparum were the most frequent and correlated positively. While no significant difference was observed on the prevalences of single and co-infections between the two localities, there was a significant difference in the density of A. lumbricoides infection between the two localities. The overall prevalence of anaemia was 42%, with individuals co-infected with T. trichiura and P. falciparum (60% being the most at risk. While the prevalence of malaria and anaemia were inversely related to age, children aged 5-14 years were more susceptible to geohelminthiasis and their co-infections with malaria.Co-existence of geohelminths and malaria parasites in Nkassomo and Vian enhances the occurrence of

Canine and Human Rabies in Cameroon | Awah | Tropical ...

African Journals Online (AJOL)

This paper is a retrospective review of recorded rabies and antirabies activities in Cameroon from 1990 to 1999 to determine the current state of rabies in both dogs and humans. Rabies and antirabies activities were recorded every year in Cameroon through out the 10-year study period with the highest values observed in ...

Gender-based violence against female sex workers in Cameroon: prevalence and associations with sexual HIV risk and access to health services and justice.

Science.gov (United States)

Decker, Michele R; Lyons, Carrie; Billong, Serge Clotaire; Njindam, Iliassou Mfochive; Grosso, Ashley; Nunez, Gnilane Turpin; Tumasang, Florence; LeBreton, Matthew; Tamoufe, Ubald; Baral, Stefan

2016-12-01

Female sex workers (FSWs) are at risk for HIV and physical and sexual gender-based violence (GBV). We describe the prevalence of lifetime GBV and its associations with HIV risk behaviour, access to health services and barriers in accessing justice among FSWs in Cameroon. FSWs (n=1817) were recruited for a cross-sectional study through snowball sampling in seven cities in Cameroon. We examined associations of lifetime GBV with key outcomes via adjusted logistic regression models. Overall, 60% (1098/1817) had experienced physical or sexual violence in their lifetime. GBV was associated with inconsistent condom use with clients (adjusted OR (AOR) 1.49, 95% CI 1.18 to 1.87), being offered more money for condomless sex (AOR 2.09, 95% CI 1.56 to 2.79), having had a condom slip or break (AOR 1.53, 95% CI 1.25 to 1.87) and difficulty suggesting condoms with non-paying partners (AOR 1.47, 95% CI 1.16 to 1.87). Violence was also associated with fear of health services (AOR 2.25, 95% CI 1.61 to 3.16) and mistreatment in a health centre (AOR 1.66, 95% CI 1.01 to 2.73). Access to justice was constrained for FSWs with a GBV history, specifically feeling that police did not protect them (AOR 1.41, 95% CI 1.12 to 1.78). Among FSWs in Cameroon, violence is prevalent and undermines HIV prevention and access to healthcare and justice. Violence is highly relevant to FSWs' ability to successfully negotiate condom use and engage in healthcare. In this setting of criminalised sex work, an integrated, multisectoral GBV-HIV strategy that attends to structural risk is needed to enhance safety, HIV prevention and access to care and justice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Public sector district health system: Is seven to ten minutes enough ...

African Journals Online (AJOL)

The development of a municipality based district health system has created an opportunity to practice family medicine in Mitchells Plain, but lack of clinical time to practice family medicine in the current setting raises questions about the quality and efficiency of primary health care in the municipality based district based ...

Digital health and the need to develop centers of expertise in sub-Saharan Africa : two examples in Mali and Cameroon.

Science.gov (United States)

Bagayoko, C-O; Bediang, G; Anne, A; Niang, M; Traoré, A-K; Geissbuhler, A

2017-11-01

It is generally agreed today that digital technology provides a lever for improving access to health care, care processes, and public health planning and activities such as education and prevention. Its use in countries that have reached a given level of development has taken place in a somewhat fragmented manner that raises important interoperability problems and sometimes makes synergy impossible between the different projects of digital health. This may be linked to several factors, principally the lack of a global vision of digital health, and inadequate methodological knowledge that prevents the development and implementation of this vision. The countries of Africa should be able to profit from these errors from the beginnings of digital health, by moving toward systemic approaches, known standards, and tools appropriate to the realities on the ground. The aim of this work is to present the methodological approaches as well as the principal results of two relatively new centers of expertise in Mali and Cameroon intended to cultivate this vision of digital governance in the domain of health and to train professionals to implement the projects. Both centers were created due to initiatives of organizations of civil society. The center in Mali developed toward an economic interest group and then to collaboration with healthcare and university organizations. The same process is underway at the Cameroon center. The principal results from these centers can be enumerated under different aspects linked to research, development, training, and implementation of digital health tools. They have produced dozens of scientific publications, doctoral dissertations, theses, and papers focused especially on subjects such as the medicoeconomic evaluation tools of e-health and health information technology systems. In light of these results, we can conclude that these two centers of expertise have well and truly been established. Their role may be decisive in the local training of

HMIS and decision-making in Zambia: re-thinking information solutions for district health management in decentralized health systems.

Science.gov (United States)

Mutemwa, Richard I

2006-01-01

At the onset of health system decentralization as a primary health care strategy, which constituted a key feature of health sector reforms across the developing world, efficient and effective health management information systems (HMIS) were widely acknowledged and adopted as a critical element of district health management strengthening programmes. The focal concern was about the performance and long-term sustainability of decentralized district health systems. The underlying logic was that effective and efficient HMIS would provide district health managers with the information required to make effective strategic decisions that are the vehicle for district performance and sustainability in these decentralized health systems. However, this argument is rooted in normative management and decision theory without significant unequivocal empirical corroboration. Indeed, extensive empirical evidence continues to indicate that managers' decision-making behaviour and the existence of other forms of information outside the HMIS, within the organizational environment, suggest a far more tenuous relationship between the presence of organizational management information systems (such as HMIS) and effective strategic decision-making. This qualitative comparative case-study conducted in two districts of Zambia focused on investigating the presence and behaviour of five formally identified, different information forms, including that from HMIS, in the strategic decision-making process. The aim was to determine the validity of current arguments for HMIS, and establish implications for current HMIS policies. Evidence from the eight strategic decision-making processes traced in the study confirmed the existence of different forms of information in the organizational environment, including that provided by the conventional HMIS. These information forms attach themselves to various organizational management processes and key aspects of organizational routine. The study results point

Country programme review Republic of Cameroon

International Nuclear Information System (INIS)

Cherif, H.C.; Hasling, W.; Hera, C.H.; Maudarbocus, A.Y.; Mtimet, S.

1993-10-01

A multi-disciplinary country programme review and programming mission was undertaken to the Republic of Cameroon, from 21 to 25 June 1993. This report reflects the findings and recommendations of the mission and falls into four sections. The first section describes the country profile and includes information about its economy and its development plans and policies. The second reviews the Agency's past and present technical co-operation programmes in Cameroon. The third section deals with a sectoral programme and institutional review, and the fourth section presents possible future technical co-operation activities

Functioning and disability in recent research from Cameroon: a ...

African Journals Online (AJOL)

Introduction: People living with disabilities in Cameroon face many barriers to daily functioning and social participation. However, there is limited research on disabilities and their impact. We sought to examine the research related to disability from Cameroon. Methods: We conducted a systematic review, bibliometric ...

Poverty and health among CDC plantation labourers in Cameroon: Perceptions, challenges and coping strategies

NARCIS (Netherlands)

Makoge, Valerie; Vaandrager, Lenneke; Maat, Harro; Koelen, Maria

2017-01-01

Creating better access to good quality healthcare for the poor is a major challenge to development. In this study, we examined inter-linkages between poverty and disease, referred to as poverty-related diseases (PRDs), by investigating how Cameroon Development Corporation (CDC) camp dwellers respond

Linguistic inequality in Cameroon: The case of advertising in Douala ...

African Journals Online (AJOL)

Linguistic inequality in Cameroon: The case of advertising in Douala. ... multilingualism and multiculturalism in Cameroon, very little has been done in advertising as it reflects language representation. Much of ... AJOL African Journals Online.

High mosquito burden and malaria transmission in a district of the city of Douala, Cameroon

Directory of Open Access Journals (Sweden)

Antonio-Nkondjio Christophe

2012-10-01

Full Text Available Abstract Background Rapid demographic growth in Douala city, Cameroon, has resulted in profound ecological and environmental changes. Although demographic changes can affect anopheline mosquito breeding sites, there is a lack of understanding about the epidemiological impact that such changes might have on vector ecology and malaria transmission. Methods A 12-month entomological study was conducted in a highly populated district of Douala called Ndogpassi. Adult mosquitoes were collected using two methods: 1 human landing catches (HLC; and 2 Centers for Disease Control and Prevention (CDC light traps; these methods were used twice monthly from January to December 2011. Mosquito genus and species were identified with morphological and molecular diagnostic tools. The sampling efficiency of the CDC light trap and HLC were compared. Anopheles gambiae infection with Plasmodium falciparum was detected using ELISA. Susceptibility to DDT, permethrin, and deltamethrin insecticides were also determined. Results A total of 6923 mosquitoes were collected by HLC (5198 and CDC light traps (1725. There was no equivalence in the sampling efficiency between light traps and human landing catches (P > 0.01. With 51% of the total, Culex was the most common, followed by Anopheles (26.14%, Mansonia (22.7% and Aedes (0.1%. An. gambiae ss (M form comprised ~98% of the total anophelines collected. An. gambiae had a biting rate of 0.25 to 49.25 bites per human per night, and was the only species found to be infected with P. falciparum. A P. falciparum infection rate of 0.5% was calculated (based on enzyme-linked immunosorbent assays using the circumsporozoite surface protein. The entomological inoculation rate was estimated at 31 infective bites per annum. Insecticide susceptibility tests on An. gambiae females revealed a mortality rate of 33%, 76% and 98% for DDT, permethrin and deltamethrin, respectively. The West African kdr allele (L1014F was detected in 38 of

CAMEROON FIGHTING BOKO HARAM

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Ж КЖ Кума

2017-12-01

Full Text Available This study proposes to retrace Boko Haram atrocities in Cameroon as well as the history of international cooperation against the Islamist sect since the declaration of the war against it in 2014. The principal internal counter-terrorist efforts are shown, including establishement of “Operational Com-mand” missions, partial reorganization of the territorial map of the army’s command, the expansion of defense policy at the subregional level and the gradual redefinition of military, the allocation of re-sources and tools adapted to these new missions. Cameroon engages in a process of multilateralization of the challenges of counter-terrorism coopera-tion, which gives a new dimension to the action of the defense and security forces as well as the multi-lateralization of the stakes of cooperation. The role of major powers and the countries of the subregion as well as the African Union and the United Nations is revealed. Cameroon is a traditional beneficiary of French military assistance. Counter-terrorist assistance also came from Russia, US, UK and Germany. The role of the Multinational Joint Task Force of Commission of the Lake Chad Basin (LCBC is shown. The author also shows that the war against Boko Haram seems to produce exceptional results that force both admiration and criticism of the Cameroonian people and the international community. The case of criticism by the NGO Amnesty International is analysed in details.

[The demographic situation in Cameroon].

Science.gov (United States)

Njeck, R A

1984-01-01

The population census in 1976 and the Cameroon Fertility Survey (CFS) of 1978 have allowed the population profile of Cameroon to be better known, but data are still scarce on many topics. Several hypotheses were adopted for the elaboration of population estimates for 1983: mortality was assumed constant between 1976-86 despite constant improvements in the health infrastructure, fertility was assumed to be constant despite increases over the previous 2 decades, net migration was assumed to be negligible, and different structures such as education and employment were assumed constant in the absence of data. The population of Cameroon was estimated at about 9,540,000 as of June 1984. 42.8% was under 15 years of age. Children of school age (6-14 years) represented 23.7% of the total population, and 4.9% was over 60 years of age. The masculinity ratio was 99.6. In some rural areas the sex ratio was under 70 between ages 20-30. According to the 1976 census, in 1976 among men and women respectively, 39.5 and 15.9% were single, 55.8% and 66.8% were married, 2.1% and 13.9% were widowed, and 2.6% and 3.4% were divorced. According to CFS data, among men and women in 1978, 36.0% and 13.6% were single, 58.5% and 69.6% were married, 2.2% and 13.5% were widowed, and 3.0% and 3.6% were divorced. CFS data indicated that 63% of women and 46% of men had never attended school. 39.9% of the population was economically active in 1976. Unemployment reached 17.2% in urban areas and 4.3% in rural areas. The birth rate increased from 43/1000 in 1960-65 to 45/1000 in 1976. The mortality rate declined from 23/1000 in 1960-65 to 20/1000 in 1976, and life expectancy at birth increased from 37.5 to 44.6 in the same period (47 years for women and 42.3 for men). The infant mortality rate was 113/1000 in 1978, and the rate of natural increase was estimated at 2.5%.

Prevalence and intensity of human soil transmitted helminth infections in the Akonolinga health district (Centre Region, Cameroon: Are adult hosts contributing in the persistence of the transmission?

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Jean Bopda

2016-06-01

Conclusion: This study reveals that STH infections are prevalent in adults in the Akonolinga health district, with moderate to high risk and light intensity of infection. These infected adults might constitute a potential parasite reservoir and a source of dissemination and persistence of these infections, highlighting the need to really take into account this neglected group of individuals in the mass treatment policy.

Condition of Health Problems in The District Health Offi ce Parigi Moutong Central Sulawesi Province, Efforts in Response of Health Problem

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Ahmad Erlan

2016-01-01

Full Text Available Background: District Parigi Moutong, Central Sulawesi Province is one of the Regional District Health Problems. Ranking Public Health Development Index Parigi Moutong to the level of Central Sulawesi was ranked 6 out of 9 districts/cities, while at the national level comes out to 320 of 440 districts/cities in Indonesia. The purpose of this study is to provide a picture of the health problems in Parigi Moutong. In more detail the objectives are observed after the implementation of such interventions and Booster Kalakarya prevention efforts in the area of health problems. Methods: The study is qualitative observational study of participatory design. Samples were taken by using purposive sampling to conduct in-depth interviews and document searches. Results: The results of in-depth interviews obtained information of some constraints inthe implementation of health programs, ie no actions/movements that were signifi cant in the response to the problem. Infant mortality in 2012, registered 7 cases. Substitution head of the health center too fast. This happens because the head of the health center has held PTT doctor working period of one year, which resulted in problems in sustainability programs in health centers. Internal monthly meeting at the Department of Health and the District Health Offi ce with the entire health center no. Effort or movement to address the problems associated Regional Health Problems has not be percieved. Conclusions: Implementation of Regional Booster Kalakarya and Health Troubled make changes to the head of health policy by forming groups Conscious Movement IHC and revitalization partnership TBA and midwives who are increasing numbers toddlersweighing scope and aid delivery by health personnel.

Do district health systems perform differently because of their managers? Preliminary insights from Indonesia

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Augustine Asante

2015-07-01

Full Text Available District health systems (DHS are central to the global efforts to improve health outcomes but many remain ineffective. In many lowresource settings, despite the generally weak DHS there is evidence that some districts consistently perform well against the odds, and this is often attributed to the calibre of managers leading such districts and their management and leadership (M&L skills. This paper examines the M&L practices of district health managers in high and low performing districts in Indonesia in an attempt to understand whether the differences in the performance of DHS can be explained, at least in part, by the differences in the performance of their health managers. We employed a mixed methods case study design focusing on two purposefully selected districts. Data were collected in 2011 using questionnaires and in-depth interviews. The preliminary results suggest that M&L practices of managers in the high and low performing districts are similar and provide little explanation for the differences in the performance of the two DHS. Contextual and health system factors offered a much better explanation for the variations in DHS performance.

Barriers to counselling support for HIV/AIDS patients in south-western Cameroon.

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Fonchingong, Charles C; Mbuagbo, Timothy O; Abong, Jennifer T

2004-11-01

The potential synergy between counselling and HIV/AIDS prevention is gaining recognition in Cameroon as counselling sessions are more often organised at health centres. In order to evaluate the actual achievements of these efforts, a qualitative ethnographic survey (based on interviews and focus group discussions) was conducted in two public and two private hospitals in the South-West Province. Churches and public health officials in Cameroon are struggling with the psycho-social, philosophical, psychological, theological, social, moral, ethical and cultural dimensions of HIV/AIDS, as they seek out viable prevention strategies. Health centres are also struggling to embrace the full meaning of counselling and to make psychological and spiritual support to AIDS patients available through the centres. Patients using these health centres may receive HIV testing against a backdrop of cultural standards that allow unsafe sex and bar open discussion on sex and sexuality. We propose that reversing the trend of the epidemic requires the intervention of the State, organisations in civil society and the family. Equally crucial is the role played by the churches - especially in confronting issues of stigmatisation and abandonment that often accompany patient disclosure, and in providing spiritual, emotional and psychological support to patients undergoing treatment.

Current practice of epidemiology in Africa: highlights of the 3rd conference of the African epidemiological association and 1st conference of the Cameroon society of epidemiology, Yaoundé, Cameroon, 2014.

Science.gov (United States)

Nkwescheu, Armand Seraphin; Fokam, Joseph; Tchendjou, Patrice; Nji, Akindeh; Ngouakam, Hermann; Andre, Bita Fouda; Joelle, Sobngwi; Uzochukwu, Benjamin; Akinroye, Kingsley; Mbacham, Wilfred; Colizzi, Vittorio; Leke, Rose; Victora, Cesar

2015-01-01

As the study of disease occurrence and health indicators in human populations, Epidemiology is a dynamic field that evolves with time and geographical context. In order to update African health workers on current epidemiological practices and to draw awareness of early career epidemiologists on concepts and opportunities in the field, the 3(rd) African Epidemiology Association and the 1st Cameroon Society of Epidemiology Conference was organized in June 2-6, 2014 at the Yaoundé Mont Febe Hotel, in Cameroon. Under the theme«Practice of Epidemiology in Africa: Stakes, Challenges and Perspectives», the conference attracted close to five hundred guest and participants from all continents. The two main programs were the pre-conference course for capacity building of African Early Career epidemiologists, and the conference itself, providing a forum for scientific exchanges on recent epidemiological concepts, encouraging the use of epidemiological methods in studying large disease burden and neglected tropical diseases; and highlighting existing opportunities.

Dentofacial injuries in contact sports in Yaounde, Cameroon

OpenAIRE

M A Agbor; C C Azodo; N. E. F. Ngagoue

2012-01-01

Background: Dentofacial injuries constitute serious problems among competitive and recreational athletes, worldwide. Objective: To determine the prevalence of dentofacial injuries and related factors among individuals participating in contact sports in Yaoundé, Cameroon. Materials and Methods: This cross-sectional study among individuals participating in karate, judo, basketball, handball, football and wrestling in Yaoundé, Cameroon was conducted between January and April, 2012. Results: Of t...

Health System Competency for Maternal Health Services in Balasore District and Jaleswar Block, Balasore, Odisha, India: An Assessment.

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Dehury, Ranjit Kumar; Samal, Janmejaya

2016-08-01

A competent health system is of paramount importance in delivering the desired health services in a particular community. The broad objective of this study was to assess the health system competency for the maternal health services in Balasore District and Jaleswar block of Balasore district, Odisha, India. A mixed method approach was adopted in order to understand the health system competency for maternal health services in the study area. There was poor accessibility through road, poor electricity connection and piped water for the health care centers in the district. Even, existing Primary Health Centres (PHCs) lack ECG and X-Ray machines for proper diagnostic services which jeopardize the catering of health services. Community Health Centres (CHC) lack basic diagnostic and ambulance services making the tribal pockets inaccessible. The tribal dominated Jaleswar block shows poor performance in terms of total registered Antenatal Checkups (ANC) (only 77%). A gradual decrease in the rate of ANC, from first to fourthcheckup, was observed in the district. Lack of public health infrastructure in general and non-compliance to Indian Public Health Standards (IPHS) in particular, affect the health of tribal women resulting in lack of interest in availing the institutional delivery services and other pertinent maternal health services.

What variables should be considered in allocating Primary health care Pharmaceutical budgets to districts in Uganda?

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Mujasi, Paschal N; Puig-Junoy, Jaume

2015-01-01

A key policy question for the government of Uganda is how to equitably allocate primary health care pharmaceutical budgets to districts. This paper seeks to identify variables influencing current primary health care pharmaceutical expenditure and their usefulness in allocating prospective pharmaceutical budgets to districts. This was a cross sectional, retrospective observational study using secondary administrative data. We collected data on the value of pharmaceuticals procured by primary health care facilities in each district from National Medical Stores for the financial year 2011/2012. The dependent variable was expressed as per capita district pharmaceutical expenditure. By reviewing literature we identified 26 potential explanatory variables. They include supply, need and demand, and health system organization variables that may influence the demand and supply of health services and the corresponding pharmaceutical expenditure. We collected secondary data for these variables for all the districts in Uganda (n = 112). We performed econometric analysis to estimate parameters of various regression models. There is a significant correlation between per capita district pharmaceutical expenditure and total district population, rural poverty, access to drinking water and outpatient department (OPD) per capita utilisation.(P Uganda (Adjusted R(2) = 0.528). All variables in the model are significant (p Uganda are: district outpatient department attendance per capita, total district population, total number of government health facilities in the district and the district human poverty index.

The role of women's secret societies in cameroon's contemporary ...

African Journals Online (AJOL)

Although there are many secret societies, most of which belong to the male folk in the North West Province of Cameroon, little was and/or is known about their activities. However, Takumbeng, a women's secret society from the North West Province of Cameroon came to prominence in the 1990's during the political upheaval ...

Utilization of Health Information System at District Level in Jimma ...

African Journals Online (AJOL)

Therefore, in-service training and updating of staff involved in health information system (HIS) at district, strengthening health information system inputs, timely and concrete feedbacks with establishment of functional health management information system (HMIS). KEY WORDS: Health Management Information System, ...

International Uranium Resources Evaluation Project (IUREP) orientation phase mission summary report: Cameroon

International Nuclear Information System (INIS)

1985-01-01

A report has recently been published which describes the findings of the International Uranium Resources Evaluation Project (IUREP) Mission to Cameroon. The IUREP Orientation Phase Mission to Cameroon estimates the Speculative Resources of that country to be in the order of 10 000 tonnes uranium for syenite-associated U-deposits in southern Cameroon, and in the order of 5 000 tonnes uranium for uranium deposits associated with albitized and desilicified late tectonic Panafrican granites (episyenite) and Paleozoic volcanics in northern Cameroon. No specific tonnage is given for Francevillian equivalents (DJA-Series) and for Mesozoic and Cenozoic sedimentary basins, which are thought to hold limited potential for sandstone hosted uranium. However the Douala basin, consisting of mixed marine and continental sequences merits some attention. No specific budget and programme for uranium exploration are proposed for Cameroon. Instead specific recommendations concerning specific potential environments and general recommendation concerning the methodology of exploration are made. (author)

The contractual and legal framework for petroleum exploration in Cameroon

International Nuclear Information System (INIS)

Ndi, George

1992-01-01

Cameroon has been a producer and net exporter of oil now for almost 15 years, although the country remains a minor player in the international oil industry. However, with its privileged location on the West African coast and an offshore oil industry which is centred on the Gulf of Guinea, Cameroon has been, and remains, a regional oil producer of some importance. This article sets out to analyse the legal aspects of the commercial exploitation of oil in Cameroon by examining the applicable law, exploration/production contracts, and the fiscal regime. Its purpose is to try to provide a setting which facilitates a proper understanding of the legal frame-work in which the petroleum industry operates in Cameroon, as well as an indication of the direction of government policy towards the further development and expansion of the industry. But first, it will be useful to begin the discussion with an examination of the role of petroleum production in the national economy. (author)

Mount Oku, Cameroon Volcanic Line

African Journals Online (AJOL)

and continental sectors especially for trace elements in basalts. ... continental sector of the trend is a complex .... values higher than those of HIMU but is within ...... (Mount Cameroon, Central Africa): petrogenetic implications. Miner. Petrol.,.

Factors influencing the work efficiency of district health managers in low-resource settings: a qualitative study in Ghana.

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Bonenberger, Marc; Aikins, Moses; Akweongo, Patricia; Wyss, Kaspar

2016-01-14

There is increasing evidence that good district management practices can improve health system performance and conversely, that poor and inefficient management practices have detrimental effects. The aim of the present study was to identify factors contributing to inefficient management practices of district health managers and ways to improve their overall efficiency. Nineteen semi-structured interviews were conducted with district health managers in three districts of the Eastern Region in Ghana. The 19 interviews conducted comprised 90% of the managerial workforce in these districts in 2013. A thematic analysis was carried out using the WHO's leadership and management strengthening framework to structure the results. Key factors for inefficient district health management practices were identified to be: human resource shortages, inadequate planning and communication skills, financial constraints, and a narrow decision space that constrains the authority of district health managers and their ability to influence decision-making. Strategies that may improve managerial efficiency at both an individual and organizational level included improvements to planning, communication, and time management skills, and ensuring the timely release of district funds. Filling District Health Management Team vacancies, developing leadership and management skills of district health managers, ensuring a better flow of district funds, and delegating more authority to the districts seems to be a promising intervention package, which may result in better and more efficient management practices and stronger health system performance.

CTBTO international monitoring system: Status of work in Cameroon and perspectives

International Nuclear Information System (INIS)

Nyobe, J.B.

2002-01-01

The presentation outlines Cameroon's participation in CTBTO programme and its seismic activities. Areas of inter-regional and international cooperation are described. Suggestions are made on ways in which Cameroon can contribute to the work of the commission

Analysis the Development of Mother and Infant Health in Sampang District Hospital

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Rukmini Rukmini

2016-01-01

Full Text Available Background: The hospital have a strategic role in efforts to reduce maternal and infant mortality. This study aimed to determine the development of maternal and infant health services carried out in Sampang District hospital between 2010 and May 2012. Methods: The quantitative study with ecology design carried out in Sampang District hospital east Java Province Indonesia in 2012. The collection of secondary data such as coverage of maternal and infant health care in the period of 2010 to May 2012, as well as qualitative data collection with in depth interview to the Head of Service, Obstetrics and Gynecology Specialist Doctors and midwives. Data were analyzed descriptively. Result: In Sampang District hospital in period 2010 – May 2012 showed, an increase in maternal and child health services, where an increase in the handling of complications of pregnancy, normal delivery or Sectio Caesar and management of newborn complications and maternal and neonatal deaths are relatively increased . The coverage of family planning services was still low and the vast majority was IUD. Conclusion: The maternal and child health services in Sampang District hospital in period of 2010 – May 2012, showed an increase in the quantity of service coverage. The majority cases of delivery in hospitals were referral cases and complications. Howefer, the number of Sectio Caesar, maternal and neonatal mortality were still high. Recommendation: Sampang District Health Offi ce and Sampang District Hospital should create a policis and programs to reduce neonatal mortality in an integrated, continuous with proper implementation of standard procedures at every level of service, supported by well trained human resources, infrastructure and adequate fi nancing.

Journal of the Cameroon Academy of Sciences: About this journal

African Journals Online (AJOL)

Journal of the Cameroon Academy of Sciences: About this journal. Journal Home > Journal of the Cameroon Academy of Sciences: About this journal. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Journal Home · ABOUT THIS JOURNAL · Advanced Search ...

Research evidence and policy: qualitative study in selected provinces in South Africa and Cameroon.

Science.gov (United States)

Naude, Celeste E; Zani, Babalwa; Ongolo-Zogo, Pierre; Wiysonge, Charles S; Dudley, Lillian; Kredo, Tamara; Garner, Paul; Young, Taryn

2015-09-03

The translation of research into policy and practice is enhanced by policymakers who can recognise and articulate their information needs and researchers that understand the policymakers' environment. As researchers, we sought to understand the policymaking process and how research evidence may contribute in South Africa and Cameroon. We conducted qualitative in-depth interviews in South Africa and focus group discussions in Cameroon with purposively sampled subnational (provincial and regional) government health programme managers. Audio recorded interviews were transcribed, thematically coded and analysed. Participants in both countries described the complex, often lengthy nature of policymaking processes, which often include back-and-forth consultations with many diverse stakeholder groups. These processes may be influenced by political structures, relationships between national and subnational levels, funding and international stakeholder agendas. Research is not a main driver of policy, but rather current contextual realities, costs, logistics and people (clinicians, NGOs, funders) influence the policy, and research plays a part. Research evidence is frequently perceived as unavailable, inaccessible, ill-timed or not applicable. The reliability of research on the internet was questioned. Evidence-informed health decision-making (EIDM) is regarded as necessary in South Africa but is less well understood in Cameroon. Insufficient time and capacity were hindrances to EIDM in both countries. Good relationships between researchers and policymakers may facilitate EIDM. Researchers should have a good understanding of the policymaking environment if they want to influence it. Greater interaction between policymakers and researchers is perceived as beneficial when formulating research and policy questions as it raises researchers' awareness of implementation challenges and enables the design of tailored and focused strategies to respond to policymakers' needs

Prevalence and predictors of major depression in HIV-infected patients on antiretroviral therapy in Bamenda, a semi-urban center in Cameroon.

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Bradley N Gaynes

Full Text Available Recent blue-ribbon panel reports have concluded that HIV treatment programs in less wealthy countries must integrate mental health identification and treatment into normal HIV clinical care and that research on mental health and HIV in these settings should be a high priority. We assessed the epidemiology of depression in HIV patients on antiretroviral therapy in a small urban setting in Cameroon by administering a structured interview for depression to 400 patients consecutively attending the Bamenda Regional Hospital AIDS Treatment Center. One in five participants met lifetime criteria for MDD, and 7% had MDD within the prior year. Only 33% had ever spoken with a health professional about depression, and 12% reported ever having received depression treatment that was helpful or effective. Over 2/3 with past-year MDD had severe or very severe episodes. The number of prior depressive episodes and the number of HIV symptoms were the strongest predictors of past-year MDD. The prevalence of MDD in Cameroon is as high as that of other HIV-associated conditions, such as tuberculosis and Hepatitis B virus, whose care is incorporated into World Health Organization guidelines. The management of depression needs to be incorporated in HIV-care guidelines in Cameroon and other similar settings.

Reactions of some potato genotypes to late blight in Cameroon ...

African Journals Online (AJOL)

Reactions of some potato genotypes to late blight in Cameroon. D. K. Njualem, P. Demo, H. A. Mendoza, J. T. Koi, S. F. Nana. Abstract. Field experiments were conducted in Cameroon in 1995 and 1996 to evaluate reactions of different potato genotypes to late blight. There were significant differences among genotypes for ...

Social capital and self-rated health: experiences from Makete district ...

African Journals Online (AJOL)

Social capital and self-rated health: experiences from Makete district, Tanzania. ... social capital including visiting neighbour, trusting neighbour, interaction with ... promote social capital in their communities as one of the health interventions ...

An evaluation of the District Health Information System in rural South ...

African Journals Online (AJOL)

An evaluation of the District Health Information System in rural South Africa. ... Design and subjects. Semi-structured key informant interviews were conducted with clinic managers, supervisors and district information staff. ... of the data collection and collation process but little analysis, interpretation or utilisation of data.

Adaptation of Regional Representative Soil Project and Soil Judging for Cameroon

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Che, Celestine Akuma

2013-01-01

Representative regional soils have agricultural, cultural, economic, environmental, and historical importance to Cameroon. Twenty seven regional representative soils have been identified in Cameroon. A set of laboratory exercises, assignments and exam questions have been developed utilizing the Regional Representative Soil Project (RRSP) that…

Economic management in neo-colonial states : a case study of Cameroon

NARCIS (Netherlands)

Jua, N.

1990-01-01

This study examines the economic management strategies adopted by the Government of Cameroon. Economic planning in Cameroon has been anchored to the principles of planned liberalism, self-reliant development, balanced development and social justice. These concepts are elaborated and it is shown that

Challenges and Opportunities of Implementing District-based Health Information System in Ethiopia

DEFF Research Database (Denmark)

Mengiste, Shegaw Anagaw

2005-01-01

This paper has analyzed the challenges of sustainability and scalability of HIS. The empirical analysis was conducted in a backward and disadvantaged region of Ethiopia. An ongoing process of HISP (Health Information System Program) was addressed and the main challenges in the implementation...... of sustainable and scalable district-based health information system in the context of Primary Health Care (PHC) sector in Ethiopia were identified. Human resource, infrastructure, and HIS related problems are the main challenges hindering the implementation of sustainable and scalable district-based health...... information systems in the region....

Timing of Premarital Intercourse in Bandjoun (West Cameroon

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Zacharie Tsala Dimbuene

2013-03-01

Full Text Available This article examined the effects of family environment on the risks of premarital intercourse for male and female youth. Previous research in sub-Saharan Africa (SSA on the linkages between family structures and sexual debut mainly utilized cross-sectional data. In a sample drawn from Cameroon Family and Health Survey (N = 2,166, descriptive and multivariate results showed that youth who resided in nuclear two-parent families, those who reported higher levels of parental monitoring and higher quality of parent–child relationships during childhood and/or adolescence, had significantly lower rates of premarital intercourse. Polygynous families, parent–child communication, orphanhood, and change in family structure were significantly associated with higher rates of premarital intercourse. Programmatic implications for reproductive health interventions in SSA are discussed.

Developing district health systems in the rural Transvaal

African Journals Online (AJOL)

Close attention needs to be given to district- level health management, the ..... pilot efforts to inrroduce village-level healrh committees. A detailed proposal from ... authorities and the divided interests that have resulted from years of fragmented ...

Bacteriuria amongst pregnant women in the Buea Health District, Cameroon: prevalence, predictors, antibiotic susceptibility patterns and diagnosis.

Science.gov (United States)

Mokube, Morike Ngoe; Atashili, Julius; Halle-Ekane, Gregory Edie; Ikomey, George M; Ndumbe, Peter M

2013-01-01

Bacteriuria is associated with significant maternal and foetal risks. However, its prevalence is not known in our community. This study was carried out to determine the prevalence and predictors of bacteriuria in pregnant women of the Buea Health District (BHD) as well as the antibiotic sensitivity patterns of bacterial isolates. It also sought to determine the diagnostic performance of the nitrite and leucocyte esterase tests in detecting bacteriuria in these women. An observational analytic cross-sectional study was carried out amongst pregnant women attending selected antenatal care centres in Buea. We recruited 102 consenting pregnant women for the study. Demographic and clinical data were collected using structured questionnaires. Clean catch midstream urine was collected from each participant in sterile leak proof containers. Samples were examined biochemically, microscopically and by culture. Significant bacteriuria was defined as the presence of ≥10⁸ bacteria/L of cultured urine. Identification and susceptibility of isolates was performed using API 20E and ATB UR EU (08) (BioMerieux, Marcy l'Etoile, France). Significant bacteriuria was found in the urine of 24 of the 102 women tested giving a bacteriuria prevalence of 23.5% in pregnant women of the BHD. Asymptomatic bacteriuria was detected in 8(7.8%) of the women. There was no statistically significant predictor of bacteriuria. Escherichia coli were the most isolated (33%) uropathogens and were 100% sensitive to cefixime, cefoxitin and cephalothin. The nitrite and leucocyte esterase tests for determining bacteriuria had sensitivities of 8%, 20.8% and specificities of 98.7% and 80.8% respectively. Bacteriuria is frequent in pregnant women in the BHD suggesting the need for routine screening by urine culture. Empiric treatment with cefixime should be instituted until results of urine culture and sensitivity are available. Nitrite and leucocyte esterase tests were not sensitive enough to replace urine

Getting by on credit: how district health managers in Ghana cope with the untimely release of funds.

Science.gov (United States)

Asante, Augustine D; Zwi, Anthony B; Ho, Maria T

2006-08-17

District health systems in Africa depend largely on public funding. In many countries, not only are these funds insufficient, but they are also released in an untimely fashion, thereby creating serious cash flow problems for district health managers. This paper examines how the untimely release of public sector health funds in Ghana affects district health activities and the way district managers cope with the situation. A qualitative approach using semi-structured interviews was adopted. Two regions (Northern and Ashanti) covering the northern and southern sectors of Ghana were strategically selected. Sixteen managers (eight directors of health services and eight district health accountants) were interviewed between 2003/2004. Data generated were analysed for themes and patterns. The results showed that untimely release of funds disrupts the implementation of health activities and demoralises district health staff. However, based on their prior knowledge of when funds are likely to be released, district health managers adopt a range of informal mechanisms to cope with the situation. These include obtaining supplies on credit, borrowing cash internally, pre-purchasing materials, and conserving part of the fourth quarter donor-pooled funds for the first quarter of the next year. While these informal mechanisms have kept the district health system in Ghana running in the face of persistent delays in funding, some of them are open to abuse and could be a potential source of corruption in the health system. Official recognition of some of these informal managerial strategies will contribute to eliminating potential risks of corruption in the Ghanaian health system and also serve as an acknowledgement of the efforts being made by local managers to keep the district health system functioning in the face of budgetary constraints and funding delays. It may boost the confidence of the managers and even enhance service delivery.

Getting by on credit: how district health managers in Ghana cope with the untimely release of funds

Directory of Open Access Journals (Sweden)

Ho Maria T

2006-08-01

Full Text Available Abstract Background District health systems in Africa depend largely on public funding. In many countries, not only are these funds insufficient, but they are also released in an untimely fashion, thereby creating serious cash flow problems for district health managers. This paper examines how the untimely release of public sector health funds in Ghana affects district health activities and the way district managers cope with the situation. Methods A qualitative approach using semi-structured interviews was adopted. Two regions (Northern and Ashanti covering the northern and southern sectors of Ghana were strategically selected. Sixteen managers (eight directors of health services and eight district health accountants were interviewed between 2003/2004. Data generated were analysed for themes and patterns. Results The results showed that untimely release of funds disrupts the implementation of health activities and demoralises district health staff. However, based on their prior knowledge of when funds are likely to be released, district health managers adopt a range of informal mechanisms to cope with the situation. These include obtaining supplies on credit, borrowing cash internally, pre-purchasing materials, and conserving part of the fourth quarter donor-pooled funds for the first quarter of the next year. While these informal mechanisms have kept the district health system in Ghana running in the face of persistent delays in funding, some of them are open to abuse and could be a potential source of corruption in the health system. Conclusion Official recognition of some of these informal managerial strategies will contribute to eliminating potential risks of corruption in the Ghanaian health system and also serve as an acknowledgement of the efforts being made by local managers to keep the district health system functioning in the face of budgetary constraints and funding delays. It may boost the confidence of the managers and even enhance

The Anglophone Cameroon-Nigeria boundary: Opportunities and conflicts

International Nuclear Information System (INIS)

Konings, Piet

2005-01-01

Recent studies of African boundaries have tended to focus either on the growing number of border disputes between states or on frontier regions that are said to offer local inhabitants a wide range of economic opportunities. This article attempts to combine both approaches and to demonstrate the ambiguous nature of the Anglophone Cameroon-Nigeria border. On the one hand, the border has been subject to regular skirmishes between Cameroon and Nigeria, culminating in a protracted war over the sovereignty of the Bakassi peninsula - an area rich in oil reserves. On the other hand, it has for historical and economic reasons never constituted a real barrier to cross-border movements of labour and goods. The large Nigerian migrant community in Anglophone Cameroon, in particular, has been able to benefit from formal and informal cross-border trade for a long time. Unsurprisingly, its dominant position in the host community's commercial sector has been a continuous source of conflict. (Author)

Cameroon's national literatures: An introduction

African Journals Online (AJOL)

2016-03-28

Mar 28, 2016 ... In the Afterword of my book The Sacred Door and Other Stories: .... (Cameroon National Union) in 1966, and declared a unitary state in 1972 known as ... censorship, and to the general feeling of hopelessness of the 2000s.

Comprehensive assessment of health education and health promotion in five non-communicable disease demonstration districts in China: a cross-sectional study.

Science.gov (United States)

Xu, Qiaohua; Huang, Yuelong; Chen, Biyun

2017-12-26

This study aims to develop assessment indicators of health education and promotion for non-communicable disease (NCD) demonstration districts in China and to identify significant factors associated with NCD health education and promotion work. Three complementary techniques were used to conduct this study in Hunan Province, China, between late 2013 and 2015. The Delphi technique was used to develop weighted assessment indicators, followed by the rank sum ratio (RSR) to normalise the weights through rank conversion. Lastly, the technique for order of preference by similarity to ideal solution was conducted to assess five randomly selected NCD demonstration districts representing five different orientations in the province. A total of 24 assessment indicators were constructed covering the following sections: organisational management, fund support, personnel supplies, health education and promotion, people's awareness of NCDs, management and control of patients with NCD, satisfaction with health education and promotion and health literacy of residents. Five districts were selected as samples for evaluation (Furong District, Ziyang District, Shaodong County, Shuangfeng County and Luxi County). Performance varied among the sites, with Furong District greatly surpassing the other sites, especially in fund support, media promotion, technical support for publicity materials, community promotion and supportive environment supplies. The latter four factors were also much greater in the second-ranked Luxi County site than those in the other sites (except Furong District). There were gaps in health education and promotion work in NCD demonstration districts in Hunan Province. The districts that performed better had obvious advantages in fund support, media promotion, technical support, community promotion and supportive environment supplies. Our study provided both a methodological reference and an assessment indicator framework for similar future studies. © Article author

Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership.

Science.gov (United States)

Drobac, Peter C; Basinga, Paulin; Condo, Jeanine; Farmer, Paul E; Finnegan, Karen E; Hamon, Jessie K; Amoroso, Cheryl; Hirschhorn, Lisa R; Kakoma, Jean Baptise; Lu, Chunling; Murangwa, Yusuf; Murray, Megan; Ngabo, Fidele; Rich, Michael; Thomson, Dana; Binagwaho, Agnes

2013-01-01

Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005. Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes. Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership. The partnership is guided by the belief that HSS interventions should be comprehensive, integrated, responsive to local conditions, and address health care access, cost, and quality. The PHIT Partnership represents a collaboration between the MOH and PIH, with support from the National University of Rwanda School of Public Health, the National Institute of Statistics, Harvard Medical School, and Brigham and Women's Hospital. The PHIT Partnership's health systems support aligns with the World Health Organization's six health systems building blocks. HSS activities focus across all levels of the health system - community, health center, hospital, and district leadership - to improve health care access, quality, delivery, and health outcomes. Interventions are concentrated on three main areas: targeted support for health facilities, quality improvement initiatives, and a strengthened network of community health workers. The impact of activities will be assessed using population-level outcomes data collected through oversampling of the demographic and health survey (DHS) in the intervention districts. The overall impact evaluation is complemented by an analysis of trends in facility health care utilization. A comprehensive costing project captures the total expenditures and financial inputs of the health care system to determine the cost of systems improvement. Targeted evaluations and operational research pieces focus on specific

Upper Triassic mafic dykes of Lake Nyos, Cameroon (West Africa) I: K-Ar age evidence within the context of Cameroon Line magmatism, and the tectonic significance

Science.gov (United States)

Aka, Festus Tongwa; Hasegawa, Takeshi; Nche, Linus Anye; Asaah, Asobo Nkengmatia Elvis; Mimba, Mumbfu Ernestine; Teitchou, Isidore; Ngwa, Caroline; Miyabuchi, Yasuo; Kobayashi, Tetsuo; Kankeu, Boniface; Yokoyama, Tetsuya; Tanyileke, Gregory; Ohba, Takeshi; Hell, Joseph Victor; Kusakabe, Minoru

2018-05-01

The hydrodynamic fragmentation that formed Lake Nyos in northwest Cameroon did not only make it the most unpopular lake in the world from a gas disaster perspective, it also opened a rare and formidable window through which much of the geology of Cameroon can be studied in a single locality. The Cambrian quartz monzonite cliff excavated by the maar-forming explosion and exposed in its northeastern shore is intruded by mafic dykes, two of which we dated. Even though close to one another, the dykes are different in composition. The alkaline dyke yields a slightly older (Carnian) K-Ar fedspar age of 231.1 ± 4.8 Ma, while the sub alkaline dyke yields an age of 224.8 ± 4.7 Ma (Norian). Based on radioisotopic age data available over the last 48 years (347 data) for the Cameroon Line magmatism comprising eruptives and volcano-plutonic complexes, the Nyos dykes are way older than the Cameroon Line, and even pre-date the Lower Cretaceous initiation of west Gondwana fragmentation in Equatorial Atlantic domain. They would therefore not have been directly linked to the formation of the Cameroon Line. Alternatively, they might be associated with the development of intra-continental rift systems in West Central Africa that pre-dated west Gondwana breakup to form the Atlantic Ocean.

District Partners Support Students' Mental Health

Science.gov (United States)

Elliot, Laura

2018-01-01

Asheville City Schools and Buncombe County Schools in Asheville, N.C., have partnered with the United Way of Asheville and Buncombe County to develop strategies for responding to the emotional and mental health needs of middle school students in those districts. More than 40 community partners have joined their efforts, which include a focus on…

Primary health services at district level in South Africa: a critique of the primary health care approach

Directory of Open Access Journals (Sweden)

Dookie Sunitha

2012-07-01

Full Text Available Abstract Background The rhetoric of primary health care philosophy in the district health system is widely cited as a fundamental component of the health transformation process in post-apartheid South Africa. Despite South Africa’s progress and attempts at implementing primary health care, various factors still limit its success. Discussion Inconsistencies and poor understanding of primary care and primary health care raises unrealistic expectations in service delivery and health outcomes, and blame is apportioned when expectations are not met. It is important for all health practitioners to consider the contextual influences on health and ill-health and to recognise the role of the underlying determinants of ill-health, namely, social, economic and environmental influences. The primary health care approach provides a strong framework for this delivery but it is not widely applied. There is a need for renewed political and policy commitments toward quality primary health care delivery, re-orientation of health care workers, integration of primary health care activities into other community-based development, improved management skills and effective coordination at all levels of the health system. There should also be optimal capacity building, and skills development in problem-solving, communication, networking and community participation. Summary A well-functioning district health system is required for the re-engineering of primary health care. This strategy requires a strong leadership, a strengthening of the current district heath system and a greater emphasis on health promotion, prevention, and community participation and empowerment.

District health care between quality assurance and crisis management. Possibilities within the limits, Mporokoso and Kaputa District, Zambia

NARCIS (Netherlands)

van Bergen, J. E.

1995-01-01

A tension exists between objectives of health policy makers to achieve high quality standards of care on one hand, and district multi-crisis reality in sub-Saharan Africa on the other hand where sheer survival of the (public) health system is questioned. The collapsing health services as well as the

Mental health care in Nepal: current situation and challenges for development of a district mental health care plan.

Science.gov (United States)

Luitel, Nagendra P; Jordans, Mark Jd; Adhikari, Anup; Upadhaya, Nawaraj; Hanlon, Charlotte; Lund, Crick; Komproe, Ivan H

2015-01-01

Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal. A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records. Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry

Does malaria epidemiology project Cameroon as

Indian Academy of Sciences (India)

2014-07-16

Jul 16, 2014 ... migration from the rural to urban areas as well as population exchange with adjoining countries, high ... cultural practices, deforestation, etc., have also resulted in ..... (Cameroon): influence of urban agriculture and pollution.

[Factors contributing to endemic cholera in Douala, Cameroon].

Science.gov (United States)

Guévart, E; Noeske, J; Solle, J; Essomba, J M; Edjenguele, Mbonji; Bita, A; Mouangue, A; Manga, B

2006-06-01

Cholera has been endemic in Douala, Cameroon since 1971. A number of environmental factors favourize the survival of the Vibrio in Douala including location at the mouth of Wouri delta on the Atlantic Ocean, sandy clay soil, shallow dirty polluted foul-smelling groundwater, presence of vast expanses of swamp, streams/drainage ditches infested with algae, and high temperatures with low rainfall and drought during certain periods of the year. Most outbreaks have started in Bepanda, a slum area built on a garbage dump in a swampy zone fed by drainage ditches carrying the faecal pollution from neighbouring upstream districts. It is a densely overcrowded area of uncontrolled urbanization generated by the influx of poor city new-comers who live without adequate access to clean water or basic sanitary facilities. The most affected areas are those resulting from recent unregulated urban sprawl in polluted swamp zones or garbage dumps. Since access to the public water system is inadequate with only 65000 persons connected for 3 million inhabitants, dwellers in most areas must take water from the 70000 urban wells (estimated in 2004) that are often not more than 1.5 m deep. Sewage facilities are insufficient to provide complete evacuation of solid and liquid waste. The network of rivers, streams and man-made ditches waste are poorly maintained and often overflow during the rainy season. The contents of latrines are often discharged directly into the environment. Social factors such as the reformation of urban tribes and persistence of traditional attitudes toward waste disposal and water use have not only led to high-risk behaviour but also created barriers to sanitation and hygiene education. With an inadequate sanitation inspection system, a large but purely accessible public health system and a highly disorganized private health sector exists, effective preventive measures are difficult to implement. The combination of these factors probably account for the endemicity of

The Dilemma of Civil Society in Cameroon Since 1990: Which Way ...

African Journals Online (AJOL)

sulaiman.adebowale

2008-04-09

Apr 9, 2008 ... of civil society when it has an impact on the society; if not it should be left out. .... campaign and the post-October 1992 election results. As a matter of ... from the General Agreement on Tariffs (GATT) text on Cameroon. ..... Nyamnjoh, F. B., 1997, 'Media, Tribalism and Democracy in Cameroon, in Gerddes,.

Community-directed interventions for priority health problems in Africa: results of a multicountry study.

Science.gov (United States)

2010-07-01

To determine the extent to which the community-directed approach used in onchocerciasis control in Africa could effectively and efficiently provide integrated delivery of other health interventions. A three-year experimental study was undertaken in 35 health districts from 2005 to 2007 in seven research sites in Cameroon, Nigeria and Uganda. Four trial districts and one comparison district were randomly selected in each site. All districts had established ivermectin treatment programmes, and in the trial districts four other established interventions - vitamin A supplementation, use of insecticide-treated nets, home management of malaria and short-course, directly-observed treatment for tuberculosis patients - were progressively incorporated into a community-directed intervention (CDI) process. At the end of each of the three study years, we performed quantitative evaluations of intervention coverage and provider costs, as well as qualitative assessments of the CDI process. With the CDI strategy, significantly higher coverage was achieved than with other delivery approaches for all interventions except for short-course, directly-observed treatment. The coverage of malaria interventions more than doubled. The district-level costs of delivering all five interventions were lower in the CDI districts, but no cost difference was found at the first-line health facility level. Process evaluation showed that: (i) participatory processes were important; (ii) recurrent problems with the supply of intervention materials were a major constraint to implementation; (iii) the communities and community implementers were deeply committed to the CDI process; (iv) community implementers were more motivated by intangible incentives than by external financial incentives. The CDI strategy, which builds upon the core principles of primary health care, is an effective and efficient model for integrated delivery of appropriate health interventions at the community level in Africa.

Bacteriuria amongst pregnant women in the Buea Health District, Cameroon: prevalence, predictors, antibiotic susceptibility patterns and diagnosis.

Directory of Open Access Journals (Sweden)

Morike Ngoe Mokube

Full Text Available BACKGROUND: Bacteriuria is associated with significant maternal and foetal risks. However, its prevalence is not known in our community. OBJECTIVES: This study was carried out to determine the prevalence and predictors of bacteriuria in pregnant women of the Buea Health District (BHD as well as the antibiotic sensitivity patterns of bacterial isolates. It also sought to determine the diagnostic performance of the nitrite and leucocyte esterase tests in detecting bacteriuria in these women. METHODS: An observational analytic cross-sectional study was carried out amongst pregnant women attending selected antenatal care centres in Buea. We recruited 102 consenting pregnant women for the study. Demographic and clinical data were collected using structured questionnaires. Clean catch midstream urine was collected from each participant in sterile leak proof containers. Samples were examined biochemically, microscopically and by culture. Significant bacteriuria was defined as the presence of ≥10⁸ bacteria/L of cultured urine. Identification and susceptibility of isolates was performed using API 20E and ATB UR EU (08 (BioMerieux, Marcy l'Etoile, France. RESULTS: Significant bacteriuria was found in the urine of 24 of the 102 women tested giving a bacteriuria prevalence of 23.5% in pregnant women of the BHD. Asymptomatic bacteriuria was detected in 8(7.8% of the women. There was no statistically significant predictor of bacteriuria. Escherichia coli were the most isolated (33% uropathogens and were 100% sensitive to cefixime, cefoxitin and cephalothin. The nitrite and leucocyte esterase tests for determining bacteriuria had sensitivities of 8%, 20.8% and specificities of 98.7% and 80.8% respectively. CONCLUSION: Bacteriuria is frequent in pregnant women in the BHD suggesting the need for routine screening by urine culture. Empiric treatment with cefixime should be instituted until results of urine culture and sensitivity are available. Nitrite and

TROPFOMS, a decision support model for sustainabele management of south Cameroon's rainforests

NARCIS (Netherlands)

Eba'a Atyi, R.

2000-01-01

Natural forests play an important role in the economy of Cameroon, at both the national and local levels. Unfortunately, there is still a general sense that in Cameroon, like in most tropical countries, forests are not managed in a sustainable way. The poor forest management practices,

Benefits of task-shifting HIV care to nurses in terms of health-related quality of life in patients initiating antiretroviral therapy in rural district hospitals in Cameroon [Stratall Agence Nationale de Recherche sur le SIDA (ANRS) 12110/Ensemble pour une Solidarité Thérapeutique Hospitalière en Réseau (ESTHER) substudy].

Science.gov (United States)

Suzan-Monti, M; Blanche, J; Boyer, S; Kouanfack, C; Delaporte, E; Bonono, R-C; Carrieri, P M; Protopopescu, C; Laurent, C; Spire, B

2015-05-01

The World Health Organization (WHO) recommends task-shifting HIV care to nurses in low-resource settings with limited numbers of physicians. However, the effect of such task-shifting on the health-related quality of life (HRQL) of people living with HIV (PLHIV) has seldom been evaluated. We aimed to investigate the effect of task-shifting HIV care to nurses on HRQL outcomes in PLHIV initiating antiretroviral therapy (ART) in rural district hospitals in Cameroon. Outcomes in PLHIV were longitudinally collected in the 2006-2010 Stratall trial. PLHIV were followed up for 24 months by nurses and/or physicians. Six HRQL dimensions were assessed during face-to-face interviews using the WHO Quality of Life (WHOQOL)-HIV BREF scale: physical health; psychological health; independence level; social relationships; environment; and spirituality/religion/personal beliefs. The degree of task-shifting was estimated using a consultant ratio (i.e. the ratio of nurse-led to physician-led visits). The effect of task-shifting and other potential correlates on HRQL dimensions was explored using a Heckman two-stage approach based on linear mixed models to adjust for the potential bias caused by missing data in the outcomes. Of 1424 visits in 440 PLHIV (70.5% female; median age 36 years; median CD4 count 188 cells/μL at enrolment), 423 (29.7%) were task-shifted to nurses. After multiple adjustment, task-shifting was associated with higher HRQL level for four dimensions: physical health [coefficient 0.7; 95% confidence interval (CI) 0.1-1.2; P = 0.01], psychological health (coefficient 0.5; 95% CI 0.0-1.0; P = 0.05), independence level (coefficient 0.6; 95% CI 0.1-1.1; P = 0.01) and environment (coefficient 0.6; 95% CI 0.1-1.0; P = 0.02). Task-shifting HIV care to nurses benefits the HRQL of PLHIV. Together with the previously demonstrated comparable clinical effectiveness of physician-based and nurse-based models of HIV care, our results support the WHO recommendation

Strengthening health district management competencies in Ghana, Tanzania and Uganda: lessons from using action research to improve health workforce performance.

Science.gov (United States)

Martineau, Tim; Raven, Joanna; Aikins, Moses; Alonso-Garbayo, Alvaro; Baine, Sebastian; Huss, Reinhard; Maluka, Stephen; Wyss, Kaspar

2018-01-01

To achieve Universal Health Coverage (UHC), more health workers are needed; also critical is supporting optimal performance of existing staff. Integrated human resource management (HRM) strategies, complemented by other health systems strategies, are needed to improve health workforce performance, which is possible at district level in decentralised contexts. To strengthen the capacity of district management teams to develop and implement workplans containing integrated strategies for workforce performance improvement, we introduced an action-research-based management strengthening intervention (MSI). This consisted of two workshops, follow-up by facilitators and meetings between participating districts. Although often used in the health sector, there is little evaluation of this approach in middle-income and low-income country contexts. The MSI was tested in three districts in Ghana, Tanzania and Uganda. This paper reports on the appropriateness of the MSI to the contexts and its effects. Documentary evidence (workshop reports, workplans, diaries, follow-up visit reports) was collected throughout the implementation of the MSI in each district and interviews (50) and focus-group discussions (6) were conducted with managers at the end of the MSI. The findings were analysed using Kirkpatrick's evaluation framework to identify effects at different levels. The MSI was appropriate to the needs and work patterns of District Health Management Teams (DHMTs) in all contexts. DHMT members improved management competencies for problem analysis, prioritisation and integrated HRM and health systems strategy development. They learnt how to refine plans as more information became available and the importance of monitoring implementation. The MSI produced changes in team behaviours and confidence. There were positive results regarding workforce performance or service delivery; these would increase with repetition of the MSI. The MSI is appropriate to the contexts where tested and

Examining the influence of family physician supply on district health system performance in South Africa: An ecological analysis of key health indicators.

Science.gov (United States)

Von Pressentin, Klaus B; Mash, Bob J; Esterhuizen, Tonya M

2017-04-28

The supply of appropriate health workers is a key building block in the World Health Organization's model of effective health systems. Primary care teams are stronger if they contain doctors with postgraduate training in family medicine. The contribution of such family physicians to the performance of primary care systems has not been evaluated in the African context. Family physicians with postgraduate training entered the South African district health system (DHS) from 2011. This study aimed to evaluate the impact of family physicians within the DHS of South Africa. The objectives were to evaluate the impact of an increase in family physician supply in each district (number per 10 000 population) on key health indicators. All 52 South African health districts were included as units of analysis. An ecological study evaluated the correlations between the supply of family physicians and routinely collected data on district performance for two time periods: 2010/2011 and 2014/2015. Five years after the introduction of the new generation of family physicians, this study showed no demonstrable correlation between family physician supply and improved health indicators from the macro-perspective of the district. The lack of a measurable impact at the level of the district is most likely because of the very low supply of family physicians in the public sector. Studies which evaluate impact closer to the family physician's circle of control may be better positioned to demonstrate a measurable impact in the short term.

Thanking Responders in Cameroon English

Science.gov (United States)

Ouafeu, Yves Talla Sando

2009-01-01

An analysis of authentic or genuine interactions among Cameroon English speakers reveals that conversational routines in this variety of English differ a good deal from those obtained in other varieties of English, non-native varieties of English inclusive, and more specifically in native varieties of English. This paper looks at "thanking…

Factors associated with health facility childbirth in districts of Kenya, Tanzania and Zambia

DEFF Research Database (Denmark)

Phiri, Selia Ng'anjo; Kiserud, Torvid; Kvåle, Gunnar

2014-01-01

of delivery. Socioeconomic position was measured by employing a construct of educational attainment and wealth index. All analyses were stratified by district and urban-rural residence. RESULTS: There were substantial inter-district differences in proportion of health facility childbirth. Facility childbirth......BACKGROUND: Maternal mortality continues to be a heavy burden in low and middle income countries where half of all deliveries take place in homes without skilled attendance. The study aimed to investigate the underlying and proximate determinants of health facility childbirth in rural and urban...... areas of three districts in Kenya, Tanzania and Zambia. METHODS: A population-based survey was conducted in 2007 as part of the 'REsponse to ACcountable priority setting for Trust in health systems' (REACT) project. Stratified random cluster sampling was used and the data included information on place...

Teachers' Perceptions of Students with Special Education Needs in Cameroon Secondary Schools

Science.gov (United States)

Arrah, Rosemary Oneke; Swain, Kristine D.

2014-01-01

This study examined teachers' perceptions of including students with special education needs in Cameroon secondary schools. Teachers (N = 130) from five secondary government, denominational or lay private schools in Buea subdivision of Cameroon, Africa, completed a 26-item survey. The survey was analyzed using descriptive statistics, t-tests, and…

The decentralisation-centralisation dilemma: recruitment and distribution of health workers in remote districts of Tanzania.

Science.gov (United States)

Munga, Michael A; Songstad, Nils Gunnar; Blystad, Astrid; Maestad, Ottar

2009-04-30

The implementation of decentralisation reforms in the health sector of Tanzania started in the 1980s. These reforms were intended to relinquish substantial powers and resources to districts to improve the development of the health sector. Little is known about the impact of decentralisation on recruitment and distribution of health workers at the district level. Reported difficulties in recruiting health workers to remote districts led the Government of Tanzania to partly re-instate central recruitment of health workers in 2006. The effects of this policy change are not yet documented. This study highlights the experiences and challenges associated with decentralisation and the partial re-centralisation in relation to the recruitment and distribution of health workers. An exploratory qualitative study was conducted among informants recruited from five underserved, remote districts of mainland Tanzania. Additional informants were recruited from the central government, the NGO sector, international organisations and academia. A comparison of decentralised and the reinstated centralised systems was carried out in order to draw lessons necessary for improving recruitment, distribution and retention of health workers. The study has shown that recruitment of health workers under a decentralised arrangement has not only been characterised by complex bureaucratic procedures, but by severe delays and sometimes failure to get the required health workers. The study also revealed that recruitment of highly skilled health workers under decentralised arrangements may be both very difficult and expensive. Decentralised recruitment was perceived to be more effective in improving retention of the lower cadre health workers within the districts. In contrast, the centralised arrangement was perceived to be more effective both in recruiting qualified staff and balancing their distribution across districts, but poor in ensuring the retention of employees. A combination of centralised

A framework to assess management performance in district health systems: a qualitative and quantitative case study in Iran.

Science.gov (United States)

Tabrizi, Jafar Sadegh; Gholipour, Kamal; Iezadi, Shabnam; Farahbakhsh, Mostafa; Ghiasi, Akbar

2018-01-01

The aim was to design a district health management performance framework for Iran's healthcare system. The mixed-method study was conducted between September 2015 and May 2016 in Tabriz, Iran. In this study, the indicators of district health management performance were obtained by analyzing the 45 semi-structured surveys of experts in the public health system. Content validity of performance indicators which were generated in qualitative part were reviewed and confirmed based on content validity index (CVI). Also content validity ratio (CVR) was calculated using data acquired from a survey of 21 experts in quantitative part. The result of this study indicated that, initially, 81 indicators were considered in framework of district health management performance and, at the end, 53 indicators were validated and confirmed. These indicators were classified in 11 categories which include: human resources and organizational creativity, management and leadership, rules and ethics, planning and evaluation, district managing, health resources management and economics, community participation, quality improvement, research in health system, health information management, epidemiology and situation analysis. The designed framework model can be used to assess the district health management and facilitates performance improvement at the district level.

A framework to assess management performance in district health systems: a qualitative and quantitative case study in Iran

Directory of Open Access Journals (Sweden)

Jafar Sadegh Tabrizi

2018-04-01

Full Text Available The aim was to design a district health management performance framework for Iran’s healthcare system. The mixed-method study was conducted between September 2015 and May 2016 in Tabriz, Iran. In this study, the indicators of district health management performance were obtained by analyzing the 45 semi-structured surveys of experts in the public health system. Content validity of performance indicators which were generated in qualitative part were reviewed and confirmed based on content validity index (CVI. Also content validity ratio (CVR was calculated using data acquired from a survey of 21 experts in quantitative part. The result of this study indicated that, initially, 81 indicators were considered in framework of district health management performance and, at the end, 53 indicators were validated and confirmed. These indicators were classified in 11 categories which include: human resources and organizational creativity, management and leadership, rules and ethics, planning and evaluation, district managing, health resources management and economics, community participation, quality improvement, research in health system, health information management, epidemiology and situation analysis. The designed framework model can be used to assess the district health management and facilitates performance improvement at the district level.

Community Based Social Audit of Health Services in Two Districts of ...

International Development Research Centre (IDRC) Digital Library (Canada)

Community Based Social Audit of Health Services in Two Districts of ... The health system in Afghanistan has been chronically neglected during decades of war ... Organization for Women in Science for the Developing World (OWSD), IDRC is ...

Recruitment Of International Students Into Cameroon Tertiary ...

African Journals Online (AJOL)

Recruitment Of International Students Into Cameroon Tertiary Institutions In The Absence Of International Offices. ... The present system of recruiting international students is haphazardly been handled by ... AJOL African Journals Online.

78 FR 38287 - Bitterroot National Forest, Darby Ranger District, Como Forest Health Project

Science.gov (United States)

2013-06-26

... DEPARTMENT OF AGRICULTURE Forest Service Bitterroot National Forest, Darby Ranger District, Como Forest Health Project AGENCY: Forest Service. ACTION: Notice; Correction. SUMMARY: The Department of Agriculture (USDA), Forest Service, Bitterroot National Forest, Darby Ranger District published a document in...

Contaminants in Foods of Animal Origin in Cameroon: A One Health Vision for Risk Management "from Farm to Fork".

Science.gov (United States)

Pouokam, Guy B; Foudjo, B U Saha; Samuel, Chi; Yamgai, Philomina Fankam; Silapeux, A Kamda; Sando, Joel Taguemkam; Atonde, G Fankam; Frazzoli, Chiara

2017-01-01

Foods of animal origin represent an important share in the diet of Cameroonian populations. Cameroon is known to be a food basket in the west and central Africa sub-region, and an important supplier of foods on the international markets. In the meantime, food importation is continuously increasing to meet the high demand of a more westernized segment of the population. Cereals, fish, sea products, eggs, honey, shrimps, chicken, and feed ingredients are important share in the international trade of agricultural products. Few controls are made on the quality and safety of these products. Certain safety standards do exist but are still yet to be enforced. Inspections done so far by regulatory authorities are partial and do not cover important hazards that require laboratory analysis. The increasing awareness of population, the burden of new types of disease, as well as the recurrence of food scandals have recently launched a scientific and population debate on the contribution of foods items, especially those of animal origin, to the toxic exposure of food producing animals and humans. This paper critically reviews the occurrence of toxicants in most consumed foods of animal origin in Cameroon. This study included the most consumed food of animal origin, identified during the national household budget survey and contributing to 8.1% of the total diet of an individual. Data evaluated suggest an important contamination by toxic metals, mycotoxins, veterinary drugs' residues, and pesticides. The current national legal framework is briefly analyzed to explore possible intervention measures in the frame of the One Health approach.

Interventions for hiring, retaining and training district health systems managers in low- and middle-income countries.

Science.gov (United States)

Rockers, Peter C; Bärnighausen, Till

2013-04-30

District managers are playing an increasingly important role in determining the performance of health systems in low- and middle-income countries as a result of decentralization. To assess the effectiveness of interventions to hire, retain and train district health systems managers in low- and middle-income countries. We searched a wide range of international databases, including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. We also searched online resources of international agencies, including the World Bank, to find relevant grey literature. Searches were conducted in December 2011. District health systems managers are those persons who are responsible for overseeing the operations of the health system within a defined, subnational geographical area that is designated as a district. Hiring and retention interventions include those that aim to increase the attractiveness of district management positions, as well as those related to hiring and retention processes, such as private contracting. Training interventions include education programs to develop future managers and on-the-job training programs for current managers. To be included, studies needed to use one of the following study designs: randomized controlled trial, nonrandomized controlled trial, controlled before-and-after study, and interrupted time series analysis. We report measures of effect in the same way that the primary study authors have reported them. Due to the varied nature of interventions included in this review we could not pool data across studies. Two studies met our inclusion criteria. The findings of one study conducted in Cambodia provide low quality evidence that private contracts with international nongovernmental organizations (NGOs) for district health systems management ('contracting-in') may improve health care access and utilization. Contracting-in increased use of antenatal care by 28% and use of public facilities by 14%. However, contracting

[The judicialization of health in the Federal District of Brazil].

Science.gov (United States)

Diniz, Debora; Machado, Teresa Robichez de Carvalho; Penalva, Janaina

2014-02-01

This paper seeks to analyze the Judiciary's approach with respect to demands for the judicialization of the right to health by means of a case study of civil lawsuits for access to health care in Brazil's Federal District. Judicialization of the right to health signifies the judicialization of various of the health services provided. This is a descriptive and exploratory case study that covers the Federal District and uses mixed techniques to gather and analyze data. This study analyzed 385 lawsuits (87% of the total number of cases of judicialization of health for the period from 2005 to 2010 that reached the Appellate court). The results indicate that the most judicialized service is access to intensive care unit, followed by drugs and health care. Almost all lawsuits are filed by public defenders, with medical prescriptions and recommendations from the public health service. The results of this study challenge some dominant themes in the national debate, particularly the claim that judicialization is a phenomenon of the elites and that the services judicialized are drugs. The study does not seek to make generalizations, but highlights the fact that the phenomenon of judicialization of health has different aspects encompassed under the same concept.

Knowledge and practice of traditional healers in oral health in the Bui Division, Cameroon

Directory of Open Access Journals (Sweden)

Naidoo Sudeshni

2011-01-01

Full Text Available Abstract Background The majority of Cameroonians depend on traditional medicines for their health care needs and about seven per cent of the average household health budget is spent on traditional medicines irrespective of their incomes. The aim of the present study was to determine the oral care knowledge and practices of Traditional Healers (TH on oral health delivery in the urban and rural areas of Bui Division of Cameroon and the objectives to determine the cost of treatment and reasons why people visit TH. Methods The present study was cross sectional and utilized semi-structured questionnaires to collect data. Results The sample consisted of 21 TH and 52 clients of TH. Sixty two percent of the TH's were above 40 years and 90% male. The mean age was 46 years (range 20-77 years. Twenty four percent of the TH practiced as herbalists and the remainder both divination and herbalism. Sixty seven percent of people in the Bui Division, who patronize TH for their oral health needs, fall within the 20-40 year age group. There is little collaboration between the oral health workers and TH and only 6% of all patients seen by TH are referred to the dentist. Socio-cultural and economic factors affect the oral health care seeking behavior of patients in this area and only 6.5% of patients visit dental clinics. Reasons for not attending dental clinics included high cost, poor accessibility, superstition and fear. TH's are not experienced in the treatment of pulpitis - the majority of patients who presented with toothache had temporary or no relief, but despite this 67% reported being satisfied with their treatment. Sixty nine percent of the patients visited TH because of low cost - the average cost of treatment with TH (approximately $5 is very low, as compared to conventional treatment ($50. Conclusions Traditional healers are willing to co-operate with oral health workers in improving oral health. Since they have a vital role to play in health care

Knowledge and practice of traditional healers in oral health in the Bui Division, Cameroon.

Science.gov (United States)

Agbor, Ashu M; Naidoo, Sudeshni

2011-01-15

The majority of Cameroonians depend on traditional medicines for their health care needs and about seven per cent of the average household health budget is spent on traditional medicines irrespective of their incomes. The aim of the present study was to determine the oral care knowledge and practices of Traditional Healers (TH) on oral health delivery in the urban and rural areas of Bui Division of Cameroon and the objectives to determine the cost of treatment and reasons why people visit TH. The present study was cross sectional and utilized semi-structured questionnaires to collect data. The sample consisted of 21 TH and 52 clients of TH. Sixty two percent of the TH's were above 40 years and 90% male. The mean age was 46 years (range 20-77 years). Twenty four percent of the TH practiced as herbalists and the remainder both divination and herbalism. Sixty seven percent of people in the Bui Division, who patronize TH for their oral health needs, fall within the 20-40 year age group. There is little collaboration between the oral health workers and TH and only 6% of all patients seen by TH are referred to the dentist. Socio-cultural and economic factors affect the oral health care seeking behavior of patients in this area and only 6.5% of patients visit dental clinics. Reasons for not attending dental clinics included high cost, poor accessibility, superstition and fear. TH's are not experienced in the treatment of pulpitis - the majority of patients who presented with toothache had temporary or no relief, but despite this 67% reported being satisfied with their treatment. Sixty nine percent of the patients visited TH because of low cost - the average cost of treatment with TH (approximately $5) is very low, as compared to conventional treatment ($50). Traditional healers are willing to co-operate with oral health workers in improving oral health. Since they have a vital role to play in health care seeking attitudes in this community and barriers affecting the oral

Sustainable development in Cameroon's forestry sector: Progress ...

African Journals Online (AJOL)

African Journal of Environmental Science and Technology ... sector, and proffers a series of policy recommendations for advancing sustainable forest management in ... Since the enactment of Cameroon's comprehensive forestry law (Law N0.

Health insurance premium increases for the 5 largest school districts in the United States, 2004-2008.

Science.gov (United States)

Cantillo, John R

2010-03-01

Local school districts are often one of the largest, if not the largest, employers in their respective communities. Like many large employers, school districts offer health insurance to their employees. There is a lack of information about the rate of health insurance premiums in US school districts relative to other employers. To assess the change in the costs of healthcare insurance in the 5 largest public school districts in the United States, between 2004 and 2008, as representative of large public employers in the country. Data for this study were drawn exclusively from a survey sent to the 5 largest public school districts in the United States. The survey requested responses on 3 data elements for each benefit plan offered from 2004 through 2008; these included enrollment, employee costs, and employer costs. The premium growth for the 5 largest school districts has slowed down and is consistent with other purchasers-Kaiser/Health Research & Educational Trust and the Federal Employee Health Benefit Program. The average increase in health insurance premium for the schools was 5.9% in 2008, and the average annual growth rate over the study period was 7.5%. For family coverage, these schools provide the most generous employer contribution (80.8%) compared with the employer contribution reported by other employers (73.5%) for 2008. Often the largest employers in their communities, school districts demonstrate a commitment to provide choice of benefits and affordability for employees and their families. Despite constraints typical of public employers, the 5 largest school districts in the United States have decelerated in premium growth consistent with other purchasers, albeit at a slower pace.

Pro Poor Growth in Cameroon

Directory of Open Access Journals (Sweden)

Samuel Fambon

2017-06-01

Full Text Available The purpose of this paper is to analyze the relationship between economic growth, poverty and income distribution in Cameroon, using both the data derived from three Cameroonian household surveys and the Poverty Equivalent Growth Rate (PEGR methodology developed by Kakwani et al. (2004, The study found that economic growth in Cameroon was pro poor over the period 1996–2007, which suggests that instead of increasing the economic growth rate alone, the poverty equivalent growth rate should also be maximized to achieve the poverty reduction objective, meaning that on the one hand, the growth rate should be boosted, and on the other, the distribution of income should also be concurrently improved. A decomposition of changes in poverty using the Kakwani (1997 approach reveal that the growth component dominates the redistribution component in the reduction of poverty. This suggests that the fall in absolute poverty over the survey period may be attributed to an increase in average household income, and not to the redistributive policies of the government.

Causality analysis of diesel consumption and economic growth in Cameroon

International Nuclear Information System (INIS)

Tamba, Jean Gaston; Njomo, Donatien; Limanond, Thirayoot; Ntsafack, Borel

2012-01-01

This study examines the causal relationship between diesel consumption and economic growth in Cameroon by using a three-step modern time-series technique. Tests for unit roots, cointegration, and Granger-causality based on error correction model are employed on annual data covering the period 1975–2008. Empirical results of the study confirm the presence of a long-run equilibrium relationship between diesel consumption and economic growth. The error correction model shows that an estimated 1% increase in economic growth causes a rise in diesel consumption of 1.30% in the long-run. The overall results show that there exists bidirectional causality in the long-run relationship and no causality in the short-run relationship between diesel consumption and economic growth at the 5% level of significance. Thus, the energy policies in Cameroon should place priority on the discovery of new oil field and building capacity additions of the refinery to increase production of petroleum products, as this would propel the economic growth of the country. - Highlights: ► We examine the causal relationship between diesel consumption and GDP in Cameroon. ► we analyze the petroleum products sector in Cameroon. ► 1% increase in economic growth causes a rise in diesel consumption of 1.30%. ► The policy aimed at improving diesel supply have a positive impact on economics.

The puzzle of Buruli ulcer transmission, ethno-ecological history and the end of "love" in the Akonolinga district, Cameroon.

Science.gov (United States)

Giles-Vernick, Tamara; Owona-Ntsama, Joseph; Landier, Jordi; Eyangoh, Sara

2015-03-01

The "One World One Health Initiative" has attended little to the priorities, concepts and practices of resource-poor communities confronting disease and the implications of these concerns for its biomedical, ecological and institutional approach to disease surveillance and control. Using the example of Buruli ulcer (BU) and its bacterial etiology, Mycobacterium ulcerans, in south-central Cameroon, we build on debates about the contributions of "local knowledge" and "alternative models" to biomedical knowledge of disease transmission. BU's mode of transmission remains poorly understood. Our approach employs ethno-ecological histories - local understandings of the putative emergence and expansion of a locally important, neglected disease. We develop these histories from 52 individual and small group interviews, group discussions, and participant-observation of daily and seasonal activities, conducted in 2013-2013. These histories offer important clues about past environmental and social change that should guide further ecological, epidemiological research. They highlight a key historical moment (the late 1980s and 1990s); specific ecological transformations; new cultivation practices in unexploited zones that potentially increased exposure to M. ulcerans; and ecological degradation that may have lowered nutritional standards and heightened susceptibility to BU. They also recast transmission, broadening insight into BU and its local analog, atom, by emphasizing the role of social change and economic crisis in its emergence and expansion. Copyright © 2014 Elsevier Ltd. All rights reserved.

Factors Associated with Fatal Outcomes Following Cholera-Like Syndrome in Far North Region of Cameroon: A Community-Based Survey.

Science.gov (United States)

Djouma, Fabrice N; Ateudjieu, Jerome; Ram, Malathi; Debes, Amanda K; Sack, David A

2016-12-07

This study demonstrates that most cholera deaths in this region of Cameroon occur out of hospital. This is a region which is prone to cholera, and interventions are needed to improve access to emergency medical care, especially during cholera outbreaks. Cameroon has experienced 14 cholera epidemics during the last 20 years, and these have had high case fatality rates. This study attempted to assess the effect of delays in seeking care and the locations of care as possible risk factors for cholera mortality. The study used data from a community-based survey regarding the circumstances of 97 fatal cases and 197 control (nonfatal) cases following a cholera-like syndrome in villages with cholera-like diseases during cholera outbreaks in Cameroon during 2009-2011. Deaths occurred in one of four environments: the community, in a temporary community treatment center (TCTC), in transit to a treatment center, or in a hospital (39%, 32%, 5%, and 24%, respectively). Using a case-control analysis, factors associated with deaths included the nonuse of a cholera treatment center, receiving health care in a TCTC instead of a hospital, and greater than 4 hours delay between the onset of symptoms and the decision to go to a treatment center (odds ratios of 17.1 [confidence interval (CI): 7.0-41.8], 2.5 [CI: 1.2-5.0], and 2.2 [CI: 1.0-4.6], respectively). During cholera epidemics, a higher proportion of deaths are still occurring in communities. The nonuse and delays in deciding to go a treatment center, and treatment at TCTC rather than a hospital were risk factors for death among patients with cholera-like syndrome in Cameroon. Informing people on community management of cholera-like syndrome and improving care in all health facilities are needed to reduce deaths during cholera epidemics. © The American Society of Tropical Medicine and Hygiene.

Wealth and sexual behaviour among men in Cameroon

Directory of Open Access Journals (Sweden)

Nana Philip

2006-09-01

Full Text Available Abstract Background The 2004 Demographic and Health Survey (DHS in Cameroon revealed a higher prevalence of HIV in richest and most educated people than their poorest and least educated compatriots. It is not certain whether the higher prevalence results partly or wholly from wealthier people adopting more unsafe sexual behaviours, surviving longer due to greater access to treatment and care, or being exposed to unsafe injections or other HIV risk factors. As unsafe sex is currently believed to be the main driver of the HIV epidemic in sub-Saharan Africa, we designed this study to examine the association between wealth and sexual behaviour in Cameroon. Methods We analysed data from 4409 sexually active men aged 15–59 years who participated in the Cameroon DHS using logistic regression models, and have reported odds ratios (OR with confidence intervals (CI. Results When we controlled for the potential confounding effects of marital status, place of residence, religion and age, men in the richest third of the population were less likely to have used a condom in the last sex with a non-spousal non-cohabiting partner (OR 0.43, 95% CI 0.32–0.56 and more likely to have had at least two concurrent sex partners in the last 12 months (OR 1.38, 95% CI 1.12–1.19 and more than five lifetime sex partners (OR 1.97, 95% CI 1.60–2.43. However, there was no difference between the richest and poorest men in the purchase of sexual services. Regarding education, men with secondary or higher education were less likely to have used a condom in the last sex with a non-spousal non-cohabiting partner (OR 0.24, 95% CI 0.16–0.38 and more likely to have started sexual activity at age 17 years or less (OR 2.73, 95% CI 2.10–3.56 and had more than five lifetime sexual partners (OR 2.59, 95% CI 2.02–3.31. There was no significant association between education and multiple concurrent sexual partnerships in the last 12 months or purchase of sexual services

A multi-perspective view of genetic variation in Cameroon.

Science.gov (United States)

Coia, V; Brisighelli, F; Donati, F; Pascali, V; Boschi, I; Luiselli, D; Battaggia, C; Batini, C; Taglioli, L; Cruciani, F; Paoli, G; Capelli, C; Spedini, G; Destro-Bisol, G

2009-11-01

In this study, we report the genetic variation of autosomal and Y-chromosomal microsatellites in a large Cameroon population dataset (a total of 11 populations) and jointly analyze novel and previous genetic data (mitochondrial DNA and protein coding loci) taking geographic and cultural factors into consideration. The complex pattern of genetic variation of Cameroon can in part be described by contrasting two geographic areas (corresponding to the northern and southern part of the country), which differ substantially in environmental, biological, and cultural aspects. Northern Cameroon populations show a greater within- and among-group diversity, a finding that reflects the complex migratory patterns and the linguistic heterogeneity of this area. A striking reduction of Y-chromosomal genetic diversity was observed in some populations of the northern part of the country (Podokwo and Uldeme), a result that seems to be related to their demographic history rather than to sampling issues. By exploring patterns of genetic, geographic, and linguistic variation, we detect a preferential correlation between genetics and geography for mtDNA. This finding could reflect a female matrimonial mobility that is less constrained by linguistic factors than in males. Finally, we apply the island model to mitochondrial and Y-chromosomal data and obtain a female-to-male migration Nnu ratio that was more than double in the northern part of the country. The combined effect of the propensity to inter-populational admixture of females, favored by cultural contacts, and of genetic drift acting on Y-chromosomal diversity could account for the peculiar genetic pattern observed in northern Cameroon.

Developing management capacity building package to district health manager in northwest of Iran: A sequential mixed method study.

Science.gov (United States)

Tabrizi, Jafar Sadegh; Gholipour, Kamal; Farahbakhsh, Mostafa; Jahanbin, Hasan; Karamuz, Majid

2016-11-01

To assess districts health managers educational needs and develop management training programmes. This mixed-method study was carried out between August 2014 and August 2015 in Tabriz, Iran. Four focus group discussion sessions and three semi-structured face-to-face interviews were conducted among district health managers and experts of a health centre. Besides, 52 questionnaires were completed to weigh and finalise management education module and courses. Interviews and focus group discussions were tape-recorded, transcribed and analysed using content analysis method. Data was analysed using SPSS17. There were 52 participants, of whom 40(78.8%) were men and 12(21.2%) were women. All of the subjects (100%) took part in the quantitative phase, while 25(48.08%) participated in the qualitative phase. In the qualitative section, 11(44%) participants were heads of unit/departments in provincial health centre and 14(56%) were district health managers. In the quantitative phase, 30(57.7%) participants were district health managers and 8(28.8%) were heads of units/departments. Moreover, 33(63.4%) participants had medical education. The job experience of 3(5.8%) participants in the current position was below five years. Districts health management training programme consisted of 10modules with 53 educational topics. The normalised score out of a total of 100 for rules and ethics was 75.51, health information management 71.19, management and leadership 69.27, district management 68.08, human resources and organisational creativity 67.58,quality improvement 66.6, health resources management 62.37, planning and evaluation 61.87, research in health system 59.15, and community participation was 53.15. Considering district health managers' qualification in health and medicine, they had not been trained in basic management. Almost all the management and leadership courses were prioritised as most necessary.

Lead exposure from aluminum cookware in Cameroon

International Nuclear Information System (INIS)

Weidenhamer, Jeffrey D.; Kobunski, Peter A.; Kuepouo, Gilbert; Corbin, Rebecca W.; Gottesfeld, Perry

2014-01-01

Blood lead levels have decreased following the removal of lead from gasoline in most of the world. However, numerous recent studies provide evidence that elevated blood lead levels persist in many low and middle-income countries around the world at much higher prevalence than in the more developed countries. One potential source of lead exposure that has not been widely investigated is the leaching of lead from artisanal aluminum cookware, which is commonly used in the developing world. Twenty-nine samples of aluminum cookware and utensils manufactured by local artisans in Cameroon were collected and analyzed for their potential to release lead during cooking. Source materials for this cookware included scrap metal such as engine parts, radiators, cans, and construction materials. The lead content of this cookware is relatively low (< 1000 ppm by X-ray fluorescence), however significant amounts of lead, as well as aluminum and cadmium were released from many of the samples using dilute acetic acid extractions at boiling and ambient temperatures. Potential exposures to lead per serving were estimated to be as high as 260 μg, indicating that such cookware can pose a serious health hazard. We conclude that lead, aluminum and cadmium can migrate from this aluminum cookware during cooking and enter food at levels exceeding recommended public health guidelines. Our results support the need to regulate lead content of materials used to manufacture these pots. Artisanal aluminum cookware may be a major contributor to lead poisoning throughout the developing world. Testing of aluminum cookware in other developing countries is warranted. - Highlights: • Cookware is manufactured in Cameroon from scrap aluminum including car parts. • Twenty-nine cookware samples were evaluated for their potential to leach lead. • Boiling extractions to simulate the effects of cooking released significant lead. • Potential lead exposures per serving are estimated as high as 260 μg. �

Lead exposure from aluminum cookware in Cameroon

Energy Technology Data Exchange (ETDEWEB)

Weidenhamer, Jeffrey D.; Kobunski, Peter A. [Department of Chemistry, Geology and Physics, 401 College Ave., Ashland University, Ashland, OH 44805 (United States); Kuepouo, Gilbert [Research and Education Centre for Development (CREPD), Yaounde (Cameroon); Corbin, Rebecca W. [Department of Chemistry, Geology and Physics, 401 College Ave., Ashland University, Ashland, OH 44805 (United States); Gottesfeld, Perry, E-mail: pgottesfeld@okinternational.org [Occupational Knowledge International, San Francisco, CA (United States)

2014-10-15

Blood lead levels have decreased following the removal of lead from gasoline in most of the world. However, numerous recent studies provide evidence that elevated blood lead levels persist in many low and middle-income countries around the world at much higher prevalence than in the more developed countries. One potential source of lead exposure that has not been widely investigated is the leaching of lead from artisanal aluminum cookware, which is commonly used in the developing world. Twenty-nine samples of aluminum cookware and utensils manufactured by local artisans in Cameroon were collected and analyzed for their potential to release lead during cooking. Source materials for this cookware included scrap metal such as engine parts, radiators, cans, and construction materials. The lead content of this cookware is relatively low (< 1000 ppm by X-ray fluorescence), however significant amounts of lead, as well as aluminum and cadmium were released from many of the samples using dilute acetic acid extractions at boiling and ambient temperatures. Potential exposures to lead per serving were estimated to be as high as 260 μg, indicating that such cookware can pose a serious health hazard. We conclude that lead, aluminum and cadmium can migrate from this aluminum cookware during cooking and enter food at levels exceeding recommended public health guidelines. Our results support the need to regulate lead content of materials used to manufacture these pots. Artisanal aluminum cookware may be a major contributor to lead poisoning throughout the developing world. Testing of aluminum cookware in other developing countries is warranted. - Highlights: • Cookware is manufactured in Cameroon from scrap aluminum including car parts. • Twenty-nine cookware samples were evaluated for their potential to leach lead. • Boiling extractions to simulate the effects of cooking released significant lead. • Potential lead exposures per serving are estimated as high as 260 μg. �

Assessing health impacts of the Chad-Cameroon petroleum development and pipeline project: challenges and a way forward

International Nuclear Information System (INIS)

Utzinger, Juerg; Wyss, Kaspar; Moto, Daugla D.; Yemadji, N'Diekhor; Tanner, Marcel; Singer, Burton H.

2005-01-01

Health impact assessment (HIA) of projects, programmes and policies is increasingly recognized as a powerful methodology for mitigating negative health impacts and enhancing equitable and sustainable development, yet applications in the developing world are sparse. Here, we focus on a large infrastructure development in sub-Saharan Africa, namely the Chad-Cameroon petroleum development and pipeline project. We adapted a five-step process for HIA, consisting of (1) screening of project documents, (2) profiling of affected communities, (3) identifying priority health areas, predicting potential impacts, and proposing mitigation measures, (4) implementing interventions, and (5) monitoring and evaluation of health impacts. We found that project scoping was broad, including extensive environmental and social assessments. Innovative features of the project include the high degree of public-private partnerships, and the management of oil revenues for purposes of poverty reduction. The project also addressed occupational and public health issues, and developed and implemented measures to prevent or mitigate potential health impacts. However, there was a disproportionate emphasis on workers' health, particularly on the prevention/mitigation of construction-related injuries, sexually transmitted infections (STIs; mainly HIV/AIDS), and malaria. Health impacts among surrounding communities, and cumulative health impacts in the larger region were not considered in a comprehensive way. Concluding, there is a need for a more systemic approach to HIA and its incorporation within 'Equator Principles', which are increasingly adopted by the international financial community. This process would include clarification of corporate social responsibility beyond the project fence line in the mitigation of health problems at regional levels. Finally, we propose the establishment and running of a longitudinal demographic surveillance system, which--coupled with regular household surveys

[Frequent attendance in a Primary Health Care District].

Science.gov (United States)

Menéndez Granados, Nicolás; Vaquero Abellán, Manuel; Toledano Estepa, Manuel; Pérez Díaz, Manuel Modesto; Redondo Pedraza, Rosa

2017-10-09

To describe the distribution of frequent attenders (FA) through the different primary care practices in Cordoba-Guadalquivir Health District (Córdoba, Spain). An ecological study was performed, including data from 2011 to 2015. Defining FA as those subjects who made12 or more appointments per year; independently analysed for nursing, general practice and paediatrics. Prevalence of frequent attendance and FA/professional ratio were used as dependent variables. Demographic characteristics from district population, number of health professionals and use of general facilities were also examinated. Aiming to understand FA distribution, primary health settings were classified according to facility size and environmental location (urban, suburban and rural). The mean prevalence for FA was 10.86% (0.5 SE) for nursing; general practice 21.70% (0.7 SE) and for paediatrics 16.96% (0.7 SE). FA/professional ratios for the different professional categories were: 101.07 (5.0 SE) for nursing, 239.74 (9.0 SE) for general practice and 159.54 (9.8 SE) for paediatrics. A major part of primary health care users make a high number of consultations. From this group, women overuse nursing and general practitioner services more compared to men. A higher prevalence of FAs was observed in smaller settings, in rural areas. Although taking the FAs:professional ratio as the bar, medium-size practices are more highly overused. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Cost of delivering secondary-level health care services through public sector district hospitals in India

Science.gov (United States)

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-01-01

Background & objectives: Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Methods: Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. Results: The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was 844 (USD 15.5), i; 3481 (USD 64) and 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was 139 (USD 2.5). Interpretation & conclusions: The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India. PMID:29355142

Cost of delivering secondary-level health care services through public sector district hospitals in India.

Science.gov (United States)

Prinja, Shankar; Balasubramanian, Deepak; Jeet, Gursimer; Verma, Ramesh; Kumar, Dinesh; Bahuguna, Pankaj; Kaur, Manmeet; Kumar, Rajesh

2017-09-01

Despite an impetus for strengthening public sector district hospitals for provision of secondary health care in India, there is lack of robust evidence on cost of services provided through these district hospitals. In this study, an attempt was made to determine the unit cost of an outpatient visit consultation, inpatient bed-day of hospitalization, surgical procedure and overall per-capita cost of providing secondary care through district hospitals. Economic costing of five randomly selected district hospitals in two north Indian States - Haryana and Punjab, was undertaken. Cost analysis was done using a health system perspective and employing bottom-up costing methodology. Quantity of all resources - capital or recurrent, used for delivering services was measured and valued. Median unit costs were estimated along with their 95 per cent confidence intervals. Sensitivity analysis was undertaken to assess the effect of uncertainties in prices and other assumptions; and to generalize the findings for Indian set-up. The overall annual cost of delivering secondary-level health care services through a public sector district hospital in north India was ' 11,44,13,282 [US Dollars (USD) 2,103,185]. Human resources accounted for 53 per cent of the overall cost. The unit cost of an inpatient bed-day, surgical procedure and outpatient consultation was ' 844 (USD 15.5), ' 3481 (USD 64) and ' 170 (USD 3.1), respectively. With the current set of resource allocation, per-capita cost of providing health care through district hospitals in north India was ' 139 (USD 2.5). The estimates obtained in our study can be used for Fiscal planning of scaling up secondary-level health services. Further, these may be particularly useful for future research such as benefit-incidence analysis, cost-effectiveness analysis and national health accounts including disease-specific accounts in India.

Environmental Health Risk Assesement in Flood-prone Area in Tamangapa Sub-District Makassar

Science.gov (United States)

Haris, Ibrahim Abdul; Basir, Basir

2018-05-01

Environmental health in Indonesia is still caution to concern, poor sanitation in Indonesia is characterized by the high incidence of infectious diseases in society. The society in flood-prone area has a high-risk exposure on the disease based on the environment because they live in disaster-prone area. This research aimed to describe the condition of sanitary facilities and risky behavior on public health in flood-prone areas in Manggala district particularly in Tamangapa sub-district of Makassar. This reserach uses an observation method with a descriptive approach. The data is processed by using SPSS and Arc View GIS applications. Environmental risk category is determined by the approach of Environmental Health Risk Assessment (EHRA). The results showed that the flood-prone area in RT 04 RW 06 was included in very high-risk category at 229 with an index value of environmental health risks 212-229. Meanwhile, RT 04 RW 05 was in the category of low risk in the amount of 155 with an index of 155-173. Environmental health hazards identified in Tamangapa flood-prone areas sub-district includes domestic sources of clean water, domestic wastewater, and household garbage.

Financial viability of district mutual health insurance schemes of ...

African Journals Online (AJOL)

Since its implementation, unsubstantiated reports indicate increasing health care and administra-tive costs of the various DMHIS across the country without any corresponding increase in the premium level. We sought to assess the financial viability of the DMHIS in Lawra (LDMHIS) and Sissala East (SEDMHIS) districts, ...

Contaminants in Foods of Animal Origin in Cameroon: A One Health Vision for Risk Management “from Farm to Fork”

Directory of Open Access Journals (Sweden)

Guy B. Pouokam

2017-09-01

Full Text Available Foods of animal origin represent an important share in the diet of Cameroonian populations. Cameroon is known to be a food basket in the west and central Africa sub-region, and an important supplier of foods on the international markets. In the meantime, food importation is continuously increasing to meet the high demand of a more westernized segment of the population. Cereals, fish, sea products, eggs, honey, shrimps, chicken, and feed ingredients are important share in the international trade of agricultural products. Few controls are made on the quality and safety of these products. Certain safety standards do exist but are still yet to be enforced. Inspections done so far by regulatory authorities are partial and do not cover important hazards that require laboratory analysis. The increasing awareness of population, the burden of new types of disease, as well as the recurrence of food scandals have recently launched a scientific and population debate on the contribution of foods items, especially those of animal origin, to the toxic exposure of food producing animals and humans. This paper critically reviews the occurrence of toxicants in most consumed foods of animal origin in Cameroon. This study included the most consumed food of animal origin, identified during the national household budget survey and contributing to 8.1% of the total diet of an individual. Data evaluated suggest an important contamination by toxic metals, mycotoxins, veterinary drugs’ residues, and pesticides. The current national legal framework is briefly analyzed to explore possible intervention measures in the frame of the One Health approach.

Task shifting to non-physician clinicians for integrated management of hypertension and diabetes in rural Cameroon: a programme assessment at two years

Directory of Open Access Journals (Sweden)

Grimm Jean-Jacques

2010-12-01

Full Text Available Abstract Background The burden of non-communicable chronic diseases, such as hypertension and diabetes, increases in sub-Saharan Africa. However, the majority of the rural population does still not have access to adequate care. The objective of this study is to examine the effectiveness of integrating care for hypertension and type 2 diabetes by task shifting to non-physician clinician (NPC facilities in eight rural health districts in Cameroon. Methods Of the 75 NPC facilities in the area, 69 (87% received basic equipment and training in hypertension and diabetes care. Effectiveness was assessed after two years on status of equipment, knowledge among trained NPCs, number of newly detected patients, retention of patients under care, treatment cost to patients and changes in blood pressure (BP and fasting plasma glucose (FPG among treated patients. Results Two years into the programme, of 54 facilities (78% available for re-assessment, all possessed a functional sphygmomanometer and stethoscope (65% at baseline; 96% stocked antihypertensive drugs (27% at baseline; 70% possessed a functional glucose meter and 72% stocked oral anti-diabetics (15% and 12% at baseline. NPCs' performance on multiple-choice questions of the knowledge-test was significantly improved. During a period of two years, trained NPCs initiated treatment for 796 patients with hypertension and/or diabetes. The retention of treated patients at one year was 18.1%. Hypertensive and diabetic patients paid a median monthly amount of 1.4 and 0.7 Euro respectively for their medication. Among hypertensive patients with ≥ 2 documented visits (n = 493, systolic BP decreased by 22.8 mmHg (95% CI: -20.6 to -24.9; p Conclusions The integration of hypertension and diabetes into primary health care of NPC facilities in rural Cameroon was feasible in terms of equipment and training, accessible in terms of treatment cost and showed promising BP- and FPG-trends. However, low case-detection rates

JOURNAL, OF THE CAMEROON ACADEMY OFSCII:NCES

African Journals Online (AJOL)

Institute of Agronomic Research for development (IRAD) Box 33 Maroua, Cameroon;. E-maîl: rckenga(Gºyahoo. ... genetic transformation (Arriola, 1995). The continued ..... Grenier, C., Bramel-Cox, P.J., and P. Hamon. 2001. Core collection of ...

Sustainable development in Cameroon's forestry sector: Progress ...

African Journals Online (AJOL)

EJIRO

passed to facilitate the implementation of this law. (Oyono, 2004; Alemagi ... to be responsible for their negative environmental impacts and offers a vision for ... socio-economic sustainability within the forestry sector in. Cameroon, it is important ...

Rationing hepatitis C treatment in the context of austerity policies in France and Cameroon: A transnational perspective on the pharmaceuticalization of healthcare systems.

Science.gov (United States)

Chabrol, Fanny; David, Pierre-Marie; Krikorian, Gaëlle

2017-08-01

New powerful drugs against hepatitis C can cure the disease, but they are not widely distributed because their exorbitant prices are destabilizing healthcare systems in both African and European countries. This article takes access to hepatitis C treatments since 2013 in France and in Cameroon as a lens to analyze the rationing of pharmaceutical treatments in relation to recent transformations of health systems. Access to these treatments is analyzed thanks to ethnographic observation and interviews lead in Paris and Yaoundé, with patients, associations, health professionals and public health experts. In Cameroon, rationing takes place through various layers of socio-economic restrictions, and no patient organization advocates for hepatitis treatment. In France, access to hepatitis C treatments has become politicized, and collective mobilizations have denounced rationing as a threat to the promise of universal social security. In this study, we examine Africa's long experience with rationing in the context of structural adjustment, and we bring together experiences in France and Cameroon. This article analyses the phenomenon of the pharmaceuticalization of healthcare systems, that is to say the growing use of pharmaceuticals in healthcare systems, by documenting the social and political construction of scarcity. Indeed, whereas pharmaceuticalization is a concept that has often been used in situations of drugs abundance, a parallel analysis of rationing highlights a political economy of pharmaceuticals that shapes public health debates and policies according to an economy of scarcity, especially in times of austerity. Copyright © 2017. Published by Elsevier Ltd.

Trends and determining factors associated with adherence to antiretroviral therapy (ART in Cameroon: a systematic review and analysis of the CAMPS trial

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Mbuagbaw Lawrence

2012-12-01

Full Text Available Abstract Background The benefits of antiretroviral therapy (ART cannot be experienced if they are not taken as prescribed. Yet, not all causes of non-adherence are dependent on the patient. Having to pay for medication reduces adherence rates. Non- adherence has severe public health implications which must be addressed locally and globally. This paper seeks to describe the trends in adherence rates reported in Cameroon and to investigate the determinants of adherence to ART in the Cameroon Mobile Phone SMS (CAMPS trial. Methods We conducted a systematic review of electronic databases (PubMed, Google Scholar, Web of Science, CINAHL, EMBASE and PSYCINFO for publications on adherence to ART in Cameroon (from January 1999 to May 2012 and described the trend in reported adherence rates and the factors associated with adherence. Data were extracted in duplicate. We used multivariable analyses on the baseline data for 200 participants in the CAMPS trial to determine the factors associated with adherence in four models using different measures of adherence (more than 90% or 95% on the visual analogue scale, no missed doses and a composite measure: 100% on the visual analogue scale, no missed doses and all pills taken on time. Results We identified nine studies meeting our inclusion criteria. Adherence to ART in Cameroon has risen steadily between 2000 and 2010, corresponding to reductions in the cost of medication. The factors associated with adherence to ART in Cameroon are grouped into patient, medication and disease related factors. We also identified factors related to the health system and the patient-provider relationship. In the CAMPS trial, education, side effects experienced and number of reminder methods were found to improve adherence, but only using multiple reminder methods was associated with better adherence in all the regression models (Adjusted Odds Ratio [AOR] 4.11, 95% Confidence Interval [CI] 1.89, 8.93; p Conclusions Reducing the

Water Access, Sanitation, and Hygiene Conditions and Health Outcomes among Two Settlement Types in Rural Far North Cameroon

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Gorham, Tyler J.; Yoo, Joshua; Garabed, Rebecca; Mouhaman, Arabi; Lee, Jiyoung

2017-01-01

The Far North region in Cameroon has been more heavily impacted by cholera than any other region over the past decade, but very little has been done to study the drivers of waterborne diseases in the region. We investigated the relationship between water, sanitation, and hygiene (WASH) parameters, microbial and antibiotic resistance (AR) contamination levels in drinking water, and health outcomes using health survey and molecular analysis during June and July of 2014 in two settlement types (agro-pastoralist villages and transhumant pastoralist camps). Quantitative polymerase chain reaction was used to determine fecal contamination sources, enteric pathogens, and antibiotic resistance genes. Ruminant-associated fecal contamination was widespread in both settlement types (81.2%), with human-associated contamination detected in 21.7% of the samples. Salmonella spp. (59.4%) and Shiga toxin-producing E. coli (stx1 44.9% and stx2 31.9%) were detected across all samples. Tetracycline resistance was found only in village samples. A significant difference in diarrheal incidence within the past 28 days among young children was found between camps (31.3%) and villages (0.0%). Our findings suggest that water contamination may play an important role in contributing to gastrointestinal illness, supporting the need for future research and public health intervention to reduce gastrointestinal illness in the area. PMID:28425935

Water Access, Sanitation, and Hygiene Conditions and Health Outcomes among Two Settlement Types in Rural Far North Cameroon.

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Gorham, Tyler J; Yoo, Joshua; Garabed, Rebecca; Mouhaman, Arabi; Lee, Jiyoung

2017-04-20

The Far North region in Cameroon has been more heavily impacted by cholera than any other region over the past decade, but very little has been done to study the drivers of waterborne diseases in the region. We investigated the relationship between water, sanitation, and hygiene (WASH) parameters, microbial and antibiotic resistance (AR) contamination levels in drinking water, and health outcomes using health survey and molecular analysis during June and July of 2014 in two settlement types (agro-pastoralist villages and transhumant pastoralist camps). Quantitative polymerase chain reaction was used to determine fecal contamination sources, enteric pathogens, and antibiotic resistance genes. Ruminant-associated fecal contamination was widespread in both settlement types (81.2%), with human-associated contamination detected in 21.7% of the samples. Salmonella spp. (59.4%) and Shiga toxin-producing E. coli ( stx 1 44.9% and stx 2 31.9%) were detected across all samples. Tetracycline resistance was found only in village samples. A significant difference in diarrheal incidence within the past 28 days among young children was found between camps (31.3%) and villages (0.0%). Our findings suggest that water contamination may play an important role in contributing to gastrointestinal illness, supporting the need for future research and public health intervention to reduce gastrointestinal illness in the area.

Health Insurance Premium Increases for the 5 Largest School Districts in the United States, 2004–2008

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Cantillo, John R.

2010-01-01

Background Local school districts are often one of the largest, if not the largest, employers in their respective communities. Like many large employers, school districts offer health insurance to their employees. There is a lack of information about the rate of health insurance premiums in US school districts relative to other employers. Objective To assess the change in the costs of healthcare insurance in the 5 largest public school districts in the United States, between 2004 and 2008, as representative of large public employers in the country. Methods Data for this study were drawn exclusively from a survey sent to the 5 largest public school districts in the United States. The survey requested responses on 3 data elements for each benefit plan offered from 2004 through 2008; these included enrollment, employee costs, and employer costs. Results The premium growth for the 5 largest school districts has slowed down and is consistent with other purchasers—Kaiser/Health Research & Educational Trust and the Federal Employee Health Benefit Program. The average increase in health insurance premium for the schools was 5.9% in 2008, and the average annual growth rate over the study period was 7.5%. For family coverage, these schools provide the most generous employer contribution (80.8%) compared with the employer contribution reported by other employers (73.5%) for 2008. Conclusions Often the largest employers in their communities, school districts demonstrate a commitment to provide choice of benefits and affordability for employees and their families. Despite constraints typical of public employers, the 5 largest school districts in the United States have decelerated in premium growth consistent with other purchasers, albeit at a slower pace. PMID:25126311

Demographic Differences in District-Level Policies Related to School Mental Health and Social Services--United States, 2012

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Demissie, Zewditu; Brener, Nancy

2017-01-01

Background: Mental health conditions among youth are a major concern. Schools can play an important role in supporting students affected by these conditions. This study examined district-level school health policies related to mental health and social services to determine if they varied by district demographic characteristics. Methods: The School…

Democratising health care governance? New Zealand's inaugural district health board elections, 2001.

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Gauld, Robin

2002-01-01

New Zealand's 'district health board' (DHB) system has been under implementation since the 1999 general election. A key factor motivating the change to DHBs is the democratisation of health care governance. A majority of the new DHB members are popularly elected. Previously, hospital board members were government appointees. Inaugural DHB elections were held in October 2001. This article reports on the election results and the wider operating context for DHBs. It notes organisational issues to be considered for the next DHB elections in 2004, and questions the extent to which the elections and DHB governance structure will enhance health care democratisation in New Zealand.

Homosexuality in Cameroon: identity and persecution

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Geschiere, P.; Dubel, I.; Hielkema, A.

2010-01-01

What does it mean to come out of the closet in Cameroon? It is clear that it takes courage, particularly lately, as the law has always expressly prohibited homosexuality. (1) The police, generally feared because of their brutal extortion of money from people, are eager to react to accusations of

Women and Economic Development in Cameroon.

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Bryson, Judy C.

Based on a survey of written sources and perspectives of knowledgeable individuals, the report provides information on women's economic roles in Cameroon, and on aspects of social life which effect their economic performance. A description of the importance of traditional social systems and their evolution over the last 30 years follows a brief…

A new tectonic model for the Cameroon Line, Central Africa

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Moreau, C.; Regnoult, J.-M.; Déruelle, B.; Robineau, B.

1987-10-01

The Cameroon Line, a major geological feature in Central Africa, has been considered successively as a series of horsts and grabens, a continental rift and a mega-shear zone. It is marked out by about 60 anorogenic complexes and a dozen volcanic centres, all of which have alkaline affinity. Remote sensing allows us recognition of the main lineament trends: N70°, N-S, N135° and E-W, while autocorrelation analysis reveals a major fault zone striking N30° in western Cameroon and N15° in the northern region. A mega left-lateral shear zone is the model that best accounts for the fracture pattern and associated features such as linear and circular structures alignment of subvolcanic complexes, syntectonic leucogranites marking out older shear zones and vein dykes. The N70° Adamawa fault zone, a Pan-African fracture reworked during Albian-Aptian times, is the only shear zone of continental scale that could have initiated "en echelon" mega-tension gashes within the Cameroon Line during a Cainozoic left-lateral transcurrent movement.

The impact of a community mobilization project on health-related knowledge and practices in Cameroon.

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Babalola, S; Sakolsky, N; Vondrasek, C; Mounlom, D; Brown, J; Tchupo, J P

2001-12-01

The analyses presented in this paper document the impact of a community mobilization effort in Cameroon. Between 1997 and 1998, a local non-governmental organization worked with community associations, Njangi, in one urban and one rural location to promote knowledge and positive practices concerning family planning, sexually transmitted diseases, and treatment of common childhood diseases. Based on a multi-tiered structure, the project involved selecting and training two prominent and influential members of each community as "relais" or middlemen. The "relais" then trained mobilizers from participating Njangis to provide relevant information and help to mobilize their fellow members in favor of the positive attitudes and practices promoted by the project. The project was evaluated using baseline and follow-up measurement of pertinent indicators, and service statistics. Results suggest that the intervention had significant influence in the rural location with noticeable positive effects on knowledge and practices of family planning, knowledge and attitudes about HIV/AIDS and STIs, and use of health services. In the urban location, for programmatic and extraneous factors, the intervention was not effective. The paper discusses the lessons learnt from the intervention and offers pertinent suggestions for replicating the intervention in rural settings.

Evidence from district level inputs to improve quality of care for maternal and newborn health: interventions and findings.

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Salam, Rehana A; Lassi, Zohra S; Das, Jai K; Bhutta, Zulfiqar A

2014-09-04

District level healthcare serves as a nexus between community and district level facilities. Inputs at the district level can be broadly divided into governance and accountability mechanisms; leadership and supervision; financial platforms; and information systems. This paper aims to evaluate the effectivness of district level inputs for imporving maternal and newborn health. We considered all available systematic reviews published before May 2013 on the pre-defined district level interventions and included 47 systematic reviews. Evidence suggests that supervision positively influenced provider's practice, knowledge and client/provider satisfaction. Involving local opinion leaders to promote evidence-based practice improved compliance to the desired practice. Audit and feedback mechanisms and tele-medicine were found to be associated with improved immunization rates and mammogram uptake. User-directed financial schemes including maternal vouchers, user fee exemption and community based health insurance showed significant impact on maternal health service utilization with voucher schemes showing the most significant positive impact across all range of outcomes including antenatal care, skilled birth attendant, institutional delivery, complicated delivery and postnatal care. We found insufficient evidence to support or refute the use of electronic health record systems and telemedicine technology to improve maternal and newborn health specific outcomes. There is dearth of evidence on the effectiveness of district level inputs to improve maternal newborn health outcomes. Future studies should evaluate the impact of supervision and monitoring; electronic health record and tele-communication interventions in low-middle-income countries.

An exploration of the political economy dynamics shaping health worker incentives in three districts in Sierra Leone.

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Bertone, Maria Paola; Witter, Sophie

2015-09-01

The need for evidence-based practice calls for research focussing not only on the effectiveness of interventions and their translation into policies, but also on implementation processes and the factors influencing them, in particular for complex health system policies. In this paper, we use the lens of one of the health system's 'building blocks', human resources for health (HRH), to examine the implementation of official policies on HRH incentives and the emergence of informal practices in three districts of Sierra Leone. Our mixed-methods research draws mostly from 18 key informant interviews at district level. Data are organised using a political economy framework which focuses on the dynamic interactions between structure (context, historical legacies, institutions) and agency (actors, agendas, power relations) to show how these elements affect the HRH incentive practices in each district. It appears that the official policies are re-shaped both by implementation challenges and by informal practices emerging at local level as the result of the district-level dynamics and negotiations between District Health Management Teams (DHMTs) and nongovernmental organisations (NGOs). Emerging informal practices take the form of selective supervision, salary supplementations and per diems paid to health workers, and aim to ensure a better fit between the actors' agendas and the incentive package. Importantly, the negotiations which shape such practices are characterised by a substantial asymmetry of power between DHMTs and NGOs. In conclusion, our findings reveal the influence of NGOs on the HRH incentive package and highlight the need to empower DHMTs to limit the discrepancy between policies defined at central level and practices in the districts, and to reduce inequalities in health worker remuneration across districts. For Sierra Leone, these findings are now more relevant than ever as new players enter the stage at district level, as part of the Ebola response and

Rethinking and Reconfiguring English Language Education: Averting Linguistic Genocide in Cameroon

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Carlous Muluh Nkwetisama

2017-09-01

Full Text Available The over 285 indigenous languages of Cameroon may be crushed by the English language. To ensure a sustainable linguistic ecological balance whose peace is undoubtedly threatened by the global imperialistic terrors of English colonialism, an overhaul of ELT practitioners is needed. The English language is taught and learned in Cameroon against a conflictual linguistic platform of French (the other official language of questionable equal status as English, Pidgin English and over 285 indigenous languages. Of these local languages, just about 40 are currently being used (taught in education at the different levels of education in the country. The aim of this paper was to examine the English language politics, practices and teaching. It thereafter evaluated English language teachers’ perception of the so called English Language Teaching Tenets. It also aimed at assessing the functional load of English and it ascertained the extent to which it was threatening the development of local languages as well as effective access to education in Cameroon.

Stable Isotopic Composition of Rainfall in Western Cameroon

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Ketchemen-Tandia, B.; Ngo Boum, S.; Ebonji Seth, C. R.; Nkoue Ndong, G. R.; Wonkam, C. [Universite de Douala, Douala (Cameroon); Huneau, F. [Universite de Bordeaux, EA Georessources and Environnement, Talence (France); Celle-Jeanton, H. [Clermont Universite, Clermont-Ferrand (France)

2013-07-15

Monthly rainfall collected at the douala station (Western cameroon) from 2006 to 2008 was analysed for oxygen-18 and deuterium content. The dataset, which is now integrated into the GNIP database, was compared to the local groundwater record in order to define the input function of regional hydrosystems. The isotope data displays a wide range of values from -0.59 to -6.14 per mille for oxygen-18 and from -7.75 to -38.8 per mille for deuterium, closely following the GMWL (global Meteoric Water line), suggesting that rain formation processes occurred under isotopic equilibrium conditions between the condensate and the corresponding vapour. No significant evaporation tendency was found. The comparison with the previous studies in the area provides a realistic pattern of isotope concentrations in both surface and groundwater throughout Cameroon. (author)

Journal of the Cameroon Academy of Sciences

African Journals Online (AJOL)

Revue de L'academie des Sciences du Cameroun The Journal of the Cameroon Academy of Sciences is a multi-disciplinary publication devoted to all aspects of fundamental and applied research. It also publishes topical reviews on science and technology in development, arts, humanities and culture.

Addressing urban sprawl in Douala, Cameroon: Lessons from Xiamen integrated coastal management

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Suinyuy Derrick Ngoran

2015-06-01

The conclusions of this effort portray that sprawl in Cameroon is caused by inadequate policy implementation, outdated master plan, insufficient information, disparity in resources distribution among the different regions of the State and the gaps expounded by the traditional management. Grounded in the knowledge drawn from Xiamen ICM, the paper recommends the creation of an autonomous coastal interagency in Douala to address the gaps disrupted by sectoral management, and thus, improve coastal management in Cameroon.

ON THE SUSTAINABILITY OF CURRENT ACCOUNT DEFICITS IN CAMEROON

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Edouard T. Djeutem

2013-04-01

Full Text Available Two approaches are used to analyze the sustainability of the current account deficits of Cameroon in order to find out whether current economic policies are sound enough to guarantee the country’ s financial solvency. The first uses a structural procedure to compare current account deficits relative to an optimal benchmark using the Campbell-Shiller’s methodology. The second uses a reduced form approach to test for intertemporal budget constraint through cointegration tests between imports and exports plus net transfer payments on foreign obligations. Our results suggest that the current account imbalances for Cameroon based on data from the period 1970-2002 are “excessive” and the deficits are currently unsustainable.

Local Rulers in North Cameroon. The Interplay of Politics and Conversion

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Kees Schilder

1993-03-01

Full Text Available This article analyses the conversion to Islam of indigenous chiefs in North Cameroon. The chiefs studied belong to the Mundang ethnic group. Their islamisation is interpreted as the outcome of the ambivalence brought about by their intermediary role between local society and the wider society. This approach offers insights in (a the connection between conversion and political careers; (b the relation between Islam and ethnic identities; and (c the popular legitimacy of conversion. KEY WORDS: Cameroon, Mundang, chiefs, Islam, ethnicity, cosmology

Do Management and Leadership Practices in the Context of Decentralisation Influence Performance of Community Health Fund? Evidence From Iramba and Iringa Districts in Tanzania.

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Joseph, Chakupewa; Maluka, Stephen Oswald

2016-09-26

In early 1990s, Tanzania like other African countries, adopted health sector reform (HSR). The most strongly held centralisation system that informed the nature of services provision including health was, thus, disintegrated giving rise to decentralisation system. It was within the realm of HSR process, user fees were introduced in the health sector. Along with user fees, various types of health insurances, including the Community Health Fund (CHF), were introduced. While the country's level of enrolment in the CHF is low, there are marked variations among districts. This paper highlights the role of decentralised health management and leadership practices in the uptake of the CHF in Tanzania. A comparative exploratory case study of high and low performing districts was carried out. In-depth interviews were conducted with the members of the Council Health Service Board (CHSB), Council Health Management Team (CHMT), Health Facility Committees (HFCs), in-charges of health facilities, healthcare providers, and Community Development Officers (CDOs). Minutes of the meetings of the committees and district annual health plans and district annual implementation reports were also used to verify and triangulate the data. Thematic analysis was adopted to analyse the collected data. We employed both inductive and deductive (mixed coding) to arrive to the themes. There were no differences in the level of education and experience of the district health managers in the two study districts. Almost all district health managers responsible for the management of the CHF had attended some training on management and leadership. However, there were variations in the personal initiatives of the top-district health leaders, particularly the district health managers, the council health services board and local government officials. Similarly, there were differences in the supervision mechanisms, and incentives available for the health providers, HFCs and board members in the two study

Drivers of Live Cattle Price in the Livestock Trading System of Central Cameroon

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Motta, Paolo; Handel, Ian G.; Rydevik, Gustaf; Hamman, Saidou M.; Ngwa, Victor Ngu; Tanya, Vincent N.; Morgan, Kenton L.; Bronsvoort, Barend M. deC.; Porphyre, Thibaud

2018-01-01

Livestock production and trade are critical for the food security and welfare of rural households in sub-Saharan Africa. In Cameroon, animal trade consists mainly of live cattle commercialized through livestock markets. Identifying the factors contributing to cattle price formation is critical for designing effective policies for sustainable production and for increasing food availability. In this study, we evaluated the influence of a range of individual- and market-level factors on the price of cattle that were sold in all transactions (n = 118,017) recorded over a 12-month period from 31 livestock markets in the main cattle production area of the country. An information-theoretic approach using a generalized additive mixed-effect model was implemented to select the best explanatory model as well as evaluate the robustness of the identified drivers and the predictive ability of the model. The age and gender of the cattle traded were consistently found to be important drivers of the price (p livestock market and the price of the traded live cattle (p < 0.01). Although our analysis did not account for factors informing on specific phenotypic traits nor breed characteristics of cattle traded, nearly 50% of the observed variation in live cattle prices was explained by the final model. Ultimately, our model gives a large scale overview of drivers of cattle price formation in Cameroon and to our knowledge is the first study of this scale in Central Africa. Our findings represent an important milestone in designing efficient and sustainable animal health management programme in Cameroon and ensure livelihood sustainability for rural households. PMID:29387687

The impact of urban regeneration programmes on health and health-related behaviour: Evaluation of the Dutch District Approach 6.5 years from the start.

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Annemarie Ruijsbroek

Full Text Available Large-scale regeneration programmes to improve the personal conditions and living circumstances in deprived areas may affect health and the lifestyle of the residents. Previous evaluations concluded that a large-scale urban regeneration programme in the Netherlands had some positive effects within 3.5 years. The aim of the current study was to evaluate the effects at the longer run.With a quasi-experimental research design we assessed changes in the prevalence of general health, mental health, physical activity, overweight, obesity, and smoking between the pre-intervention (2003-04 -mid 2008 and intervention period (mid 2008-2013-14 in 40 deprived target districts and comparably deprived control districts. We used the Difference-in-Difference (DiD to assess programme impact. Additionally, we stratified analyses by sex and by the intensity of the regeneration programme.Changes in health and health related behaviours from pre-intervention to the intervention period were about equally large in the target districts as in control districts. DiD impact estimates were inconsistent and not statistically significant. Sex differences in DiD estimates were not consistent or significant. Furthermore, DiD impact estimates were not consistently larger in target districts with more intensive intervention programmes.We found no evidence that this Dutch urban regeneration programme had an impact in the longer run on self-reported health and related behaviour at the area level.

LINKING CHILD HEALTH, MATERNAL LABOUR FORCE PARTICIPATION AND HOUSEHOLD ASSET ENDOWMENTS IN CAMEROON: WHAT THE PEOPLE SAY

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Mbu Daniel Tambi

2014-10-01

Full Text Available This paper is targeted objectives: to document the determinants of child health as informed by focus group discussion, to analyze what the people say concerning the relationship between child health and maternal labour force participation, to explore the perception of the people on the effects of child health on asset accumulation and to suggest public policies on the basis of the findings. We used seven focus groups to explore what the people say based on different health domains: access to public goods; inputs to health; benefits from better health; better child health and complementary activities; benefits of maternity leave and better child health, decision making concerning family health. Each focus group was made of eight participants: housewife, traders, farmers, drivers, teachers, technicians, medical personnel and military drawn from different religious groups: catholic, protestant mainline, protestant non-mainline, other protestant, Muslim, systemic and traditional belief. We observed that, parents make used of the extra time accrue to them due to better health for their children and family to do extra work that fetched them money. The increased family income is use to send their children to better schools, carter for their wellbeing as well as to promote asset growth and redistribution, thus, improving economic well-being and reducing poverty. In case of retirement or sudden retrenchment from the labour market, parents make use of the accumulated assets to increase their family income and maintain well-being, hence, reducing the psychological trauma on parents due to poverty. Based on these findings, we recommend that decision makers and actors concern with child health issues should considered, ease and promote child health outcomes. This is a key to narrowing the poverty and inequality gap between the poor and non-poor, rural and urban household residence, married and unmarried, employed and the unemployed, promote maternal labour

Retrospective analysis of the prevalence of and factors associated with condom use among young HIV-infected women in Cameroon

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Mariecel Pilapil

2016-01-01

Full Text Available Objectives: Young women are more likely to be infected with HIV globally, in sub-Saharan Africa, and in Cameroon. Despite its clear clinical and public health benefits, condom use among HIV-infected women continues to be low. The objective of this study was to describe the prevalence of inconsistent condom use among HIV-infected women in Cameroon and the factors associated with it. Methods: We conducted a cross-sectional study of HIV-infected young women aged 17–26 years from three semi-urban HIV clinics in the Northwest Region of Cameroon. This study was a subgroup analysis of a previously reported study on inconsistent condom use in HIV-infected and -uninfected youth. Inconsistent condom use was defined as reporting “sometimes” or “never” to questions regarding frequency of condom use. Logistic regression modeling was used to determine factors associated with inconsistent condom use. Results: A total of 84 participants were recruited and submitted completed questionnaires for analysis. Median age was 24 years (interquartile range = 22–25 and the median age at HIV diagnosis was 21 years (interquartile range = 20–23. Fifty percent of the participants reported no prior schooling or only primary school education. Overall, 61/84 (73% reported inconsistent condom use. After adjusting for potential confounders, education to the secondary school level was protective against inconsistent condom use (odds ratio = 0.19; confidence interval: 0.04–0.95, and having ≥2 pregnancies was associated with inconsistent condom use (odds ratio = 7.52; confidence interval: 1.67–34.00. Conclusion: There is a high prevalence of inconsistent condom use among young HIV-infected women in Cameroon, which appears to be associated with lower levels of educational attainment and higher parity. Further larger studies assessing the factors associated with poor condom use in this population are warranted and may inform public health

Health dynamics in camps and on campuses: stressors and coping strategies for wellbeing among labourers and students in Cameroon

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Maat, Harro; Vaandrager, Lenneke; Koelen, Maria

2018-01-01

ABSTRACT Purpose: For many people living in low-income countries, poverty implies an increased exposure to conditions that threaten health and wellbeing as well as reduced capacity to maintain health. Despite the challenging conditions caused by poverty, people may consider themselves healthy because they have learned to cope with their situation probably as a result of life experiences which expose people to both challenges and potential solutions. In this paper we present results from studying health and wellbeing challenges and mechanisms to cope with challenges among two different groups of people who are living under conditions of poverty: workers of the Cameroon Development Corporation (CDC) and students of the university of Buea and the university of Yaoundé. Methods: We performed a cross-sectional study, interviewing 21 CDC workers and 21 students. Results Our study reveals context-specific stressors emerging from poor work conditions and study pressure as well as non-context-specific stressors perceived by respondents as living conditions, poor healthcare and financial uncertainty. Respondents devised coping mechanisms to overcome exactly those stressors such as searching for additional money sources, preventive action towards hazardous living conditions and alternative medical support. Conclusion: We conclude that supporting and promoting such avenues is essential for enhanced and continuous coping with stressors. PMID:29436294

Strengthening fairness, transparency and accountability in health care priority setting at district level in Tanzania

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Stephen Maluka

2011-11-01

Full Text Available Health care systems are faced with the challenge of resource scarcity and have insufficient resources to respond to all health problems and target groups simultaneously. Hence, priority setting is an inevitable aspect of every health system. However, priority setting is complex and difficult because the process is frequently influenced by political, institutional and managerial factors that are not considered by conventional priority-setting tools. In a five-year EU-supported project, which started in 2006, ways of strengthening fairness and accountability in priority setting in district health management were studied. This review is based on a PhD thesis that aimed to analyse health care organisation and management systems, and explore the potential and challenges of implementing Accountability for Reasonableness (A4R approach to priority setting in Tanzania. A qualitative case study in Mbarali district formed the basis of exploring the sociopolitical and institutional contexts within which health care decision making takes place. The study also explores how the A4R intervention was shaped, enabled and constrained by the contexts. Key informant interviews were conducted. Relevant documents were also gathered and group priority-setting processes in the district were observed. The study revealed that, despite the obvious national rhetoric on decentralisation, actual practice in the district involved little community participation. The assumption that devolution to local government promotes transparency, accountability and community participation, is far from reality. The study also found that while the A4R approach was perceived to be helpful in strengthening transparency, accountability and stakeholder engagement, integrating the innovation into the district health system was challenging. This study underscores the idea that greater involvement and accountability among local actors may increase the legitimacy and fairness of priority

Wind Power Potentials in Cameroon and Nigeria: Lessons from South Africa

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Abdullahi Abubakar Mas’ud

2017-03-01

Full Text Available Wind energy has seen a tremendous growth for electricity generation worldwide and reached 456 GW by the end of June 2016. According to the World Wind Energy Association, global wind power will reach 500 GW by the end of 2016. Africa is a continent that possesses huge under-utilized wind potentials. Some African countries, e.g., Morocco, Egypt, Tunisia and South Africa, have already adopted wind as an alternative power generation source in their energy mix. Among these countries, South Africa has invested heavily in wind energy with operational wind farms supplying up to 26,000 GWh annually to the national grid. However, two African countries, i.e., Cameroon and Nigeria, have vast potentials, but currently are lagging behind in wind energy development. For Nigeria, there is slow implementation of renewable energy policy, with no visible operational wind farms; while Cameroon does not have any policy plan for wind power. These issues are severely hindering both direct foreign and local investments into the electricity sector. Cameroon and Nigeria have huge wind energy potentials with similar climatic conditions and can benefit greatly from the huge success recorded in South Africa in terms of policy implementation, research, development and technical considerations. Therefore, this paper reviews the wind energy potentials, policies and future renewable energy road-maps in Cameroon and Nigeria and identifies their strength and weakness, as well as providing necessary actions for future improvement that South Africa has already adopted.

The Bildungsroman in Cameroon Anglophone Literature: John ...

African Journals Online (AJOL)

This paper investigates the bildungsroman genre in postcolonial Cameroon Anglophone fiction through a textual analysis of John Nkemngong Nkengasong's Across the Mongolo and Margaret Afuh's Born before Her Time. It seeks to show that these two writers have borrowed a foreign genre and successfully manipulated ...

The lesson of Monsieur Nouma: effects of a culturally sensitive communication tool to improve health-seeking behavior in rural Cameroon.

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Gessler, Noemi; Labhard, Niklaus Daniel; Stolt, Pelle; Manga, Engelbert; Balo, Jean-Richard; Boffolo, Adelaide; Langewitz, Wolf

2012-06-01

To test the effect of patient counseling using educational tools, on rates of return for follow-up in newly diagnosed hypertensive and/or diabetic patients in a rural African context. Free screening for hypertension and elevated blood glucose was offered in primary health care centers in central Cameroon during 9 campaigns of 3 days each. Individuals with untreated hypertension and/or diabetes were divided into 2 groups: a control group receiving counseling according to routine procedures, and an intervention group receiving counseling with different educational tools to explain the diagnosis and its implications to the patient. Prevalence of hypertension and/or diabetes in the screened population was 41%. At 3 months from screening, rates of return visits were higher in the intervention group than in the control group: 55/169 (32%) vs. 15/92 (16%), OR 2.4; 95%CI 1.3-4.7; peducational tools, may bring important benefits and increase the effectiveness of public health measures to combat chronic diseases in settings of limited resources. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Sero-prevalence of Human Immunodeficiency Virus and hepatitis ...

African Journals Online (AJOL)

Sero-prevalence of Human Immunodeficiency Virus and hepatitis viruses and their correlation with CD4 T-cell lymphocyte counts in pregnant women in the Buea Health District of Cameroon. Rebecca Enow Tanjong, Pride Teyim, Henry Lucien Kamga, Edwin Suh Neba, Theresia Nkuo-Akenji ...

Technical efficiency of primary health units in Kailahun and Kenema districts of Sierra Leone

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Kirigia Joses M

2011-05-01

Full Text Available Abstract Background The objectives of the study reported in this paper were to (i estimate the technical efficiency of samples of community health centres (CHCs, community health posts (CHPs and maternal and child health posts (MCHPs in Kailahun and Kenema districts of Sierra Leone, (ii estimate the output increases needed to make inefficient MCHPs, CHCs and CHPs efficient, and (iii explore strategies for increasing technical efficiency of these institutions. Methods This study applies the data envelopment analysis (DEA approach to analyse technical efficiency of random samples of 36 MCHPs, 22 CHCs and 21 CHPs using input and output data for 2008. Results The findings indicate that 77.8% of the MCHPs, 59.1% of the CHCs and 66.7% of the CHPs were variable returns to scale technically inefficient. The average variable returns to scale technical efficiency was 68.2% (SD = 27.2 among the MCHPs, 69.2% (SD = 33.2 among the CHCs and 59% (SD = 34.7 among the CHPs. Conclusion This study reveals significant technical inefficiencies in the use of health system resources among peripheral health units in Kailahun and Kenema districts of Sierra Leone. There is need to strengthen national and district health information systems to routinely track the quantities and prices of resources injected into the health care systems and health service outcomes (indicators of coverage, quality and health status to facilitate regular efficiency analyses.

Implementation of tuberculosis infection control in health facilities in Mukono and Wakiso districts, Uganda.

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Buregyeya, Esther; Nuwaha, Fred; Verver, Suzanne; Criel, Bart; Colebunders, Robert; Wanyenze, Rhoda; Kalyango, Joan N; Katamba, Achilles; Mitchell, Ellen Mh

2013-08-01

Tuberculosis infection control (TBIC) is rarely implemented in the health facilities in resource limited settings. Understanding the reasons for low level of implementation is critical. The study aim was to assess TBIC practices and barriers to implementation in two districts in Uganda. We conducted a cross-sectional study in 51 health facilities in districts of Mukono and Wakiso. The study included: a facility survey, observations of practices and eight focus group discussions with health workers. Quantitative: Only 16 facilities (31%) had a TBIC plan. Five facilities (10%) were screening patients for cough. Two facilities (4%) reported providing masks to patients with cough. Ventilation in the waiting areas was inadequate for TBIC in 43% (22/51) of the facilities. No facility possessed N95 particulate respirators. Qualitative: Barriers that hamper implementation of TBIC elicited included: under-staffing, lack of space for patient separation, lack of funds to purchase masks, and health workers not appreciating the importance of TBIC. TBIC measures were not implemented in health facilities in the two Ugandan districts where the survey was done. Health system factors like lack of staff, space and funds are barriers to implement TBIC. Effective implementation of TBIC measures occurs when the fundamental health system building blocks--governance and stewardship, financing, infrastructure, procurement and supply chain management are in place and functioning appropriately.

Review of the evolution of insecticide resistance in main malaria vectors in Cameroon from 1990 to 2017.

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Antonio-Nkondjio, Christophe; Sonhafouo-Chiana, N; Ngadjeu, C S; Doumbe-Belisse, P; Talipouo, A; Djamouko-Djonkam, L; Kopya, E; Bamou, R; Awono-Ambene, P; Wondji, Charles S

2017-10-10

Malaria remains a major public health threat in Cameroon and disease prevention is facing strong challenges due to the rapid expansion of insecticide resistance in vector populations. The present review presents an overview of published data on insecticide resistance in the main malaria vectors in Cameroon to assist in the elaboration of future and sustainable resistance management strategies. A systematic search on mosquito susceptibility to insecticides and insecticide resistance in malaria vectors in Cameroon was conducted using online bibliographic databases including PubMed, Google and Google Scholar. From each peer-reviewed paper, information on the year of the study, mosquito species, susceptibility levels, location, insecticides, data source and resistance mechanisms were extracted and inserted in a Microsoft Excel datasheet. The data collected were then analysed for assessing insecticide resistance evolution. Thirty-three scientific publications were selected for the analysis. The rapid evolution of insecticide resistance across the country was reported from 2000 onward. Insecticide resistance was highly prevalent in both An. gambiae (s.l.) and An. funestus. DDT, permethrin, deltamethrin and bendiocarb appeared as the most affected compounds by resistance. From 2000 to 2017 a steady increase in the prevalence of kdr allele frequency was noted in almost all sites in An. gambiae (s.l.), with the L1014F kdr allele being the most prevalent. Several detoxification genes (particularly P450 monooxygenase) were associated with DDT, pyrethroids and bendiocarb resistance. In An. funestus, resistance to DDT and pyrethroids was mainly attributed to the 119F-GSTe2 metabolic resistance marker and over-expression of P450 genes whereas the 296S-RDL mutation was detected in dieldrin-resistant An. funestus. The review provides an update of insecticide resistance status in malaria vector populations in Cameroon and stresses the need for further actions to reinforce malaria

Do Management and Leadership Practices in the Context of Decentralisation Influence Performance of Community Health Fund? Evidence From Iramba and Iringa Districts in Tanzania

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Chakupewa Joseph

2017-05-01

Full Text Available Background In early 1990s, Tanzania like other African countries, adopted health sector reform (HSR. The most strongly held centralisation system that informed the nature of services provision including health was, thus, disintegrated giving rise to decentralisation system. It was within the realm of HSR process, user fees were introduced in the health sector. Along with user fees, various types of health insurances, including the Community Health Fund (CHF, were introduced. While the country’s level of enrolment in the CHF is low, there are marked variations among districts. This paper highlights the role of decentralised health management and leadership practices in the uptake of the CHF in Tanzania. Methods A comparative exploratory case study of high and low performing districts was carried out. In-depth interviews were conducted with the members of the Council Health Service Board (CHSB, Council Health Management Team (CHMT, Health Facility Committees (HFCs, in-charges of health facilities, healthcare providers, and Community Development Officers (CDOs. Minutes of the meetings of the committees and district annual health plans and district annual implementation reports were also used to verify and triangulate the data. Thematic analysis was adopted to analyse the collected data. We employed both inductive and deductive (mixed coding to arrive to the themes. Results There were no differences in the level of education and experience of the district health managers in the two study districts. Almost all district health managers responsible for the management of the CHF had attended some training on management and leadership. However, there were variations in the personal initiatives of the top-district health leaders, particularly the district health managers, the council health services board and local government officials. Similarly, there were differences in the supervision mechanisms, and incentives available for the health providers

Assessment of the impact of family physicians in the district health system of the Western Cape, South Africa

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Meyer Swanepoel

2014-12-01

Full Text Available Background: In 2007, South Africa made family medicine a new speciality. Family physicians that have trained for this new speciality have been employed in the district health system since 2011. The aim of the present study was to explore the perceptions of district managers on the impact of family physicians on clinical processes, health system performance and health outcomes in the district health system (DHS of the Western Cape. Methods: Nine in-depth interviews were performed: seven with district managers and two with the chief directors of the metropolitan and rural DHS. Interviews were recorded, transcribed and analysed using the ATLAS-ti and the framework method. Results: There was a positive impact on clinical processes for HIV/AIDS, TB, trauma, noncommunicable chronic diseases, mental health, maternal and child health. Health system performance was positively impacted in terms of access, coordination, comprehensiveness and efficiency. An impact on health outcomes was anticipated. The impact was not uniform throughout the province due to different numbers of family physicians and different abilities to function optimally. There was also a perception that the positive impact attributed to family physicians was in the early stages of development. Unanticipated effects included concerns with their roles in management and training of students, as well as tensions with career medical officers. Conclusion: Early feedback from district managers suggests that where family physicians are employed and able to function optimally, they are making a significant impact on health system performance and the quality of clinical processes. In the longer term, this is likely to impact on health outcomes.

Impact of agribusiness labour on the child education in Cameroon

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Tiwang N Gildas

2015-12-01

Full Text Available This paper aimed to assess the involvement of child labour in agribusinesses as well as the schooling pattern of children involved in these agribusinesses in Cameroon. For this study, some descriptive statistics and cross tabulations were computed using SPSS.20 and stata 13 software packages. The population of this study was made up of 51,190 individuals of both sexes that were concerned by the third Cameroon National Household Survey. The sample drawn from this population was constituted of individuals of age 5-17 years old, making a total of 17,550 children. The main results of this study revealed that agribusiness child labour was present everywhere in Cameroon and by both boys and girls. Children of all ages of the sample were concerned by the phenomenon and their level of education was essentially the primary. The impact of agribusiness child labour on education was positive because it helped the working and schooling children to provide means to finance their education and other needs. On the other hand, it has a negative impact on education because some children went for these jobs and finally stayed there and did not return back to school.

Dinosaur trackways from the early Late Cretaceous of western Cameroon

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Martin, Jeremy E.; Menkem, Elie Fosso; Djomeni, Adrien; Fowe, Paul Gustave; Ntamak-Nida, Marie-Joseph

2017-10-01

Dinosaur trackways have rarely been reported in Cretaceous strata across the African continent. To the exception of ichnological occurrences in Morocco, Tunisia, Niger and Cameroon, our knowledge on the composition of Cretaceous dinosaur faunas mostly relies on skeletal evidence. For the first time, we document several dinosaur trackways from the Cretaceous of the Mamfe Basin in western Cameroon. Small and medium-size tridactyl footprints as well as numerous large circular footprints are present on a single horizon showing mudcracks and ripple marks. The age of the locality is considered Cenomanian-Turonian and if confirmed, this ichnological assemblage could be younger than the dinosaur footprints reported from northern Cameroon, and coeval with or younger than skeletal remains reported from the Saharan region. These trackways were left in an adjacent subsiding basin along the southern shore of the Benue Trough during a time of high-sea stand when the Trans-Saharan Seaway was already disconnecting West Africa from the rest of the continent. We predict that other similar track sites may be occurring along the margin of the Benue Trough and may eventually permit to test hypotheses related to provincialism among African dinosaur faunas.

Health worker preferences for performance-based payment schemes in a rural health district in Burkina Faso

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Maurice Yé

2016-01-01

Full Text Available Background: One promising way to improve the motivation of healthcare providers and the quality of healthcare services is performance-based incentives (PBIs also referred as performance-based financing. Our study aims to explore healthcare providers’ preferences for an incentive scheme based on local resources, which aimed at improving the quality of maternal and child health care in the Nouna Health District. Design: A qualitative and quantitative survey was carried out in 2010 involving 94 healthcare providers within 34 health facilities. In addition, in-depth interviews involving a total of 33 key informants were conducted at health facility levels. Results: Overall, 85% of health workers were in favour of an incentive scheme based on the health district's own financial resources (95% CI: [71.91; 88.08]. Most health workers (95 and 96% expressed a preference for financial incentives (95% CI: [66.64; 85.36] and team-based incentives (95% CI: [67.78; 86.22], respectively. The suggested performance indicators were those linked to antenatal care services, prevention of mother-to-child human immunodeficiency virus transmission, neonatal care, and immunization. Conclusions: The early involvement of health workers and other stakeholders in designing an incentive scheme proved to be valuable. It ensured their effective participation in the process and overall acceptance of the scheme at the end. This study is an important contribution towards the designing of effective PBI schemes.

Clinical waste incinerators in Cameroon--a case study

DEFF Research Database (Denmark)

Mochungong, Peter Ikome Kuwoh; Gulis, Gabriel; Sodemann, Morten

2012-01-01

Incinerators are widely used to treat clinical waste in Cameroon's Northwest Region. These incinerators cause public apprehension owing to purported risks to operators, communities and the environment. This article aims to summarize findings from an April 2008 case study....

Evaluating quality of health services in health centres of Zanjan district of Iran.

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Mohammadi, Ali; Mohammadi, Jamshid

2012-01-01

To assess quality of health services in Zanjan health centres based on clients' expectations and perceptions. The study was conducted by using service quality (SERVQUAL) scale on a sample of 300 females, clients of health care centres in the district of Zanjan, selected by cluster sampling. The results indicated that there were negative quality gaps at five SERVQUAL dimensions. The most and least negative quality gap mean scores were in reliability dimension (-2.1) and tangible (-1.13) respectively. There was statistically significant difference between clients' perceptions and expectations mean scores at all of the five service quality dimensions (P<0.001). The negative quality gap level in health service dimensions can be used as a guideline for redistribution of resources and managerial attempts to reduce quality gaps and improvement of health care quality.

System-level determinants of immunization coverage disparities among health districts in Burkina Faso: a multiple case study.

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Haddad, Slim; Bicaba, Abel; Feletto, Marta; Taminy, Elie; Kabore, Moussa; Ouédraogo, Boubacar; Contreras, Gisèle; Larocque, Renée; Fournier, Pierre

2009-10-14

Despite rapid and tangible progress in vaccine coverage and in premature mortality rates registered in sub-Saharan Africa, inequities to access remain firmly entrenched, large pockets of low vaccination coverage persist, and coverage often varies considerably across regions, districts, and health facilities' areas of responsibility. This paper focuses on system-related factors that can explain disparities in immunization coverage among districts in Burkina Faso. A multiple-case study was conducted of six districts representative of different immunization trends and overall performance. A participative process that involved local experts and key actors led to a focus on key factors that could possibly determine the efficiency and efficacy of district vaccination services: occurrence of disease outbreaks and immunization days, overall district management performance, resources available for vaccination services, and institutional elements. The methodology, geared toward reconstructing the evolution of vaccine services performance from 2000 to 2006, is based on data from documents and from individual and group interviews in each of the six health districts. The process of interpreting results brought together the field personnel and the research team. The districts that perform best are those that assemble a set of favourable conditions. However, the leadership of the district medical officer (DMO) appears to be the main conduit and the rallying point for these conditions. Typically, strong leadership that is recognized by the field teams ensures smooth operation of the vaccination services, promotes the emergence of new initiatives and offers some protection against risks related to outbreaks of epidemics or supplementary activities that can hinder routine functioning. The same is true for the ability of nurse managers and their teams to cope with new situations (epidemics, shortages of certain stocks). The discourse on factors that determine the performance or

Epidemiology of sudden cardiac death in Cameroon: the first population-based cohort survey in sub-Saharan Africa.

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Bonny, Aimé; Tibazarwa, Kemi; Mbouh, Samuel; Wa, Jonas; Fonga, Réné; Saka, Cecile; Ngantcha, Marcus

2017-08-01

Incidence estimates of sudden cardiac death (SCD) in sub-Saharan Africa (SSA) are unknown. Over 12 months, the household administrative office and health community committee within neighbourhoods in two health areas of Douala, Cameroon, registered all deaths among 86 188 inhabitants aged >18 years. As part of an extended multi-source surveillance system, the Emergency Medical Service (EMS), local medical examiners and district hospital mortuaries were also surveyed. Whereas two physicians investigated every natural death, two cardiologists reviewed all unexpected natural deaths. There were 288 all-cause deaths and 27 (9.4%) were SCD. The crude incidence rate was 31.3 [95% confidence interval (CI): 20.3-40.6]/100 000 person-years. The age-standardized rate by the African standard population was 33.6 (95% CI: 22.4-44.9)/100 000 person-years. Death occurred at night in 37% of cases, including 11% of patients who died while asleep. Out-of-hospital sudden cardiac arrest occurred in 63% of cases, 55.5% of which occurred at home. Of the 88.9% cases of witnessed cardiac arrest, 63% occurred in the presence of a family member and cardiopulmonary resuscitation was attempted only in 3.7%. The burden of SCD in this African population is heavy with distinct characteristics, whereas awareness of SCD and prompt resuscitation efforts appear suboptimal. Larger epidemiological studies are required in SSA in order to implement preventive measures, especially in women and young people. © The Author 2017; Published by Oxford University Press on behalf of the International Epidemiological Association

[Challenges in primary health care: the experience in Vila Mariana District, São Paulo, Brazil].

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Villela, Wilza Vieira; Araújo, Eliane Cardoso de; Ribeiro, Sandra Aparecida; Cuginotti, Aloísio Punhagui; Hayana, Eliana Tiemi; Brito, Francisco Carlos de; Ramos, Luiz Roberto

2009-06-01

This article presents the results of a case study aimed at identifying challenges for the delivery of primary health care in a health district in the city of São Paulo, Brazil, considering comprehensiveness as a central device for organizing work at this level of care. Five units in the district's primary care network were studied. We collected the data by observing work routines and flows, conducting interviews with managers and health professionals from different backgrounds, and through focus groups with family health teams. The analysis shows a mismatch between users' characteristics and their presumed needs and the heterogeneity of the health professionals' perceptions concerning their work. Lack of staff and time and difficulties with referrals were the main problems identified by interviewees.

Measuring health system strengthening: application of the balanced scorecard approach to rank the baseline performance of three rural districts in Zambia.

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Mutale, Wilbroad; Godfrey-Fausset, Peter; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Chintu, Namwinga; Balabanova, Dina; Spicer, Neil; Ayles, Helen

2013-01-01

There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff -0.40, p = 0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04) and service readiness (coeff 0.54, p = 0.03). The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery performing poorly in all study districts. This tool could

[Some reflections on the introduction of family planning into businesses in Cameroon].

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Ngambi Kunga

1990-01-01

Cameroon has announced that it favors family planning as a means of improving family welfare. In the local context, family planning would refer to spacing and to a lesser extent limiting births, as well as combatting infertility. This work argues that, at a time of deep economic and financial crisis for Cameroon and of growing need and demand for family planning services, the introduction of employment-based family planning services could reinforce the family planning activities of the government and private agencies. The work broadly outlines national family planning policy, identifies weaknesses of proposed family planning strategies, and points out the advantages of employment-based services. Cameroon's infant mortality rate of 90/1000 live births and maternal mortality of 420/100,000 are partly related to its very high fertility rate, closely spaced births, and early pregnancy. The national family planning program goal is to promote health and wellbeing by preventing early and unwanted pregnancies and illnesses in high-risk groups. A decline in unwanted births would be achieved through voluntary use of contraception. The main strategy would be an ambitious IEC program to inform the population of the advantages of family planning using mass media, print materials, and interpersonal communication. The general objectives of the IEC program would be to reduce maternal mortality to 300/100,000 and infant mortality from 90 to 70/1000 and increase contraceptive prevalence from 3 to 20% by 1994. Family planning services and commercial distribution centers would be created, taking advantage of existing health facilities wherever possible as well as community based systems of service delivery for the population not yet served by the traditional distribution system. Experience with the IEC strategy in other countries demonstrates that there is a great disproportion between the population touched by IEC and contraceptive prevalence. The strategy would probably be more

Phylogenic analysis of human bocavirus detected in children with acute respiratory infection in Yaounde, Cameroon.

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Kenmoe, Sebastien; Vernet, Marie-Astrid; Njankouo-Ripa, Mohamadou; Penlap, Véronique Beng; Vabret, Astrid; Njouom, Richard

2017-07-17

Human Bocavirus (HBoV) was first identified in 2005 and has been shown to be a common cause of respiratory infections and gastroenteritis in children. In a recent study, we found that 10.7% of children with acute respiratory infections (ARI) were infected by HBoV. Genetic characterization of this virus remains unknown in Central Africa, particularly in Cameroon Leeding us to evaluate the molecular characteristics of HBoV strains in Cameroonian children with ARI. Phylogenetic analysis of partial HBoV VP1/2 sequences showed a low level of nucleotide variation and the circulation of HBoV genotype 1 (HBoV-1) only. Three clades were obtained, two clustering with each of the reference strains ST1 and ST2, and a third group consisting of only Cameroon strains. By comparing with the Swedish reference sequences, ST1 and ST2, Cameroon sequences showed nucleotide and amino acid similarities of respectively 97.36-100% and 98.35-100%. These results could help improve strategies for monitoring and control of respiratory infections in Cameroon.

Sexual risk behaviours of high school female learners in Mbonge subdivision of rural Cameroon.

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Tarkang, Elvis Enowbeyang

2015-01-01

Since female learners in high schools in Cameroon fall within the age group hardest hit by HIV/AIDS, it is assumed that these learners might be exposed to sexual risk behaviours. However, little has been explored on the sexual risk behaviours of high school female learners in Cameroon. This study aimed at examining the sexual risk behaviours of high school female learners in Mbonge subdivision of rural Cameroon. A cross sectional design was adopted, using a self-administered questionnaire for data collection. Respondents were selected through disproportional stratified simple random sampling resulting in 210 female grade 10 to grade 12 learners from three participating high schools in Mbonge subdivision, Cameroon. Descriptive and inferential statistics were calculated using SPSS version 20 software program. Majority of the respondents, 54.0% reported being sexually active, of whom only 39.8% used condoms during first sex; 49.5% used condoms during last sex and 29.6% used condoms consistently. Up to 32% of the sexually active respondents had multiple sexual partners in the past one year before the study, while 9.3% had multiple sexual partners during the study period. The mean age of first sex was 15.6 years. Lack of parental control, religion, academic profile, poverty, place of residence and perception of risk of HIV infection were the main factors significantly associated with sexual risk behaviours. The findings indicate that sexual risk behaviours exist among high school female learners in Mbonge, Cameroon. There is need for campaigns and interventions to bring about sexual behaviour change.

Measuring sustainability as a programming tool for health sector investments: report from a pilot sustainability assessment in five Nepalese health districts.

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Sarriot, Eric; Ricca, Jim; Ryan, Leo; Basnet, Jagat; Arscott-Mills, Sharon

2009-01-01

Sustainability is a critical determinant of scale and impact of health sector development assistance programs. Working with USAID/Nepal implementing partners, we adapted a sustainability assessment framework to help USAID test how an evaluation tool could inform its health portfolio management. The essential first process step was to define the boundaries of the local system being examined. This local system-the unit of analysis of the study-was defined as the health district.We developed a standardized set of assessment tools to measure 53 indicators. Data collection was carried out over 4 weeks by a Nepalese agency. Scaling and combining indicators into six component indices provided a map of progress toward sustainable maternal, child, health, and family planning results for the five districts included in this pilot study, ranked from "no sustainability" to "beginning of sustainability."We conclude that systematic application of the Sustainability Framework could improve the health sector investment decisions of development agencies. It could also give districts an information base on which to build autonomy and accountability. The ability to form and test hypotheses about the sustainability of outcomes under various funding strategies-made possible by this approach-will be a prerequisite for more efficiently meeting the global health agenda.

Geochemistry of the Bayonplutonic Complex – Western Cameroon ...

African Journals Online (AJOL)

The BayonNeoproterozoic plutonic complex located in Western Cameroon intrudes gneisses of Paleo to Neo Proterozoic age. The complex is composed of gabbro, monzogabbro and monzonites frequently crosscut by trachytic and granitic veins. The primary mineral assemblages of the gabbro and monzogabbro is ...

Task shifting to non-physician clinicians for integrated management of hypertension and diabetes in rural Cameroon: a programme assessment at two years.

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Labhardt, Niklaus D; Balo, Jean-Richard; Ndam, Mama; Grimm, Jean-Jacques; Manga, Engelbert

2010-12-14

The burden of non-communicable chronic diseases, such as hypertension and diabetes, increases in sub-Saharan Africa. However, the majority of the rural population does still not have access to adequate care. The objective of this study is to examine the effectiveness of integrating care for hypertension and type 2 diabetes by task shifting to non-physician clinician (NPC) facilities in eight rural health districts in Cameroon. Of the 75 NPC facilities in the area, 69 (87%) received basic equipment and training in hypertension and diabetes care. Effectiveness was assessed after two years on status of equipment, knowledge among trained NPCs, number of newly detected patients, retention of patients under care, treatment cost to patients and changes in blood pressure (BP) and fasting plasma glucose (FPG) among treated patients. Two years into the programme, of 54 facilities (78%) available for re-assessment, all possessed a functional sphygmomanometer and stethoscope (65% at baseline); 96% stocked antihypertensive drugs (27% at baseline); 70% possessed a functional glucose meter and 72% stocked oral anti-diabetics (15% and 12% at baseline). NPCs' performance on multiple-choice questions of the knowledge-test was significantly improved. During a period of two years, trained NPCs initiated treatment for 796 patients with hypertension and/or diabetes. The retention of treated patients at one year was 18.1%. Hypertensive and diabetic patients paid a median monthly amount of 1.4 and 0.7 Euro respectively for their medication. Among hypertensive patients with ≥ 2 documented visits (n = 493), systolic BP decreased by 22.8 mmHg (95% CI: -20.6 to -24.9; p < 0.0001) and diastolic BP by 12.4 mmHg (-10.9 to -13.9; p < 0.0001). Among diabetic patients (n = 79) FPG decreased by 3.4 mmol/l (-2.3 to -4.5; p < 0.001). The integration of hypertension and diabetes into primary health care of NPC facilities in rural Cameroon was feasible in terms of equipment and training, accessible in

Environmental radioactivity level and soil radon measurement of a volcanic region in Cameroon

International Nuclear Information System (INIS)

Ngachin, M.; Garavaglia, M.; Giovani, C.; Kwato Njock, M.G.

2007-02-01

A part of the survey programme on the evaluation of environmental radioactivity in Cameroon has just been initiated. The radioactivity level of soils in a volcanic area in Cameroon was determined and discussed. 30 soils samples were collected from Buea and Limbe cities located in the south-western Cameroon. These two regions are known for theirs volcanic grounds due to the presence of Mount Cameroon mountain. The activity concentrations of natural radionuclides as well as that of the fission product were evaluated by gamma-ray spectrometry using a hyper purity germanium detector (HPGe). The ranges of concentrations in the surveyed soils were 11 - 17 Bq kg -1 , 22 - 36 Bq kg -1 and 43 - 201 Bq kg -1 for 226 Ra, 232 Th and 40 K, respectively. The radioisotope 137 Cs was also found but in a very small amount. The outdoor absorbed dose rate 1 m above ground with the corresponding annual effective dose rate, assuming a 20% occupancy factor were estimated. The radium equivalent and the external hazard index were also evaluated and results are compared with available data from other studies and with the world average value (UNSCEAR, 1988, 2000). A solid state nuclear track detector (SSNTDs), LR-115 was used for soil radon measurements at a depth of 50 cm. The ranges of soil radon concentrations were 6.7 - 10.8 kBq m -3 and 5.5 - 8.7 kBq m -3 in Buea and Limbe, respectively. A positive correlation was found between concentrations of radium measured with γ-spectrometry and the soil radon concentrations measured with the nitrate cellulose detectors. The results of this study provide the radioactivity level in soil of a volcanic area, which has been found to be within the safety limits. The south-western Cameroon can be considered as having normal natural background radiation in normal living conditions. (author)

Situating mobile health: a qualitative study of mHealth expectations in the rural health district of Nouna, Burkina Faso.

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Duclos, Vincent; Yé, Maurice; Moubassira, Kagoné; Sanou, Hamidou; Sawadogo, N Hélène; Bibeau, Gilles; Sié, Ali

2017-07-12

The implementation of mobile health (mHealth) projects in low- and middle-income countries raises high and well-documented expectations among development agencies, policymakers and researchers. By contrast, the expectations of direct and indirect mHealth users are not often examined. In preparation for a proposed intervention in the Nouna Health District, in rural Burkina Faso, this study investigates the expected benefits, challenges and limitations associated with mHealth, approaching these expectations as a form of situated knowledge, inseparable from local conditions, practices and experiences. The study was conducted within the Nouna Health District. We used a qualitative approach, and conducted individual semi-structured interviews and group interviews (n = 10). Participants included healthcare workers (n = 19), godmothers (n = 24), pregnant women (n = 19), women with children aged 12-24 months (n = 33), and women of childbearing age (n = 92). Thematic and content qualitative analyses were conducted. Participants expect mHealth to help retrieve patients lost to follow-up, improve maternal care monitoring, and build stronger relationships between pregnant women and primary health centres. Expected benefits are not reducible to a technological realisation (sending messages), but rather point towards a wider network of support. mHealth implementation is expected to present considerable challenges, including technological barriers, organisational challenges, gender issues, confidentiality concerns and unplanned aftereffects. mHealth is also expected to come with intrinsic limitations, to be found as obstacles to maternal care access with which pregnant women are confronted and on which mHealth is not expected to have any significant impact. mHealth expectations appear as situated knowledges, inseparable from local health-related experiences, practices and constraints. This problematises universalistic approaches to mHealth knowledge, while nevertheless hinting at

Sustainable Development and Corporate Social Responsibility in Sub-Saharan Africa: Evidence from Industries in Cameroon

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Oyewole Simon Oginni

2016-05-01

Full Text Available Present technological innovations and social organizations continue to impose risks and limitations on the efficient performance of the biosphere. Human activities have increasingly short-lived sustainable natural endowments, to the extent that, the multiplier effects have ripples beyond the traditional benefits of economic production and consumption. Therefore, this study addressed practical concerns on how industries in Sub-Saharan Africa promote sustainable development in their corporate social responsibility models, using industries in Cameroon as a case study; it examined economic, social, and environmental components of sustainable development and corporate social responsibility (CSR. Our sample consists of 335 business enterprises from the last Censure Survey of Enterprises in Cameroon. The study adopted a systematic analysis through the Adjusted Residual Test, and the Phi and Cramer’s V tests. Findings revealed that industries in Cameroon prioritize environmental and social dimensions over economic dimensions. However, a few large enterprises implement a broad CSR that promotes sustainable business practices, whereas smaller ones do not; industries in Cameroon implement environmental dimensions of CSR as a safe buffer and a social dimension as philanthropy. Hence, there is no concrete evidence that industries promote sustainable development via CSR in Cameroon. The implementation of a sustainable business model is a precondition for promoting sustainable development via CSR. Industries should realize the concrete value in implementing a sustainable business model that helps to adjust to the complex and increasingly changing business environment.

Do the factors associated with female HIV infection vary by socioeconomic status in Cameroon?

Science.gov (United States)

Mumah, Joyce N; Jackson-Smith, Douglas

2014-07-01

One of the most consistent findings in social epidemiology is an inverse relationship between indicators of SES and most types of illness. However, a growing body of research on HIV in sub-Saharan Africa suggests an intriguing reversal of this pattern, particularly with respect to HIV among women. In Cameroon, specifically, high-SES women have higher rates of HIV infection compared with low-SES women. Using data from the 2004 Cameroon DHS, this study explored the relationships between SES and HIV and tested a multivariate model designed to highlight the distinctive factors associated with increased risk of HIV among women in different SES classes. The results revealed that high-SES women who reported engaging in riskier sexual behaviour had the highest levels of HIV infection. Surprisingly, among this group increased knowledge of HIV, more domestic decision-making authority and access to health care did not reduce vulnerability. Meanwhile, among low-SES women relative gender inequality was significantly related to HIV risk. Specifically, among this group of women, having a partner with higher education was strongly associated with greater HIV risk. The results suggest that different approaches targeting each sub-group are needed to effectively combat the disease.

Evaluating the fate of organic compounds in the Cameroon ...

African Journals Online (AJOL)

ISHIOMA

A level III fugacity model was developed to evaluate the fate of chemicals in the Cameroon ... environment, quantify intermedia transfer processes and the major loss ... perform baseline exposure and risk assessment of chemicals used in ...

Metabolic monitoring in New Zealand district health board mental health services.

Science.gov (United States)

Staveley, Aimee; Soosay, Ian; O'Brien, Anthony J

2017-11-10

To audit New Zealand district health boards' (DHBs) metabolic monitoring policies in relation to consumers prescribed second-generation antipsychotic medications using a best practice guideline. Metabolic monitoring policies from DHBs and one private clinic were analysed in relation to a best practice standard developed from the current literature and published guidelines relevant to metabolic syndrome. Fourteen of New Zealand's 20 DHBs currently have metabolic monitoring policies for consumers prescribed antipsychotic medication. Two of those policies are consistent with the literature-based guideline. Eight policies include actions to be taken when consumers meet criteria for metabolic syndrome. Four DHBs have systems for measuring their rates of metabolic monitoring. There is no consensus on who is clinically responsible for metabolic monitoring. Metabolic monitoring by mental health services in New Zealand reflects international experience that current levels of monitoring are low and policies are not always in place. Collaboration across the mental health and primary care sectors together with the adoption of a consensus guideline is needed to improve rates of monitoring and reduce current rates of physical health morbidities.

Factors associated with perception of risk of contracting HIV among secondary school female learners in Mbonge subdivision of rural Cameroon.

Science.gov (United States)

Tarkang, Elvis Enowbeyang

2014-01-01

Since learners in secondary schools fall within the age group hardest hit by HIV/AIDS, it is obvious that these learners might be at high risk of contracting HIV/AIDS. However, little has been explored on the perception of risk of contracting HIV among secondary school learners in Cameroon. This study aimed at examining the perception of risk of contracting HIV among secondary school learners in Mbonge subdivision of rural Cameroon using the Health Belief Model (HBM) as framework. A quantitative, correlational design was adopted, using a self-administered questionnaire to collect data from 210 female learners selected through disproportional, stratified, simple random sampling technique, from three participating senior secondary schools. Statistics were calculated using SPSS version 20 software program. Only 39.4% of the respondents perceived themselves to be at high risk of contracting HIV, though the majority, 54.0% were sexually active. Multinomial logistic regression analyses show that sexual risk behaviours (p=0.000) and the Integrated Value Mapping (IVM) of the perception components of the HBM are the most significant factors associated with perception of risk of contracting HIV at the level p<0.05. The findings of this study can play an instrumental role in the development of effective preventive and interventional messages for adolescents in Cameroon.

Human resources for health at the district level in Indonesia: the smoke and mirrors of decentralization

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Harahap Nida P

2009-02-01

Full Text Available Abstract Background In 2001 Indonesia embarked on a rapid decentralization of government finances and functions to district governments. One of the results is that government has less information about its most valuable resource, the people who provide the services. The objective of the work reported here is to determine the stock of human resources for health in 15 districts, their service status and primary place of work. It also assesses the effect of decentralization on management of human resources and the implications for the future. Methods We enumerated all health care providers (doctors, nurses and midwives, including information on their employment status and primary place of work, in each of 15 districts in Java. Data were collected by three teams, one for each province. Results Provider density (number of doctors, nurses and midwives/1000 population was low by international standards – 11 out of 15 districts had provider densities less than 1.0. Approximately half of all three professional groups were permanent public servants. Contractual employment was also important for both nurses and midwives. The private sector as the primary source of employment is most important for doctors (37% overall and increasingly so for midwives (10%. For those employed in the public sector, two-thirds of doctors and nurses work in health centres, while most midwives are located at village-level health facilities. Conclusion In the health system established after Independence, the facilities established were staffed through a period of obligatory service for all new graduates in medicine, nursing and midwifery. The last elements of that staffing system ended in 2007 and the government has not been able to replace it. The private sector is expanding and, despite the fact that it will be of increasing importance in the coming decades, government information about providers in private practice is decreasing. Despite the promise of decentralization to

Human resources for health at the district level in Indonesia: the smoke and mirrors of decentralization.

Science.gov (United States)

Heywood, Peter F; Harahap, Nida P

2009-02-03

In 2001 Indonesia embarked on a rapid decentralization of government finances and functions to district governments. One of the results is that government has less information about its most valuable resource, the people who provide the services. The objective of the work reported here is to determine the stock of human resources for health in 15 districts, their service status and primary place of work. It also assesses the effect of decentralization on management of human resources and the implications for the future. We enumerated all health care providers (doctors, nurses and midwives), including information on their employment status and primary place of work, in each of 15 districts in Java. Data were collected by three teams, one for each province. Provider density (number of doctors, nurses and midwives/1000 population) was low by international standards--11 out of 15 districts had provider densities less than 1.0. Approximately half of all three professional groups were permanent public servants. Contractual employment was also important for both nurses and midwives. The private sector as the primary source of employment is most important for doctors (37% overall) and increasingly so for midwives (10%). For those employed in the public sector, two-thirds of doctors and nurses work in health centres, while most midwives are located at village-level health facilities. In the health system established after Independence, the facilities established were staffed through a period of obligatory service for all new graduates in medicine, nursing and midwifery. The last elements of that staffing system ended in 2007 and the government has not been able to replace it. The private sector is expanding and, despite the fact that it will be of increasing importance in the coming decades, government information about providers in private practice is decreasing. Despite the promise of decentralization to increase sectoral "decision space" at the district level, the

Increased fairness in priority setting processes within the health sector: the case of Kapiri-Mposhi District, Zambia.

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Zulu, Joseph M; Michelo, Charles; Msoni, Carol; Hurtig, Anna-Karin; Byskov, Jens; Blystad, Astrid

2014-02-18

The challenge of priority setting (PS) in health care within contexts of severe resource limitations has continued to receive attention. Accountability for Reasonableness (AFR) has emerged as a useful framework to guide the implementation of PS processes. In 2006, the AFR approach to enhance legitimate and fair PS was introduced by researchers and decision makers within the health sector in the EU funded research project entitled 'Response to Accountable priority setting for Trust in health systems' (REACT). The project aimed to strengthen fairness and accountability in the PS processes of health systems at district level in Zambia, Tanzania and Kenya. This paper focuses on local perceptions and practices of fair PS (baseline study) as well as at the evolution of such perceptions and practices in PS following an AFR based intervention (evaluation study), carried out at district level in Kapiri-Mposhi District in Zambia. Data was collected using in depth interviews (IDIs), focus group discussions (FGDs) and review of documents from national to district level. The study population for this paper consisted of health related stakeholders employed in the district administration, in non-governmental organizations (NGO) and in health facilities. During the baseline study, concepts of legitimacy and fairness in PS processes were found to be grounded in local values of equity and impartiality. Government and other organizational strategies strongly supported devolution of PS and decision making procedures. However, important gaps were identified in terms of experiences of stakeholder involvement and fairness in PS processes in practice. The evaluation study revealed that a transformation of the views and methods regarding fairness in PS processes was ongoing in the study district, which was partly attributed to the AFR based intervention. The study findings suggest that increased attention was given to fairness in PS processes at district level. The changes were linked to a

District nursing in Dominica

NARCIS (Netherlands)

Kolkman, PME; Luteijn, AJ; Nasiiro, RS; Bruney, [No Value; Smith, RJA; Meyboom-de Jong, B

1998-01-01

District nurses constitute the basis of the primary health care services in Dominica. All encounters of three district nurses were registered using the international classification of primary care. Information on other aspects of district nursing was collected by participating observation and the

Health financing at district level in Malawi: an analysis of the distribution of funds at two points in time.

Science.gov (United States)

Borghi, Josephine; Munthali, Spy; Million, Lameck B; Martinez-Alvarez, Melisa

2018-01-01

There is growing attention to tracking country level resource flows to health, but limited evidence on the sub-national allocation of funds. We examined district health financing in Malawi in 2006 and 2011, and equity in the allocation of funding, together with the association between financing and under five and neonatal mortality. We explored the process for receiving and allocating different funding sources at district level. We obtained domestic and external financing data from the Integrated Financial Management Information System (2006-11) and AidData (2000-12) databases. Out-of-pocket payment data came from two rounds of integrated household budget surveys (2005; 2010). Mortality data came from the Multiple Indicator Cluster Survey (2006) and Demographic and Health Survey (2010). We described district level health funding by source, ran correlations between funding and outcomes and generated concentration curves and indices. 41 semi-structured interviews were conducted at the national level and in 10 districts with finance and health managers. Per capita spending from all sources varied substantially across districts and doubled between 2006 and 2011 from 7181 Kwacha to 15 312 Kwacha. In 2011, external funding accounted for 74% of funds, with domestic funding accounting for 19% of expenditure, and out of pocket (OOP) funding accounting for 7%. All funding sources were concentrated among wealthier districts, with OOP being the most pro-rich, followed by domestic expenditure and external funding. Districts with higher levels of domestic and external funding had lower levels of post-neonatal mortality, and those with higher levels of out-of-pocket payments had higher levels of 1-59 month mortality in 2006. There was no association between changes in financing and outcomes. Districts reported delayed receipt of lower-than-budgeted funds, forcing them to scale-down activities and rely on external funding. Governments need to track how resources are allocated

Writing in Cameroon, the first hundred years

African Journals Online (AJOL)

2016-03-28

Mar 28, 2016 ... in Bulu territory, the American pastor Adolphus Good, it won the London African .... same year, Le Vieux Nègre et la médaille is a critique of the vieux nègre (old black man), .... Cameroon, cautious editorial choices and writers' self-censorship, a limited range of ... many also used film and other media.

Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods

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Odaga, John; Henriksson, Dorcus K.; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K.; Valadez, Joseph J.

2016-01-01

Background Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting

Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods

Directory of Open Access Journals (Sweden)

John Odaga

2016-05-01

Full Text Available Background: Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs. The Community and District Empowerment for Scale-up (CODES project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design: Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results: All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions: In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying

Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods.

Science.gov (United States)

Odaga, John; Henriksson, Dorcus K; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K; Valadez, Joseph J

2016-01-01

Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival.

Production performance and exploitation of heterosis in Cameroon ...

African Journals Online (AJOL)

A crossbreeding experiment using Cameroon indigenous (CF) and German Dahlem Red (GR) chickens was undertaken to determine production performance and heterosis estimates of body weight of cockerels and laying hens at various ages and and egg production traits in layers. Four genetic groups were involved, ...

Occupation of public space : anglophone nationalism in Cameroon

NARCIS (Netherlands)

Jua, N.; Konings, P.J.J.

2004-01-01

This article examines the historical process leading to the emergence of Anglophone nationalism in public space during the liberalisation process in the 1990s in Cameroon. Anglophone nationalism poses a severe threat to the post-colonial State's nation-building project that has been driven by the

THE PLIGHT OF GERMAN MISSIONS IN MANDATE CAMEROON: AN HISTORICAL ANALYSIS

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Lang Michael Kpughe

2017-09-01

Full Text Available The First World War and its resultant Mandate and Trusteeship systems greatly affected the German mission enterprise in Cameroon. Apart from causing the forceful ousting of German missionaries from Cameroon, the British and the French whom the League of Nations and United Nations successively chose as administering powers within the Mandate and Trusteeship frameworks adopted hostile policies towards German missions. From the beginning of the war to the post-Second World War era, the foundation of German missions was seriously threatened. This paper critically examines the treatment of German missions in both British and French Cameroons during the Mandate and Trusteeship periods, focusing especially on the opposing attitudes of both administering powers towards the missions in their spheres of influence. The paper establishes that the administering powers’ treatment of German missions, which was underpinned by imperial and nationalist exigencies, roiled the attainment of the triple missionization agenda of planting self-supporting, self-governing and self-evangelizing churches. It thus argues that the First World War triggered the mistreatment of German missions, with some missions forced to terminate their activities while others were allowed to continue their mission work under difficult conditions.

Pesticides use in cocoa sector in Cameroon: characterization of ...

African Journals Online (AJOL)

International Journal of Biological and Chemical Sciences ... Journal Home > Vol 8, No 5 (2014) > ... The chemical control is the widely control method applied in Cameroon for pests and diseases by all the cocoa producers without technical ...

The Relation among School District Health, Total Quality Principles for School Organization and Student Achievement

Science.gov (United States)

Marshall, Jon; Pritchard, Ruie; Gunderson, Betsey

2004-01-01

The purpose of this study was to determine the congruence among W. E. Deming's 14 points for Total Quality Management (TQM), the organizational health of school districts, and student achievement. Based on Kanter's (1983) concept of a Culture of Pride with a Climate of Success, healthy districts were defined as having an organizational culture…

Challenges and opportunities for implementing integrated mental health care: a district level situation analysis from five low- and middle-income countries.

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Charlotte Hanlon

Full Text Available Little is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda participating in the PRogramme for Improving Mental health carE (PRIME. The purpose was to inform development and implementation of a comprehensive district plan to integrate mental health into primary care.A situation analysis tool was developed for the study, drawing on existing tools and expert consensus. Cross-sectional information obtained was largely in the public domain in all five districts.The PRIME study districts face substantial contextual and health system challenges many of which are common across sites. Reliable information on existing treatment coverage for mental disorders was unavailable. Particularly in the low-income countries, many health service organisational requirements for mental health care were absent, including specialist mental health professionals to support the service and reliable supplies of medication. Across all sites, community mental health literacy was low and there were no models of multi-sectoral working or collaborations with traditional or religious healers. Nonetheless health system opportunities were apparent. In each district there was potential to apply existing models of care for tuberculosis and HIV or non-communicable disorders, which have established mechanisms for detection of drop-out from care, outreach and adherence support. The extensive networks of community-based health workers and volunteers in most districts provide further opportunities to expand mental health care.The low level of baseline health system preparedness across sites underlines that interventions at the levels of health care organisation, health facility and community will all be essential

Locating the depth of magma supply for volcanic eruptions, insights from Mt. Cameroon.

Science.gov (United States)

Geiger, Harri; Barker, Abigail K; Troll, Valentin R

2016-10-07

Mt. Cameroon is one of the most active volcanoes in Africa and poses a possible threat to about half a million people in the area, yet knowledge of the volcano's underlying magma supply system is sparse. To characterize Mt. Cameroon's magma plumbing system, we employed mineral-melt equilibrium thermobarometry on the products of the volcano's two most recent eruptions of 1999 and 2000. Our results suggest pre-eruptive magma storage between 20 and 39 km beneath Mt. Cameroon, which corresponds to the Moho level and below. Additionally, the 1999 eruption products reveal several shallow magma pockets between 3 and 12 km depth, which are not detected in the 2000 lavas. This implies that small-volume magma batches actively migrate through the plumbing system during repose intervals. Evolving and migrating magma parcels potentially cause temporary unrest and short-lived explosive outbursts, and may be remobilized during major eruptions that are fed from sub-Moho magma reservoirs.

Measuring health system strengthening: application of the balanced scorecard approach to rank the baseline performance of three rural districts in Zambia.

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Wilbroad Mutale

Full Text Available INTRODUCTION: There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. METHODOLOGY: The Better Health Outcome through Mentoring and Assessment (BHOMA project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. RESULTS: Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58% and highest in Luangwa district (77%. Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively. Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff -0.40, p = 0.02. Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04 and service readiness (coeff 0.54, p = 0.03. CONCLUSION: The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service

Measuring Health System Strengthening: Application of the Balanced Scorecard Approach to Rank the Baseline Performance of Three Rural Districts in Zambia

Science.gov (United States)

Mutale, Wilbroad; Godfrey-Fausset, Peter; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Chintu, Namwinga; Balabanova, Dina; Spicer, Neil; Ayles, Helen

2013-01-01

Introduction There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. Methodology The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. Results Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff −0.40, p = 0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04) and service readiness (coeff 0.54, p = 0.03). Conclusion The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery

Dentofacial injuries in commercial motorcycle accidents in Cameroon

African Journals Online (AJOL)

Objective: To assess the pattern of dentofacial injuries in commercial motorcycle accidents among riders and passengers in Cameroon. Materials and Methods: This was a hospital based study conducted in 6 out of 10 regional capitals in the months of December 2011 to September 2012. Analyzed information included age, ...

Factors affecting livestock predation by lions in Cameroon

NARCIS (Netherlands)

Bommel, van L.; Vaate, bij de M.D.; Boer, de W.F.; Iongh, de H.H.

2007-01-01

Interviews were carried out in six villages south-west of Waza National Park, Cameroon, to investigate the impact of factors related to the occurrence of livestock raiding by lions. Data were analysed at the village and individual level. Livestock losses (cattle, sheep and/or goats) caused by lions

Money Supply, Interest Rate, and Economic Growth in Cameroon: A ...

African Journals Online (AJOL)

2008-12-11

Dec 11, 2008 ... However, different predictions of monetary theories have assigned different degrees of .... Sources: World Bank, World Table, Cameroon Financial Bill 2007, and African Development Indicators. ..... of Accounting and Statistics.

Social, Psychological and Health Concerns of People Living with HIV/AIDS in Mysore District, Karnataka.

Science.gov (United States)

Sebastian, Shibu Thomas; Siddanna, Sunitha

2016-03-01

One of the significant health and social problem the world facing today is Acquired immune deficiency syndrome (AiDS). The patients affected with HIV and their family may face various psychosocial problems during diagnosis and treatment due to the stigma associated with this disease. The objective of the study was to identify social, psychological and health concerns of people living with HIV/AIDS (PLWHA) and its association with the demographic factors in Mysore District, Karnataka, India. A questionnaire based study was conducted among 194 participants in Mysore District, Karnataka state who were receiving care and support services. A 22-item questionnaire provided information regarding social, psychological and health concerns of PLWHA in Mysore district. A general linear regression model was used for assessing the predictors of social, psychological and health concerns. The main social concern was that of "Fear of Losing a loved one" whereas the main psychological concern was "Too much worry", "No cure for AIDS" was the highly rated health concern. Males had more social, psychological and health concerns when compared to females but was not statistically significant. Employed people were having fewer psychological concerns when compared to unemployed people. Unemployed people were having fewer health concerns than employed people. For every unit increase in age there were fewer social and health concerns and both these findings were statistically significant. PLWHA in the present study reported that they were concerned about social, psychological and health issues in spite of the fact they were attending counseling. Health care workers, including those in public health sector should be educated about the importance of these factors that influence the health of the population they are caring for.

A practical approach to low protein diets for patients with chronic kidney disease in Cameroon.

Science.gov (United States)

Ashuntantang, Gloria Enow; Fouda, Hermine; Kaze, Francois Folefack; Halle, Marie-Patrice; Tabi-Arrey, Crista; Biwole-Sida, Magloire

2016-09-07

Cameroon is a low-middle income country with a rich diversity of culture and cuisine. Chronic kidney disease (CKD) is common in Cameroon and over 80 % of patients present late for care, precluding the use of therapies such as low protein diets (LPDs) that slow its progression. Moreover, the prescription of LPDs is challenging in Cameroon because dieticians are scarce, there are no renal dieticians, and people often have to fund their own healthcare. The few nephrologists that provide care for CKD patients have limited expertise in LPD design. Therefore, only moderate LPDs of 0.6 g protein per kg bodyweight per day, or relatively mild LPDs of 0.7-0.8 g protein per kg bodyweight per day are prescribed. The moderate LPD is prescribed to patients with stage 3 or 4 CKD with non-nephrotic proteinuria, no evidence of malnutrition and no interrcurrent acute illnesses. The mild LPD is prescribed to patients with stage 3 or 4 CKD with nephrotic proteinuria, non-symptomatic stage 5 CKD patients or stage 5 CKD patients on non-dialysis treatment. In the absence of local sources of amino and keto acid supplements, traditional mixed LPDs are used. For patients with limited and sporadic access to animal proteins, the prescribed LPDs do not restrict vegetable proteins, but limit intake of animal proteins (when available) to 70 % of total daily protein intake. For those with better access to animal proteins, the prescribed LPDs limit intake of animal proteins to 50-70 % of total daily protein intake, depending on their meal plan. Images of 100 g portions of meat, fish and readily available composite meals serve as visual guides of quantities for patients. Nutritional status is assessed before LPD prescription and during follow up using a subjective global assessment and serum albumin. In conclusion, LPDs are underutilised and challenging to prescribe in Cameroon because of weakness in the health system, the rarity of dieticians, a wide diversity of dietary habits, the limited

Prevalence and predictors of giving birth in health facilities in Bugesera District, Rwanda

Directory of Open Access Journals (Sweden)

Joharifard Shahrzad

2012-12-01

Full Text Available Abstract Background The proportion of births attended by skilled health personnel is one of two indicators used to measure progress towards Millennium Development Goal 5, which aims for a 75% reduction in global maternal mortality ratios by 2015. Rwanda has one of the highest maternal mortality ratios in the world, estimated between 249–584 maternal deaths per 100,000 live births. The objectives of this study were to quantify secular trends in health facility delivery and to identify factors that affect the uptake of intrapartum healthcare services among women living in rural villages in Bugesera District, Eastern Province, Rwanda. Methods Using census data and probability proportional to size cluster sampling methodology, 30 villages were selected for community-based, cross-sectional surveys of women aged 18–50 who had given birth in the previous three years. Complete obstetric histories and detailed demographic data were elicited from respondents using iPad technology. Geospatial coordinates were used to calculate the path distances between each village and its designated health center and district hospital. Bivariate and multivariate logistic regressions were used to identify factors associated with delivery in health facilities. Results Analysis of 3106 lifetime deliveries from 859 respondents shows a sharp increase in the percentage of health facility deliveries in recent years. Delivering a penultimate baby at a health facility (OR = 4.681 [3.204 - 6.839], possessing health insurance (OR = 3.812 [1.795 - 8.097], managing household finances (OR = 1.897 [1.046 - 3.439], attending more antenatal care visits (OR = 1.567 [1.163 - 2.112], delivering more recently (OR = 1.438 [1.120 - 1.847] annually, and living closer to a health center (OR = 0.909 [0.846 - 0.976] per km were independently associated with facility delivery. Conclusions The strongest correlates of facility-based delivery in Bugesera District include previous delivery at a

Health worker attrition at a rural district hospital in Rwanda: a need ...

African Journals Online (AJOL)

Health worker attrition at a rural district hospital in Rwanda: a need for improved placement and retention strategies. Jackline Odhiambo, Felix Cyamatare Rwabukwisi, Christian Rusangwa, Vincent Rusanganwa, Lisa Ruth Hirschhorn, Evrard Nahimana, Patient Ngamije, Bethany Lynn Hedt-Gauthier ...

[High school student and skin bleaching in Cameroon].

Science.gov (United States)

Mayoughouo Mouliom, Adeline; Wamba, André

2017-04-27

Introduction: Skin bleaching is a common practice in Africa, particularly in Cameroon. Studies show that it represents a danger for health, in terms of a demonstrated increased risk of dermatological diseases. However, increasing numbers of people are using skin bleaching in African cities, despite the fact that they are sometimes aware of the risk. This study proposed to transform the knowledge and perceptions of skin bleaching practices into educational strategies that can be used both by health professionals and educators. These strategies can also be used as preventive measures against skin bleaching among young schoolgirls. Methods: Data collection was based on a qualitative approach, in the form of a focus group discussion attended by 40 girls aged between 14 and 20 years, selected by convenient random sampling. Results: The results indicated that girls have an approximate knowledge about the consequences of skin bleaching on their health. On the contrary, they have a good knowledge about prevention, which can be used to develop a prevention strategy in order to reduce or eradicate skin bleaching, by educational awareness campaigns Conclusion: These elements can be used as a basis for better prevention and health promotion in schools; so that students adopt healthy behaviours and to prevent those students at risk.

District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data

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Gautham, Meenakshi; Spicer, Neil; Subharwal, Manish; Gupta, Sanjay; Srivastava, Aradhana; Bhattacharyya, Sanghita; Avan, Bilal Iqbal; Schellenberg, Joanna

2016-01-01

Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identified key inputs required for data sharing. Between March 2013 and August 2014, we conducted 74 key informant interviews at national, state and district levels. Respondents were stakeholders from national, state and district health departments, professional associations, non-governmental programmes and private commercial health facilities with 3–200 beds. Qualitative data were analysed using a framework based on a priori and emerging themes. Private facilities registered for ultrasounds and abortions submitted standardized records on these services, which is compulsory under Indian laws. Data sharing for other services was weak, but most facilities maintained basic records related to institutional deliveries and newborns. Public health facilities in blocks collected these data from a few private facilities using different methods. The major barriers to data sharing included the public sector’s non-standardized data collection and utilization systems for MNCH and lack of communication and follow up with private facilities. Private facilities feared information disclosure and the additional burden of reporting, but were willing to share data if asked officially, provided the process was simple and they were assured of confidentiality. Unregistered facilities, managed by providers without a biomedical qualification, also conducted institutional deliveries, but were outside any reporting loops. Our findings suggest that even without legislation, the public sector could set up an effective MNCH data sharing strategy with

New Zealand evidence for the impact of primary healthcare investment in Capital and Coast District Health Board.

Science.gov (United States)

Tan, Lee; Carr, Julia; Reidy, Johanna

2012-03-30

This paper provides New Zealand evidence on the effectiveness of primary care investment, measured through the Capital and Coast District Health Board's (DHB) Primary Health Care Framework. The Framework was developed in 2002/2003 to guide funding decisions at a DHB level, and to provide a transparent basis for evaluation of the implementation of the Primary Health Care Strategy in this district. The Framework used a mixed method approach; analysis was based on quantitative and qualitative data. This article demonstrates the link between investment in primary health care, increased access to primary care for high-need populations, workforce redistribution, and improved health outcomes. Over the study period, ambulatory sensitive hospitalisations and emergency department use reduced for enrolled populations and the District's immunisation coverage improved markedly. Funding and contracting which enhanced both 'mainstream' and 'niche' providers combined with community-based health initiatives resulted in a measurable impact on a range of health indicators and inequalities. Maori primary care providers improved access for Maori but also for their enrolled populations of Pacific and Other ethnicity. Growth and redistribution of primary care workforce was observed, improving the availability of general practitioners, nurses, and community workers in poorer communities.

Schistosomiasis and soil-transmitted helminthiasis control in Cameroon and Côte d'Ivoire: implementing control on a limited budget.

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Tchuenté, L A Tchuem; N'goran, E K

2009-11-01

Schistosomiasis and soil-transmitted helminthiasis occur throughout the developing world and remain a major public health problem in the poorest communities with enormous consequences for development. The extent of the problem has long been neglected because these diseases rarely kill at a young age and also because of their insidious nature. Today there exists a momentum and an unprecedented opportunity for a cost-effective control of these neglected tropical diseases. The control of these diseases has become a priority on the agenda of many governments, donors and international agencies. This paper highlights the progress made and future control activities in Cameroon and Côte d'Ivoire, where schistosomiasis and soil-transmitted helminthiasis control measures have been implemented over the past decade with limited budgets. In Cameroon, deworming activities were increased to encompass all ten regions in 2007 as a result of a co-ordinated effort of the Ministry of Health and the Ministry of Education with national and international partners. In Côte d'Ivoire, focal control activities were achieved with support from various partners. Prospects, opportunities and challenges for the control of neglected tropical diseases in these two countries are discussed.

Psychosocial stressors of sickle cell disease on adult patients in Cameroon.

Science.gov (United States)

Wonkam, Ambroise; Mba, Caryl Zameyo; Mbanya, Dora; Ngogang, Jeanne; Ramesar, Raj; Angwafo, Fru F

2014-12-01

Sickle Cell Disease (SCD) is a debilitating illness that affects quality of life. Studies of the psychosocial burden of SCD on patients have been rarely reported in Africa. We used a quantitative method, with face-to-face administered questionnaires, to study indices of psychosocial stressors on adult SCD patients in Cameroon. The questionnaire included a 36-item stress factors scale evaluating general perceptions of stress and five main stressors' domain: disease factors, hospital factors, financial factors, family factors and quality of personal-life factors. Items pertaining to psychosocial stressors involved four response options with increasing severity: 0, 1, 2 or 3. Non-parametric tests were used for analysis. The majority of the 83 participants were urban dwellers, female, 20-30 years old, single, unemployed, with at least a secondary or tertiary education. Median age at diagnosis was 100 months; 47.8% had >3 painful vaso-oclusive crises annually. Only 4.8% had been treated with hydroxyurea. The majority reported moderate to severe difficulty coping with SCD. The "degree of clinical severity" category displayed the highest median score (2.0), while familial stressors showed the lowest (0.8). Being female, married, with low education level, an additional affected sibling and low direct income were significantly associated with specific stressors' categories. In Cameroon, there is an urgent need to implement policies that ensure affordable access to health-care and practices to reduce SCD morbidity and improve patients' quality of life.

Alcohol use and extramarital sex among men in Cameroon

Directory of Open Access Journals (Sweden)

Wiysonge Charles

2007-08-01

Full Text Available Abstract Background The spread of HIV in sub-Saharan Africa is believed to be driven by unsafe sex, and identification of modifiable risk factors of the latter is needed for comprehensive HIV prevention programming in the region. Some previous studies suggest an association between alcohol abuse and unsafe sexual behaviour, such as multiple concurrent sexual partnerships and inconsistent condom use in sex with non-spousal non-cohabiting partners. However, most of these studies were conducted in developed countries and the few studies in Africa were conducted among well-defined social groups such as men attending beer halls or sexually transmitted infection clinics. We therefore examined the association between alcohol and extramarital sex (a sign of multiple concurrent sexual partnerships among men in a population-based survey in Cameroon; a low-income country in sub-Saharan Africa with a high rate of alcohol abuse and a generalised HIV epidemic. Methods We analyzed data from 2678 formally married or cohabiting men aged 15 to 59 years, who participated in the 2004 Cameroon Demographic and Health Survey, using a multivariate regression model. Results A quarter of the men (25.8% declared having taken alcohol before their last sexual intercourse and 21% indicated that the last sex was with a woman other than their wife or cohabiting partner. After controlling for possible confounding by other socio-demographic characteristics, alcohol use was significantly associated with having extramarital sex: adjusted odds ratio (OR 1.70, 95% confidence intervals (CI 1.40 to 2.05. Older age (30–44 years: OR 3.06, 95%CI 2.16–4.27 and 45–59 years: OR 4.10, 95%CI 2.16–4.27, higher education (OR 1.25, 95%CI 1.10–1.45, and wealth (OR 1.71, 95%CI 1.50–1.98 were also significantly associated with higher odds of having extramarital sex. The men were more likely to have used a condom in their last sex if it was extramarital (OR 10.50, 95%CI 8.10–13

Trends in perinatal health indices in the Amajuba District, KwaZulu ...

African Journals Online (AJOL)

Trends in perinatal health indices in the Amajuba District, KwaZulu-Natal, South Africa, 1990 - 2012. FS Bondi, TI Runsewe-Abiodun. Abstract. Background. In order to address the high perinatal mortality rate, South Africa (SA) commenced a number of interventions from 1995. These included the abolition of user fees, basic ...

Performance of health product risk management and surveillance conducted by health personnel at sub-district health promotion hospitals in the northeast region of Thailand

OpenAIRE

Kanjanarach, Tipaporn; Jaisa-ard, Raksaworn; Poonaovarat, Nantawan

2014-01-01

Tipaporn Kanjanarach,1,2 Raksaworn Jaisa-ard,1,2 Nantawan Poonaovarat3 1Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand; 2Center for Research and Development of Herbal Health Products, Khon Kaen University, Khon Kaen, Thailand; 3Health Consumer Protection, Chaiyapum Health Provincial Office, Chaiyapum, Thailand Background: Health personnel at sub-district health promotion hospitals (SD-HPHs) are assigned to take responsibility for 15 activities related to health...

Access to potable water and sanitation in Cameroon within the context of Millennium Development Goals (MDGS).

Science.gov (United States)

Ako, Andrew Ako; Shimada, Jun; Eyong, Gloria Eneke Takem; Fantong, Wilson Yetoh

2010-01-01

Cameroon has been fully engaged with the Millennium Development Goals (MDGs) since their inception in 2000. This paper examines the situation of access to potable water and sanitation in Cameroon within the context of the Millennium Development Goals (MDGs), establishes whether Cameroon is on the track of meeting the MDGs in these domains and proposes actions to be taken to bring it closer to these objectives. Based on analyzed data obtained from national surveys, government ministries, national statistical offices, bibliographic research, reports and interviews, it argues that Cameroon will not reach the water and sanitation MGDs. While Cameroon is not yet on track to meet the targets of the MDGs for water and sanitation, it has made notable progress since 1990, much more needs to be done to improve the situation, especially in rural areas. In 2006, 70% of the population had access to safe drinking water and the coverage in urban centres is 88%, significantly better than the 47% in rural areas. However, rapid urbanization has rendered existing infrastructure inadequate with periurban dwellers also lacking access to safe drinking water. Sanitation coverage is also poor. In urban areas only 58% of the population has access to improved sanitation facilities, and the rate in rural areas is 42%. Women and girls shoulder the largest burden in collecting water, 15% of urban and 18% rural populations use improved drinking water sources over 30 minutes away. Cameroon faces the following challenges in reaching the water and sanitation MDGs: poor management and development of the resources, coupled with inadequate political will and commitment for the long term; rapid urbanization; urban and rural poverty and regulation and legislative lapses. The authors propose that: bridging the gap between national water policies and water services; recognizing the role played by Civil Society Organizations (CSOs) in the attainment of MDGs; developing a Council Water Resource Management

Simulation of off-grid generation options for remote villages in Cameroon

International Nuclear Information System (INIS)

Nfah, E.M.; Ngundam, J.M.; Vandenbergh, M.; Schmid, J.

2008-01-01

Off-grid generation options have been simulated for remote villages in Cameroon using a load of 110 kWh/day and 12 kWp. The energy costs of proposed options were simulated using HOMER, a typical village load profile, the solar resource of Garoua and the flow of river Mungo. For a 40% increase in the cost of imported power system components, the cost of energy was found to be 0.296 EUR/kWh for a micro-hydro hybrid system comprising a 14 kW micro-hydro generator, a 15 kW LPG generator and 36 kWh of battery storage. The cost of energy for photovoltaic (PV) hybrid systems made up of an 18 kWp PV generator, a 15 kW LPG generator and 72 kWh of battery storage was also found to be 0.576 EUR/kWh for remote petrol price of 1 EUR/l and LPG price of 0.70 EUR/m 3 . The micro-hydro hybrid system proved to be the cheapest option for villages located in the southern parts of Cameroon with a flow rate of at least 200l/s, while the PV hybrid system was the cheapest option for villages in the northern parts of Cameroon with an insolation level of at least 5.55 kWh/m 2 /day. For a single-wire grid extension cost of 5000 EUR/km, operation and maintenance costs of 125 EUR/yr/km and a local grid power price of 0.1 EUR/kWh, the breakeven grid extension distances were found to be 15.4 km for micro-hydro/LPG generator systems and 37.4 km for PV/LPG generator systems respectively. These results could be used in Cameroon's National Energy Action Plan for the provision of energy services in the key sectors involved in the fight against poverty. (author)

78 FR 45208 - Children's Health Insurance Program (CHIP); Final Allotments to States, the District of Columbia...

Science.gov (United States)

2013-07-26

... 0938-AR79 Children's Health Insurance Program (CHIP); Final Allotments to States, the District of... and expand health insurance coverage to uninsured, low-income children under the Children's Health...). States may implement the Children's Health Insurance Program (CHIP) through a separate state program...

Implications of the Bakassi conflict resolution for Cameroon | Baye ...

African Journals Online (AJOL)

This paper sketches a conceptual framework of international conflict dynamics and resolution, examines the geopolitics of the Bakassi dispute between Nigeria and Cameroon, and outlines socio-economic implications of its peaceful settlement. Neglect and subsequent discovery of oil deposits subjected the Bakassi ...

The mount Cameroon height determined from ground gravity data ...

African Journals Online (AJOL)

Abstract This paper deals with the accurate determination of mount Cameroon orthometric height, by combining ground gravity data, global navigation satellite system (GNSS) observations and global geopotential models. The elevation of the highest point (Fako) is computed above the WGS84 reference ellipsoid.

Money Supply, Interest Rate, and Economic Growth in Cameroon: A ...

African Journals Online (AJOL)

Money Supply, Interest Rate, and Economic Growth in Cameroon: A Time Series ... the impacts of money and interest rate on economic growth and development. ... Money Supply, Interest Rates, Economic growth, Co-integration and Inflation.

Measuring unmet obstetric need at district level: how an epidemiological tool can affect health service organization and delivery.

Science.gov (United States)

Guindo, Gabriel; Dubourg, Dominique; Marchal, Bruno; Blaise, Pierre; De Brouwere, Vincent

2004-10-01

A national retrospective survey on the unmet need for major obstetric surgery using the Unmet Obstetric Need Approach was carried out in Mali in 1999. In Koutiala, the district health team decided to carry on the monitoring of the met need for several years in order to assess their progress over time. The first prospective study, for 1999, estimated that more than 100 women in need of obstetric care never reached the hospital and probably died as a consequence. This surprising result shocked the district health team and the resulting increased awareness of service deficits triggered operational measures to tackle the problem. The Unmet Obstetric Need study in Koutiala district was implemented without financial support and only limited external technical back-up. The appropriation of the study by the district team for solving local problems of access to obstetric care may have contributed to the success of the experience. Used as a health service management tool, the study and its results started a dialogue between the hospital staff and both health centre staff and community representatives. This had not only the effect of triggering consideration of coverage, but also of quality of obstetric care. Copyright 2004 Oxford University Press

A job analysis of selected health workers in a district health system in KwaZulu Natal - Part three: Other categories of health workers

Directory of Open Access Journals (Sweden)

B Groenewald

2003-09-01

Full Text Available This article described the third part of a study aimed at doing a job analysis of nurses and non-professional health workers in a district health system. This article describes the tasks of five categories of workers, their training and their work-load over an ordinary week.

77 FR 43290 - Children's Health Insurance Program (CHIP); Final Allotments to States, the District of Columbia...

Science.gov (United States)

2012-07-24

... 0938-AR45 Children's Health Insurance Program (CHIP); Final Allotments to States, the District of... and expand health insurance coverage to uninsured, low-income children under the Children's Health... under title XXI of the Social Security Act (the Act). States may implement Children's Health Insurance...

Health seeking behaviour and challenges in utilising health facilities in Wakiso district, Uganda.

Science.gov (United States)

Musoke, David; Boynton, Petra; Butler, Ceri; Musoke, Miph Boses

2014-12-01

The health seeking behaviour of a community determines how they use health services. Utilisation of health facilities can be influenced by the cost of services, distance to health facilities, cultural beliefs, level of education and health facility inadequacies such as stock-out of drugs. To assess the health seeking practices and challenges in utilising health facilities in a rural community in Wakiso district, Uganda. The study was a cross sectional survey that used a structured questionnaire to collect quantitative data among 234 participants. The sample size was obtained using the formula by Leslie Kish. While 89% of the participants were aware that mobile clinics existed in their community, only 28% had received such services in the past month. The majority of participants (84%) did not know whether community health workers existed in their community. The participants' health seeking behaviour the last time they were sick was associated with age (p = 0.028) and occupation (p = 0.009). The most significant challenges in utilising health services were regular stock-out of drugs, high cost of services and long distance to health facilities. There is potential to increase access to health care in rural areas by increasing the frequency of mobile clinic services and strengthening the community health worker strategy.

HIV/AIDS and older adults in Cameroon: Emerging issues and ...

African Journals Online (AJOL)

Perpetua Lum Tanyi

2018-02-06

Feb 6, 2018 ... ... social policy are discussed. Keywords: HIV/AIDS, older adults, African family, caregiving, Cameroon ...... and treatment that may be spread out over the full period of illness. ..... anxiety, relationships, grief, loss and addictions.

Gaps and gains from engaging districts stakeholders for community-based health professions education in Uganda: a qualitative study.

Science.gov (United States)

Okello, Elialilia S; Nankumbi, Joyce; Ruzaaza, Gad Ndaruhutse; Bakengesa, Evelyn; Gumikiriza, Joy; Arubaku, Wilfred; Acio, Christine; Samantha, Mary; Matte, Michael

2015-12-01

Community-based education research and service (COBERS) is a brand of community-based education that has been adopted by the Medical Education and Service for All Ugandans consortium. The COBERS programme is aimed at equipping students in health professional education with the knowledge, attitudes and skills required to provide appropriate health care services. For sustainability purposes, the health professional training institutions have made efforts to involve various stakeholders in the implementation of the programme. However, the actual engagement process and outcome of such efforts have not been documented. This paper documents gaps and gains made in engaging district stakeholders for community-based education. Key informant interviews, focus group discussions and document review were used to collect data. Atlas.ti, computer software for qualitative data was used to aid analysis. The analysis revealed that the adopted engagement model has registered some gains including increased awareness among district leaders about potential opportunities offered by COBERS such as boosting of human resources at health facilities, opportunities for professional development for health care workers at health facilities, and establishment of linkages between prospective employees and employers. However, the engagement model left some gaps in terms of knowledge, awareness and ownership of the programme among some sections of stakeholders. The apparent information gap about the programme among district stakeholders, especially the political leadership, may hinder concerted partnership. The findings highlight the need for health professional education institutions to broaden the scope of actively engaged stakeholders with the district level.

District-level variations in childhood immunizations in India: The role of socio-economic factors and health infrastructure.

Science.gov (United States)

Rammohan, Anu; Awofeso, Niyi

2015-11-01

Routine childhood immunizations against measles and DPT are part of the World Health Organization's (WHO) Expanded Program on Immunization (EPI) set up in 1974, with the aim of reducing childhood morbidity and mortality. Despite this, immunization rates are sub-optimal in developing countries such as India, with wide heterogeneity observed across districts and socio-economic characteristics. The aim of this paper is to examine district-level variations in the propensity to vaccinate a child in India for measles and DPT3, and analyse the extent to which these immunizations are given age-inappropriately, either prematurely or delayed. The present study uses data from the Indian District Level Household Survey (DLHS-3) collected in 2008, and the final sample contains detailed information on 42157 children aged between 12 and 60 months, across 549 Indian districts for whom we have complete information on immunization history. Our empirical study analyses: (i) the district-level average immunization rates for measles and DPT3, and (ii) the extent to which these immunizations have been given age-appropriately. A key contribution of this paper is that we link the household-level data at the district level to data on availability and proximity to health infrastructure and district-level socio-economic factors. Our results show that after controlling for an array of socio-economic characteristics, across all our models, the district's income per capita is a strong predictor of better immunization outcomes for children. Mother's education level at the district-level has a statistically significant and positive influence on immunization outcomes across all our models. Copyright © 2015 Elsevier Ltd. All rights reserved.

The path dependence of district manager decision-space in Ghana

Science.gov (United States)

Kwamie, Aku; van Dijk, Han; Ansah, Evelyn K; Agyepong, Irene Akua

2016-01-01

The district health system in Ghana today is characterized by high resource-uncertainty and narrow decision-space. This article builds a theory-driven historical case study to describe the influence of path-dependent administrative, fiscal and political decentralization processes on development of the district health system and district manager decision-space. Methods included a non-exhaustive literature review of democratic governance in Ghana, and key informant interviews with high-level health system officials integral to the development of the district health system. Through our analysis we identified four periods of district health system progression: (1) development of the district health system (1970–85); (2) Strengthening District Health Systems Initiative (1986–93); (3) health sector reform planning and creation of the Ghana Health Service (1994–96) and (4) health sector reform implementation (1997–2007). It was observed that district manager decision-space steadily widened during periods (1) and (2), due to increases in managerial profile, and concerted efforts at managerial capacity strengthening. Periods (3) and (4) saw initial augmentation of district health system financing, further widening managerial decision-space. However, the latter half of period 4 witnessed district manager decision-space contraction. Formalization of Ghana Health Service structures influenced by self-reinforcing tendencies towards centralized decision-making, national and donor shifts in health sector financing, and changes in key policy actors all worked to the detriment of the district health system, reversing early gains from bottom-up development of the district health system. Policy feedback mechanisms have been influenced by historical and contemporary sequencing of local government and health sector decentralization. An initial act of administrative decentralization, followed by incomplete political and fiscal decentralization has ensured that the balance of

The path dependence of district manager decision-space in Ghana.

Science.gov (United States)

Kwamie, Aku; van Dijk, Han; Ansah, Evelyn K; Agyepong, Irene Akua

2016-04-01

The district health system in Ghana today is characterized by high resource-uncertainty and narrow decision-space. This article builds a theory-driven historical case study to describe the influence of path-dependent administrative, fiscal and political decentralization processes on development of the district health system and district manager decision-space. Methods included a non-exhaustive literature review of democratic governance in Ghana, and key informant interviews with high-level health system officials integral to the development of the district health system. Through our analysis we identified four periods of district health system progression: (1) development of the district health system (1970-85); (2) Strengthening District Health Systems Initiative (1986-93); (3) health sector reform planning and creation of the Ghana Health Service (1994-96) and (4) health sector reform implementation (1997-2007). It was observed that district manager decision-space steadily widened during periods (1) and (2), due to increases in managerial profile, and concerted efforts at managerial capacity strengthening. Periods (3) and (4) saw initial augmentation of district health system financing, further widening managerial decision-space. However, the latter half of period 4 witnessed district manager decision-space contraction. Formalization of Ghana Health Service structures influenced by self-reinforcing tendencies towards centralized decision-making, national and donor shifts in health sector financing, and changes in key policy actors all worked to the detriment of the district health system, reversing early gains from bottom-up development of the district health system. Policy feedback mechanisms have been influenced by historical and contemporary sequencing of local government and health sector decentralization. An initial act of administrative decentralization, followed by incomplete political and fiscal decentralization has ensured that the balance of power has

Risk factors analysis and implications for public health of bovine ...

African Journals Online (AJOL)

Bovine tuberculosis (TB) is a neglected zoonosis of cattle that is prevalent but under-investigated in Cameroon. Based on epidemiological data of the disease, this study was designed to assess the risks and public health implications for zoonotic M. bovis infection in cattle and humans in the highlands of Cameroon.

New attitudes key to progress in Malawi, Cameroon | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

2011-11-08

Nov 8, 2011 ... New attitudes key to progress in Malawi, Cameroon ... in Malawi — good laws protecting women's rights — but they are not working. Why? ... Colonial rule — first by the Germans and later the French and British — brought in a ...

Floodplain rehabilitation in North Cameroon: impact on vegetation dynamics

NARCIS (Netherlands)

Scholte, P.; Kirda, P.; Adam, S.; Kadiri, B.

2000-01-01

Since the construction in 1979 of a dam in the Logone floodplain in the Sahelo-Sudanian zone of Cameroon, annual inundations have decreased, reducing perennial vegetation as important grazing source for nomadic herds and wildlife during the dry season. Presently, possibilities exist to release

Genetic structure of the tiger mosquito, Aedes albopictus, in Cameroon (Central Africa.

Directory of Open Access Journals (Sweden)

Basile Kamgang

Full Text Available Aedes albopictus (Skuse, 1884 (Diptera: Culicidae, a mosquito native to Asia, has recently invaded all five continents. In Central Africa it was first reported in the early 2000s, and has since been implicated in the emergence of arboviruses such as dengue and chikungunya in this region. Recent genetic studies of invasive species have shown that multiple introductions are a key factor for successful expansion in new areas. As a result, phenotypic characters such as vector competence and insecticide susceptibility may vary within invasive pest species, potentially affecting vector efficiency and pest management. Here we assessed the genetic variability and population genetics of Ae. albopictus isolates in Cameroon (Central Africa, thereby deducing their likely geographic origin.Mosquitoes were sampled in 2007 in 12 localities in southern Cameroon and analyzed for polymorphism at six microsatellite loci and in two mitochondrial DNA regions (ND5 and COI. All the microsatellite markers were successfully amplified and were polymorphic, showing moderate genetic structureamong geographic populations (F(ST  = 0.068, P < 0.0001. Analysis of mtDNA sequences revealed four haplotypes each for the COI and ND5 genes, with a dominant haplotype shared by all Cameroonian samples. The weak genetic variation estimated from the mtDNA genes is consistent with the recent arrival of Ae. albopictus in Cameroon. Phylogeographic analysis based on COI polymorphism indicated that Ae. albopictus populations from Cameroon are related to tropical rather than temperate or subtropical outgroups.The moderate genetic diversity observed among Cameroonian Ae. albopictus isolates is in keeping with recent introduction and spread in this country. The genetic structure of natural populations points to multiple introductions from tropical regions.

Seroprevalence of Human Herpesvirus-8 in HIV-1 Infected and Uninfected Individuals in Cameroon

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Owen Wood

2013-09-01

Full Text Available We evaluated the prevalence of HHV-8 antibodies in 516 plasma samples collected from HIV positive and negative patients from blood banks and urban areas of Cameroon. Among HIV-1 positive samples, HHV-8 seropositivity rate was 61% based on combined reactivity using both ELISA and IFA techniques. HIV negative samples showed 62% seropositivity rate for HHV-8 antibodies. Our results indicate a high HHV-8 prevalence rate in both HIV infected and uninfected individuals in Cameroon.

DOT for patients with limited access to health care facilities in a hill district of eastern Nepal.

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Wares, D F; Akhtar, M; Singh, S

2001-08-01

The hill district in Nepal, where access to health care facilities is difficult. To compare results before and after a decentralised directly observed treatment (DOT) intervention. Prospective study of patients registered in Dhankuta district, Nepal, 1996-1999. Patients received their intensive phase treatment under health worker supervision via one of three DOT options: 1) ambulatory from the peripheral government health facilities; 2) ambulatory from an international non-governmental organisation (INGO) TB clinic in district centre; or 3) resident in INGO TB hostel in district centre. Historical data from 1995-1996, with unsupervised short-course chemotherapy, were used for comparison. Of 307 new cases, respectively 126 (41%), 86 (28%) and 95 (31%) took their intensive phase treatment via options 1, 2 and 3. Smear conversion (at 2 months) and cure rates in new smear-positive pulmonary tuberculosis cases were respectively 81.6% (vs. 58.8% historical, P = 0.001) and 84.9% (vs. 76.7% historical, P = 0.03). Overall costs to the INGO provider fell by 7%, mainly as a result of staffing reductions in the INGO services made possible by rationalisation with government services during the intervention. By offering varied DOT delivery routes, including an in-patient option, satisfactory results are possible with DOT even in areas where access to health care facilities is difficult. Provision of in-patient care via an INGO TB hostel allowed a significant proportion of new cases (31%) to receive their intensive phase treatment who otherwise may have had difficulty accessing treatment, due either to the distance to the nearest health facility or to disease severity. Substitution of government hospital beds or local hotel beds for the INGO hostel beds may allow the model to be reproduced elsewhere in similar geographical conditions in Nepal, but further studies should be performed in a non-INGO supported district beforehand.

Assessment of the Ehlanzeni District health transport and logistics function: Enhancing rural healthcare delivery systems

CSIR Research Space (South Africa)

Mashiri, MAM

2009-07-01

Full Text Available This paper seeks to establish a baseline against which to assess the impacts of the ‘Ehlanzeni District Health Transport Function’ for the district’s healthcare service delivery output, and by extension, health and welfare outcomes. The main...

Origin and evolution of primitive melts from the Debunscha Maar, Cameroon: Consequences for mantle source heterogeneity within the Cameroon Volcanic Line

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Ngwa, Caroline N.; Hansteen, Thor H.; Devey, Colin W.; van der Zwan, Froukje M.; Suh, Cheo E.

2017-09-01

Debunscha Maar is a monogenetic volcano forming part of the Mt. Cameroon volcanic field, located within the Cameroon Volcanic Line (CVL). Partly glassy cauliflower bombs have primitive basanite-picrobasalt compositions and contain abundant normally and reversely zoned olivine (Fo 77-87) and clinopyroxene phenocrysts. Naturally quenched melt inclusions in the most primitive olivine phenocrysts show compositions which, when corrected for post-entrapment modification, cover a wide range from basanite to alkali basalt (MgO 6.9-11.7 wt%), and are generally more primitive than the matrix glasses (MgO 5.0-5.5 wt%) and only partly fall on a common liquid line of descent with the bulk rock samples and matrix glasses. Melt inclusion trace element compositions lie on two distinct geochemical trends: one (towards high Ba/Nb) is thought to represent the effect of various proportions of anhydrous lherzolite and amphibole-bearing peridotite in the source, while the other (for example, high La/Y) reflects variable degrees of partial melting. Comparatively low fractionation-corrected CaO in the melt inclusions with the highest La/Y suggests minor involvement of a pyroxenite source component that is only visible at low degrees of melting. Most of the samples show elevated Gd/Yb, indicating up to 8% garnet in the source. The range of major and trace elements represented by the melt inclusions covers the complete geochemical range given by basalts from different volcanoes of the Cameroon volcanic line, indicating that geochemical signatures that were previously thought to be volcano-specific in fact are probably present under all volcanoes. Clinopyroxene-melt barometry strongly indicates repeated mixing of compositionally diverse melts within the upper mantle at 830 ± 170 MPa prior to eruption. Mantle potential temperatures estimated for the primitive melt inclusions suggest that the thermal influence of a mantle plume is not required to explain the magma petrogenesis.

Indian public health standards in primary health centers and community health centers in Shimla District of Himachal Pradesh: A descriptive evaluation

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Raman Chauhan

2016-01-01

Full Text Available Introduction: The health planners in India have visualized primary health centers (PHCs and community health centers (CHCs as the key healthcare delivery institutions in rural areas. These centers are supposed to have health manpower, infrastructure, and service delivery as per the Indian public health standards (IPHS guidelines (2010. Materials and Methods: A cross-sectional study was conducted in seven CHCs and 12 PHCs, randomly selected from eight blocks of Shimla District and evaluated in terms of health manpower, infrastructure, and services from September 2011 to August 2012. Data was collected from the selected units using structured data collection instruments designed by the IPHS. Results: The health centers were assessed according to IPHS guidelines. Outpatient department services and referral services were provided in all the centers studied. No specialist doctor was posted at any of CHCs against a sanctioned strength of at least four (surgeon, physician, obstetrician, and pediatrician per CHC. In 3 (42.8% CHCs and 8 (75% PHCs, no pharmacist was posted. Eight (75% PHCs did not have any staff nurse posted. Three (42.8% CHCs and 10 (83.3% PHCs did not have a laboratory technician. In CHCs, separate labor room was available in 6 (85.7% whereas a separate laboratory was available in all seven. Separate labor room and laboratory were available in four (25% PHCs. Conclusions: IPHS guidelines are not being followed at PHC and CHC levels of the district. Health manpower shortage is the key bottleneck in service delivery. Political advocacy is needed to ensure sufficient health manpower availability to deliver quality healthcare.

Household-level Social Capital in Cameroon and Children's Schooling

African Journals Online (AJOL)

This article examines household-level social capital as a determinant of children's schooling using a cross-sectional data of the 2001 Cameroon Household Survey. Reduced form demand equations of schooling for the entire sample, male and female children are estimated separately. Results indicate that parent's ...

Comparison of bacterial communities of tilapia fish from Cameroon ...

African Journals Online (AJOL)

Comparison of bacterial communities of tilapia fish from Cameroon and Vietnam using PCR-DGGE (polymerase chain reaction-denaturing gradient gel electrophoresis) ... The different PCR-DGGE 16S rDNA banding profiles obtained were analysed and results showed that there were specific bands for each geographical ...

Differences in Food and Beverage Marketing Policies and Practices in US School Districts, by Demographic Characteristics of School Districts, 2012.

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Merlo, Caitlin L; Michael, Shannon; Brener, Nancy D; Coffield, Edward; Kingsley, Beverly S; Zytnick, Deena; Blanck, Heidi

2016-12-15

Foods and beverages marketed in schools are typically of poor nutritional value. School districts may adopt policies and practices to restrict marketing of unhealthful foods and to promote healthful choices. Students' exposure to marketing practices differ by school demographics, but these differences have not yet been examined by district characteristics. We analyzed data from the 2012 School Health Policies and Practices Study to examine how food and beverage marketing and promotion policies and practices varied by district characteristics such as metropolitan status, size, and percentage of non-Hispanic white students. Most practices varied significantly by district size: a higher percentage of large districts than small or medium-sized districts restricted marketing of unhealthful foods and promoted healthful options. Compared with districts whose student populations were majority (>50%) non-Hispanic white, a higher percentage of districts whose student populations were minority non-Hispanic white (≤50% non-Hispanic white) prohibited advertising of soft drinks in school buildings and on school grounds, made school meal menus available to students, and provided families with information on school nutrition programs. Compared with suburban and rural districts, a higher percentage of urban districts prohibited the sale of soft drinks on school grounds and used several practices to promote healthful options. Preliminary findings showing significant associations between district demographics and marketing policies and practices can be used to help states direct resources, training, and technical assistance to address food and beverage marketing and promotion to districts most in need of improvement.

Assessing the implementation of the family care team in the district health system of health region 2, Thailand

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Nithra Kitreerawutiwong

2018-02-01

Full Text Available Background: The family care team (FCT was established to improve the quality of care. This study aimed to explore the perceptions of FCT implementation and describe the challenges inherent in implementing the FCT. Methods: Forty in-depth interviews were conducted. The interviewees consisted of five primary care managers in the provincial medical health office, five directors of community hospitals, five administrators in district health offices, ten subdistrict health-promoting hospital directors, representatives from ten local organizations, and five heads of village health volunteers. Data were collected in accordance with semistructured interview guidelines and analyzed by thematic analysis. Results: Participants’ expressed their opinions through five themes: (1 the role and scope of practice, (2 the communication in collaboration of the FCT, (3 the management of the FCT, (4 the impact of the FCT on the team members’ feelings and primary care performance, and (5 the main challenges, including the insufficiency of a teamwork culture and a biomedical approach. Conclusion: The information suggests the importance of issues such as the clarification of the team members’ roles and managers’ roles, communication within and across FCTs, and the preparation for training of interprofessionals to enhance collaborative management to achieve the optimal care for people in the district health system.

Evaluation of Maternal Health Component of Reproductive and Child Health (RCH II Programme in Beed District, Maharashtra, India 2013

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Dnyaneshwar Nipte,

2015-04-01

Full Text Available Introduction: Situation analysis of Reproductive and Child Health programme of Government of India in Beed district of Maharashtra state in India indicated lack of achievement of targeted maternal health indicators. Evaluation of the utilization of maternal health services component of Reproductive and Child Health (RCH II programme in Beed district of Maharashtra state in India was undertaken. Material and Methods: A cross sectional survey in the rural area of Beed district using cluster sampling method was conducted. The information about the utilization of maternal health services was collected from mothers who delivered between 1st April and 30th June 2013. A facility survey using pre tested check list was undertaken. Analysis of the data using Epi Info Version 3.5.3 and proportion for selected maternal health care indicators were calculated. Results: Out of the 374 mothers included in the study, 122 (33.0% had registered within first trimester of pregnancy; nearly 50% had received more than three antenatal care (ANC visits and 90% had institutional delivery. Of the 70 mothers, who made phone call for ambulance service, 56 (80% utilized ambulance from their residence to the hospitals. Of the 183 mothers who delivered in Government hospitals, 103 (56.3% utilized it to reach home from hospitals after delivery. Of the eligible women, 96 (76.2% were registered for Janani Suraksha Yojana (JSY scheme of the Government and 67 (69.8% received the benefit. In all 46 (16.4% Auxiliary Nurse Midwives (ANMs were trained as Skilled Birth Attendant (SBA. Of the 22 facilities, 14 (63.6% had delivery kits and in 6 (27.3% facilities maternal health services were monitored by medical officers. Conclusion: The utilization of maternal health care services and knowledge and implementation regarding JSY Scheme and ambulance service utilization among mothers was less than desirable. The coverage of training of ANMs as SBA was low. Provision of antenatal services in

Shortcomings in snake bite management in rural Cameroon: a case report.

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Tianyi, Frank-Leonel; Dimala, Christian Akem; Feteh, Vitalis Fambombi

2017-06-08

Snake bites are an important public health problem in developing countries with most bites occurring in rural areas. Severe envenomation often occurs in children and following bites to the face. Prompt administration of potent anti-venom remains the mainstay of management. However in Cameroon, the use of anti-venoms is limited by non-availability, high cost (where available) and poor mastery of treatment guidelines. We present a 10-year-old muslim Cameroonian child from an enclaved rural area, brought to the hospital 12 h after a snake bite to the face, with signs of severe envenomation. Despite the suboptimal anti-venom dose administered to this patient due to a stock out of this medication, supportive therapy was beneficial in ensuring a positive outcome and satisfactory recovery. This highlights snake bites as a public health problem due to the lack of snake anti-venoms in peripheral health facilities, rendering them unable to appropriately manage these cases. National health policies should encourage constant peripheral availability of anti-venoms and the institution of an intervention package for snake bite management, comprising: treatment protocol, staff training, monitoring of compliance and community education to help reduce the mortality and morbidity from snake bites.

HIV/AIDS in Cameroon: Rising gender issues in policy-making ...

African Journals Online (AJOL)

kemrilib

The review found that in Cameroon women were at increased risk of being infected with HIV/AIDS ... the high prevalence of HIV/AIDS among women. However ...... (Assessed 10 March 2006). 2. .... Prevention. Washington DC 1999: pp 1-7. 45.

The role of the Association of Cameroon Accountants as a ...

African Journals Online (AJOL)

ONECCA); as a regulatory body for the accounting profession in Cameroon. The data collected have been used to carefully assess the effectiveness of the accounting institution, as a regulatory body. The data reveals the extent to which effective ...

Analysis of Cameroon newspaper coverage of cross border conflicts

African Journals Online (AJOL)

Nexus of conflict reporting: Analysis of Cameroon newspaper coverage of cross ... The conflicts taking place in the Central African Republic, Chad, Nigeria and Gabon have raised ... Consequently, it is in the interest of the public .... of Humanitarian Affairs (OCHA, 2014), ... As what concerns the case of Nigeria, UNHCR.

THE EFFECTS OF A DONOR SUPPORT ON DISTRICT HEALTH SERVICE UTILIZATION IN ENUGU STATE, NIGERIA

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2016-11-01

Full Text Available Health outcomes are poor in the developing world, hence donor organizations usually support health care delivery system of developing countries. In 2005, Enugu State commenced implementation of District Health System with a unitarised healthcare delivery structure. The aim of this study is to evaluate the effect of the PATHS programme (DFID support on the District Health service utilization in Enugu State. Seventy seven supported public primary health care facilities constituted the study population, while same number of non-supported ones were selected randomly as the control health facilities. Retrospective Intervention study technique was used. The study period was the last six months of the PATHS programme in the state (January to June, 2008. The study revealed among other findings that the support by DFID to Enugu State health sector through the PATHS programme resulted in significant increase in district health service utilization, as demonstrated in increased outpatient attendance from 15052 to 73336 (percentage increase of 387.22%, Chi square = 279.11, P and lt;0.0001 and delivery of babies from 647 to 1052 (percentage increase of 62.60%, Chi square = 32.08, P and lt;0.0001 in the supported health facilities. For control facilities, outpatient attendance increased from 8216 to 35126 (percentage increase of 327.50%, Chi square of 233.76, P and lt; 0.0001 and delivery from 370 to 441 (percentage increase of 19.19%, Chi square = 4.60, P and lt;0.47. The difference between the study and control facilities\\' outpatient attendance became wider after the intervention. The out-patient attendance increased significantly in both the study and control facilities after the intervention. Deliveries increased significantly in the supported facilities, while the increase in the control facilities was not significant.

A familial study of Hallermann–Streiff–François syndrome

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Epée E

2017-06-01

Full Text Available E Epée,1 D Beleho,2 AT Bitang,3 VA Njami,4 C Bengondo,5 Côme Ebana Mvogo1 1Ophthalmology Department, Yaoundé University Teaching Hospital, Yaoundé, Cameroon; 2Ophthalmology Department, Okola District Hospital, Okola, Cameroon; 3Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon; 4Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon; 5Stomatology Department, Yaoundé University Teaching Hospital, Yaoundé, Cameroon Abstract: Hallermann–Streiff–François syndrome is a rare sporadic genetic pathology characterized by a phenotype consisting of growth retardation, ocular abnormalities, and a “bird-like head”. We hereby report a case of this syndrome found in three generations of the same family – father, daughter, and grand-daughter – who presented with a short stature and facial dysmorphic features, nystagmus, cataract, and bilateral microphthalmia. The discussion is based on the clinical and genetic aspects, and the challenges in management of this oculo-mandibulo-facial syndrome. The association of congenital cataract, facial dysmorphic features, and microphthalmia, should guide the diagnosis of dysmorphic syndromes such as Hallermann–Streiff–François syndrome. Keywords: Hallermann–Streiff–François syndrome, familial cataract, dysmorphic features, rare, Cameroon

An implementation evaluation of a policy aiming to improve financial access to maternal health care in Djibo district, Burkina Faso.

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Belaid, Loubna; Ridde, Valéry

2012-12-08

To bring down its high maternal mortality ratio, Burkina Faso adopted a national health policy in 2007 that designed to boost the assisted delivery rate and improving quality of emergency obstetrical and neonatal care. The cost of transportation from health centres to district hospitals is paid by the policy. The worst-off are exempted from all fees. The objectives of this paper are to analyze perceptions of this policy by health workers, assess how this health policy was implemented at the district level, identify difficulties faced during implementation, and highlight interactional factors that have an influence on the implementation process. A multiple site case study was conducted at 6 health centres in the district of Djibo in Burkina Faso. The following sources of data were used: 1) district documents (n = 23); 2) key interviews with district health managers (n = 10), health workers (n = 16), traditional birth attendants (n = 7), and community management committees (n = 11); 3) non-participant observations in health centres; 4) focus groups in communities (n = 62); 5) a feedback session on the findings with 20 health staff members. All the activities were implemented as planned except for completely subsidizing the worst-off, and some activities such as surveys for patients and the quality assurance service team aiming to improve quality of care. District health managers and health workers perceived difficulties in implementing this policy because of the lack of clarity on some topics in the guidelines. Entering the data into an electronic database and the long delay in reimbursing transportation costs were the principal challenges perceived by implementers. Interactional factors such as relations between providers and patients and between health workers and communities were raised. These factors have an influence on the implementation process. Strained relations between the groups involved may reduce the effectiveness of the policy

An implementation evaluation of a policy aiming to improve financial access to maternal health care in Djibo district, Burkina Faso

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Belaid Loubna

2012-12-01

Full Text Available Abstract Background To bring down its high maternal mortality ratio, Burkina Faso adopted a national health policy in 2007 that designed to boost the assisted delivery rate and improving quality of emergency obstetrical and neonatal care. The cost of transportation from health centres to district hospitals is paid by the policy. The worst-off are exempted from all fees. Methods The objectives of this paper are to analyze perceptions of this policy by health workers, assess how this health policy was implemented at the district level, identify difficulties faced during implementation, and highlight interactional factors that have an influence on the implementation process. A multiple site case study was conducted at 6 health centres in the district of Djibo in Burkina Faso. The following sources of data were used: 1 district documents (n = 23; 2 key interviews with district health managers (n = 10, health workers (n = 16, traditional birth attendants (n = 7, and community management committees (n = 11; 3 non-participant observations in health centres; 4 focus groups in communities (n = 62; 5 a feedback session on the findings with 20 health staff members. Results All the activities were implemented as planned except for completely subsidizing the worst-off, and some activities such as surveys for patients and the quality assurance service team aiming to improve quality of care. District health managers and health workers perceived difficulties in implementing this policy because of the lack of clarity on some topics in the guidelines. Entering the data into an electronic database and the long delay in reimbursing transportation costs were the principal challenges perceived by implementers. Interactional factors such as relations between providers and patients and between health workers and communities were raised. These factors have an influence on the implementation process. Strained relations between the groups involved

Measles outbreak in a poorly vaccinated region in Cameroon: a ...

African Journals Online (AJOL)

preventable deaths in Africa; especially in unvaccinated populations. We reviewed the medical reports of the measles outbreak that occurred in Misaje, in the North west region of Cameroon from 11/03/2015 to 14/05/2015. Six measles cases ...

Improving quality of reproductive health care in Senegal through formative supervision: results from four districts.

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Suh, Siri; Moreira, Philippe; Ly, Moussa

2007-11-29

In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. The most notable improvement across regions was in infection prevention.Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality.

Improving quality of reproductive health care in Senegal through formative supervision: results from four districts

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Moreira Philippe

2007-11-01

Full Text Available Abstract Background In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers' competence. In response to this challenge, Management Sciences for Health (MSH has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. Methods This study evaluated changes in service quality and community involvement after two rounds of supervision in 45 health facilities in four districts of Senegal. We used checklists to assess quality in four areas of service delivery: infrastructure, staff and services management, record-keeping, and technical competence. We also measured community involvement in improving service quality using the completion rates of action plans. Results The most notable improvement across regions was in infection prevention. Management of staff, services, and logistics also consistently improved across the four districts. Record-keeping skills showed variable but lower improvement by region. The completion rates of action plans suggest that communities are engaged in improving service quality in all four districts. Conclusion Formative supervision can improve the quality of reproductive health services, especially in areas where there is on-site skill building and refresher training. This approach can also mobilize communities to participate in improving service quality.

The perceptions of nurses in a district health system in KwaZulu-Natal of their supervision, self-esteem and job satisfaction

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L.R. Uys

2004-09-01

Full Text Available Supervision has been identified as a major issue in quality of care. Although increasing attention is being given to supervision in the District Health System, there have been no studies describing the current situation. This article describes a survey done in two health districts in KwaZulu-Natal involving 319 nurses from all types of government health care settings.

Differences in Food and Beverage Marketing Policies and Practices in US School Districts, by Demographic Characteristics of School Districts, 2012

Science.gov (United States)

Michael, Shannon; Brener, Nancy D.; Coffield, Edward; Kingsley, Beverly S.; Zytnick, Deena; Blanck, Heidi

2016-01-01

Introduction Foods and beverages marketed in schools are typically of poor nutritional value. School districts may adopt policies and practices to restrict marketing of unhealthful foods and to promote healthful choices. Students’ exposure to marketing practices differ by school demographics, but these differences have not yet been examined by district characteristics. Methods We analyzed data from the 2012 School Health Policies and Practices Study to examine how food and beverage marketing and promotion policies and practices varied by district characteristics such as metropolitan status, size, and percentage of non-Hispanic white students. Results Most practices varied significantly by district size: a higher percentage of large districts than small or medium-sized districts restricted marketing of unhealthful foods and promoted healthful options. Compared with districts whose student populations were majority (>50%) non-Hispanic white, a higher percentage of districts whose student populations were minority non-Hispanic white (≤50% non-Hispanic white) prohibited advertising of soft drinks in school buildings and on school grounds, made school meal menus available to students, and provided families with information on school nutrition programs. Compared with suburban and rural districts, a higher percentage of urban districts prohibited the sale of soft drinks on school grounds and used several practices to promote healthful options. Conclusion Preliminary findings showing significant associations between district demographics and marketing policies and practices can be used to help states direct resources, training, and technical assistance to address food and beverage marketing and promotion to districts most in need of improvement. PMID:27978408

Hzard and risk assessment of pollution on the groundwater resources and residents’ health of Salfit District, Palestine

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Amjad Aliewi

2015-09-01

New hydrological insights for the region: There are many pollutants in the Salfit's aquifer recharge area and thus percolating and polluting the groundwater aquifers. Using a Durov diagram, the sources of water proved to be polluted and, therefore, the health of the residents of Salfit District is directly threatened. A hazard map was developed to classify all polluting activities in the district. Microbiological analysis of the drinking water revealed higher levels of total and fecal Coliforms. The high incidence rate of water related diseases is an indication of the drinking water pollution. This paper contains research findings and policy recommendations to help Salfit District alleviate health and pollution problems associated with this vital resource of groundwater. In addition, Salfit governorate is encouraged to begin addressing the institutional issues and improving public awareness.

Smoke-Free Worksites and Public Spaces in Cameroon | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

Smoke-Free Worksites and Public Spaces in Cameroon. Existing data indicate a tobacco epidemic of the first order in Africa, but the rapid increase in tobacco consumption continues. This situation justifies the current project by Research for International Tobacco Control (RITC), an initiative of IDRC and the Bill and Melinda ...

DRUG MANAGEMENT REVIEWS IN DISTRICT DRUG MANAGEMENT UNIT AND GENERAL HOSPITAL

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Max Joseph Herman

2009-12-01

Full Text Available Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following thedecentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had no been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years.

Pneumocystis jirovecii colonisation in HIV-positive and HIV-negative subjects in Cameroon.

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Riebold, D; Enoh, D O; Kinge, T N; Akam, W; Bumah, M K; Russow, K; Klammt, S; Loebermann, M; Fritzsche, C; Eyong, J E; Eppel, G; Kundt, G; Hemmer, C J; Reisinger, E C

2014-06-01

To determine the prevalence of Pneumocystis pneumonia (PCP), a major opportunistic infection in AIDS patients in Europe and the USA, in Cameroon. Induced sputum samples from 237 patients without pulmonary symptoms (126 HIV-positive and 111 HIV-negative outpatients) treated at a regional hospital in Cameroon were examined for the prevalence of Pneumocystis jirovecii by specific nested polymerase chain reaction (nPCR) and staining methods. CD 4 counts and the history of antiretroviral therapy of the subjects were obtained through the ESOPE database system. Seventy-five of 237 study participants (31.6%) were colonised with Pneumocystis, but none showed active PCP. The Pneumocystis colonisation rate in HIV-positive subjects was more than double that of HIV-negative subjects (42.9% vs. 18.9%, P 500 cells/μl were colonised at a rate of 20.0%, subjects with CD 4 counts between 200 and 500 cells/μl of 42.5%, and subjects with CD 4 counts <200 cells/μl of 57.1%. Colonisation with Pneumocystis in Cameroon seems to be comparable to rates found in Western Europe. Prophylactic and therapeutic measures against Pneumocystis should be taken into account in HIV care in western Africa. © 2014 John Wiley & Sons Ltd.

Health Care Reform Bureaucracy In The District Merauke In Perspective Agency Theory

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Samel W. Ririhena

2015-04-01

Full Text Available Abstract Reforms are demands to improve services especially health services to the community in Merauke. The purpose of writing is to analyze the theory of agency in order to verify the health care bureaucracy reformas Merauke district which includes reform of the bureaucracy adverse selection and moral hazard. This study used a qualitative approach and data collection is done by using interviews and intervieuw based on interactive model of Milles and Huberman. The results showed that the reform of health care bureaucracy in Merauke not running optimally and the problem of adverse selection and moral hazard is still happening in the agency relationship between the Department of Health and the Health Center.

Nutritional composition, bioactive compounds and volatile profile of cocoa beans from different regions of Cameroon.

Science.gov (United States)

Caprioli, Giovanni; Fiorini, Dennis; Maggi, Filippo; Nicoletti, Marcello; Ricciutelli, Massimo; Toniolo, Chiara; Prosper, Biapa; Vittori, Sauro; Sagratini, Gianni

2016-06-01

Analysis of the complex composition of cocoa beans provides fundamental information for evaluating the quality and nutritional aspects of cocoa-based food products, nutraceuticals and supplements. Cameroon, the world's fourth largest producer of cocoa, has been defined as "Africa in miniature" because of the variety it habitats. In order to evaluate the nutritional characteristics of cocoa beans from five different regions of Cameroon, we studied their polyphenolic content, volatile compounds and fatty acids composition. The High Performance Thin Layer Chromatography (HPTLC) analysis showed that the Mbalmayo sample had the highest content of theobromine (11.6 mg/g) and caffeic acid (2.1 mg/g), while the Sanchou sample had the highest level of (-)-epicatechin (142.9 mg/g). Concerning fatty acids, the lowest level of stearic acid was found in the Mbalmayo sample while the Bertoua sample showed the highest content of oleic acid. Thus, we confirmed that geographical origin influences the quality and nutritional characteristics of cocoa from these regions of Cameroon.

Does malaria epidemiology project Cameroon as `Africa in miniature'?

Indian Academy of Sciences (India)

Cameroon, a west-central African country with a ∼20 million population, is commonly regarded as 'Africa in miniature' due to the extensive biological and cultural diversities of whole Africa being present in a single-country setting. This country is inhabited by ancestral human lineages in unique eco-climatic conditions and ...

Molecular characterization and phylogenetic relatedness of dog-derived Rabies Viruses circulating in Cameroon between 2010 and 2016.

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Serge Alain Sadeuh-Mba

2017-10-01

Full Text Available Rabies is enzootic among dog populations in some parts of Cameroon and the risk of human rabies is thought to be steadily high in these regions. However, the molecular epidemiology of circulating Rabies Virus (RABV has been hardly considered in Cameroon as well as in most neighboring central African countries. To address this fundamental gap, 76 nucleoprotein (N gene sequences of dog-derived RABV were obtained from 100 brain specimens sampled in Cameroon from 2010 to 2016. Studied sequences were subjected to molecular and phylogenetic analyses with reference strains retrieved from databases. The 71 studied Africa-1 isolates displayed 93.5-100% nucleotide (nt and 98.3-100% amino-acid (aa identities to each other while, the 5 studied Africa-2 isolates shared 99.4-99.7% sequence similarities at nt and aa levels. Maximum Likelihood based phylogenies inferred from nucleotide sequences confirmed all studied RABV isolates as members of the dog-related species 1 of the Lyssavirus genus. Individual isolates could be unambiguously assigned as either the Africa-1 subclade of the Cosmopolitan clade or the Africa 2 clade. The Africa-1 subclade appeared to be more prevalent and diversified. Indeed, 70 studied isolates segregated into 3 distinct circulating variants within Africa-1a lineage while a unique isolate was strikingly related to the Africa-1b lineage known to be prevalent in the neighboring Central African Republic and eastern Africa. Interestingly, all five Africa-2 isolates fell into the group-E lineage even though they appeared to be loosely related to databases available reference RABV; including those previously documented in Cameroon. This study uncovered the co-circulation of several Africa-1 and Africa-2 lineages in the southern regions of Cameroon. Striking phylogenetic outcasts to the geographic differentiation of RABV variants indicated that importation from close regions or neighboring countries apparently contributes to the sustainment

Molecular characterization and phylogenetic relatedness of dog-derived Rabies Viruses circulating in Cameroon between 2010 and 2016.

Science.gov (United States)

Sadeuh-Mba, Serge Alain; Momo, Jean Blaise; Besong, Laura; Loul, Sévérin; Njouom, Richard

2017-10-01

Rabies is enzootic among dog populations in some parts of Cameroon and the risk of human rabies is thought to be steadily high in these regions. However, the molecular epidemiology of circulating Rabies Virus (RABV) has been hardly considered in Cameroon as well as in most neighboring central African countries. To address this fundamental gap, 76 nucleoprotein (N) gene sequences of dog-derived RABV were obtained from 100 brain specimens sampled in Cameroon from 2010 to 2016. Studied sequences were subjected to molecular and phylogenetic analyses with reference strains retrieved from databases. The 71 studied Africa-1 isolates displayed 93.5-100% nucleotide (nt) and 98.3-100% amino-acid (aa) identities to each other while, the 5 studied Africa-2 isolates shared 99.4-99.7% sequence similarities at nt and aa levels. Maximum Likelihood based phylogenies inferred from nucleotide sequences confirmed all studied RABV isolates as members of the dog-related species 1 of the Lyssavirus genus. Individual isolates could be unambiguously assigned as either the Africa-1 subclade of the Cosmopolitan clade or the Africa 2 clade. The Africa-1 subclade appeared to be more prevalent and diversified. Indeed, 70 studied isolates segregated into 3 distinct circulating variants within Africa-1a lineage while a unique isolate was strikingly related to the Africa-1b lineage known to be prevalent in the neighboring Central African Republic and eastern Africa. Interestingly, all five Africa-2 isolates fell into the group-E lineage even though they appeared to be loosely related to databases available reference RABV; including those previously documented in Cameroon. This study uncovered the co-circulation of several Africa-1 and Africa-2 lineages in the southern regions of Cameroon. Striking phylogenetic outcasts to the geographic differentiation of RABV variants indicated that importation from close regions or neighboring countries apparently contributes to the sustainment of the enzootic

The Fallacy of Promoting Non Native Varieties of English in Postcolonial Multilingual Settings: The Case of Cameroon English (CamE) in Cameroon

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Essossomo, Serges Moïse

2015-01-01

This research endeavour is a major contribution to the current debate on the integration of non-native varieties into the school curriculum in non-native settings. Taking the specific case of Cameroon, this work rests on the solid assumption that the promotion of CamE to the detriment of Standard British English accent is definitely a fallacy. The…

Rivers and ports in transport history of Cameroon, 1916-1961 | Nkwi ...

African Journals Online (AJOL)

Rivers and ports in transport history of Cameroon, 1916-1961. ... rivers and ports for their physical mobility, transportation of bulky goods, mails migration and above all European consumer ... EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

Local vegetables in Cameroon: Corchorus species used as a vegetable.

NARCIS (Netherlands)

Westphal-Stevels, J.M.C.

1986-01-01

An agro-botanical study of local vegetables in Cameroon is in preparation, including the taxonomy, identity, morphology, agronomy and nutritional value of about 70 species. Corchorus olitorius L. and other edible species of the genus Corchorus L. (Tiliaceae) are part of this study. The wide

Privatisation of agro-industrial parastatals and anglophone opposition in Cameroon

NARCIS (Netherlands)

Konings, P.J.J.

1996-01-01

This article focuses on the regional anglophone opposition in Cameroon which arose after 15 July 1994, when the government was forced by international donors to announce the privatization of 15 public enterprises, notably in the transport and agroindustrial sectors. The most prominent among them was

Geographic variation in health insurance benefits in Qianjiang District, China: a cross-sectional study.

Science.gov (United States)

Wu, Yue; Zhang, Liang; Liu, Xuejiao; Ye, Ting; Wang, Yongfei

2018-02-05

Health insurance contributes to reducing the economic burden of disease and improving access to healthcare. In 2016, the Chinese government announced the integration of the New Cooperative Medical Scheme (NCMS) and Urban Resident Basic Medical Insurance (URBMI) to reduce system segmentation. Nevertheless, it was unclear whether there would be any geographic variation in health insurance benefits if the two types of insurance were integrated. The aim of this study was to identify the potential geographic variation in health insurance benefits and the related contributing factors. This cross-sectional study was carried out in Qianjiang District, where the NCMS and URBMI were integrated into Urban and Rural Resident Basic Medical Insurance Scheme (URRBMI) in 2010. All beneficiaries under the URRBMI were hospitalized at least once in 2013, totaling 445,254 persons and 65,877 person-times, were included in this study. Town-level data on health insurance benefits, healthcare utilization, and socioeconomic and geographical characteristics were collected through health insurance system, self-report questionnaires, and the 2014 Statistical Yearbook of Qianjiang District. A simplified Theil index at town level was calculated to measure geographic variation in health insurance benefits. Colored maps were created to visualize the variation in geographic distribution of benefits. The effects of healthcare utilization and socioeconomic and geographical characteristics on geographic variation in health insurance benefits were estimated with a multiple linear regression analysis. Different Theil index values were calculated for different towns, and the Theil index values for compensation by person-times and amount were 2.5028 and 1.8394 in primary healthcare institutions and 1.1466 and 0.9204 in secondary healthcare institutions. Healthcare-seeking behavior and economic factors were positively associated with health insurance benefits in compensation by person-times significantly

Ritual use of currency in Laimbwe history, Cameroon | Kah | Lwati: A ...

African Journals Online (AJOL)

Ritual use of currency in Laimbwe history, Cameroon. ... exchange and a measurement of value to replace other indigenous currencies, had an impact ... social classes and the re-enforcement of the socio-political order of the Laimbwe people.

Paying health workers for performance in Battagram district, Pakistan

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Javeed Sarah

2011-10-01

Full Text Available Abstract Background There is a growing interest in using pay-for-performance mechanisms in low and middle-income countries in order to improve the performance of health care providers. However, at present there is a dearth of independent evaluations of such approaches which can guide understanding of their potential and risks in differing contexts. This article presents the results of an evaluation of a project managed by an international non-governmental organisation in one district of Pakistan. It aims to contribute to learning about the design and implementation of pay-for-performance systems and their impact on health worker motivation. Methods Quantitative analysis was conducted of health management information system (HMIS data, financial records, and project documents covering the period 2007-2010. Key informant interviews were carried out with stakeholders at all levels. At facility level, in-depth interviews were held, as were focus group discussions with staff and community members. Results The wider project in Battagram had contributed to rebuilding district health services at a cost of less than US$4.5 per capita and achieved growth in outputs. Staff, managers and clients were appreciative of the gains in availability and quality of services. However, the role that the performance-based incentive (PBI component played was less clear--PBI formed a relatively small component of pay, and did not increase in line with outputs. There was little evidence from interviews and data that the conditional element of the PBIs influenced behaviour. They were appreciated as a top-up to pay, but remained low in relative terms, and only slightly and indirectly related to individual performance. Moreover, they were implemented independently of the wider health system and presented a clear challenge for longer term integration and sustainability. Conclusions Challenges for performance-based pay approaches include the balance of rewarding individual

Comparison of District-level Smoking Prevalence and Their Income Gaps from Two National Databases: the National Health Screening Database and the Community Health Survey in Korea, 2009-2014.

Science.gov (United States)

Kim, Ikhan; Bahk, Jinwook; Kim, Yeon Yong; Lee, Jeehye; Kang, Hee Yeon; Lee, Juyeon; Yun, Sung Cheol; Park, Jong Heon; Shin, Soon Ae; Khang, Young Ho

2018-02-05

We compared age-standardized prevalence of cigarette smoking and their income gaps at the district-level in Korea using the National Health Screening Database (NHSD) and the Community Health Survey (CHS). Between 2009 and 2014, 39,049,485 subjects participating in the NHSD and 989,292 participants in the CHS were analyzed. The age-standardized prevalence of smoking and their interquintile income differences were calculated for 245 districts of Korea. We examined between-period correlations for the age-standardized smoking prevalence at the district-level and investigated the district-level differences in smoking prevalence and income gaps between the two databases. The between-period correlation coefficients of smoking prevalence for both genders were 0.92-0.97 in NHSD and 0.58-0.69 in CHS, respectively. When using NHSD, we found significant income gaps in all districts for men and 244 districts for women. However, when CHS was analyzed, only 167 and 173 districts for men and women, respectively, showed significant income gaps. While correlation coefficients of district-level smoking prevalence from two databases were 0.87 for men and 0.85 for women, a relatively weak correlation between income gaps from the two databases was found. Based on two databases, income gaps in smoking prevalence were evident for nearly all districts of Korea. Because of the large sample size for each district, NHSD may provide stable district-level smoking prevalence and its income gap and thus should be considered as a valuable data source for monitoring district-level smoking prevalence and its socioeconomic inequality. © 2018 The Korean Academy of Medical Sciences.

Structure of the Crust beneath Cameroon, West Africa, from the Joint Inversion of Rayleigh Wave Group Velocities and Receiver Functions

Energy Technology Data Exchange (ETDEWEB)

Tokam, A K; Tabod, C T; Nyblade, A A; Julia, J; Wiens, D A; Pasyanos, M E

2010-02-18

The Cameroon Volcanic Line (CVL) is a major geologic feature that cuts across Cameroon from the south west to the north east. It is a unique volcanic lineament which has both an oceanic and a continental sector and consists of a chain of Tertiary to Recent, generally alkaline volcanoes stretching from the Atlantic island of Pagalu to the interior of the African continent. The oceanic sector includes the islands of Bioko (formerly Fernando Po) and Sao Tome and Principe while the continental sector includes the Etinde, Cameroon, Manengouba, Bamboutos, Oku and Mandara mountains, as well as the Adamawa and Biu Plateaus. In addition to the CVL, three other major tectonic features characterize the region: the Benue Trough located northwest of the CVL, the Central African Shear Zone (CASZ), trending N70 degrees E, roughly parallel to the CVL, and the Congo Craton in southern Cameroon. The origin of the CVL is still the subject of considerable debate, with both plume and non-plume models invoked by many authors (e.g., Deruelle et al., 2007; Ngako et al, 2006; Ritsema and Allen, 2003; Burke, 2001; Ebinger and Sleep, 1998; Lee et al, 1994; Dorbath et al., 1986; Fairhead and Binks, 1991; King and Ritsema, 2000; Reusch et al., 2010). Crustal structure beneath Cameroon has been investigated previously using active (Stuart et al, 1985) and passive (Dorbath et al., 1986; Tabod, 1991; Tabod et al, 1992; Plomerova et al, 1993) source seismic data, revealing a crust about 33 km thick at the south-western end of the continental portion of the CVL (Tabod, 1991) and the Adamawa Plateau, and thinner crust (23 km thick) beneath the Garoua Rift in the north (Stuart et al, 1985) (Figure 1). Estimates of crustal thickness obtained using gravity data show similar variations between the Garoua rift, Adamawa Plateau, and southern part of the CVL (Poudjom et al., 1995; Nnange et al., 2000). In this study, we investigate further crustal structure beneath the CVL and the adjacent regions in

Desire for a child among HIV-infected women receiving antiretroviral therapy in Cameroon: results from the national survey EVAL (ANRS 12-116).

Science.gov (United States)

Marcellin, Fabienne; Protopopescu, Camelia; Abé, Claude; Boyer, Sylvie; Blanche, Jérôme; Ongolo-Zogo, Pierre; Koulla-Shiro, Sinata; Moatti, Jean-Paul; Carrieri, Maria Patrizia; Spire, Bruno

2010-04-01

The majority of HIV-infected people in sub-Saharan Africa are women, many of reproductive age. Cameroon is severely hit by the AIDS epidemic and has developed a large national program for improving access to antiretroviral treatment (ART). The reproductive intentions of women living with HIV/AIDS (WLHA) who obtain access to ART in this country remain poorly documented. Our study aimed at exploring factors associated with the desire to have a child among 1433 ART-treated fertile WLHA aged matrimonial status, number of biological children, and sexual activity, the main factors independently associated with this desire in a multivariate analysis were having a good physical health-related quality of life (1.02 [1.01-1.03] for a one-point increment on the 12-item Short-Form Health Survey scale) and a CD4 count at ART initiation <200 cells/mm(3) (1.7 [1.2-2.4]). As a conclusion, the desire to have a child is frequent among ART-treated WLHA in Cameroon. HIV care and family planning programs should be integrated more thoroughly in order to support WLHA's reproductive choices.

High rate of malnutrition in young children aged 0 to 59 months and lack of intervention in rural west Cameroon

International Nuclear Information System (INIS)

Kana Sop, Marie Modestine; Nolla, Nicolas; Djeukeu Assongni, Williams; Gouado, Inocent; Mananga, Mananga Marlyne-Josephine; Tetanye, Ekoe

2014-01-01

Full text: Background: Micronutrients deficiencies are public health problem in Cameroon and with physiological and economic consequences. National prevalences of stunting (69%) among Cameroonian children as reports in the last ESDC-MIC are very high. In rural area in real context, no strategies exist either at the health centers or the community. The aim: This work aimed at determining by anthropometric measurements (aged, weights and heights), the nutritional status of children aged 0 to 59 months in Bangang rural community in Cameroon, in order to prepare nutrition education and intervention mostly focused on food based approaches. Methods: Across-sectional study was conducted in six health areas in Bangang rural community in western region of Cameroon. Four hundred and forty (440) children (214 boys, 226 f girls) aged 0 to 59 months were randomly selected for anthropometric measurements (heights and weights) NCHS/WHO international growth reference. A questionnaire was developed to collect information on food consumption, food frequency, socio-economic and demographic status of mothers. Statistical analyses of results were done using ENA Smart and SPSS software. Results: Using NCHS (1976), standard of reference and z-scores, stunting, wasting and underweight rates were respectively: 42.22% (114) (with 18.52% (28) moderate), 3.33% (09) (with 1.85% (05) moderate) and 6.67% (18) (with 5.18% (14) moderate) of children. From BMI classification of nutrition status done according to WHO criteria, 3.38 %, 55.40 %, and 41.22 % of the mothers were underweight, normal and overweight respectively. The most frequents consumed food were cereals and tubers (93.24 %) whose nutrients are poorly bioavailable. The daily intakes of food sources of proteins, minerals, vitamins, were generally poor. Only 3% and 2% of fruits and animal food were consumed in family respectively. No skill on nutrition was observed in families and in health and community centers. No anthropometric

The socio-cultural implications of climate change in Cameroon ...

African Journals Online (AJOL)

Climate change impact has remained a serious threat to man and more particularly in the water-stressed environment of north Cameroon where in most cases, man struggles for bare survival by eking out a living from a harsh or hostile climatic environment. In this region, the socio-cultural impacts can be devastating as has ...

Financing Of Small And Medium-Size Enterprises In Cameroon ...

African Journals Online (AJOL)

Financing Of Small And Medium-Size Enterprises In Cameroon. ... Available data from the banking sector shows that as much as 78.7% of all ... SMEs and large companies pay back their loans better than the other ... Even the SME loan repayment rate of 62.9% is still low by World Bank ... AJOL African Journals Online.

Survey of Minerai Status of Cattle in the Adamaoua Region of Cameroon

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Njwe, RM.

1994-01-01

Full Text Available Serum and liver samples were collected from Zebu Gudali and Zebu Banyo cattle freshly slaughtered in abattoirs at eight different locations in each of the five administrative divisions of the Adamaoua region of Cameroon during the wet season (September to October, 1983 and the dry season (February to March, 1984. Liver samples were analysed for iron, copper and manganese while serum samples were analysed for calcium, magnesium and copper. Most of the animals were adequate in calcium, magnesium, iron and manganese. Copper was deficient in liver and sera of most of the animals. There is a need to intensif/research on the mineral status of cattle in the Adamaoua region of Cameroon. Copper sulphate is recommended in sait licks for cattle in this region.

Gynaecological morbidity among HIV positive pregnant women in Cameroon

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Nana Philip N

2008-07-01

Full Text Available Abstract Objective To compare the prevalence of gynaecological conditions among HIV infected and non-infected pregnant women. Methods Two thousand and eight (2008 pregnant women were screened for HIV, lower genital tract infections and lower genital tract neoplasia at booking antenatal visit. Results About 10% (198/2008 were HIV positive. All lower genital tract infections except candidiasis were more prevalent among HIV positive compared to HIV negative women: vaginal candidiasis (36.9% vs 35.4%; p = 0.678, Trichomoniasis (21.2% vs 10.6%; p p p = 0.026, syphilis (35.9% vs 10.6%; p Chlamydia trachomatis (38.4% vs 7.1%; p p p Conclusion We conclude that (i sexually transmitted infections (STIs are common in both HIV positive and HIV negative pregnant women in Cameroon, and (ii STIs and preinvasive cervical lesions are more prevalent in HIV-infected pregnant women compared to their non-infected compatriots. We recommend routine screening and treatment of STIs during antenatal care in Cameroon and other countries with similar social profiles.

The protection of juveniles under Cameroon criminal law and procedures through the lens of international standards

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Thomas Ojong

2017-10-01

Full Text Available While the legislative framework on the adminitration of juvenile justice in Cameroon may currently be adequate and in compliance with the international conventions ratified by the State, the implementation of the national law should be the primary mechanism through which human rights are realized. Cameroon is usually said to be a State with good laws but poor implementation. With recourse to the normative and empirical methods, this article explores the provisions on the protection of juveniles in Cameroon criminal law and procedures through the lens of internationally recognized principles. It looks at the provisions as they are interpreted and applied by the Courts. The prospect being to invite the Government and all the stakeholders to embark on establishing the structures provided for and ensure effectiveness in the enforcement of juvenile justice in the country so as to overcome the current weaknesses that the system is experiencing.

A Critical Appraisal of the Juvenile Justice System under Cameroon's 2005 Criminal Procedure Code: Emerging Challenges

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S Tabe

2012-03-01

Full Text Available The objective of this article is to examine the changes introduced by the 2005 Cameroonian Criminal Procedure Code on matters of juvenile justice, considering that before this Code, juvenile justice in Cameroon was governed by extra-national laws. In undertaking this analysis, the article highlights the evolution of the administration of juvenile justice 50 years after independence of Cameroon. It also points out the various difficulties and shortcomings in the treatment of juvenile offenders in Cameroon since the enactment of the new Criminal Procedure Code. The article reveals that the 2005 Code is an amalgamation of all hitherto existing laws in the country that pertained to juvenile justice, and that despite the considerable amount of criticism it has received, the Code is clearly an improvement of the system of juvenile justice in Cameroon, since it represents a balance of the due process rights of young people, the protection of society and the special needs of young offenders. This is so because the drafters of the Code took a broad view of the old laws on juvenile justice. Also a wide range of groups were consulted, including criminal justice professionals, children’s service organisations, victims, parents, young offenders, educators, advocacy groups and social-policy analysts. However, to address the challenges that beset the juvenile justice system of Cameroon, the strategy of the government should be focussed on three areas: the prevention of youth crime, the provision of meaningful consequences for the actions of young people, and the rehabilitation and reintegration of young offenders. Cameroonian law should seek educative solutions rather than to impose prison sentences or other repressive measures on young offenders. Special courts to deal with young offenders should be established outside the regular penal system and should be provided with resources that are adequate for and appropriate to fostering their understanding of

Decentralization in Zambia: resource allocation and district performance.

Science.gov (United States)

Bossert, Thomas; Chitah, Mukosha Bona; Bowser, Diana

2003-12-01

Zambia implemented an ambitious process of health sector decentralization in the mid 1990s. This article presents an assessment of the degree of decentralization, called 'decision space', that was allowed to districts in Zambia, and an analysis of data on districts available at the national level to assess allocation choices made by local authorities and some indicators of the performance of the health systems under decentralization. The Zambian officials in health districts had a moderate range of choice over expenditures, user fees, contracting, targeting and governance. Their choices were quite limited over salaries and allowances and they did not have control over additional major sources of revenue, like local taxes. The study found that the formula for allocation of government funding which was based on population size and hospital beds resulted in relatively equal per capita expenditures among districts. Decentralization allowed the districts to make decisions on internal allocation of resources and on user fee levels and expenditures. General guidelines for the allocation of resources established a maximum and minimum percentage to be allocated to district offices, hospitals, health centres and communities. Districts tended to exceed the maximum for district offices, but the large urban districts and those without public district hospitals were not even reaching the minimum for hospital allocations. Wealthier and urban districts were more successful in raising revenue through user fees, although the proportion of total expenditures that came from user fees was low. An analysis of available indicators of performance, such as the utilization of health services, immunization coverage and family planning activities, found little variation during the period 1995-98 except for a decline in immunization coverage, which may have also been affected by changes in donor funding. These findings suggest that decentralization may not have had either a positive or

Local innovation for improving primary care cardiology in resource-limited African settings: an insight on the Cardio Pad(®) project in Cameroon.

Science.gov (United States)

Noubiap, Jean Jacques N; Jingi, Ahmadou M; Kengne, André Pascal

2014-10-01

Cardiovascular disease (CVD) is an emerging threat to the health of populations in Africa. With the inadequate health infrastructures, understaffed and underfunded health systems, African countries are ill-prepared to cope with the increasing demand for care for CVD, particularly for populations in remote and underserved rural areas, where 60% of the population currently reside. Task shifting and telehealth have been suggested as strategies to overcome the current health workforce shortage in African countries, and to increase access to prevention and curative services for emerging CVD. However, strategies for promoting their incorporation into the existing health systems, have yet to be developed. The Cardio Pad(®) initiative (originating from Cameroon) seeks to provide appropriate solutions to improve the application of telemedicine for CVD prevention and control in remote African settings. The Cardio Pad(®) is a tele-cardiology device which provides a number of advantages in terms of cost, ease of use, autonomy and reduced technology requirements. It is a fully touch screen medical device which enables cardiac tests such as electrocardiograms (ECG) to be performed in remote underserved areas (rural areas for instance), while the test results are transferred wirelessly via mobile phone connection, to specialist physicians who can interpret them and provide assistance with case management. While most of the current telemedicine clinical services on the African continent receive most expertise from developed countries, the Cardio Pad(®), a local invention by a 26-year-old Cameroon-trained engineer demonstrates how much innovative solutions to combat CVD and other health issues could and should be developed locally in Africa.

An evaluation of the effectiveness of targeted social marketing to promote adolescent and young adult reproductive health in Cameroon.

Science.gov (United States)

Van Rossem, R; Meekers, D

2000-10-01

This study examines the effectiveness of the PSI/PMSC Horizon Jeunes youth-targeted social marketing program for improving adolescent reproductive health in urban Cameroon. The program targeted adolescents through peer education, youth clubs, mass media promotion, and behavior change communications. After about 13 months of intervention, knowledge of the program was nearly universal, and the majority of youths had direct contact with the program. Program effectiveness is examined using a quasi-experimental research design with a preintervention and postintervention survey in an intervention and comparison site. The intervention had a significant effect on several determinants of preventive behavior, including awareness of sexual risks, knowledge of birth control methods, and discussion of sexuality and contraceptives. The intervention increased the proportion of female youths who reported using oral contraceptives and condoms for birth control. However, condom use is not yet consistent. Although the proportion of young men who reported using condoms for birth control also increased, this change could not be attributed to the intervention. Although this short intervention successfully increased the reported use of various birth control methods, including condoms, there is no evidence that the intervention increased use of condoms for STD prevention of sexually transmitted diseases.

Cameroon's main marketing board : history and scope of the ONCPB

NARCIS (Netherlands)

Laan, van der H.L.

1987-01-01

The creation of the ONCPB (Office national de commercialisation des produits de base) in 1976 was a turning point in the history of government regulation of agricultural marketing in Cameroon. It went a long way in unifying and harmonizing the marketing arrangements in francophone and anglophone

Audiovisual translation in Cameroon: An Analysis of Voice-over in ...

African Journals Online (AJOL)

Cameroon is a multilingual country with people from different backgrounds with English and French as the official languages. The need to render information broadcast on television channels across the country to the population is accordingly of paramount importance. This can be achieved through subtitling and dubbing ...

Primarity and biometric indices of native goats in western Cameroon ...

African Journals Online (AJOL)

Goats are well integrally part of communities' livelihoods in both rural and urban regions in Cameroon. Our study intended to contribute to genetic characterization of native goats populations found in one of the highest populated region based on morphometric indices as developed by Lauvergne and COGNOSAG ...

What do District Health Planners in Tanzania think about improving priority setting using 'Accountability for Reasonableness'?

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Olsen Oystein

2007-11-01

Full Text Available Abstract Background Priority setting in every health system is complex and difficult. In less wealthy countries the dominant approach to priority setting has been Burden of Disease (BOD and cost-effectiveness analysis (CEA, which is helpful, but insufficient because it focuses on a narrow range of values – need and efficiency – and not the full range of relevant values, including legitimacy and fairness. 'Accountability for reasonableness' is a conceptual framework for legitimate and fair priority setting and is empirically based and ethically justified. It connects priority setting to broader, more fundamental, democratic deliberative processes that have an impact on social justice and equity. Can 'accountability for reasonableness' be helpful for improving priority setting in less wealthy countries? Methods In 2005, Tanzanian scholars from the Primary Health Care Institute (PHCI conducted 6 capacity building workshops with senior health staff, district planners and managers, and representatives of the Tanzanian Ministry of Health to discussion improving priority setting in Tanzania using 'accountability for reasonableness'. The purpose of this paper is to describe this initiative and the participants' views about the approach. Results The approach to improving priority setting using 'accountability for reasonableness' was viewed by district decision makers with enthusiastic favour because it was the first framework that directly addressed their priority setting concerns. High level Ministry of Health participants were also very supportive of the approach. Conclusion Both Tanzanian district and governmental health planners viewed the 'accountability for reasonableness' approach with enthusiastic favour because it was the first framework that directly addressed their concerns.

Involving new actors to achieve ART scaling-up: difficulties in an HIV/AIDS counselling and testing centre in Cameroon.

Science.gov (United States)

Yakam, J C Y Tantchou; Gruénais, M-E

2009-03-01

The high HIV/AIDS-related mortality among young adults is devastating countries in sub-Saharan Africa. The implementing capacity of the health systems is the main limiting factor of antiretroviral treatment (ART) scaling-up;(1) this capacity depends mainly on the health workforce. Tackling the issue of human resources for health is thus of paramount importance to achieve universal access to ART and for the survival of health systems in time of AIDS. To support such a process, the World Health Organization stresses the importance of task shifting(2) from medical doctors to nurses and from nurses to community health workers. Such task shifting is not easy to achieve but undoubtedly needed. This paper raises issues about the involvement of new actors(3) without precise redefinitions of roles and task-shifting procedures. We take the example of a 'Centre de Prévention et de Dépistage Volontaire du VIH/sida'(4) in one major town of the Far-North province of Cameroon (Central Africa). The study was qualitative. Observations were carried out in the service and in-depth interviews conducted with health workers and actors of Cameroon's National AIDS Control Committee. These interviews were recorded and transcribed. The material was analysed using keywords. KEY RESULT: The involvement of new actors in a context of human resources for health shortage and health system crisis creates confusion and role conflicts, which lead to frustration. It favours the appearance of chinks within which these new actors slip and 'find their way' in the system; it finally raises problems related to their legitimacy and position within the existing hierarchy. KEY POLICY MESSAGE: It is necessary, when involving new staff members (particularly when they do not belong to internationally recognized health professionals such as nurses, doctors and pharmacists), to redefine roles and build precise task-shifting procedures so that everyone may still have a place in the whole system and feel useful.

Motorcycle injury among secondary school students in the Tiko municipality, Cameroon.

Science.gov (United States)

Nyagwui, Asonganyi Edwin; Fredinah, Namatovu; Che, Longho Bernard; Yulia, Blomstedt

2016-01-01

Injury from motorcycle is a considerable cause of disability and death in the world and especially in low and middle-income countries; it is one of the most serious public health problems. In Cameroon, motorcycle is commonly used for transportation particularly among students. The aim of this paper is to study the risk-factors of the motorcycle-related accidents and injuries among secondary school students' in the Tiko municipality, Cameroon. A cross sectional study was conducted in January 2012 on 391 students age 16-24 from public and private schools in the Tiko Municipality. Logistic regression was used to estimate the association between risk factors and injuries. A closed-ended and few open-ended questionnaire was used to collect data. The study showed that over 70% of students used motorcycles always or often. Few had undergone any formal training for driving a motorcycle. The vast majority reported not wearing protective gear while driving or riding a motorcycle. Usage of protective gear was particularly low among girls. Over 16% reported using a motorbike always or occasionally under the influence of alcohol or drugs. Over 58% of respondents reported having an accident and over 35% were injured when driving or riding a motorcycle. Those who lived at the Tiko-Douala road have three times higher probability to sustain accidents and injuries than students residing elsewhere (OR 3.19 (1.20-8.46). It is deeply alarming that every second respondent in the study reported having been in an accident and every third motorcycle user was somehow injured. We therefore call for an immediate attention and a deeper investigation into the highlighted situation, particularly at Tiko-Douala road.

Savannah Forest Beekeepers in Cameroon: Actions to Reduce Vulnerability. Chapter 7

NARCIS (Netherlands)

Ingram, V.J.

2016-01-01

The savannah forests in Adamaoua, Cameroon, are home to traditional, forest-based beekeepers, subsistence farmers and pastoralists. This sparsely populated region is economically marginal and little developed, with lower than national average incomes. Forest apiculture is important here: honey,

A comparison of hierarchical cluster analysis and league table rankings as methods for analysis and presentation of district health system performance data in Uganda.

Science.gov (United States)

Tashobya, Christine K; Dubourg, Dominique; Ssengooba, Freddie; Speybroeck, Niko; Macq, Jean; Criel, Bart

2016-03-01

In 2003, the Uganda Ministry of Health introduced the district league table for district health system performance assessment. The league table presents district performance against a number of input, process and output indicators and a composite index to rank districts. This study explores the use of hierarchical cluster analysis for analysing and presenting district health systems performance data and compares this approach with the use of the league table in Uganda. Ministry of Health and district plans and reports, and published documents were used to provide information on the development and utilization of the Uganda district league table. Quantitative data were accessed from the Ministry of Health databases. Statistical analysis using SPSS version 20 and hierarchical cluster analysis, utilizing Wards' method was used. The hierarchical cluster analysis was conducted on the basis of seven clusters determined for each year from 2003 to 2010, ranging from a cluster of good through moderate-to-poor performers. The characteristics and membership of clusters varied from year to year and were determined by the identity and magnitude of performance of the individual variables. Criticisms of the league table include: perceived unfairness, as it did not take into consideration district peculiarities; and being oversummarized and not adequately informative. Clustering organizes the many data points into clusters of similar entities according to an agreed set of indicators and can provide the beginning point for identifying factors behind the observed performance of districts. Although league table ranking emphasize summation and external control, clustering has the potential to encourage a formative, learning approach. More research is required to shed more light on factors behind observed performance of the different clusters. Other countries especially low-income countries that share many similarities with Uganda can learn from these experiences. © The Author 2015

Understanding poverty-related diseases in Cameroon from a salutogenic perspective

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Makoge, Valerie

2017-01-01

Poverty-related diseases (PRDs) assume poverty as a determinant in catching disease and an obstacle for cure and recovery. In Cameroon, over 48 % of the population lives below the poverty line. This dissertation starts from the premise that the relation between poverty and disease is mediated by

HIV/AIDS and older adults in Cameroon: Emerging issues and ...

African Journals Online (AJOL)

The burden of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) on the elderly population in three divisions within the Northwest Region of Cameroon was examined. Data for this paper were extracted from a larger study which had been conducted concerning the burden of ...

Reinstating district nursing: A UK perspective.

Science.gov (United States)

Morris, Hannah

2017-09-01

As policy directives gather pace for service provision to be delivered in primary care, district nursing has not been recognised as a valuable asset to facilitate this agenda. Investment in district nursing and specialist district nursing education has fallen. This is concurrent with an ageing district nursing workforce, a lack of recruitment and growing caseloads, as district nursing adapts to meet the challenges of the complexities of contemporary healthcare in the community. The district nurse role is complex and multifaceted and includes working collaboratively and creatively to coordinate care. Redressing the shortages of specialist district nurse practitioners with increased numbers of health care support workers will not replace the skill, knowledge, experience required to meet the complex care needs of today's society. District nursing needs to be reinstated as the valuable asset it is, through renewed investment in the service, research development and in specialist practice education. To prevent extinction district nurses need to be able to demonstrate and articulate the complexities and dynamisms of the role to reinstate themselves to their commissioners as a valuable asset for contemporary practice that can meet current health and social care needs effectively. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

New evidence for the asthenospheric origin of the Cameroon Volcanic Line from 1D shear wave velocities

CSIR Research Space (South Africa)

Tokam, AP

2013-10-01

Full Text Available the mantle composition beneath Ethiopia and southern Brazil (Keranen et al., 2009; Julia et al., 2008). Many petrological studies of ultramafic orogenic massifs and ultramafic xenoliths along the CVL (mainly around Mount Cameroon and the Adamawa....N. and Oya, M. 2010. Petrological and chemical variability of peridotite xenoliths from the Cameroon Volcanic Line, West Africa: an evidence from Plume emplacement. Journal of Mineralogical and Petrological Sciences, 107, 57-69. McKenzie, D...

FACTORS OF DEVELOPMENT OF THE MARKET OF HEALTH RESORT OF THE CRIMEAN FEDERAL DISTRICT

Directory of Open Access Journals (Sweden)

M. S. Oborin

2015-01-01

Full Text Available The Republic of Crimea was a part of the Russian Federation as the certain federal district not so long ago and is the most important center of development of tourist and recreational activity and resort business. Historically this territory has the huge natural medical potential and well developed network of the sanatorium organizations specializing on treatment of various profiles of diseases. Modernization of health resort of the region is the main objective of further development of all district. Sanatorium activity is branch of economy for all territory and promotes active development of other types of economic activity. 

Hope and despair: community health assistants' experiences of working in a rural district in Zambia.

Science.gov (United States)

Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

2014-05-25

In order to address the challenges facing the community-based health workforce in Zambia, the Ministry of Health implemented the national community health assistant strategy in 2010. The strategy aims to address the challenges by creating a new group of workers called community health assistants (CHAs) and integrating them into the health system. The first group started working in August 2012. The objective of this paper is to document their motivation to become a CHA, their experiences of working in a rural district, and how these experiences affected their motivation to work. A phenomenological approach was used to examine CHAs' experiences. Data collected through in-depth interviews with 12 CHAs in Kapiri Mposhi district and observations were analysed using a thematic analysis approach. Personal characteristics such as previous experience and knowledge, passion to serve the community and a desire to improve skills motivated people to become CHAs. Health systems characteristics such as an inclusive work culture in some health posts motivated CHAs to work. Conversely, a non-inclusive work culture created a social structure which constrained CHAs' ability to learn, to be innovative and to effectively conduct their duties. Further, limited supervision, misconceptions about CHA roles, poor prioritisation of CHA tasks by some supervisors, as well as non- and irregular payment of incentives also adversely affected CHAs' ability to work effectively. In addition, negative feedback from some colleagues at the health posts affected CHA's self-confidence and professional outlook. In the community, respect and support provided to CHAs by community members instilled a sense of recognition, appreciation and belonging in CHAs which inspired them to work. On the other hand, limited drug supplies and support from other community-based health workers due to their exclusion from the government payroll inhibited CHAs' ability to deliver services. Programmes aimed at integrating

Radioactivity level and soil radon measurement of a volcanic area in Cameroon

International Nuclear Information System (INIS)

Ngachin, M.; Garavaglia, M.; Giovani, C.; Kwato Njock, M.G.; Nourreddine, A.

2008-01-01

The radioactivity level of soils in a volcanic area in Cameroon was determined and discussed. Thirty soils samples were collected from Buea and Limbe cities located in the south-western Cameroon. These two regions are known for theirs volcanic grounds due to the presence of Mount Cameroon Mountain. The activity concentrations of natural radionuclides as well as that of the fission product were evaluated by gamma-ray spectrometry using a hyper-purity germanium detector (HPGe). The ranges of concentrations in the surveyed soils were 11-17 Bq kg -1 , 22-36 Bq kg -1 and 43-201 Bq kg -1 for 226 Ra, 232 Th and 40 K, respectively. The radioisotope 137 Cs was also found but in a very small amount. The outdoor absorbed dose rate 1 m above ground with the corresponding annual effective dose rate, assuming a 20% occupancy factor was estimated. The radium equivalent and the external hazard index were also evaluated and results are compared with available data from other studies and with the world average value [United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), 1988. Sources, Effects and Risks of Ionizing Radiation. Report to the General Assembly on the Effects of Atomic Radiation. United Nations, New York; UNSCEAR, 2000. Sources and Effects of Ionizing Radiations. Report to the General Assembly with Scientific Annexes. United Nations, New York]. A solid state nuclear track detector (SSNTD), LR-115 was used for soil radon measurements at a depth of 50 cm. The ranges of soil radon concentrations were 6.7-10.8 kBq m -3 and 5.5-8.7 kBq m -3 in Buea and Limbe, respectively. A positive correlation was found between concentrations of radium measured with γ-spectrometry and the soil radon concentrations measured with the nitrate cellulose detectors. The results of this study provide the radioactivity level in soil of a volcanic area, which has been found to be within the safety limits. The south-western Cameroon can be considered as having normal

Governance of disaster risk reduction in Cameroon: The need to empower local government

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Henry N. Bang

2013-02-01

Full Text Available The impact of natural hazards and/or disasters in Cameroon continues to hit local communities hardest, but local government lacks the ability to manage disaster risks adequately. This is partly due to the fact that the necessity to mainstream disaster risk reduction into local governance and development practices is not yet an underlying principle of Cameroon’s disaster management framework. Using empirical and secondary data, this paper analyses the governance of disaster risks in Cameroon with particular focus on the challenges local government faces in implementing disaster risk reduction strategies. The hypothesis is that the governance of disaster risks is too centralised at the national level, with huge implications for the effective governance of disaster risks at the local level. Although Cameroon has reinvigorated efforts to address growing disaster risks in a proactive way, it is argued that the practical actions are more reactive than proactive in nature. The overall aim is to explore the challenges and opportunities that local government has in the governance of disaster risks. Based on the findings from this research, policy recommendations are suggested on ways to mainstream disaster risk reduction strategies into local governance, and advance understanding and practice in the local governance of disaster risks in the country.

Conservation Concern for the Deteriorating Geographical Range of the Grey Parrot in Cameroon

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Simon A. Tamungang

2014-01-01

Full Text Available The need for information on Grey Parrot distribution and vegetation associations for informed management and policy decisions was the basis for this study. A nationwide survey of the Grey Parrot population and habitat status was carried out, using questionnaire and point count methods. From the results, the extent of the contemporary range of the parrots was restricted to Southern Cameroon, which harbours the rainforest. Regional parrot population means ranged from 3,487 parrots in the Littoral to 1,351,275 parrots in the East Regions. The extent of the contemporary range as a percentage of the whole country was 25.4% and as a percentage of the regions with rainforest was 44.5%. The historic range of the bird has been reduced by over 55.5%. Estimated percentage of forest lost per region ranged from 20.4% in the Centre to 57.1% in the East and South Regions. At a global level, Cameroon contributed 9% to the total extent of the range of the Grey Parrot in Africa. The range is increasingly fragmented, contracted, and lost through land-based socioeconomic activities. These degradation pressures on the range called for urgent conservation considerations for long-term survival of the parrot species and its associated biodiversity in Cameroon.

Advancing the application of systems thinking in health: realist evaluation of the Leadership Development Programme for district manager decision-making in Ghana.

Science.gov (United States)

Kwamie, Aku; van Dijk, Han; Agyepong, Irene Akua

2014-06-16

Although there is widespread agreement that strong district manager decision-making improves health systems, understanding about how the design and implementation of capacity-strengthening interventions work is limited. The Ghana Health Service has adopted the Leadership Development Programme (LDP) as one intervention to support the development of management and leadership within district teams. This paper seeks to address how and why the LDP 'works' when it is introduced into a district health system in Ghana, and whether or not it supports systems thinking in district teams. We undertook a realist evaluation to investigate the outcomes, contexts, and mechanisms of the intervention. Building on two working hypotheses developed from our earlier work, we developed an explanatory case study of one rural district in the Greater Accra Region of Ghana. Data collection included participant observation, document review, and semi-structured interviews with district managers prior to, during, and after the intervention. Working backwards from an in-depth analysis of the context and observed short- and medium-term outcomes, we drew a causal loop diagram to explain interactions between contexts, outcomes, and mechanisms. The LDP was a valuable experience for district managers and teams were able to attain short-term outcomes because the novel approach supported teamwork, initiative-building, and improved prioritisation. However, the LDP was not institutionalised in district teams and did not lead to increased systems thinking. This was related to the context of high uncertainty within the district, and hierarchical authority of the system, which triggered the LDP's underlying goal of organisational control. Consideration of organisational context is important when trying to sustain complex interventions, as it seems to influence the gap between short- and medium-term outcomes. More explicit focus on systems thinking principles that enable district managers to better cope with

Determining the Optimum Level of Working Capital in the Cameroon ...

African Journals Online (AJOL)

The issue of working capital is very important to the operations of the Cameroon Development Corporation (CDC) Net working capital (i.e. the excess of liquid current assets over current liabilities) is an indispensable component of any business organization's capital structure. For any company to make profit in order to ...

Inequity in maternal health care service utilization in Gujarat: analyses of district-level health survey data.

Science.gov (United States)

Saxena, Deepak; Vangani, Ruchi; Mavalankar, Dileep V; Thomsen, Sarah

2013-03-06

Two decades after the launch of the Safe Motherhood campaign, India still accounts for at least a quarter of maternal death globally. Gujarat is one of the most economically developed states of India, but progress in the social sector has not been commensurate with economic growth. The purpose of this study was to use district-level data to gain a better understanding of equity in access to maternal health care and to draw the attention of the policy planers to monitor equity in maternal care. Secondary data analyses were performed among 7,534 ever-married women who delivered since January 2004 in the District Level Household and Facility Survey (DLHS-3) carried out during 2007-2008 in Gujarat, India. Based on the conceptual framework designed by the Commission on the Social Determinants of Health, associations were assessed between three outcomes - Institutional delivery, antenatal care (ANC), and use of modern contraception - and selected intermediary and structural determinants of health using multiple logistic regression. Inequities in maternal health care utilization persist in Gujarat. Structural determinants like caste group, wealth, and education were all significantly associated with access to the minimum three antenatal care visits, institutional deliveries, and use of any modern method of contraceptive. There is a significant relationship between being poor and access to less utilization of ANC services independent of caste category or residence. Poverty is the most important determinant of non-use of maternal health services in Gujarat. In addition, social position (i.e. caste) has a strong independent effect on maternal health service use. More focused and targeted efforts towards these disadvantaged groups needs to be taken at policy level in order to achieve targets and goals laid out as per the MDGs. In particular, the Government of Gujarat should invest more in basic education and infrastructural development to begin to remove the structural causes

Inequity in maternal health care service utilization in Gujarat: analyses of district-level health survey data

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Dileep V. Mavalankar

2013-03-01

Full Text Available Background: Two decades after the launch of the Safe Motherhood campaign, India still accounts for at least a quarter of maternal death globally. Gujarat is one of the most economically developed states of India, but progress in the social sector has not been commensurate with economic growth. The purpose of this study was to use district-level data to gain a better understanding of equity in access to maternal health care and to draw the attention of the policy planers to monitor equity in maternal care. Methods: Secondary data analyses were performed among 7,534 ever-married women who delivered since January 2004 in the District Level Household and Facility Survey (DLHS-3 carried out during 2007–2008 in Gujarat, India. Based on the conceptual framework designed by the Commission on the Social Determinants of Health, associations were assessed between three outcomes – Institutional delivery, antenatal care (ANC, and use of modern contraception – and selected intermediary and structural determinants of health using multiple logistic regression. Results: Inequities in maternal health care utilization persist in Gujarat. Structural determinants like caste group, wealth, and education were all significantly associated with access to the minimum three antenatal care visits, institutional deliveries, and use of any modern method of contraceptive. There is a significant relationship between being poor and access to less utilization of ANC services independent of caste category or residence. Discussion and conclusions: Poverty is the most important determinant of non-use of maternal health services in Gujarat. In addition, social position (i.e. caste has a strong independent effect on maternal health service use. More focused and targeted efforts towards these disadvantaged groups needs to be taken at policy level in order to achieve targets and goals laid out as per the MDGs. In particular, the Government of Gujarat should invest more in basic

RITUAL USE OF CURRENCY IN LAIMBWE HISTORY, CAMEROON

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Henry Kam Kah

2018-02-01

Full Text Available The advent of Europeans in Cameroon in the 15th century and the introduction of a western currency as a standard of exchange and a measurement of value to replace other indigenous currencies had an impact on initiation into regulatory and entertainment societies in Cameroonian communities including the Laimbwe of the North West Region. Male and female institutions eventually began using these currencies during initiation rites. These included nwerong, ngiri, ngumba, takembeng, ndofoumgbui, kwifoyn (also kwifo’o, kwifeu, kuiifuai kefa’a, tschong, libah and ikuum in the grasslands and Liengu, male, ahon, muankum, nganya, monekim, ekpe and obasinjom in the forest region of Cameroon. Prior to the introduction of standard money, some local currencies like cowrie shells were used together with the provision of material things like goats, pigs, fowls and bush meat. Money is effectively a measure of value, status and a store of wealth within the Laimbwe traditional milieu. This paper examines how and why the introduction of money in initiation and other ritual activities led to the emergence of new social classes and the re-enforcement of the socio-political order of the Laimbwe people. The study essentially relies on discussions with members of societies, observation and written material.

Violence against female sex workers in Cameroon: accounts of violence, harm reduction, and potential solutions.

Science.gov (United States)

Lim, Sahnah; Peitzmeier, Sarah; Cange, Charles; Papworth, Erin; LeBreton, Matthew; Tamoufe, Ubald; Kamla, Aristide; Billong, Serge; Fokam, Pamella; Njindam, Iliassou; Decker, Michele R; Sherman, Susan G; Baral, Stefan

2015-03-01

Female sex workers (FSWs) in Cameroon, and West Africa generally, suffer a disproportionate burden of HIV. Although violence against FSWs has been documented extensively in other parts of the world, data on violence from West African countries are lacking. The aim of this study was to qualitatively document violence and harm reduction strategies from the perspective of FSWs in Cameroon as well as to understand how experiences of violence may increase FSWs' HIV risk. FSWs from 7 major cities in Cameroon (Douala, Yaounde, Bamenda, Bertoua, Nagoundere, Kribi, and Bafoussam) were purposively recruited. Data from 31 in-depth interviews and 7 focus groups (n = 70; with some overlapping participants from in-depth interviews) conducted with these FSWs in 6 of these 7 cities (excluding Kribi) were analyzed using a grounded theory approach. Transcripts revealed 3 primary themes related to violence: (1) sources and types of violence, including sexual, physical, and financial violence perpetrated by clients and police, (2) harm reduction strategies, including screening clients and safe work locations, receipt of payment before sexual act, and formation of an informal security network, and (3) recommendations on structural changes to reduce violence that emphasized sex work decriminalization and increased police accountability. As in other parts of the world, violence against FSWs is pervasive in Cameroon. Interventions targeting violence and HIV must address the forms of violence cited locally by FSWs and can build on FSWs' existing strengths and harm reduction strategies. Structural changes are needed to ensure access to justice for this population.

Clinical safety of a polyvalent F(ab')2 equine antivenom in 223 African snake envenomations : a field trial in Cameroon

OpenAIRE

Chippaux, Jean-Philippe; Lang, J.; Amadi Eddine, S; Fagot, P.; Rage, V.; Peyrieux, J.C.; Le Mener, V.

1998-01-01

A large-scale clinical trial was conducted, according to World Health Organization Good Clinical Practice guidelines, in 7 centres in North Cameroon to determine the safety and efficacy of a polyvalent antivenom composed of purified F(ab')2. This study included 223 patients presenting clinically with an obvious snake bite, predominantly due to #Echis ocellatus$ (viper), the most abundant species in this savannah region. Clinical surveillance was maintained for 5 d in all patients and until th...

Structure of the Crust Beneath Cameroon, West Africa, from the Joint Inversion of Rayleigh Wave Group Velocities and Receiver Functions

International Nuclear Information System (INIS)

Tokam, Alain-Pierre K.; Tabod, Charles T.; Nyblade, Andrew A.; Jordi Julia; Wiens, Douglas A.; Pasyanos, Michael E.

2009-09-01

The joint inversion of Rayleigh wave group velocities and receiver functions was carried out to investigate the crustal and uppermost mantle structures beneath Cameroon. This was achieved using data from 32 broadband seismic stations installed for 2 years across Cameroon. The Moho depth estimates reveal that the Precambrian crust is variable across the country and shows some significant differences compared to other similar geologic units in East and South Africa. These differences suggest that the setting of the Cameroon Volcanic Line (CVL) and the eastward extension of the Benue Trough have modified the crust of the Panafrican mobile belt in Cameroon by thinning beneath the Rift area and CVL. The velocity models obtained from the joint inversion show at most stations, a layer with shear wave velocities ≥ 4.0 km/s, indicating the presence of a mafic component in the lower crust, predominant beneath the Congo Craton. The lack of this layer at stations within the Panafrican mobile belt may partly explain the crustal thinning observed beneath the CVL and rift area. The significant presence of this layer beneath the Craton, results from the 2100 Ma magmatic events at the origin of the emplacement of swarms of mafic dykes in the region. The CVL stations are underlain by a crust of 35 km on average except near Mt-Cameroon where it is about 25 km. The crustal thinning observed beneath Mt. Cameroon supported by the observed positive gravity anomalies here, suggests the presence of dense astenospheric material within the lithosphere. Shear wave velocities are found to be slower in the crust and uppermost mantle beneath the CVL than the nearby tectonic terrains, suggesting that the origin of the line may be an entirely mantle process through the edge-flow convection process. (author)

Building a competent health manager at district level: a grounded theory study from Eastern Uganda.

Science.gov (United States)

Tetui, Moses; Hurtig, Anna-Karin; Ekirpa-Kiracho, Elizabeth; Kiwanuka, Suzanne N; Coe, Anna-Britt

2016-11-21

Health systems in low-income countries are often characterized by poor health outcomes. While many reasons have been advanced to explain the persistently poor outcomes, management of the system has been found to play a key role. According to a WHO framework, the management of health systems is central to its ability to deliver needed health services. In this study, we examined how district managers in a rural setting in Uganda perceived existing approaches to strengthening management so as to provide a pragmatic and synergistic model for improving management capacity building. Twenty-two interviews were conducted with district level administrative and political managers, district level health managers and health facility managers to understand their perceptions and definitions of management and capacity building. Kathy Charmaz's constructive approach to grounded theory informed the data analysis process. An interative, dynamic and complex model with three sub-process of building a competent health manager was developed. A competent manager was understood as one who knew his/her roles, was well informed and was empowered to execute management functions. Professionalizing health managers which was viewed as the foundation, the use of engaging learning approaches as the inside contents and having a supportive work environment the frame of the model were the sub-processes involved in the model. The sub-processes were interconnected although the respondents agreed that having a supportive work environment was more time and effort intensive relative to the other two sub-processes. The model developed in our study makes four central contributions to enhance the WHO framework and the existing literature. First, it emphasizes management capacity building as an iterative, dynamic and complex process rather than a set of characteristics of competent managers. Second, our model suggests the need for professionalization of health managers at different levels of the health

A Policy Review on The Distribution of Health Operational Aid Funds in Achieving Maternal and Child Health Program (MDGs 4, 5 in Three Districts/Cities of East Java Province

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Niniek Lely Pratiwi

2015-06-01

Full Text Available Background: Health Policy Regulation Number 494/Menkes/SK/IV/2010 on the distribution of BOK funds to local government is one of the government’s responsibility for the development of public health in improving health promotion and prevention efforts in order to accelerate the achievement of MDGs in Health. The purpose of the study is to provide policy recommendations regarding to BOK in achieving the goals of maternal and child health programs. Methods: Secondary data review of the district health profile in 2009-2011 and analysis on the primary data collected from focus group discussion (FGD with invited technical implementor from district health office and health centers as well as some of the staffs of the local government that handle BOK. Results: The decline in maternal and infant mortality rates are still slow and cases of malnutrition increased from the three profile data review Sampang, Gresik and Sidoarjo. Local governments pay little commitment in developing priority strategies of maternal and child health programs in the form of a local action and innovation plan. BOK preventive promotive activities are lacking of monitoring and accountability controls, especially in health centers located far from the district center. Financial accountability is less precise to the programs and targetes, having seen the data of maternal and child health outcomes KN1-KN4 coverage which rose in 2010, but then fell back in 2011. Conclusion: Evaluation and monitoring are needed on the utilization of BOK funds, supervising the activities by the district/city health office, as well as by local community leaders. Prioritise monitoring the health centers in the area with high MMR and IMR. Suggestion: Needed routine and periodic mentoring and coaching in the form of technical assistance related to the utilization of BOK.