Some limitations in healthcare services in Dschang, West Region, Cameroon

Abstract

Successful scaling up of health services in any locality requires knowledge about extant resources, constraints in health policy implementation and delivery of interventions, achievable through biomedical research, thus, this study. Health systems in Dschang, and primary care delivery in three hospitals viz the Dschang District Hospital, the Adlucem Medical Foundation and the “Hôpital Saint Vincent de Paul,” were assessed from September 2007 to April 2008, through interviews and administration of structured questionnaires to heads, personnel and patients, including researchers’ observations. Ambulatory services, nursing and residential care facilities, many allied health professions, intensive care units, hospital infection surveillance and control programs, and informatics were notably absent. Poor hospital reforms led to severe implications particularly for end users. Records carry important information and provide a source of epidemiological data for surveillance systems but personnel were negligent about them. Understaffing, lateness, absenteeism and unawareness resulted in incomplete tasks. Lack of training and incentives, loss of privileges, ethical misconduct, tribal loyalty, socio-cultural and religious barriers, and stigma led to apathy and/or laxity. Cleaners were not well paid nor equipped for their jobs, and where they were non-existent, staff who of course were not motivated, limited cleaning to the wards, leaving out yards and the greater environment littered by wastes. Improving medical and diagnostic services, ferocious attention to nursing and hygiene care, barrier precautions, effective antibiotic formularies, adequate waste disposal and refresher courses to create or enhance awareness were prioritized from May 2009. Hospital administration had to work in synergy with staff and patients to overcome loopholes and scams in healthcare delivery. In the face of global economic down turn, cost efficiency and services boost especially consultations at regional levels should ensure equitable access to health services in the country. The introduction of telephone and computerized bookings for appointments, medical secretaries, receptionists, healthcare assistants and epidemiologists were recommended for consideration.

Keywords: Health systems, personnel, patients, primary care delivery, barriers, mitigation