The ramification of Cameroon's Anglophone crisis: conceptual analysis of a looming "Complex Disaster Emergency"

Structural barriers to maternity care in Cameroon: a qualitative study

BACKGROUND

The maternal mortality and perinatal mortality rate in Cameroon are among the highest worldwide. To improve these outcomes, we conducted a formative qualitative assessment to inform the adaptation of a mobile provider-to-provider intervention in Cameroon. We explored the complex interplay of structural barriers on maternity care in this low-resourced nation. The study aimed to identify structural barriers to maternal care during the early adaptation of the mobile Medical Information Service via Telephone (mMIST) program in Cameroon.

METHODS

We conducted in-depth interviews and focus groups with 56 key stakeholders including previously and currently pregnant women, primary healthcare providers, administrators, and representatives of the Ministry of Health, recruited by purposive sampling. Thematic coding and analysis via modified grounded theory approach were conducted using NVivo12 software.

RESULTS

Three main structural barriers emerged: (1) civil unrest (conflict between Ambazonian militant groups and the Cameroonian government in the Northwest), (2) limitations of the healthcare system, (3) inadequate physical infrastructure. Civil unrest impacted personal security, transportation safety, and disrupted medical transport system. Limitations of healthcare system involved critical shortages of skilled personnel and medical equipment, low commitment to evidence-based care, poor reputation, ineffective health system communication, incentives affecting care, and inadequate data collection. Inadequate physical infrastructure included frequent power outages and geographic distribution of healthcare facilities leading to logistical challenges.

CONCLUSION

Dynamic inter-relations among structural level factors create barriers to maternity care in Cameroon. Implementation of policies and intervention programs addressing structural barriers are necessary to facilitate timely access and utilization of high-quality maternity care.

Assessing the status and spatial-temporal dynamics of the Bamenda Mountains (BM), North West region of Cameroon

Change in land use and land cover (LULC) contributes in worsening ecological issues. Studying the trends of change in land use is highly significant to deal with global climate change and sustainable development. The aim of this paper is to evaluate the spatial-temporal dynamics of LULC of the Bamenda Mountains (BM) in the North West region of Cameroon, over a period of 34 years (1988-2022) and predict 34 years (2022-2056) future land use scenario of this site using time series satellite imagery (MSS, TM, ETM+, and OLI-TIRS) and ancillary data and to comprehend the driving forces of land use/land cover change (LULCC). The trends of LULCC were quantified; LULC maps were derived by classifying time series satellite images. Six LULC categories were identified during the study period (1988-2022). The research revealed a significant LULCC of the BM which can be justified by increase in the human population observed in the study area and the desire to extend agricultural lands to sustain the growing population. Overall, cultivated area 5684 ha (10.47%), 10680 ha (19.57 %), and 15163 ha (27.78%) and built-up area 449 ha (0.83%), 996 ha (1.83%), and 3242 ha (5.94%) for the study years 1988, 2003, and 2022, respectively, were all on the increase throughout the study period at the expense of other land cover types. The predicted figures of 2056 showed a continuous reduction of montane forest and savanna: 2401.92 ha (4.40%) and 25,862.67 ha (47.39%), respectively. Bare area is expected to drop in 2056 (2905.92 ha (5.32%)). The above decrease, when compared to 2022 figures, represents a loss of 3.97%, 4.53%, and 0.57%, respectively. The losses observed are gained by built-up and cultivated land (5.72% and 3.39%, respectively), covering surfaces areas of 6364.89 ha (11.66%) and 17,008.56 ha (31.17%), respectively. The above findings suggest that population growth is likely the major menace to the natural environment. It is thus safe to say that substantial LULCC was observed throughout the study period and will undoubtedly continue if nothing is done. This necessitates urgent measures such as reforestation and afforestation, encouraging off-farm activities and even improving technologies to combat the rate of forest degradation of the BM. Additionally, rebuilding trust between the French and English Cameroons through dialogue is premodial, to end the curent conflictual civil war and lessen the landscape configuration in Bamenda.

Developing a Low-Cost IoT-Based Remote Cardiovascular Patient Monitoring System in Cameroon

(1) Background: Cameroonians are exposed to poor health services, more so citizens with cardiovascular-related diseases. The global high cost of acquiring healthcare-related technologies has prompted the government and individuals to promote the need for local research and the development of the health system. (2) Objectives: The main goal of this study is to design and develop a low-cost cardiovascular patient monitoring system (RPM) with wireless capabilities that could be used in any region of Cameroon, accessible, and very inexpensive, that are able to capture important factors, well reflecting the patient's condition and provide alerting mechanisms. (3) Method: Using the lean UX process from the Gothelf and Seiden framework, the implemented IoT-based application measures the patients' systolic, diastolic, and heart rates using various sensors, that are automated to record directly to the application database for analysis. The validity of the heuristic evaluation was examined in an ethnographic study of paramedics using a prototype of the system in their work environment. (4) Results: We obtained a system that was pre-tested on demo patients and later deployed and tested on seven real human test subjects. The users' task performances partially verified the heuristic evaluation results. (5) Conclusions: The data acquired by the sensors have a high level of accuracy and effectively help specialists to properly monitor their patients at a low cost. The proposed system maintains a user-friendliness as no expertise is required for its effective utilization.

Conflict, healthcare and professional perseverance: A qualitative study in a remote hospital in an Anglophone Region of Cameroon

Armed conflicts are a major contributor to global disease burden owing to their deleterious effects on health and healthcare delivery. The Anglophone crisis in Cameroon is one of the ongoing conflicts in Sub-Saharan Africa and has led to massive displacement of healthcare workers (HCWs). However, some HCWs have stayed back and continued working. An understanding of their experiences, perspectives and professional perseverance is lacking. We designed a phenomenological study using Focused Group Discussions (FGDs) and in-depth interviews to: understand the experiences of 12 HCWs in a remote hospital in the North West region of Cameroon with armed groups; evaluate how it affects healthcare delivery from HCWs perspective and examine HCWs coping mechanisms during the conflict with a view of informing HCW protection policies in conflict zones. Results revealed that HCWs go through all forms of violence including threats, assaults and murders. Overall insecurity and shortage of health personnel were major barriers to healthcare delivery which contributed to underutilization of healthcare services. Participants observed an increase in complications due to malaria, malnutrition and a rise in maternal and infant mortality. The hospital management and Non-Governmental Organizations (NGOs) played an essential role in HCWs adaptation to the crisis. Nevertheless they unanimously advocated for a cease fire to end the conflict. In the meantime, passion for their job was the main motivating factor to stay at work.