Privatisation des soins de santé en Afrique: Une solution miracle au bénéfice (et au détriment) de qui?

How are healthcare demand determinants changing during the decentralization process in Cameroon?

“…From some developing countries health sector decentralization experiences, it emerges that: (i) not differentiating between approaches in terms of strategic and commercial services and those in terms of social services has led to reforms oriented towards a market approach rather than a social approach to services (in Viet Nam) with negative effects on the universality of access to care, equity and efficiency [14] with the final consequence that poor health cost was higher than that of the rich; ii) the opening up to the private sector has increased the number of patients to this sector by 60% over a period of 10 years, still in the Vietnamese case, with a surge in demand for pharmacies, with a consequence on the increase of self-medication (mainly the poorer strata, less covered by health insurance) and drug resistance risk [15]; iii) decentralization has generated three types of informal care markets in Africa: traditional medicine, street drug market and an informal health insurance market born from tontines [16]. In addition, there is a notable increase in private forprofit structures in urban areas, as rural areas are not able to ensure their profitability [17].…”