National Staff Health Policy: CAMEROON Mission

NATIONAL STAFF HEALTH POLICY
CAMEROON Mission
October 2019
DOCTORS WITHOUT BORDERS (DWB) – OCBA - SW CAMEROON Mission
SUMMARY
SUMMARY_________________________________________________________________________2
I. OBJECTIVES OF THE PRESENT DOCUMENT_____________________________________________3
II. DEFINITIONS & COVERAGE_________________________________________________________3
1. Definitions 3
2. Global Coverage . 3
III. INTRODUCTION__________________________________________________________________4
The Medical responsible______________________________________________________________4
IV. FIRST AIDS______________________________________________________________________5
1. First Aid kit in the office 5
2. First Aid kit in the Vehicles 5
V. HEALTH CARE____________________________________________________________________5
1. General Coverage 5
2. The Health Services Covered………………………………………………………………………….......................... 6

2.1. Primary Health Care......................................................................................................6
2.2. Specialist consultation...............................................................................................................6
2.3. Dental care....................................................................................................................6
2.4. Vision care.....................................................................................................................7
2.5. Hospitalization..............................................................................................................7
2.6. Pregnancy and Follow-up.........................................................................................................7
2.7. Emergency Hospitalization.......................................................................................................7
2.8. Chronic Illness...............................................................................................................8
2.9. Mental Health Support..............................................................................................................8
2.10. Specialized care..........................................................................................................................8
2.11. Work related accidents.............................................................................................................8
2.12. Profesional Illnes........................................................................................................................9
2.13. Others..........................................................................................................................................9
3. Financial participation outside or beyond the scope of the National Staff Health Policy. 10
3.1. Financial contribution in case of sickness and accident not related to work . ...............10
3.2. Financial participation in the context of work accident. ...................................................10
3.3. Financial Participation for pregnant women.......................................................................10
4. Inclusion & Exclusion……………………………………………………………………….…………………………………… 10
5. CONSEQUENCES OF DISEASE OR ACCIDENTS………………….…………………………………………..……….……………..11
5.1. Sick Leave of the employee....................................................................................................11
5.2. After work related accident or occupational disease.........................................................12
5.3. Death of beneficiary................................................................................................................12
6. Procedure in case on a sick leave………………………………….……………………………………………………… 12
7. Maternity leaves……………………………………………………….…………………………………………………………. 13
A) SOCIAL COVERAGE_______________________________________________________________13
B) RULES FOR THE REIMBURSEMENT OF MEDICAL EXPENSES…….……………………………………….14
C) PLACES OF CONSULTATIONS AND HOSPITALOSATIONS……………………………………………………14
Annexe 1………………………………………………………………………………….…………………………………………………14
1.Kit A……………….…………………………………………………………….………………………….……………………….. 15
2.KIT B…………………………………………………………………………………………………….………….…………….….. 15
Annexe 2: Health Facilities approved/recommended........................................................................16
Annex 3: Health Expenses Reimbursement Form……..…………………………………….………………………………17
NSHP-October 2019 Page 2

I. OBJECTIVES OF THE PRESENT DOCUMENT

The Health policy aims to define the modalities for granting health care to national staff working for DWB in SW
region of Cameroon. It is a benefit as a part of the agreements between DWB and its national employees.
II. DEFINITIONS & COVERAGE
1. Definitions
The national staffs of DWB are the citizens and/or the persons with legal residence in Cameroon that has sign a
work contract (employees with fix-term or open contract) local with DWB in Cameroon.
Mission/Country will refer to the Mission of DWB in a country different than Spain, where DWB conducts
humanitarian activities.
The right holders are:

The official(s) spouse(s): The spouse is the person married with the beneficiary, who must provide proof of the
legality of the union. In Cameroon, de facto the polygamy is a common practice. DWB will take care of one
spouse. The salaried spouse and anyone who benefits from health coverage by third parties will not be covered
by DWB (specify the occupation of the spouse and their employer if possible).
For unmarried couples living together, DWB will not cover the partner unless the employee can produce an
official certificate (Certificate of Collective Life) issued by the town hall certifying that the couple is engage in a
legal and long relationship duration (minimum 2 years).
 Direct children (legitimate or natural) are those who have been legally recognized or adopted by the
beneficiary. The beneficiary must provide proof of this filiation and declare any new birth during the
contract. Children are right holders until the age of 18 years old, which must be proved by an official
document (for example the birth certificate)
 DWB will consider as right holder the children until the age of 25 years old in case they are studying (to be
proven by certificate of school attendance).
 The dependent children with physical or mental disabilities (proved by official medical certificate
declaring the dependency) are covered by this policy without age limitation.
The right holders will be the ones registered in the administration database. The official documents to prove the
relationship with the employee need to be within the administration.
The principal beneficiaries are the national employees of DWB and their direct dependants (spouse and children
as stated above).
The daily workers are employees under daily labor contracts within the meaning of the DWB Staff Regulations.
2. Global Coverage:
The present health policy applies essentially to the main beneficiaries. The health care coverage will start from
the first day of work.
The provisions concerning chronic diseases are applicable only to primary beneficiaries under permanent

employment contract or under a fixed-term contract for a minimum duration of one year or permanent positions.
The right holders will receive medical benefits, but are not entitled to any loss of earnings, unless is explicitly
stated. Where the right holders are already covered by other employer or other health insurance, DWB coverage
will apply only after and in addition to such insurance and will be implemented only to supplement the existing
health coverage within the limits defined in this policy.
The coverage in case of work related accident or occupational disease, cover only the employee (and not he
members of the family.
The daily workers are excluded from the medical coverage in this policy, except the work-related accidents and
occupational diseases.
A list of the employees and their beneficiaries is produced by human resources after identification, and provided
to all the actors involved in the chain of care of the health staff and the beneficiaries. This list will be added the
beneficiaries of employees living in Yaounde, Douala or in the Southwest & Northwest provinces. This list will be
updated according to the hiring schedule and once per year during January. These lists will be used to establish
professional and health cards that provide access to health facilities with which care agreements are signed.
III. INTRODUCTION
The objective of this document is to give support the medical and human resources departments to ensure the
minimum of care is in place at mission level in Cameroon.
DWB requires its staff to keep strict medical confidentiality. All medical information concerning people and events
is regarded with the utmost discretion. DWB medical department ensures that the number of persons having
access to medical files and information is limited to the very minimum. Therefore, Medical Coordinator (MedCo)
and the person identified as a Medical Responsible for this activity. In capital mostly the MedCo Assistant and in
the projects the Project Medical Referents (PMRs) and National Staff (NS) Doctor or Nurse (see below ).
The expenses validation and follow up when applicable, is done by the medical department to ensure strict
medical confidentiality throughout the mission.
Any intentional or unintentional breach of this clause shall be deemed serious misconduct and open to sanction
as per the applicable disciplinary process.
The Medical Responsible

The Medical Responsible of the health of the staff and the right-holders are: the Medical Coordinator, and the
Medical Coordinator Assistant; in the projects the Project Medical Referent and the Medical Focal Point for staff
health (Medical Doctor or Registered Nurse).
At the time of hiring, and before the contract is signed an interview with the medical responsible would be held
followed by a compulsory medical check-up adapted to the job, in order to learn the risks inherent to the
profession and to adopt the adequate protective measures. This doesn’t block in any way the contract process of
the employee.
In all the cases, the DWB doctors and nurses are bound by the medical confidentiality, only information necessary
for the reimbursement process will be provided (without mentioning the diagnosis, examinations and treatment).
Apart from the medical responsible involved in keeping the file, no one should be able to identify the condition
without the consent of the person concerned.
According to Art. 100 of the CTC, every employee must be subject to a medical examination before being hired.
This consultation, which serves to establish the physical fitness of the future employee, must be carried out by a
doctor. It goes without saying that hiring will not depend on the outcome of a possible screening test (eg HIV
test).

IV. FIRST AID
First aid kits have to be available in the office, house and vehicles of DWB (also in rented ones). The content and
their use are under the responsibility of the medical responsible (project and coordination).
1. First Aid kit in the office

All the offices should be equipped with at least 1 emergency kit and at best 1 emergency bag.
1. First Aid kit in the Vehicles

There are 2 types of kits:
Kit A (Annex 1) is intended to provide first aid by non-medical persons. This kit must always be available in
all cars. (Including vehicle rental).
Task Person Responsible
Verification of the presence of the kit A in the car and
Driver
inform the medical responsible when necessary.
Verification of the kit (ex. Replacement, expiration

Medical responsible
dates, etc.)
Notification of the items in the inventory sheet The person who use it
A training in first aids should be done to the drivers and a refreshment should be carry on at least every year and
for each new driver.
 KIT B : In addition to Kit A, a Kit B (DWB Standard emergency bag) must be in place in the cars every time
medical staffs is traveling.
Task Person Responsible

Verification of the presence of the Kit A and Kit B in
the car, and inform the medical responsible when Driver
necessary.
Verification of the kits (ex. Replacement, expiring Mission Pharmacist in coordination and
dates, etc.) project Pharmacist in the project.
Notification in the inventory sheet The person that use it
V. HEALTH CARE
1. General Coverage
In the case where care is given outside DWB structures, the preference will be for the structures with which
agreements are signed.
For private structures, the mission can do a selection of recommended structures (annexe 2 “Health Structures”)
This policy is applicable to the health services in Cameroon. DWB will not cover any care or medical evacuation
outside of the country.

2. The Health Services Covered:
General table of the Health coverage
Dependant, Officially
registered in the database
of administration. The
policy applies once the
Coverage Employee Daily Worker
employee is under
contract and 6 months
after the employee has
died
DWB only covers through its care policy in the

country.
General DWB health policy holds some exclusions; - -
DWB offers either care or 100% expenses.
Medical examination at the moment

Yes N/A No
of hiring
Primary health care and specialist Yes Yes No
ANC and PNC Yes Yes No

Hospitalization Yes Yes No
Emergency dental care Yes Yes No
Vision Care Yes No No
Maximum duration of 6
Maximum duration of
Continuing medical care for work- months after the end of Emergency care and
12 months after the
related accidents/ illness the contract of the possible follow ups
end of the contract
employee
Maximum duration of 6
Continuation of ongoing medical Maximum duration of
months after the end of
treatment non work related 6 months after the No
the contract of the
accident/illness end of the contract
employee
Care out of the country No No No
Long-term care in accident / work-

Case by Case No No
related illness
1.1. Primary Health Care

Consultation, medication and investigations
1.2. Specialist consultation

Include if the patient is referred by a general doctor (except for ophthalmology, gynaecology and dentist)
1.3. Dental care

DWB will cover 100% of the emergency dental care such as : treatment of caries, infections and dental abscess,
extractions, sealing.
The fix prosthesis are excluded of coverage (ex. crowns, bridges, implants). As well as cleanings and aesthetic care
are excluded from the coverage. Refunds will be made upon presentation of detailed invoices issued by a
recognized dentist previously identified by DWB . See annex validated health facilities.
1.4. Vision care

1.4.1. For the drivers

One annual check-up is mandatory for all the drivers. Cover includes one pair of basic eye-glass lenses and basic
model frame every year, prescribed by certified ophthalmologist.
1.4.2. For other employees
Every 2 years, one basic frame and lenses will be reimbursed while contact lenses are excluded. The
reimbursement of ordinary glasses and frame will be 100% of the price, up to a maximum of 80,000 CAF for the
glasses and 20,000 CAF for the frame. Refund will be done upon presentation of prescription established by a
recognized ophthalmologist, previously identify by DWB. See annex validated health facilities.
For the non-urgent treatments, in advance the medical coordinator or responsible of the health staff in the
project needs to be notified for the dental and ophtmalmological consultations to avoid misunderstandings.
Beneficiaries: Only the employees. The dependants are not covered.
1.5. Hospitalization
In case of hospitalization in the facility of reference (the one having agreement with DWB), and for all the
treatments covered by this policy, DWB will reimburse 100% of the expenses. The costs of hospitalization,
treatment, laboratory, analysis and other exams are covered to the top-up fixed by the mission.
1.6. Pregnancy and Follow-up

 According to the Art. 84 of CTC, all pregnant female has right to maternity leave of 14 weeks that start
4 weeks before the expected date of delivery. This leave can be prolonged 6 weeks in case of illness
related with the pregnancy or childbirth. In case of multiple pregnancies, the leave will be of 19 weeks
(8 weeks before and 11 weeks after the delivery). During this leave the employer cannot break the
contract of the person.
 According to Art. 85 of CTC, paragraph 1, the woman has also the right of breastfeeding, during a
period of 15 months after the delivery. This permission corresponds to a maximum of 1 hour per day
(considered as working hour).
 The breastfeeding must be promoted, and the schedules will be granted for the employee who
wishes, to allow this one without loss of salary, until the baby reaches 15 months. The time scheduled
will be determined with the supervisor.
 A medical certificate stating the approximate date of delivery must be submitted to the
Administration no later than 12 weeks before the scheduled date of start of the maternity leave.
 DWB will take the necessary measures as far as possible for the protection of the pregnant woman,
from the moment the official information is given. DWB encourages women as much as possible to
announce their pregnancy as soon as possible in order to benefit from suitable working conditions.
 DWB will take care to avoid difficult working conditions due to transport, climate or safety.
 DWB will ensure that pregnant women are prevented from working at night 8 weeks before the
expected date of delivery and 6 months after delivery. This must be taken into account in the
organization of work schedules.
 The costs of normal pregnancy follow-up (4 prenatal consultations and 3 ultrasounds), delivery and
postpartum (2 postnatal consultations, plus family planning). In case of complications during
pregnancy, the number of consultations and ultrasounds can be adapted by medical coordination as
needed.
1.7. Emergency Hospitalization

In case of emergency, the beneficiaries will sometimes have no option but to visit the nearest validated facility.
The medical responsible for the health of the staff will be informed as soon as possible and at least within 24
hours. Emergency hospitalization costs will be covered 100%.
1.8. Chronic Illness

The management of chronic diseases will preferably be done in the public facilities.
We consider some particularities:

- HIV/Tuberculosis treatment & follow-up: Patients should go to MoH trough the national program for
diagnosis and treatment. In case of access constraints DWB can cover the consultations fees and
laboratory cost required. In case of lack of access to treatment it can be discussed with Headquarters
(HQ) Advisor.
- Hypertension & Diabetes treatment & follow-up : DWB cover the consultations fees, laboratory cost
required and the treatment
- Hep C treatment & follow-up: Hep C patients should go to MoH hospital for first treatment line (Sofusvir
SOF/ ledispavir LED). In case of treatment failure, case by case discussion could be necessary with HQ
Advisor and DWB could consider covering the cost of Daclastasvir-DAC or Velpatasvir-VEL.
- Hep B treatment & follow-up: Patients should go patients to MoH for treatment, national program offers
peg-INTERFERON in case of failure treatment a technical opinion is required, and we could consult with
HQ Advisor for advice on a case by case basis.
Referral health facilities:

Yaoundé : Yaoundé General Hospital and Yaoundé Central University Hospital
Douala : Douala General Hospital and LAQUINTINIE Hospital in Douala
Buea: Buea regional Hospital or Mont Mary Hospital
Kumba: Kumba Distrcit Hospital or Kumba Presbyterian Hospital
Bamenda: Bamenda regional Hospital or St Mary Soledad Hospital
When DWB leaves the country, will identify a medical facility to ensure the management of the on-going diseases
under treatment and chronic diseases.
1.9. Mental Health (MH) Support

DWB staff whose distress is related to the general context (not linked to their work with DWB, including chronic
MH issues).
a) Treatment – The therapeutic interventions will be arranged through one external Psychologist who will do
the therapeutic treatment or physically or by phone.
In case the staffs needs psychiatric treatment, he/she will be transferred to the Mental Health units
located in the Regional Hospitals
b) Preventative activities, Session of psycho-education, Psychological first aid and stress management will be
provided by the External Psychologist.
DWB staff whose distress is coming from violence they are exposed to due to work. Psychosocial Unit PSU
together with Medical Coordinator will be the referent for their support. According to the need the external
Psychologist can support in acute phase or even for follow up of these cases.
1.10. Specialized care

Specialized care or treatment (non-emergency surgical procedures, renal dialysis, radiotherapy or cancer
chemotherapy, orthopedics, psychotherapy, kinesitherapie etc.) will be decided on a case-by-case basis after
discussion with medical coordination and for some patients cases with the staff health unit of Barcelona and
the medical Technical Health Advisor of the cell (Barcelona).
For the scheduled surgical interventions, for non-urgent long treatments, it must be discussed with the medical
coordinator or medical responsible in the project. This will allow the employee to know the extent of
reimbursment.
1.11. Work related accidents

The employer and employee have to adopt all the possible measures to prevent or minimize the accidents at
work. The medical responsible and the logistic responsible must ensure compliance with the safety rules and
correct risk behaviour.
1.11.1. Responsibilities

In conformity with the law, DWB is liable as an employer for work-related accidents if there is no evidence of
negligence on the part of the worker. Liability concerns accidents occurring during working hours, during the
performance of a professional activity or accidents occurring during round-trip work (when this journey is a direct
journey home - workplace, to schedules consistent with the beginning or cessation of professional activity). DWB
will therefore provide first aid and, if necessary, refer the injured to an appropriate health center. Accidents of
blood exposure are an emergency, the victim must announce immediately to the medical responsible or a doctor
for immediate care.
1.11.2. Payment of expenses
DWB ensures the contributions for the employees with the CNPS, so that they benefit from a cover in the event of
an accident at work. It is expected that the CNPS will pay the allowances and possibly a pension during the period
of incapacity, and this as well for the contracts of limited duration as for those of indefinite duration. However,
family members are excluded from these benefits.
1.11.3. Formalities
The victim or his representative must inform the medical responsible or supervisor of the occurrence of the
accident as soon as possible. Any accident resulting in temporary incapacity is certified by a medical certificate
which indicates the probable duration of the work stoppage. The constitution of the file for the CNPS (which
includes declaration, medical report, accident sheet, final descriptive certificate or extension) is the responsibility
of DWB. The capital administration assumes the practical arrangements, in particular the notification to the CNPS
within the required period of 3 working days. On the other hand, the administration cannot be held responsible
for the files sent late or incomplete. It is therefore important for the beneficiary or his / her representative to
promptly provide at least one medical certificate and a work accident sheet. DWB has to address one copy of the
declaration and medical certificate to:
 The National Social Welfare Fund (CNPS),
 The Labour Office
1.12. Profesional Illnes

1.12.1. Responsibilities
Occupational disease is a condition that has occurred to a worker as a result of or on the occasion of work. It may
affect everyone, although some are at higher risk (e.g. caregivers exposed to infectious agents or personnel
handling toxic products). The employer and the worker must take all possible measures to prevent or mitigate
this type of disease (protective clothing, vaccination against hepatitis B, etc.). The medical manager and the
logistics manager must ensure that there is no negligence and correct risky behaviour.
1.12.2. Payment of costs and formalities

DWB provides the contributions for employees (both for limited-term contracts and for indefinite-term contracts)
to the CNPS, so that they receive professional cover. The identification and repair criteria are formulated in the
national list of occupational diseases. The CNPS pays the benefits and possibly a pension during the period of
incapacity.
For any occupational disease, DWB undertakes to notify the CPNS of the facts within 15 days and to follow the file
so that the worker can quickly benefit from the compensation due. Pending the benefits of the CNPS, the costs
will be fully covered by DWB, which will follow the reimbursement request by the CNPS.
1.13. Others
1.13.1. Medical examination of employees
Unless prohibited by local law, DWB recommends that all employees undergo a medical check-up as soon as the
contract is signed.
For the same reason, the purpose of the medical check-up is first to protect the employee and not the employer.
Some positions may require a specific medical check up to confirm if the employee is fit to work when the
position requires a certain level of physical fitness (among other visual examination for drivers).

1.13.2. Vaccinations
DWB wants to ensure basic coverage for its employees and be proactive for the dependants. The prescription of
vaccines can be made during a medical consultation.
 If not covered by other structures, DWB bears the costs of: Vaccination of children less than 5 years old:
BCG (at birth), polio, diphtheria, tetanus, whooping cough, hepatitis B, Haemophilus influenza B,
rotavirus, measles, rubella and yellow fever (according to the national vaccination protocol in the health
structures of the Ministry of Health) The vaccines out of the national EPI will not be covered by DWB.
 Vaccinations and boosts for the staff at risk: tetanus, hepatitis B.
 Specific vaccines in case of epidemic.
 Antenatal and Postnatal vaccines
1.13.3. Prevention of HIV infection

Necessary measures for the prevention of HIV infection (screening test, condoms, gloves and protection for
health personnel, preventive treatment in case of exposure or to prevent mother-to-child transmission, infant
formula over a period of 6 months, etc.).
3. Financial participation outside or beyond the scope of the National Staff Health Policy.
1.14. Financial contribution in case of sickness and accident not related to work .
In principle DWB caps reimbursement of medical costs for employees per year and their dependant – jointly - at a
level of 50% of the average annual basic salary in the mission country.
If capping results in a situation in which the individual employees’ or their dependants’ interests are
disproportionately affected DWB may decide to override the cap on a case-by-case basis
Permanent or Total Disability. DWB will cover sick leave up to maximum 12 months. (See table: Social Coverage,
page 15)
1.15. Financial participation in the context of work accident.

The Employee who suffered a work related or non-work related accident will be on sick leave until the level of
his/her disability is confirmed by an independent medical body. During this period the maintenance of the
Employee’s salary and medical benefits will be managed in the same way as a temporary disability/illness (see
table: Social Coverage)
1.16. Financial Participation for pregnant women.

During the pregnancy, DWB will ensure the cover of the primary beneficiary
DWB covers 100% of the costs of the pregnancy under this policy, but is limited to the duration of the employee’s
contract.
4. Inclusion & Exclusion

The medical coverage includes among other:
 Medical Consultations
 Laboratory investigations
 Purchase of medicaments
 Maternal cares
 Delivery
 Hospitalization
 Work related accidents and compensation for the handicaps only for the employee
 Cost of transportation to the place of referral in other cities prior validation.

Exclusion
Except if is covered by the national social security or by a private insurance, the next services are excluded and
will not be reimbursed:
 Plastic and cosmetic surgery
 Slim surgery (ex. gastric collar, etc.)
 Aesthetic and comfort care (spa, hydro clinique, sanatorium, etc.)
 Treatments that are not prove to be effective, experimental treatments.
 Treatments given by a medical practitioner no recognized by the mission (without diploma, traditional
medicine, alternative medicines, etc.)
 Non-medical services or care provided by the hospital like private room, television, telephone, etc.
 Third level treatments (cardiac surgery, oncology, neurosurgery, psychiatry, etc.) will have to be discussed
case by case.
 Treatment for infertility.
 Treatments and surgeries out of Cameroon.
 The costs of treatments resulting of fights or intoxications.
These lists are not exhaustive and in any case, any medical care that DWB deems necessary within the policy
frame will be provided. When the situation in relation to the policy leaves room for interpretation the requested
medical treatment can be assessed by the Medical Coordinator of the mission.
5. CONSEQUENCES or DISEASES or ACCIDENTS

When an employee is unable to work because of illness or following a non-professional accident, he must inform
the medical responsible or his supervisor as soon as possible. This must be confirmed by the DWB medical doctor.
1.17. Sick Leave of the employee

In case of absence because of illness, the justification has to be presented in the 48 hours following the
notification of illness.
The first 3 days must be validated by the Medical responsible after the presentation of the supporting documents.
Beyond 3 days, the Medical responsible must communicate the circumstance of the disease to the medical
coordination, which must validate the taking of additional sick days. If the absence is not approved by DWB
Medical responsible, or if the supporting documents are not presented, sick leave will be refused and the absence
days will be deducted from their next salary payment.
1.17.1. Consequences of the suspension of work - Contract of undetermined duration

As soon as the employee is healed, he returns to his original position.
The pension for permanent disability is the responsibility of the CNPS. The daily allowance must be defined
according to national laws. DWB is however guaranteed to pay the non-professional sick leave for 1 year,
according to the following diagram:
 100% of the salary between 1st and 4th months of absence.
 75% of the salary between 5th and 8th months of absence.
 50% of the salary between 8th and 12th months of absence.
After the 12th month of inability to work, the contract will be terminated automatically and the employee will be
dismissed.
In the event that a long-term disability is established as a result of a non-occupational illness or accident, the
contract will be terminated automatically and DWB will pay the equivalent of 6 months of salary. The employee
and his dependents will continue to benefit from the same conditions of reimbursement of health expenses
during the 6 months. See table: Social Coverage Table page 15
1.17.2. After work suspension – Fix-term contract

As soon as the employee is healed, he returns to his original position. The suspension for illness or accident can go
to the end of this contract, with a maximum of 6 months. Beyond this period, or beyond the 6 months of
suspension, if the employee remains unable to return to his job (disability, confirmed by a medical certificate),
DWB reserves the right to terminate the contract of the employee concerned.
DWB-OCBA considers important to continue financial support for the treatment of chronic diseases after the
termination of a one year contract (fix-term and undetermined). This assistance will be limited to a maximum
period of 6 months for both employees and beneficiaries. The person will have the opportunity to look for
alternative solutions during this period.
The pension for permanent disability is responsibility of the CNPS. For the employees with fix-term contract,
DWB-OCBA will only pay the period originally established in the contract.
1.18. After work related accident or occupational disease

Unlike the case of ordinary sickness, workers who are victims of an occupational disease or work accident are not
affected by the 12-month limit for permanent contracts or 6 months for fixed-term contracts. If the person
concerned cannot resume his previous job, after consolidation of his condition, the employer assigns him tasks
corresponding to his new physical abilities (Special Statutes Article 11, CTC).
In principle, is responsibility of the CNPS to pay the treatments, work reincorporation, indemnities for temporary
disability or pension for permanent disability.
DWB undertakes to supplement social security benefits or to pay affected employees up to a maximum of 48
months of base salary.
For the daily workers, DWB covers all costs related to work accidents, but not salary compensation for loss of
earnings.
1.19. Death of beneficiary

I case of the death of an employee, DWB will contribute with funerary costs with a payment of 500,000 CFA. This
represents the total of the contribution for the cost in case of a death. This payment applies only for the
employees with DWB contract and not for the daily workers. In case of the death of a right holder, DWB will
contribute with funerary cost up to 250,000 CAF.
In case of the death of an employee, all dependants of the employee under treatment for chronic illness (TB, HIV,
Diabetes, Hypertension) at the moment of the death of the employee, will receive a stock of medicines needed to
finish the treatment or to cover a period of 6 months, whichever comes first.
In case of death after a work related accident, the legal heirs of the employee have right to a one-time payment
in aggregate of an amount equal to a maximum of 48 months of salary.
In case of death after a non-work related accident, the legal heirs of the employee have right to a one-time
payment of an amount equal to a maximum 6 months of salary.
Deaths because of occupational illness or work related accident: In case of death due to a work related
accident, the CNPS pay one part of the funerary services, as well as a pension to the survivors, upon presentation
of the death certificate and proof of the heir and identity status (specify the documentation to be provided and
encourage people to complete a form declaring the identity of their heir).
6. Procedure in case on a sick leave

The employee must:
a) Inform personally to the supervisor about his/her absence as soon as possible and at least during the
day of absence.
b) Inform the Medical responsible
c) The employee must provide a medical certificate for the absence. If the certificate does not give
sufficient reason, the absence will be considered as unjustified and the days will not be paid.

d) It is recommended that the direct supervisor maintain contact with the employee who is on extended
sick leave. It is also important for the employee to regularly inform (weekly if possible) his / her
supervisor of developments and dates of return to work.
e) Sick leave of more than one week must be validated by the Medical responsible
7. Maternity leaves
The employee has right to maternity leave of 14 weeks. The father has right to 2 days of paternal leave which
must be harmonized with the internal regulations.
A) SOCIAL COVERAGE
Short Term Disability/Sickness Permanent Disability Death Of Employee
Non-Work
Work Related Work Related Non-Work Related Work Related Non-Work Related
Related
100% of salary to Sick leave Permanent total Permanent total 48 Month lump- lump-sum of
a maximum of benefits up to disability: Lump-sum disability: Lump sum of sum (calculated on minimum 3 months
18 months1 maximum 12 of 48 months of salary 6 months of salary at the basis of basic an maximum 6
months at the end of the the end of the contract salary + seniority of months salaries paid
contract (calculated on (calculated on the basis the Employee) . to dependent
1-4 months: the basis of basic salary of basic salary + loyalty) This lump sum and (calculated on the
100% salary + loyalty) any severance basis of basic salary +
5-8 months: 75% Permanent partial payment are not seniority)
9-12 months: Permanent partial disability: Payment of 6 cumulative. + 6 months health
50% disability: Payment of months of salary pro care for dependants
48 months of salary rata to % of disability Contribution to
pro rata to % of (calculated on the basis burial expenses = This lump sum and
disability (calculated of basic salary + loyalty). 500.000 CFA the severance
on the basis of basic payment are not
salary + loyalty). These lump sums and cumulative.
the severance payment
This lump sum and any are not cumulative.
severance payment are
not cumulative.
The National Social Welfare Fund (CNPS)
In Cameroon, contributions paid by the employer to the CNPS give entitlement to health benefits. Contributions
are based on salary: 7% for family benefits, 1.75% for work accidents and occupational diseases, 4.2% for pension
insurance. To supplement the pension insurance, the employee must pay each month 4.2% of his salary.
DWB contributes to the CNPS so that employees and their dependents receive family allowances: 1,800 FCFA per
month and child under 21, according to part d) on page 27 of the Guide Social Benefits CNPS 2003. It is the
beneficiary to assert his rights with the CNPS, in no case DWB will grant an advance to this effect. These primes
give entitlement to the following benefits for employees who have accumulated at least six (06) months of
contribution: prenatal benefits, maternity benefits, daily allowances paid to women employees on maternity
leave and having totalled at least 06 months of contribution, benefits of medical expenses for pregnancy and
maternity, allowances for dependent children, health cover and benefits in case of illness or accident, old-age
pension, disability pension and survivors' pension.
B) RULES FOR THE REIMBURSEMENT OF MEDICAL EXPENSES
1
After this period DWB shall proceed with: 1. reclassifying the Employee to the position s/he can perform or 2. If no position is available DWB shall proceed
with contract termination according to legal obligations in the mission country.

The following rules are applicable for all medical expenses
• A reimbursement form must be collected from the administration and duly completed to claim a refund.
(Annex 3)
• Receipts must be provided to the Medical responsible with a prescription and / or medical record
(patient's medical record) where the patient's name, age, diagnosis recommendations and prescribed
medications by the consultant must be recorded.
• Receipts for prescriptions should have the names of the drugs and / or medical equipment describing the
item price, the date and the name of the pharmacy.
• The expenses of medical care will be reimbursed by the administration only after validation (signature of
the form) of the medical coordinator (or deputy) or medical referent of the project.
• Once approved; the diagnosis, prescriptions, investigation results, invoices and all other medical
documents will be archive by the medical referent/ medical responsible / MedCo with an archiving
number (noted in the reimbursement form) to find the documentation in case of audit.
• The reimbursement form will be used as piece of justification in compatibility.
NB: Attention the medical information is confidential and should not be shared with non-medical staff or
anyone not involved in the management of the case.
The administrator will only verify the following elements on the receipt:
 The name of the employee (or the dependant)
 The date
 The amount to pay and the currency
 The total cost
 The approval of the medical coordinator (or deputy) or medical referent in the project.
C) PLACE OF CONSULTATION AND HOSPITALIZATION
To ensure that DWB employees and their dependants receive quality health care without financial barriers, DWB
is committed to reach agreements with central, regional and local hospitals:
 In Buea /Coordination:
Agreements with health facilities, pharmacies, laboratories for staff working in Buea and theirs dependants; also
for DWB projects staff ´s dependants living in Buea (see annexe 2: Health Facilities approved/recommended).
Regarding hospitalizations, private rooms are not covered in this policy. Any surplus at the request of the patient
will be covered by the beneficiary. All hospitalized personnel will have to inform the medical coordinator or
medical referent in the 24 hours which follow the hospitalization.
For all care given in structures not approved by DWB the reimbursement of expenses by DWB will not be
validated unless exceptional decision, or emergency not reaching the reference structure, or prior written
agreement of the medical coordination. This agreement can be obtained directly from the medical coordination in
Buea.
Any employee wishing to receive therapy that is not validated or not recognized by DWB and any employee
wishing to receive care in structures that have not been validated will be responsible for all the costs involved in
this care. The staff will have to take their paid leave for the entire period corresponding to their professional
absence.
 In DWB intervention areas (DWB projects) :

Regarding Outpatient cases:

 For DWB staff: the first consultations are carried out by the DWB medical focal point in charge of the
staff's health, with the support of a designated doctor on the project. The drugs are directly served.
 For DWB staff’s dependants living in those areas to refer the Health Facilities approved/recommended
(annexe 2).
Regarding secondary health care:

Health facilities are identified and validated with agreements in each of these sites for hospital and specialized
care. In case of need (care not available on projects) a reference can be considered by medical coordination (see
annexe 2: Health Facilities approved/recommended).
Private rooms are not covered in this policy. Any surplus at the request of the patient will be covered by the
beneficiary. All hospitalized personnel will have to inform the medical coordinator or medical referent in the 24
hours which follow the hospitalization.
For all care given in structures not approved by DWB the reimbursement of expenses by DWB will not be
validated unless exceptional decision, or emergency not reaching the reference structure, or prior written
agreement of the medical referent in the projects.
Any employee wishing to receive therapy that is not validated or not recognized by DWB and any employee
wishing to receive care in structures that have not been validated will be responsible for all the costs involved in
this care. The staff will have to take their paid leave for the entire period corresponding to their professional
absence.
 Outside Buea or DWW projects areas:

In case of illness, health care must be taken in Health Facilities approved / recommended in the Annexe 2.
Medical coordination must be informed. The reimbursement will be done under presentation of the supporting
documents (Invoices, orders, examination reports, receipt ...)
Annex 1
1. KIT A
Car Plastic Box 1st Aid
SMSUGLOE1M- EXAMINATION GLOVE, latex, s.u. non sterile, medium 20
SDRECOMP1S- COMPRESSE GAUZE, 10 cm, 12 plies, 17 threads, sterile 25
SDRECOMN7N- COMPRESSE, NON WOVEN, 7,5 cm, 4 plies, non-sterile 25
SDREBANA103 BANDAGE ADHESIVE, elastic, 10 cm x 3 m 5
SDREBANE06N BANDAGE EXTENSIBLE, non-adhesive, 6 cm x 4 m 5
SDRETAPA025 TAPE, ADHESIVE, roll, 2 cm x 5 m 2
SDRETAPA1P5 TAPE, ADHESIVE, roll, perforated, 10 cm x 5 m 1
DEXTIODP1S2 POLYVIDONE IODINE, 10%, solution, 200 ml, dropper bot. 1
Pocket Mask with valve 1
DEXTSULZ1O5 SULFADIAZINE SILVER, 1%, cream, sterile, 50 g, tube 1
DEXTALCO5S- ALCOHOL-BASED HAND RUB, solution, 500 ml, bot 1
SMSUBLAN1-- BLANKET, SURVIVAL, 220 x 140 cm, thickness 12 microns 1
COTTON WOOL, hydrophilic, roll, 500 g 1
Scissors medium 14cm 1
2. KIT B: (DWB Standard medical emergency box -Backpack)

Annex 2: Health Facilities approved/recommended
In all the projects, certain structure of Ministry of Health and private are identify as option for the employees and
their dependants.
Health Facilities
In the locations not mentioned, consult with the medical coordinator or Medical responsible.
Village/
Health Facility Address Telephone Comments
location
Alakuma Quarter. Bamenda Madre Doris 698 618 Emergencies, Primary
St. Mary Soledad
City 288 ,Secondary cares & Laboratory
BAMENDA
Mr Richard 665 944 Emergencies, Secondary cares
Mbingo Baptist hospital Mbingo Village. Belo City
700 & Laboratory
Buea Town Quarter / Buea Mme Cecilia 677 714 Emergencies, Primary
Mt. Mary
City 267 ,Secondary cares & Laboratory
Admin office 677 866 Emergencies, Secondary cares
Mutengene Baptist Hosp Mutengene City
284 & Laboratory
Salvation pharmacy 656 574 068
BUEA Pharmacy Amazing Pharmacy 678 488 736
Winners Pharmacy 677 692 831
Dentist cares Buea Regional Hospital 670 023 299
External Laboratory Elvira Laboratory 670 441 236
Ophtalmologue Buea Regional Hospital 677 109 190
Situé au Camp SONEL au Mme AMINE Emergencies, Primary
Centre Hospitalier d’Essos (CHE)
quartier Essos 699654939 ,Secondary cares & Laboratory
YAOUNDE
Centre Medical la Cathedrale Emergencies, Primary,
Quartier Fouda 698 491 871
(CMC) Secondary cares & Laboratory
Quartier Beedi a côté
Emergencies, Secondary cares
DOUALA Douala General Hospital Boulangerie MALANGUE, +237 233 3702 49
& Laboratory
Douala.

Kumba Presbyterian Hospital Kumba town 676 861 228
& Laboratory
694 509 157 / 679 790 Emergencies, Secondary cares

KUMBA District General Hospital Kumba town
579 & Laboratory
Baptist Hospital Kumba Kumba town
& Laboratory

Project Code
Annex 3: Health Expenses Reimbursement Form
Project Code
REQUEST FOR HEALTH EXPENSES REIMBURSMENT

Procedures:
1. The Health referent keeps a copy of all documents in an archive. In order to guarantee Medical Confidentiality, only this template (without
diagnosis details and/or treatments) will be given to Administration. Original invoices remain with Medical Coordination (stamped and signed).
2. Please fill all the different rubrics of this document and attach the original invoices and the prescriptions as proves of payments.
3. The invoices must include the following information: header, name, address, stamp and signature of the health structure; name of the patient,
date of medical care provided, cost
4. This reimbursement request must be approved by the Health Referent and validated by the Finance Referent.
Employee Name:
Patient Name: (If dependent, please specify the family link)
Age / DOB:
Position within DWB
PROJECT CODE
List of services or purchase done :

consultation, hospitalization, pharmacy, laboratory investigation, etc. Place (name of the Health
Date Total Cost (XFA)
(For confidentiality reasons, please do not put details on diagnosis and Structure)
treatments)
______/________
/ _______
______/________
/ _______
______/________
/ _______
______/________
/ _______
______/________
/ _______
______/________
/ _______
______/________
/ _______
______/________
/ _______
______/________
/ _______
______/________
/ _______
______/________
/ _______
______/________
/ _______
______/________
/ _______

______/________
/ _______
______/________
/ _______
Total amount:
Checked and approved by: Approved by: Received by

Medical Coordinator FinCo, National Staff,
Name & Signature: ………………………… Name & Signature: ………………………... Name & Signature……..…

National Staff Health Policy: CAMEROON Mission

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NATIONAL STAFF HEALTH POLICY

2. First Aid kit in the Vehicles 5

2. The Health Services Covered………………………………………………………………………….......................... 6

NSHP-October 2019 Page 2

I. OBJECTIVES OF THE PRESENT DOCUMENT

II. DEFINITIONS & COVERAGE

The right holders are:

NSHP-October 2019 Page 3

The Medical Responsible

NSHP-October 2019 Page 4

IV. FIRST AID

1. First Aid kit in the office

1. First Aid kit in the Vehicles

Verification of the kit (ex. Replacement, expiration

Task Person Responsible

Notification in the inventory sheet The person that use it

NSHP-October 2019 Page 5

2. The Health Services Covered:

General table of the Health coverage

DWB only covers through its care policy in the

DWB offers either care or 100% expenses.

Medical examination at the moment

Primary health care and specialist Yes Yes No

ANC and PNC Yes Yes No

Long-term care in accident / work-

1.1. Primary Health Care

1.2. Specialist consultation

1.3. Dental care

NSHP-October 2019 Page 6

1.4.1. For the drivers

1.6. Pregnancy and Follow-up

1.7. Emergency Hospitalization

1.8. Chronic Illness

We consider some particularities:

NSHP-October 2019 Page 7

Referral health facilities:

1.9. Mental Health (MH) Support

1.10. Specialized care

1.11. Work related accidents

NSHP-October 2019 Page 8

1.12. Profesional Illnes

1.12.2. Payment of costs and formalities

NSHP-October 2019 Page 9

1.13.3. Prevention of HIV infection

1.15. Financial participation in the context of work accident.

1.16. Financial Participation for pregnant women.

4. Inclusion & Exclusion

NSHP-October 2019 Page 10

5. CONSEQUENCES or DISEASES or ACCIDENTS

1.17. Sick Leave of the employee

1.17.1. Consequences of the suspension of work - Contract of undetermined duration

1.17.2. After work suspension – Fix-term contract

NSHP-October 2019 Page 11

1.18. After work related accident or occupational disease

1.19. Death of beneficiary

6. Procedure in case on a sick leave

NSHP-October 2019 Page 12

Short Term Disability/Sickness Permanent Disability Death Of Employee

The National Social Welfare Fund (CNPS)

B) RULES FOR THE REIMBURSEMENT OF MEDICAL EXPENSES

NSHP-October 2019 Page 13

The following rules are applicable for all medical expenses

C) PLACE OF CONSULTATION AND HOSPITALIZATION