ORGANIZATION OF

HEALTH SERVICES
IN CAMEROON
 The health care system in Cameroon involves three sub-sectors:
 A sub-public sector constitutes of; a public hospitals and the
health structures under guardianship of other department
members (Departments of Defense, Department of
Employment, Labor and Social Welfare, Ministry of National
Education).

 A sub-private non-profit sector (religious denominations,

associations and various non-governmental organizations) and
those for-profit.

 A sub-sector of the traditional medicine which is an important

component to the system and that cannot be ignored.
 TheMinistry of Public Health in Cameroon is
responsible for the maintenance and
implementation of all public health services.

 The health structure in Cameroon is divided into

3 levels:
 I- Central level
 Central Services of the Ministry of Public Health: These services
coordinate, regulate, and develop concepts, strategies and policies in
the field of health.

 Structures of care: These structures are represented by: the general

and reference hospitals, the Centers Hospital-Universities, the central
hospitals

 Structures of SYNAME: These structures are represented by the

CENAME (National Center to supply essential drugs), wholesalers
private, the central purchasing of the private non-profit sector.

 Structures of this dialogue: There are the boards of directors or

management committees.
II- Intermediate level
 Administrative Structures: These structures correspond to the
different regional delegations. They provide technical support
to the health districts.
 Structures of care: These structures are represented by the
regional hospitals and assimilated.
 Structures of CENAME: These structures are represented by
the Center Pharmaceutical Supply provincial and the
pharmacies in general hospitals.
 Structures for dialogue: the management committees
 III- Peripheral level
 Administrative Structures: represented by the district health
services, they implement the national programs.
 Structures of care: These structures are represented by: the
district hospitals, medical centers and district health
centers.
 The health services are provided through a decentralized
health system including 10 regional delegations of health,
181 health districts, 2,260 public health facilities, 4 general
hospitals, 3 central hospitals, 14 regional hospitals, 164
district hospitals, 155 sub-division medical centres, and
1,920 integrated health centres.
 Overview of Healthcare in
Cameroon
 Cameroon’s healthcare system comprises a combination of
entities. There are private and public institutions, as well as
companies that offer multiple healthcare services.
 Under the government-funded schemes, most of the country’s
citizens receive free healthcare.
 These schemes get their funding from the Cameroon
government, as well as from public and private enterprises,
religious missions, foreign aid donors, and NGOs.
 The government reserves about 5.5% of its GDP to fund the
public healthcare system, and also to obtain the latest medical
equipment.
 Cameroon’s Ministry of Public Health manages the
country’s healthcare system

 The overall healthcare system of Cameroon is bleak,

with an average of two doctors for every 10,000
people.

 Several people even rely on nurses and other less

qualified medical personnel to access health services
Public Healthcare in Cameroon

 Cameroon’s public healthcare system provides

inexpensive healthcare services and medicines to
residents.
 This system works on three levels: operational, technical,
and strategic.
 Most of the operational hospitals in the country are
located in major cities, such as Douala and Yaounde.
 A few hospitals have medical professionals who are
highly knowledgeable in global healthcare ethics and
practices.
 However, a significant cause of concern in most
public hospitals is sanitation.
 Moreover, healthcare services and facilities are
almost non-existent in rural localities of the
country.
 Despite it being a free system, doctors and medical
staff often ask patients and their families to pay in
cash and insist that they procure medicines from
outside with their own money.
Emergency Services in Cameroon

 Emergency services in Cameroon are also as

lax as services in public hospitals.
 The
number to call for emergency services in
Cameroon is 112.
 However, in case of an emergency, taxi
services are the best option.
Pharmacies in Cameroon
 Many pharmacies located in significant towns of
Cameroon are adequately stocked with necessary medical
supplies.
 There are pharmacies based in remote areas too, but
those mostly do not have many essential and important
medicines.
 You may often have to go quite far to get the necessary
medical aid.
 Alternatively, traditional and Chinese herbs are also
available at many drugstores within Cameroon.
THE HEALTH OF THE
ENVIRONMENT
 LEARNING OBJECTIVES

 By the end of this section, you will be able to:

 Define environmental health
 Discuss environmental public health practice
 Describe the relationship between the environment and health
 Explain environmental public health surveillance
 Introduction
 The environment affects our health in a variety of ways.

 The interaction between human health and the

environment has been extensively studied and
environmental risks have been proven to significantly
impact human health,

 either directly by exposing people to harmful agents, or

indirectly, by disrupting life-sustaining ecosystems
 Introduction con’t
 Although the exact contribution of environmental factors to the
development of death and disease cannot be precisely
determined, the WHO has estimated that 13 million deaths
annually are attributable to preventable environmental causes

 The report also estimates that 24% of the global disease burden
(healthy life years lost) and 23% of all deaths (premature
mortality) are attributable to environmental factors,

 with the environmental burden of diseases being 15 times higher

in developing countries than in developed countries, due to
differences in exposure to environmental risks and access to
health care.
 Introduction con’t
 Healthier environments could prevent almost one quarter
of the global burden of disease. The COVID-19
pandemic is a further reminder of the delicate
relationship between people and our planet.

 Clean air, stable climate, adequate water, sanitation and

hygiene, safe use of chemicals, protection from radiation,
healthy and safe workplaces, sound agricultural
practices, health-supportive cities and built
environments, and a preserved nature are all prerequisites
for good health.
 Basic definitions
 The environment is the air we breathe, the water we drink, the
food we eat, and the places where we live, work, and play

 There is a connection between the environment and the health of

individuals and communities. Likewise, people can affect the
health of the environment.

 Environmental health is the discipline that focuses on the inter-

relationships between people and their environment, promotes
human health and well-being, and fosters a safe and healthful
environment.
 Basic definitions con’t
 An environmental health hazard is a substance that has the
ability to cause an adverse health event.
 This includes physical, chemical, and biological factors that are
external to a person.
 Hazards can be natural or human-made.
 Some examples of environmental hazards include;
• Air contaminants, Toxic waste, Radiation, Disease-causing
microorganisms and plants, Pesticides, Heavy metals,
Chemicals in consumer products, Extreme temperatures and
weather events
 The most common environmental health hazards are air and
water pollution.
 ENVIRONMENTAL HEALTH
PRACTICE

 Environmental health practitioners aim to reduce

environmental hazards and their adverse health
effects through:
 Conducting research
 Developing standards, guidelines, and
recommendations
 Implementing interventions and programs to address
environmental health issues
 ENVIRONMENTAL HEALTH
PRACTICE con’t
Environmental health practices include:
 Collecting and monitoring data on environmental hazards
and health effects
 Identifying environmental hazards
 Investigating environmental concerns
 Stopping or lessening hazards
 Assessing individuals’ exposure to hazards
 Researching possible health effects related to exposures
 Preventing and/or lessening health effects
 Diagnosing and treating health effects
 ENVIRONMENTAL HAZARDS &
HEALTH EFFECTS

 Environmental hazards—like water and air pollution, extreme

weather, or chemical exposures—can affect human health in a
number of ways, from contributing to chronic diseases like
cancer or to acute illnesses like heat exhaustion
 There are gaps in information about how the environment
affects human health.
 Some health effects are known, others are suspected.
 These health effects can be both short term (acute) and longer
term (chronic).
 ENVIRONMENTAL HAZARDS &
HEALTH EFFECTS con’t

 Science has proven some links between health conditions and

the environment. We know that:
 Poor air quality can trigger asthma attacks.
 Elevated blood lead levels in children can cause
developmental disabilities.
 Vulnerable populations like the elderly and infants are most at
risk for heat-related illnesses during heat waves.
 Extreme weather that causes power outages can lead to cases
of carbon monoxide poisoning.
ENVIRONMENTAL HAZARDS &
HEALTH EFFECTS con’t
 Many links between health conditions and the
environment are suspected but not yet proven.
 Health problems with suspected links to
environmental issues include:
 Certain cancers (i.e., bladder, liver)
 Asthma and other respiratory diseases
 Neurological diseases such as Parkinson’s disease,
multiple sclerosis, or Alzheimer’s disease
 ENVIRONMENTAL HAZARDS &
HEALTH EFFECTS con’t

 there is a lot that we don’t know about the

relationships between environmental hazards and
health.
 More research is needed to determine how exposure is
cause for health concern and what levels of exposure are
safe. For most chemicals, we do not know how low level
environmental exposures affect our health.
 After being exposed to an environmental hazard, it may
be possible to detect how much of a substance has gotten
into a person’s body. This is called biomonitoring.
 ENVIRONMENTAL HAZARDS &
HEALTH EFFECTS con’t

Biomonitoring
 Most biomonitoring involves measuring the amount of a chemical or
its breakdown product (metabolite) that is in a small sample of a
person’s blood or urine.
 The amount of the chemical or metabolite in a person’s blood or
urine depends on the amount of the chemical that has entered that
person’s body. Exposure pathways include eating, drinking,
breathing, and touching.
 This amount represents the amount of a chemical that entered the
body from all sources and through all exposure pathways combined.
 it’s important to note that being exposed to an environmental
hazard doesn’t mean that a person will have a negative health
effect.
 ENVIRONMENTAL HAZARDS &
HEALTH EFFECTS con’t

 The effect of an environmental hazard on individual

health is influenced by several factors:
 Dose: How much of the hazard a person is exposed to
 Duration: how long a person was exposed.
 Exposure Route: How a person came in contact with the
hazard (e.g., breathing, eating, drinking,
 Personal Traits: Factors like age, diet, genetics, health
status, lifestyle, and sex
 ENVIRONMENTAL HAZARDS &
HEALTH EFFECTS con’t

 Understanding the connection between our

environment and health is important.
 The more we know about the health consequences
of an environmental hazard, the better we can
protect public health
 through policies, education, and interventions. Let’s
take a closer look at the relationship between air
pollution and health.
 ENVIRONMENTAL HAZARDS &
HEALTH EFFECTS con’t
EXAMPLE: AIR POLLUTION AND HEALTH
Outdoor air quality
 Since the 1950s, air quality has been a major public health
and environmental concern. Local, state, and national
programs have helped us learn more about the problems and
how to solve them.
 National air quality has improved since the early 1990s, but
many challenges remain in protecting public health and the
environment from air quality problems.
 ENVIRONMENTAL HAZARDS &
HEALTH EFFECTS con’t

EXAMPLE: AIR POLLUTION AND HEALTH

Particle pollution
 Particle pollution, or particulate matter, consists of particles
that are in the air, including dust, dirt, soot and smoke, and
little drops of liquid.

 Some particles, such as soot or smoke, are large or dark

enough to be seen. Other particles are so small that you
cannot see them.
 ENVIRONMENTAL HAZARDS &
HEALTH EFFECTS con’t
Being exposed to any kind of particulate matter has been
linked to:
 Increased emergency department visits and hospital stays
for breathing and heart problems
 Breathing problems
 Exacerbated asthma symptoms
 Adverse birth outcomes (e.g. low birth weight)
 Decreased lung growth in children
 Lung cancer
 Early deaths
 ENVIRONMENTAL PUBLIC HEALTH
SURVEILLANCE DATA

 Health surveillance is the continuous, systematic collection,

analysis, and interpretation of health-related data needed for the
planning, implementation, and evaluation of public health practice.
 There are several types of data that are important and useful to
environmental public health practice.
 Environmental Hazard Data
 Exposure Data
 Health Data
 Population Data
 DIFFERENT ENVIRONMENTAL
HAZARD

 Air pollution: From car exhaust to wildfire and e-

cigarette smoke to ozone, pollution is a mix of natural
and manmade substances found both indoors and
outdoors.
 Flame retardants: There are hundreds of chemicals used
in consumer products from electronics to furniture that
help prevent the spread of fires.
 Lead: Old paint, contaminated soil and water, pottery
and even house dust are a few ways people are exposed
to this metal.
 DIFFERENT ENVIRONMENTAL
HAZARD
 Perfluorinated chemicals: These compounds help reduce
friction and also are used to make products resistant to
stains, water and grease.
 Smoke: A single cigarette is chock full of hundreds of
chemicals including arsenic, formaldehyde and lead.
 Pesticides: These chemicals kill, repel or control pests
from weeds and fungus to insects.
 Nanomaterials: Engineered nanomaterials are a concern
because particles are tiny and used in many consumer
materials, structures and devices.
 ENVIRONMENTAL INFLUENCES ON
RURAL EXODUS
 The question of whether environmental conditions
influence human migration has recently gained
considerable attention,
 driven by claims that global environmental change will
displace large populations
 As the evidence of global environmental change has
accumulated over the past decade, academicians, policy
makers, and the media have given more attention to
environmental influences on human migration
 ENVIRONMENTAL INFLUENCES ON
RURAL EXODUS con’t

 At issue is the extent to which factors such as climate

variability and soil degradation serve as push factors for
migration among vulnerable populations, particularly in
the rural developing world, where livelihoods are highly
dependent on natural resources

 Early discussions of this issue assumed that households

usually had few options with which to respond to
deteriorating environmental conditions, inevitably
leading to large-scale, long-distance, and permanent
population displacements
 ENVIRONMENTAL INFLUENCES ON
RURAL EXODUS con’t
 The strongest environmental impacts on migration are
found in studies with a large share of non-OECD
countries, particularly from Latin America and the
Caribbean and Sub-Saharan Africa (Sahel region and East
Africa).
 During extremes of climatic conditions, affected
populations typically migrate to places within their own
region with favorable conditions and eventually return to
their homes within a relatively short period of time
 During periods of drought and flood, populations are
forced to migrate to areas more favorable