Abstract

Lack of access to healthcare services for people living in the Buea may present challenges that can impact not only the actual health treatment, but more broadly their ability to take care of own health and well-being. The problem of distance and lack of finances are major concerns that hinder access to healthcare.

This study seeks to examine the hinderances and access to healthcare in Buea. The study adopted a descriptive survey design to answer the research questions from a randomly selected sample of 110 respondents made up of a population of patients selected from a wide range of health facilities in Buea.

The Chi-square was equally used as statistical analytic tools to analyze data relating to the study. The data revealed that distance acts as a major barrier to accessing healthcare, requiring investments in healthcare infrastructure to reduce travel distances. Financial constraints pose another substantial challenge, necessitating the development of financial assistance programs to support individuals with limited resources.

The findings underscore the significance of addressing the issues related to distance, financial constraints, and the lack of healthcare facilities. The study recommends that Government and Policy Makers should allocate adequate funding for healthcare infrastructure development, ensuring the establishment of health units in underserved areas and reducing the distance barrier to access.

CHAPTER ONE

INTRODUCTION

1.1. Background of the Study

Access to health care may vary across countries, communities, and individuals, influenced by social and economic conditions as well as health policies. (Institute of Medicine US, 1993). Factors considered in terms of health care access include financial limitations (such as insurance coverage), geographical and logistical barriers (such as additional transportation costs and the possibility to take paid time off work to use such services), sociocultural expectations and personal limitations (Rural Health Information Hub. 2019).

Limitations to health care services affects negatively the use of medical services, the efficacy of treatments, and overall outcome (well-being, mortality rates). More than half the world’s population live in cities. It is estimated that, over 90 percent of urban growth is occurring in the developing world. This represents an estimated 70 million new residents to urban areas each year in developing countries. Research concludes that, in the next two decades, the urban population of the world’s two poorest regions, South Asia and Sub-Saharan Africa are likely to double (The World Bank, 2011).

According to the United Nations (UN), the global urban population will grow from 3.3 billion people in 2008 to almost 5 billion by the year 2030 (Baker, 2008; UNFPA, 2007). Nevertheless, owing to inadequate and in some cases lack of some basic services and infrastructure, many households and individuals in many urban areas are being impoverished.

According to Garland, Massoumi, and Ruble (2007,) the pace of urbanization far exceeds the rate at which basic infrastructure and services can be provided, and the consequences for the urban poor have been dire.  Currently an estimated one third of all urban residents are poor, which represents one quarter of the world’s total poor (Ravallion, Chen, & Sangraula, 2007). Thus, contrary to the assertion that urbanization reduces deprivation; current conditions in some cities in many developing countries make the lives of inhabitants worse off. This situation constitutes the phenomenon of urban poverty which has recently attracted tremendous attention from researchers and policy makers (Garland et al., 2007).

The world’s urban poor live with several deprivations such as: limited access to employment opportunities and income; inadequate and insecure housing and services; violent and unhealthy environments; little or no social protection mechanisms and; limited access to adequate health and education opportunities (The World Bank, 2011).

Some groups and individuals including homeless youth and adults, urban slum dwellers, street and working children and households living below poverty lines in many urban areas are thus bedeviled with all these development challenges which make their lives more difficult (Garland et al., 2007; WSP, 2009).

Even though Cameroon’s proportion of doctors (1.9 per 1,000 inhabitants) is twice the minimum recommended by the World Health Organization, the country’s health statistics are paradoxically behind the curve. Life expectancy for Cameroonians has decreased by about two years since 1990, while it has increased by an average of five years in the rest of sub-Saharan Africa. Worldwide, Cameroon is also among the countries where the mortality rate for children under five years of age (122 deaths per 1,000 live births) has decreased the least.

The geographic disparities are striking: 40% of the country’s doctors practice in the Centre region (which includes Yaoundé, the capital), where only 18% of the population lives. On the other hand, the Far North region, which also holds 18% of the population, employs only 8% of Cameroon’s doctors.

Armed conflict continued to plague the Far North Region of Cameroon in 2021, taking its toll on the lives of inhabitants in the Lake Chad region, bordering Nigeria, and in Mayo-Sava and Mayo-Tsanaga departments. The North-West and South-West Regions have also been affected by persistent armed violence and deteriorating security conditions since 2018. Access to health care remains a huge challenge for vulnerable people living in these areas.

In 2021, 38 serious incidents involving health facilities, staff and patients were recorded by health-care bodies. Curfews and an increasing number of roadblocks and other checkpoints make it even more difficult for patients and sometimes even ambulances – to reach health-care facilities.

In the remotest areas, many health centres have trouble retaining staff and obtaining the supplies they need. Some communities are trying to organize themselves to improve access to health care, but the most vulnerable are struggling without systemic support. To maintain population health, primary care is the most important issue which is inexpensive and easy to deliver in a shorter waiting time than inpatient and specialty care (Guagliardo, 2004, WHO, 2008).

Even with unbelievable improvements in health since 1950, there are still a number of challenges, which should be solved easily (Shah, 2014). One longstanding and polarized debate in global health concerns is the appropriate role and balance of the public and private sector in providing health care services to populations in low- and middle-income countries (Berendes et al., 2011).

Since Public Sector delivers services at a very low cost and perhaps it is “fair” in the sense that no one is excluded from getting care on the basis of ability to pay. On the other hand, the perception that private care has better quality, or the greater convenience of private care lead a large number of people to pay for services that they could otherwise get for free or at a highly subsidized rate (Shepard et al., 2002). Interestingly, Basu et al. (2012) proved that usually private sector is not more efficient, accountable, or medically effective than the public sector, anyway, the public sector appears frequently to lack timeliness and hospitality towards patients (Heller, 1982).

People in poor countries tend to have less access to health services than those in the better-off countries, and within countries, the poor have less access to health services (Peters et al., 2008) and receive lower quality and quantity of care (Arcury et al., 2005).

Lack of access to healthcare services for people living in the Buea may present challenges that can impact not only the actual health treatment, but more broadly their ability to take care of own health and well-being. Hinderances and Challenges of accessibility to healthcare ranges from people with disabilities, physical proximity in terms of transportation to health services and the physical structure of the health facility (World Health Organization, 2013, Peters et al., 2008). Notwithstanding this, there exists limited information on access barriers to health care among persons in low and middle-income countries in particular.  This study seeks to provide empirical evidence on the hindrances of accessibility to healthcare in Buea.

1.2. Statement of the Problem

As a result of rapid population growth and socioeconomic heterogeneity, variation in the access to healthcare services can be assumed to occur. This affects the life of people in lower socioeconomic group more adversely if the variation is significantly high.

Many studies have been done focusing on physical accessibility to define spatial equity in service provision. Lu et al (2010) identified inadequate health facilities, long distances to health facilities, lack of effective and efficient transportation systems, inadequate health personnel and inability to afford the cost of health services as major hurdles constraining rural people from accessing health services. (Lu et al 2010)

In Buea, many people die without reaching the hospital. This brings to mind the focus on problems associated with access to healthcare. Firstly, most people cannot afford the transportation cost to reach the hospital. This is common with the rural population of Buea who cannot afford for their daily needs not to mention the transportation cost of reaching the hospital. Even those who can afford transportation cost, there is sometimes inadequate smooth transport means.

The situation in Buea has permitted the movement of only vehicles following the ban of motorbikes when the socioeconomic crises deteriorated. This sometimes cause traffic jams which hinder most people from reaching the hospitals on time. Added to this is the fact that lack of good roads has also caused a problem accessing healthcare services. Those who live in the Suburbs of Buea do not have good roads. This also causes a problem accessing the healthcare services.

Socio-economic hindrances are also a major call for concern. Lack of effective and efficient transportation systems are a general socio-economic challenge of most areas in Cameroon. Equally, long distance covered before accessing health facilities has equally caused a major problem for some people in Buea as some people end up not reaching the health facilities early enough.

To this end, there are no efficient transport routes or advanced transport modes which can make people easily access health facilities and services. In the light of the aforementioned problems, this study therefore seeks to give a better insight by identifying from the respondents the barriers and hindrances of accessibility to healthcare in Buea.

1.3. Research Questions

1.3.1. Main Research Question

What are the hinderances and challenges of accessibility to healthcare in Buea?

1.3.2. Specific Research Questions

1. How does distance hinder access to healthcare in Buea?
2. How are financial constraints a challenge to access to healthcare in Buea?
3. What are the effects of the lack of healthcare facilities in Buea?

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