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Ministère de la Santé Publique du Cameroun

FPAE CASS-RT / Un. Ydé I GRAPS / Un. Ydé II. Evaluation of access to ART and decentralization of health care delivery in Cameroon French Agency for AIDS Research (ANRS) Program in Economic & Social Sciences. Ministère de la Santé Publique du Cameroun. National ART Programme in Cameroon.

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Ministère de la Santé Publique du Cameroun

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  1. FPAE CASS-RT / Un. Ydé I GRAPS / Un. Ydé II Evaluation of access to ART and decentralization of health care delivery in Cameroon French Agency for AIDS Research (ANRS) Program in Economic & Social Sciences Ministère de la Santé Publique du Cameroun

  2. National ART Programme in Cameroon Use of preexisting decentralized framework of health care system (<1992- 174 districts) for ART delivery: In 2001- 2002: from reference centers in central hospitals to provincial hospitals (24 ATCs) From 2005: 106 MUs in district hospitals (WHO public health approach for care algoithms) including 35 from private sector Generic oriented procurement of ARV drugs (70% total) through monopoly of imports for CENAME (National Agency for Drug Procurement) Decrease of monthly ART prices for patients: from 250,000 FCFA in 2000 to between 3,000 and 7,000 FCFA in 2004 (1$= 496.6 FCFA) Gratuity of ARVs introduced in May 2007 85% of total AIDS budget (139,2 Million US$-2004/2007) funded by foreign aid

  3. Independent evaluation of national ART program in Cameroon

  4. Cross-sectional survey in a random sample of 3,151 adults, HIV diagnosed for at least 3 months and seeking care in 14 ATCs & 13 MUs in 6 provinces (response rate = 90%) Survey in the exhaustive sample of HIV care physicians in the same centers (n=97, resp. rate= 92%) and stratified sample of other healthcare personnel (n= 208, resp.rate= 82%) Data collection on characteristics of the 20 public and 7 private health facilities Semi-structured interviews (n=25 health personnel & 53 patients) EVAL ANRS 12 116 (methods)

  5. Characteristics of HIV-infected patients in the EVAL Survey (n=3,151)

  6. Multilevel mixed effectsmodels (ref= central level of care) ART-treated patients (n=2,132)

  7. CAMEROON • Direct out-of-pocket costs related to HIV infection(by month – median)(n=2,132 ART-treated pts) - Catastrophic Health Expenditures (≥ 20% households’ resources) : 44%

  8. CAMEROON EVAL ANRS SurveyFactors associated with the risk of catastrophic health exp.* (n=2412)

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