The reorientation of primary health care in cameroon: Rationale, obstacles and constraints

The reorientation of primary health care (PHC) that was begun in Cameroon in 1989 is presented as a natural response to the economic and health environments prevailing at that time. A brief discussion of the original PHC policy introduced following the Alma-Ata declaration identifies a lack of effective communication between the community and the health services as a major problem. The basic elements of the reorientation are presented and the obstacles and constraints encountered since beginning the reform process in 1989 are described. These have been identified as: an inadequate legal framework; incompatibilities between the political structure and the new health structure; incompatibilities between the goals of the new health policy and the organizational chart of the Ministry of Health; the lack of trained personnel in health management; a highly centralized system of management with poor coordination of human resource management; the slowness of the extension of PHC coverage; the inability of the system to ensure that medicines are available and easily accessible; an inadequate health information system; poor promotion of the new PHC policy; and poor coordination of research activities. © 1993 Oxford University Press.