Healthcare coverage and associated factors in Cameroon: analyses from a national survey

BackgroundEmergency medicine systems are vital for reducing mortality and disability, yet Cameroon faces significant healthcare access challenges, with only 0.6% of GDP allocated to public health and 70% of health expenditures paid out-of-pocket. This study assessed proportion of population benefiting from health coverage, patterns, and associated factors in Cameroon to inform policies aimed at achieving universal health coverage (UHC). MethodsA nationally representative cross-sectional survey was conducted from February to March 2024, involving 1,200 adults selected via multistage random sampling. Data were collected through face-to-face interviews by national Afrobarometer team, and analyzed with R Statistics version 4.4.2. Logistic regression identified factors associated with medical coverage, adjusting for sociodemographic, economic, and occupational variables. ResultsA proportion of 7.9% (95% CI: 6.4-9.6) of respondents reported benefiting from a health coverage in 2024, with the lowest rates reported in the North, Adamawa, Centre, and North-West regions. Private health insurance was the most common (44.3%), followed by civil servant schemes (20.5%) and community-based insurance (15.9%). Unemployed individuals were twice as likely to lack coverage (aOR = 2.22, 95% CI: 1.42-3.51). Those with secondary education had twice the odds of being uninsured compared to tertiary-educated individuals (aOR = 2.00, 95% CI: 1.21-3.27). Insured individuals were more likely to use healthcare services (9.6%; p = 0.028), reported easier access to medical care (15.8%; p = 0.010), and expressed fewer concerns about healthcare access (23.4%; p < 0.001). Barriers among the uninsured included high costs (37.1%), lack of information (31.6%), complex registration processes (8.5%) and geographical constraints. Most of the community members reported being quite (51.1%) or very satisfied (23.9%) by the medical coverage they are benefiting from. Notably, 68% of respondents supported higher taxes to improve healthcare access. ConclusionCameroons suboptimal medical coverage reflects systemic inequities tied to employment and education. Expanding employer-independent schemes, subsidizing premiums, and leveraging community-based models are critical to advancing UHC. Public willingness to contribute through taxes suggests political viability for systemic reforms.