ABSTRACT
For several decades Cameroon's healthcare system has faced a multitude of challenges. These challenges are associated with observed shifts in the country's demographic profile, epidemiology, lifestyle, technological advances, and environment change. Health outcomes are among the poorest in the world. Cameroon's medical infrastructure and available human resources fail to meet the demand for care. Public financing accounts for only 3% of the national budget, thus Cameroonians spend large shares of their household budget on healthcare. Cameroon has benefited from national and international financial support for healthcare. This has helped establish 31 healthcare financing programmes (HFP) in Cameroon. This chapter reviews the practice of economic and efficiency evaluations of HFP in Cameroon. It also presents the main challenges faced when conducting these assessments. The chapter stresses the need for continuous monitoring and evaluation of Cameroon's healthcare sector financing, both in the current COVID-19 pandemic as well as in the post-pandemic period. Such critical appraisal of current HFP is necessary to achieve optimal, effective, efficient and sustainable investment that can promote healthcare for the Cameroonian population over the long term. © Oxford University Press 2022. All rights reserved.
ABSTRACT
Nosocomial or healthcare-associated infections (HCAIs) are associated with a financial burden that affects both patients and healthcare institutions worldwide. The clinical best care practices (CBPs) of hand hygiene, hygiene and sanitation, screening, and basic and additional precautions aim to reduce this burden. The COVID-19 pandemic has confirmed these four CBPs are critically important prevention practices that limit the spread of HCAIs. This paper conducted a systematic review of economic evaluations related to these four CBPs using a discounting approach. We searched for articles published between 2000 and 2019. We included economic evaluations of infection prevention and control of Clostridioides difficile-associated diarrhoea, meticillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and carbapenem-resistant Gram-negative bacilli. Results were analysed with cost-minimization, cost-effectiveness, cost-utility, cost-benefit and cost-consequence analyses. Articles were assessed for quality. A total of 11,898 articles were screened and seven were included. Most studies (4/7) were of overall moderate quality. All studies demonstrated cost effectiveness of CBPs. The average yearly net cost savings from the CBPs ranged from $252,847 (2019 Canadian dollars) to $1,691,823, depending on the rate of discount (3% and 8%). The average incremental benefit cost ratio of CBPs varied from 2.48 to 7.66. In order to make efficient use of resources and maximize health benefits, ongoing research in the economic evaluation of infection control should be carried out to support evidence-based healthcare policy decisions.