QUALITATIVE RESEARCH ON HEALTCARE AND TREATMENT ACCESS OF
PEOPLE LIVING WITH HIV (PLWHIV) IN CAMEROON
BRIEF SUMMARY
The national policy on HIV control set by the Government set many changes in particular with the
adoption of the national strategic plan of fight against AIDS (2006-2010) and the emergence of new
dispositions such as the free access of TAR, reduction of biological examinations costs, 85 HIV care
centers covering the ten regions of the country. Consequently, throughout the country, patients
knew numerous episodes of breaks of the stocks of ARV and reagents. Uncertain and feared of
discontinuity of offered services, certain patients adopted alternate treatments while others simply
abandoned the official circuit of healthcare.
The official circuit of PLWHIV healthcare is long and suffers from a lack of follow-up and this has
considerable consequences: HIV care centers do not know exactly the number of HIV positive
patients and also the number of cases of loss-to-follow-up. This situation raises other problem of
drugs stock management. The static data on patients transmitted to the hierarchy are not reliable;
Drugs’ orders on the basis of these statistics remain rough. Even CENAME declared that "there are
more releases of medicines than declared patients ".
In front of all these challenges, we were interested in finding out what is the path adopted, what are
the realized efforts, what are the stakes and perspectives from the new policy on healthcare access
of PLWHIV. It is in fact, an evaluative approach which underlies this study.
WORK PRESENTATION
It is a qualitative research on the access to healthcare and the treatment offered to PLWHIV by the
Cameroonian public health system.
RESEARCH PROBLEM
It is established that there is a discontinuity in the healthcare so much in the administration of
TAR that in the practice of the biological examinations related to PLWHIV healthcare.
GENERAL OBJECTIVE
Produce a synoptic table on the causes and major constraints related to the discontinuity of PLWHIV
healthcare and collect suggestions for possible improvements on behalf of PLWHIV community and
the central and peripheral actors involved in the chain of PLWHIV healthcare.
METHODOLOGY
The investigation covered 10 regions in functional healthcare centers of PLWHIV at the central and
peripheral level, as well as with NGO / CBO of the PLWHIV involved in HIV control, through in-depth
interviews and focus groups.
MAIN RESULTS
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INCIDENCE OF THE CURRENT FONCTIONING OF HEALTH SYSTEM ON PLWHIV
Outbreak of the emotional sufferings,
Integration of the unofficial circuits of treatments
Proliferation of the new cases of infection,
Development of the resistance to treatment
Proliferation of the early deaths.
IMPLEMENTATION OF NATIONAL STRATEGIC PLAN PROGRAMS.
A bad system of supply and distribution “In order to avoid the total break and to supply all
the parties concerned, commands are half delivered. In other words, in the system, it can
be neither a total break, nor a command totally delivered”. A person in charge of the retail
chain
GRAVITIES ON COMMANDS mainly due to the gathering and of the transfer of statistical data
of the periphery for the central level. "The statistics reach us late and are for the greater
part incomplete; for us to better manage, we need to know the exact number of patients so
as to send sufficient stocks and well planned other ones."
Long process of distribution: A good proportion of the interviewees emphasize on long
geographical distances of certain Healthcare centers from supply structures: lacks of road
infrastructures delay deliveries of reagents and medicines even though they would be
available and free: "The supply in the enclosed regions is limited. In this case, the
beneficiaries of these regions struggle to access to medicines”
Blackmail and overcharging of the biological examinations: During periods of breaks of
reagents or TAR, PLWHIV are exposed to all kind of blackmail on behalf of the nursing staff.
For example, HIV tests which normally cost 500Fcfa are sold at 3.00Fcfa. “Every time we
come to TAR consultation in pharmacy, they ask us to collect 200fcfa by patient before
giving us TAR which are nevertheless free “, declared PLWHIV
A bad system of monitoring and evaluation
Counseling for voluntary test: done by volunteers and associations’ members, they
sometimes don’t have motivation resulting in much absenteeism.
PMTCT: The program seem to work effectively with good results (98% of success
RECOMMENDATIONS
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Effective missions of monitoring and evaluation and supervision have to be regularly
implemented
Verify and transfer reliable statistic data at time
safety stocks are set up at the level of the healthcare centers
The State subsidizes the AGR of the Associations of the PVVS to make them financially
autonomous;
The State to set up a mechanism of auto financing of healthcare of PLWHIV.