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The living conditions and experiences of caregivers: a cross-sectional study in public hospitals of Yaounde-Cameroon

Tchamani, R.; Tchapda, R.; Asahngwa, C. T.; Sikati, L. A. F.; Cheuyem, F. Z. L.

2025-09-08 health systems and quality improvement
10.1101/2025.09.07.25335277 medRxiv
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BackgroundIn Cameroons overburdened healthcare system, informal caregivers are partners in patient care. This study aimed to address the existing knowledge gap by providing a description of the living conditions, challenges, and interactions of caregivers in Yaoundes public hospitals. MethodsA cross-sectional study was conducted from April to July 2025 at two public hospitals in Yaounde. Participants included individuals aged 21 or older who had cared for a hospitalized patient for at least two days. Data were collected through face-to-face interviews using a pre-tested questionnaire. The questionnaire gathered information on socio-demographics, hospital experiences, patient care details, and relationships with medical personnel. Data were analyzed with R Statistics, and binary logistic regression was used to identify factors associated with altercations between caregivers and health workers. ResultsA total of 327 caregivers participated in the study. The majority were women (85.0%), and a significant proportion were aged between 41 and 50 years (29.4%). Most caregivers were married (58.7%) and had attained a secondary education level (47.7%). More than half of the caregivers (51.1%) had spent between 4 to 7 days in the hospital, during which they faced dire living conditions: 37.9% slept on benches in hallways, and 30.9% slept on pieces of cloth on the floor. Consequently, 51.7% reported never getting proper sleep, primarily due to poor sleeping conditions (90%) and the presence of mosquitoes (77%). Regarding their role in patient care, 73.7% performed various caregiving tasks, including cleaning patients (69%), dressing patients (61%), and feeding patients (56%). Additionally, 29.4% reported experiencing verbal altercations with healthcare providers, mainly due to patient abandonment (51%), neglect (34%), poor communication (35%), and delays in medical services (29%). Multivariate analysis revealed that caregivers who sometimes experienced difficulties sleeping (adjusted Odds Ratio (AOR) = 4.02; 95% CI: 1.27-17.8; p = 0.033) and those who knew their relatives diagnosis (AOR = 3.23; 95% CI: 1.65-6.86; p = 0.001) were significantly more likely to engage in verbal confrontations with healthcare staff. ConclusionThe findings show that informal caregivers in Yaoundes public hospitals operate under conditions that compromise their physical and psychological well-being. The lack of adequate sleeping arrangements and caregiving burden contributes to tensions. The link between sleep deprivation, knowledge of the patients diagnosis, and altercations with health workers highlights an urgent need for systemic interventions. Addressing these issues requires clear policies that formally recognize the role of caregivers, ensure their basic needs are met, and foster collaborative relationships.

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