National Health Observatory: A tool to strengthen the health information system for evidence-based decision making and health policy formulation in Cameroon.

Despite the consensus on the importance of evidence based health information for decision28 making and health policy formulation, quality information is not always available. This situation led the WHO in 2009 to recommend the establishment of an African Health Observatory and National Health Observatories. The WHO recommended 4 phases approach for the establishment of National Health Observatories was used in Cameroon: the preliminary phase, start-up, strengthening and full operation. Despite a non-optimal institutional positioning, the Cameroon's Health Observatory is in the strengthening phase and contributes to evidence-based decision making in the health system. A strong political commitment is fundamental from the beginning of the project. The establishment of National Health Observatories calls for genuine national ownership, both of the process as a whole and of the tool itself. WHO should regularly assess the progress made in the establishment of National Health Observatories in different countries and provide feedback to them. A step-by-step approach, jointly validated by national stakeholders in a roll-out plan, would be more appropriate for the sustainability of the work of National Health Observatories.

Association between cardiovascular diseases and pregnancy-induced hypertensive disorders in a population of Cameroonian women at Yaoundé: A case-control study.

BACKGROUND: Positive associations have been found between Hypertensive Disorders of Pregnancy gestational hypertension, preeclampsia and cardiovascular diseases within non-African populations, no data exist from sub-Saharan Africa. We aimed to assess this association in Cameroonian mothers. METHODS: We used a case-control study. Cases were women diagnosed with any arteriosclerotic cardiovascular disease between 2012 and 2017 at two major hospitals of Yaoundé. Controls were mothers of children who sought pediatric care at the Gyneco-obstetric hospital of Yaoundé, with no diagnosis of cardiovascular disease. We abstracted data from patient files to assess cardiovascular disease and used phone-based questionnaires to assess a prior history of Hypertensive Disorders of Pregnancy. We used logistic regression and propensity scores for data analysis. RESULTS: Out of 1228 individuals selected, 173 cases and 339 controls participated in the study. We found no increased risk of cardiovascular diseases for women with a history of Hypertensive Disorders of Pregnancy (OR = 0.83, 95% CI, 0.51 to 1.34). Women with gestational hypertension had 2.33 (95% CI, 0.99 to 5.50) times the risk of women with no history of Hypertensive Disorders of Pregnancy, an inverse association was observed between preeclampsia and cardiovascular diseases (OR = 0.28, 95% CI, 0.10 to 0.72). CONCLUSIONS: Cameroonian women with a history of gestational hypertension may have a higher risk of cardiovascular diseases. However, population-based studies with more accurate data on the exposure are needed.