Drusia C Dickson1, Sabrinah A Christie1, Alain Chichom Mefire2, Eunice Oben2, Frida N Embolo2, Ahmed N Fonje2, Patricia O'Sullivan3, Pius W Akumbu4, Marie Jose Essi5, Rochelle Dicker6, Catherine Juillard7. 1. Center for Global Surgical Studies, University of California, San Francisco, San Francisco, California. 2. Faculty of Health Sciences, Department of Clinical Sciences, University of Buea, Buea, Southwest Region, Cameroon. 3. Department of Medicine and Surgery, University of California San Francisco, San Francisco, California. 4. Center for African Languages and Cultures, University of Buea, Buea, Southwest Region, Cameroon. 5. Faculty of Medicine and Biomedical Sciences, Department of Public Health, University of Yaounde I, Yaounde, Cameroon. 6. Department of Surgery, University of California Los Angeles, Los Angeles, California. 7. Department of Surgery, University of California Los Angeles, Los Angeles, California. Electronic address: c.juillard@gmail.com.
Abstract
BACKGROUND: Populations in Cameroon, a lower middle-income country in Central Africa, have a higher than average burden of traumatic injury, suffer from more severe injuries, and face substantial barriers to accessing formal health care services after injury. The aim of this study was to identify and describe how recently injured Cameroonians use and adapt the formal and informal medical systems and what motivates these transitions. MATERIALS AND METHODS: Recently injured people or their surrogates residing in Southwest Region, Cameroon, were recruited from a larger community-based survey on injury. Semistructured interviews were conducted with 39 recently injured persons or their adult family members. Interviews were recorded, transcribed, and iteratively coded to identify major themes. RESULTS: Most injured persons had complex therapeutic itineraries involving one or more transitions, and nine of 35 injured persons used formal care exclusively. Transitions away from formal care were driven by (1) anticipated costs beyond means, (2) unacceptable length of proposed treatment, (3) poorly supported referrals, (4) dissatisfaction with treatment progress or outcome, and (5) belief that traditional methods work additively with formal care. Factors motivating people to engage with formal care included (1) perceived high value of care for cost, (2) desire for reliable diagnostic tests, (3) social support during hospitalization, and (4) financial support from family or a stranger responsible for the injury. CONCLUSIONS: These results highlight specific opportunities to improve engagement in formal care after injury and better support injured Cameroonians through the strengthening of the formal care referral process and health financing organization.
BACKGROUND: Populations in Cameroon, a lower middle-income country in Central Africa, have a higher than average burden of traumatic injury, suffer from more severe injuries, and face substantial barriers to accessing formal health care services after injury. The aim of this study was to identify and describe how recently injured Cameroonians use and adapt the formal and informal medical systems and what motivates these transitions. MATERIALS AND METHODS: Recently injured people or their surrogates residing in Southwest Region, Cameroon, were recruited from a larger community-based survey on injury. Semistructured interviews were conducted with 39 recently injured persons or their adult family members. Interviews were recorded, transcribed, and iteratively coded to identify major themes. RESULTS: Most injured persons had complex therapeutic itineraries involving one or more transitions, and nine of 35 injured persons used formal care exclusively. Transitions away from formal care were driven by (1) anticipated costs beyond means, (2) unacceptable length of proposed treatment, (3) poorly supported referrals, (4) dissatisfaction with treatment progress or outcome, and (5) belief that traditional methods work additively with formal care. Factors motivating people to engage with formal care included (1) perceived high value of care for cost, (2) desire for reliable diagnostic tests, (3) social support during hospitalization, and (4) financial support from family or a stranger responsible for the injury. CONCLUSIONS: These results highlight specific opportunities to improve engagement in formal care after injury and better support injured Cameroonians through the strengthening of the formal care referral process and health financing organization.
Authors: Anna Tupetz; Marion Quirici; Mohsina Sultana; Kazi Imdadul Hoque; Kearsley Alison Stewart; Michel Landry Journal: Med Humanit Date: 2022-05-02