Community-based mutual aid for improving financial access tos healthcare: case study of 150 community-based organizations in Cameroon

Abstract

Background: Financial access to health care has been sharply reduced in Africa following the introduction of cost recovery recommended by the Bamako initiative of 1987. Like in many countries in the world, in Cameroon, community-based organizations (CBO) which assist their members in the event of a financial crisis, death, funeral, birth, marriage, etc. added financial assistance in case of illness to alleviate this situation. This study aimed to determine models of financial assistance practiced by these organizations to rescue their members in event of illness.Method: Study was based on a sample of 150 CBO selected for convenience in 3 zones, including 50 in urban areas, 50 in semi-urban areas, and 50 in rural areas. Previously trained interviewers organized group discussions to collect data from these organizations using structured interview guide. The analysis of data collected was done manually.Results: The results show that 82.66% of organizations practice the "rescue quest model", 10.67% the "lump sum health assistance model", 2.67% "health tontine model", 2% "sickness deposit model", and 2% "subcontracting model" with an insurance company. The analysis shows that the "health tontine" and "sickness deposit" models are more forward-looking because they can make money available in time, before seeking care/before disease worsens.Conclusions: The systematization of these models could make it possible to mobilize funds on a community basis to extend the coverage of the financial risk linked to the disease to the populations of the informal and rural sector.