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.
Background: Depression in its severe form can lead to suicide. In Africa, a couple of studies have been carried to evaluate depression in medical students. These studies have provided variable findings on the prevalence of depression in medical students and associated factors. Given the considerable variability and somewhat controversial findings in the different studies, there is a need for a systematic review study to critically appraise the existing literature.Methods: This was a systematic review of studies published between January 1, 2000, and December 31, 2019 in the selected databases. We used Medical Subject Headings (MeSH) combining relevant keywords to search the databases.Results: Data was extracted from 4 studies included in this review involving a total number of 1848 medical students. The prevalence of depressive symptoms range from 23.3 to 76.5% and major depression was reported in 15.6% and 30.6% of participants in 2 studies. Female gender and being a student in higher level of studies were significantly associated with depression in all included studies. Other factors associated with higher levels of depression included smoking, alcohol consumption, being unmarried, major life events, presence of other mental health condition and the presence of chronic medical condition.Conclusion: Despite paucity of research on depression among medical students in Africa, this review shows that depressive symptoms are common and associated with a number of socioeconomic factors. Being a female student and/or higher level of medical education is associated with depression. There is need for more robust studies to evaluate the impact of depression on medical students.
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