Abstract

With the advent of the rapidly increasing population of Cameroon, it has over the years posed a challenge to the government in providing adequate health facilities and services that can satisfy the needs and wants of the citizens of Cameroon.

Coupled with the country relative low technological know-how as well as poor nature, the government has been unable to handle every sector independently such as the educational, transport, agriculture and health sector.

By this, it has led to the involvement of the private sectors in the managing and running of the country’s affairs as NGOs have over the years been involved and very evident in the health sector that has made enormous contributions very evident in towns such as in Limbe as a number of NGOs are carrying out activities to improve the health sector which is the goal and or the main objective of the study ‘examine the contributions of NGOs in the health sector and what they are doing to ameliorate the health sector in Limbe through their contributions.

The finding of the study will encourage concerned bodies and the government to be more conscious of the works of the NGOs such as how it affects the environment and man both negatively and positively.

CHAPTER ONE

INTRODUCTION

1.0 Introduction

Generally, health systems are of great importance to human beings and society. Therefore, concern with good health is one of the major objectives of social policy in both developed and developing countries.

One of the main features of health care is its delivery system, which varies across countries. Typically, advanced welfare states in Scandinavia have comprehensive systems guaranteeing universal access while most countries, especially in the developing world, have multiple micro- or -mixed systems (World Health Organization (WHO), 2000).

For example, with regard to the study of Freeman (1999), investigations were made on a number of already developed and developing countries such as Finland and Kenya, it was noted that “no pure forms exist, and all contemporary health systems are mixed” (Freeman, 1999). In reality, health infrastructures and functions are organized across diverse sectors – the public, the private and the third sector.

Differences in the organization of delivery systems reflect specific country historical, socio-economic, political and cultural contexts while it is clear that health developments in the past two decades brought by internationalization of health policy thinking have created a convergence on national reform policies. (Ollila, Koivusalo and Baru, 2002).

As it is argued, the 1978 Alma Ata Declaration on Health for All by the Year 2000 marked a “global strategy in health and health services development”. By this, a number of rules, principles and objectives have been used to guide the activities of the health sector among which are the millennium development goals of the United Nations.

The United Nations Millennium Development Goals are eight goals that all 191 UN member states agreed and signed in the year September 2000 to achieve by 2015 following a UN submit among which Cameroon one of the member states is. The Millennium Development Goals (MDGs) were derived from the September declaration and all had specific targets as listed below. (World Health Organization 2018).

Some out of the Eight Millennium Development Goals related to the health sector are;

Goal 4: Reduce child mortality. This goal was aimed at reducing the global rates at which children were dying due to health issues. To achieve this goal, the health sector organized and launched health campaigns whereby, children are being vaccinated against infection from diseases such as polio, meningitis amongst others. With such campaigns, Cameroon for example was declared polio-free in 2015 until 2019 that the campaign against polio was relaunched.

Goal 6: Combat HIV/AIDS, malaria and other diseases. Also, the health sector experienced the manifestation of deadly diseases that threatened world health such as HIV/AIDS, Malaria among many others. In this light, researches were undertaken until the emergence of the Antiretroviral drug that today helps in prolonging the death of HIV patients as well as the discovery of Quinine to fight against malaria.

Goal 8: Develop a global partnership for development that has the following as targets;

Targets of the Millennium Development Goals

Target 8.A: Develop further an open, rule-based, predictable, non-discriminatory trading and financial system Includes a commitment to good governance, development and poverty reduction—both nationally and internationally

Target 8.B: Address the special needs of the least developed countries Includes tariff and quota-free access for the least developed countries’ exports; enhanced programme of debt relief for heavily indebted poor countries (HIPC) and cancellation of official bilateral debt; and more generous ODA for countries committed to poverty reduction

Target 8.C: Address the special needs of landlocked developing countries and small island developing States such as the provision of health needs like drugs, medical instruments and other equipment (through the Programme of Action for the Sustainable Development of Small Island Developing States and the outcome of the twenty-second special session of the General Assembly)

Target 8.D: Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term

Target 8.E: In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries

Target 8.F: In cooperation with the private sector, make available the benefits of new technologies, especially information and communications Official development assistance (ODA).(World Health Organization 2018).

Worldwide, as concerns world health and the millennium development goals, over 191 countries were members involved that signed the agreement at the UN summit in September 2000 such as the United States of America, Britain, France, Germany, including African countries too of which Cameroon was among.

In Cameroon, with her population, constantly increasing and is estimated at over 24millioninhabitants with a density of 42 inhabitants per km2 , with strong regional disparities. This population is predominantly young. The population under 15 years represents 43.6%, meanwhile over half of the population is under 18 years.

Cameroon’s population has experienced a significant change thanks to efforts made particularly by the family planning programme. Thanks to different strategies adapted to the epidemiological context, specific to each disease, undeniable achievements were recorded by the health sector. (National Institute of Statistics 2010).

Health coverage by health care establishments has significantly improved,  varying from  3039 establishments in 2007 to 3370 in 2009. Cameroon’s health system is comprised of 04 general hospitals (1st category), 04 central hospitals (2nd category), 11 regional hospitals (3rdclass), 164 district hospitals, 155 sub-divisional medical centres and 1 888 integrated health centres, of which 1600 are functional. In addition to this, we enumerate 93 private hospitals, 193 non-profit private health centres, 289 clinics/polyclinics and 384 consulting rooms.

Moreover, we enumerate about 12 accredited medical laboratories among which the Centre Pasteur representing the reference, 05 drug manufacturers, 14 wholesalers, 331 pharmacies (181 in Yaounde and Douala), 01 National Centre for Essential Drugs Procurement and Medical disposables, 10 regional pharmaceutical supply centres (CAPR), 03 public medicine faculties in Yaounde, Douala and Buea and 01 private faculty of Medicine (Université des  Montagnes),  and  39  training establishments of medico sanitary personnel.  (National Institute of Statistics 2010).

In the framework of the fight against poverty, Cameroon has adhered to most health policies adopted at the international, level like the African Charter for health development and primary health care.

The health sector has three subsectors, namely the public sub-sector, the private sub-sector and the traditional medicine subsector.  The  interveners  in  this  sector comprise of  the State, households/communities, Civil Society Organizations (CSO),  private,  traditional  practitioners  and finally, technical and financial

partners.

In order to promote and make operational the complementarity between all the health actors, the government through the ministry of public health MINSANTE opted for dynamic contracting interventions. Thus, in 2007, the State embarked on 2nd Budget Tracking Survey (PETS 2) – HEALTH Component xiiPETS 2strengthening the public and private partnership,  through the signing of framework agreements and execution contracts that has led to multiple NGOs getting involved in the health sector in many areas in Cameroon such as Yaounde, Douala, Buea and Limbe which is the focus of this study. (Ibid 2010).

1.2 Problem Statement

With the advent of the rapidly increasing population of Cameroon, it has over the years posed a challenge to the government in providing adequate health facilities and services that can satisfy the needs and wants of the citizens of Cameroon.

Coupled with the country’s relative low technological know-how as well as poor nature, the government has been unable to handle every sector independently such as the educational, transport, agricultural and health sectors.

By this, it has led to the involvement of the private sectors in the managing and running of the country’s affairs as NGOs have over the years been involved and very evident in the health sector that has made enormous contributions very evident in towns such as in Limbe as a number of NGOs are carrying out activities to improve the health sector which is the goal and or the main objective of this study ‘examine the contribution of NGOs in the health sector and what they have done or are doing to improve or ameliorate the health sector in Limbe’ through their contributions.

1.3 Research Questions

This study seeks to answer the following questions;

1.3.1 Main Research Question

The main research question is to evaluate the contribution of NGOs in amelioration the health sector in Limbe

1.3.2 Specific Research Questions

The specific research questions are;

1. What contribution in terms of medication have NGOs done to improve the Health situation in Limbe?
2. What is now the current doctor-patient ratio in Limbe with the involvement of NGOs in the health sector to ameliorate the health status of Limbe inhabitants?
3. What challenges do these NGOs face in carrying out the health sector’s activities in Limbe?