Factors associated with the readiness assessment of health facility services in Yaounde, Cameroon

Introduction Reliable information on service readiness is essential for strengthening health systems and advancing universal health coverage. In Cameroon, structural imbalances and the predominance of private-sector facilities raise concerns regarding the operational capacity of health facilities to deliver essential services. This study aimed to determine factors associated with health facility readiness in Yaounde to inform evidence-based policy and service delivery improvements. Methods A cross-sectional analytical study was conducted from November 4 to December 27 2024 among health facilities in Yaounde. Data were collected using the World Health Organization Service Availability and Readiness Assessment (SARA) tool. Readiness was measured across five domains (1) trained staff and guidelines; (2) essential equipment; (3) standard precautions for infection prevention; (4) diagnostic capacity; and (5) essential medicines), comprising 47 tracer items. Facilities scoring [≥]80% were classified as having good readiness. Bivariate analyses and multivariate logistic regression were performed to identify factors associated with good readiness. Results A total of 205 health facilities were surveyed; most were urban (97.6%), private secular (89.8%), and categorized as 6th level (86.8%). Overall, 57.1% (117/205) achieved good readiness. Readiness varied significantly across health districts (p=0.015), with Efoulan (78.8%) performing highest. In multivariate analysis, absence of Prevention of Mother-to-Child Transmission (PMTCT) services (aOR=0.17; 95% CI: 0.05-0.55; p=0.003) and absence of childbirth services (aOR=0.18; 95% CI: 0.06-0.55; p=0.003) were independently associated with lower odds of good readiness. Conclusions Only slightly more than half of facilities in Yaounde met the operational readiness benchmark. Availability of PMTCT and childbirth services appears to be a strong indicator of broader facility preparedness. Strengthening maternal and child health service capacity may serve as a strategic entry point for improving overall facility readiness and advancing equitable health system strengthening in Cameroon.