Abstract

The world’s vulnerable population showed that highly vulnerable people live in the developing world and only few of the population; live in the developed economies are highly vulnerable compared to the poorest in developing countries. Many people in low and middle income countries in the world usually suffer from poor health care causing high death rate.

Among them are mostly the vulnerable group which include: persons with physical disability, and orphans. The main objective of the study was to examine access to health care among these vulnerable groups within Buea and Tiko Health district in Fako Division in South West Region of Cameroon. Sampling technique used was a purposive and convenience. The sample size was 385. Questionnaire and interview guide were used for data collection.

Data was analyzed using SPSS MS Excel and the results were presented on pie chart, bar charts and Frequencies tables. From findings, it was revealed that persons with disability have much limited access to primary health care than expected by the law. It was also found out that the health care experiences faced by orphans also influence their accessibility to healthcare.

Based on the findings it is recommended… policy development, practice consideration and future research that could lead to more equitable access to health care. Importantly, there should be the need for health policies that aim to address health problems especially with the vulnerable people, considering all the dimensions and their interactions. In terms of practice, the need to provide in-service training to health care providers on how to enhance their communication skill should have considered in order to better attend to this sector.

CHAPTER ONE

INTRODUCTION

1.1 Background to the study

Access to healthcare has been expanding steadily over the past few decades. According to the Global Burden of Disease Study, scores for the Global Healthcare Access and Quality Index increased steadily over time, rising from 37.6/100 in 1900 to 42.4 in 2000 and 54.4 in 2016. Despite the World Health Organization’s member nations adopting universal healthcare coverage, access to healthcare remains a significant issue Jacob Bae (2012). According to the 2017 Global Monitoring Report from the World Health Organization, 7.3 billion people are unable to receive all the necessary health services.

According to Kruk’s (2018) thorough review of deaths that could have been prevented in 137 countries, 8.6 million more deaths than necessary took place in 2016 as a result of access or quality issues with healthcare, primarily in Low and Middle-Income Countries. Every country’s health sector is of utmost importance to its citizens and residents since it serves as a foundation for a country’s progress and as a gauge of that country’s level of development. The majority of the vulnerable groups make up the bulk of those who suffer from poor health care, which affects most people in low- and middle-income nations. About 85% of these deaths occur in low-income countries. Widows, orphans, the elderly, people who have recently moved within their country, street children, women, and people with disabilities are a few examples of vulnerable groups.

The provision of healthcare services is a major concern for the world’s population, especially in developing nations. Cities in developing nations have been growing at a rate never before seen. The growing need for healthcare services and every other type of infrastructure and public healthcare services necessary to guarantee the fundamental quality of life are in line with the expanding population. As a result, there may be a time when the infrastructure and public facilities already in place are unable to adequately serve the continually growing population. “If population grows faster either through Kuncoro (2013) natural growth or movement in areas facilitated with more services than others, it is possible that the per-capita measure of facility availability could be worsened”. If continued, this process might gradually lead towards significant variation further fuelling inequality in service provision.

Healthcare access is a complicated idea that is intricately linked to the effectiveness of health systems. In order to achieve universal health coverage, the World Health Organization has been pressuring its member nations to overhaul the healthcare system. In the framework of universal health coverage, the financial component of access to healthcare has received a lot of attention. Spooner (2021) states that “universal health coverage ensures that all people have access to health services of sufficient quality to be effective, including prevention, promotion, treatment, rehabilitation, and palliation, while also ensuring that the use of these services does not expose the user to financial hardship”. However, there are additional aspects or abilities that need consideration when discussing healthcare access in addition to affordability. The global issue of many communities having inadequate access to healthcare has attracted attention from all across the world over the years. As a result of this focus, several initiatives to improve this situation and create cutting-edge healthcare systems that are centered on illness prevention have been launched. McCarthy (2012), expanding healthcare access.

One of the biggest obstacles to receiving medical care is a lack of proper health insurance, and variations in coverage also affect people’s levels of health. Medical debt is frequent among both insured and uninsured people, and it can cause people to put off or forego needed care (such doctor appointments, dental work, and prescription medicine). People with lower incomes are frequently uninsured, and according to Majerol (2015), minorities make up more than half of the uninsured population, making vulnerable populations particularly at risk for inadequate health care coverage. WHO states that citizens of many nations have restricted access to primary healthcare (2018). This condition is a result of a number of issues, including the socio-demographic makeup of the population, a lack of resources, difficulties with the primary-care model, and government healthcare officials’ unwillingness to take into account Uneke (2013) community input on healthcare needs. As a result, many people encounter illnesses that are not necessary, and communities have high rates of mortality and morbidity due to avoidable causes. Many African nations are experiencing this awful circumstance.

WHO states that citizens of many nations have restricted access to primary healthcare (2018). This condition is a result of a number of issues, including the socio-demographic makeup of the population, a lack of resources, difficulties with the primary-care model, and government healthcare officials’ unwillingness to take into account Uneke (2013) community input on healthcare needs. As a result, many people encounter illnesses that are not necessary, and communities have high rates of mortality and morbidity due to avoidable causes. Many African nations are experiencing this awful circumstance.

The factors that hinder people from receiving the adequate and quality care they require or from accessing the care they need are known as barriers to healthcare access. Numerous impediments to care have been found by earlier investigations. These include organizational barriers like long distance, transportation, long waiting lists, referral barriers from Tarannum (2019), primary to secondary providers, and communication barriers-migrants moving to new places and environments. Personal barriers like individual perceptions and beliefs of needs are also included. Financial barriers are also included. Low income is viewed as a barrier to health care.

African nations experience higher rates of sickness and fatalities from preventable and treatable causes than other nations. In reality, respiratory infections, pregnancy-related problems, and infectious diseases including HIV/AIDS, TB, and malaria account for 72% of all deaths in Africa. According to WHO (2016), 19 of the 20 nations with the highest maternal mortality ratios worldwide are in Africa, and deaths caused by these conditions account for 27% of all deaths in all other World Health Organization regions combined.

According to data, sub-Saharan Africa has a prevalence of HIV among people aged 15 to 49 that is nearly seven times higher than that of other regions of the world, at 5.4 percent compared to 0.8 percent, respectively. According to WHO (2013), Africans also account for 90 percent of the 300-500 million clinical cases of malaria that occur each year, 2.4 million new cases of tuberculosis each year, and 29 percent of infant mortality rates. These poor health results are a result of 58 percent of the population not having access to clean drinking water, and 36 percent of the population not having access to improved sanitation facilities. in rural areas, in particular.

Nevertheless, the history and present state of basic healthcare in Africa, and particularly in Cameroon, also contribute to these poor health conditions. Many countries have made progress in this direction, but due to the early influence of Christian missionaries, Cameroon is dependent on the French health care system, there is insufficient government capacity, and the Anglophone crisis has left the country in a state of political, economic, and social unrest and unable to accept a Spooner. (2021) governmental infrastructures to meet its citizens’ different cultural demands, particularly those of the most disadvantaged. The country’s capacity to provide adequate healthcare for its expanding population, particularly in rural areas, is particularly stretched.

1.2 Statement of the Problem

The World Health Organization estimates that over a billion people worldwide have some sort of handicap, and that number is steadily rising as a result of geographic shifts, the prevalence of health disorders, and other factors. The majority of this population, who reside in low- and middle-income nations, is typically in bad health.

Government decree N° 2018/6233 of July 28, 2018, and government law N° 2010/002 of April 13, 2010, respectively, both stipulate that people with disabilities in Cameroon are entitled to free or subsidized medical care, including exemption or reduction of medical fees for consultations, laboratory tests, radiography or medical imaging, hospitalization, medical evacuation, and the purchase of specific medications in both specialized institutions, including public or private health facilities. In accordance with this regulation, they are also entitled to discounts on a selection of goods and materials designed to cure particular illnesses or facilitate functional rehabilitation, based on the rate of their Permanent Potential Incapacity (PPI).

Physically impaired people have trouble getting access to healthcare because they don’t receive the same care as “normal” people because of their impairments. But the purpose of this study is to determine whether people with disabilities are aware of this rule and whether it is being followed in all public and private health facilities.

The rights to a personal existence and development, a typical family life, health and welfare, safety and protection, and involvement in society are also guaranteed to orphans, according to J.B. Hatt (2018). Orphans face numerous difficulties and live in poverty. If we want everyone to work together on the same platform, the most important necessity of orphans is their health (equity). Typically, orphans are not taken into account while formulating healthcare plans. Because of this, it was interesting to learn how orphans manage their health issues as well as the strategies used to lessen these problems.

People who are physically challenged and orphans typically struggle since many people view them as a burden. Because of this, they are frequently overlooked because they cannot afford medical care, physically disabled people are made fun of because of their condition, orphan children are mistreated, some are forced into child labor, and others are branded and discriminated against. All of factors make it more difficult for them to get healthcare. A thorough strategy that encompasses prevention, early diagnosis, efficient screening and treatment programs, and patient accessibility to healthcare could lower the fatality rate (Spooner. 2021).

1.3 Objectives of the Study

The objectives of this research was divided into two

1.3.1. Main Objective

To assess access to health care among the vulnerable groups: persons with disabilities, orphans and physically disabled persons within Buea and Tiko Health district in Fako Division, South West Region of Cameroon.

1.3.2. Specific Objectives

1. To examine access to consultation and treatment among persons with disabilities in Buea and Tiko Health district, as specified in government regulation.
2. To examine experiences of Persons with disabilities and Orphans on health care accessibility within Buea and Tiko Health on health district.
3. To propose measures to mitigate the challenges faced by vulnerable persons in accessing health care within Tiko and Buea Health District.

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