Public private partnership in the Cameroonian health system : a case study of staff secondment into the Maroua – Mokolo Diocese
Lower to middle-income countries are often unable to provide comprehensive health care to their citizens, and weak health systems have increasingly been identified as a key factor in this failure. Many interventions are being implemented to strengthen the health systems of lower to middle-income countries. Public-private partnership (PPP) in health care has been identified as one such key strategy and solution. Although the specific rewards of-or obstacles to PPP have not yet been strongly evidenced, PPP interventions are being advised and adopted in many countries as a key health systems intervention. It is therefore important to assess and understand the effects of such PPP efforts. This study focuses on a particular PPP arrangement in Cameroon –between non-profit faith-based providers and the Cameroonian Ministry of Health. This partnership is based primarily on the secondment of government-employed health workers into the faith-based health system. This case study focuses in particular on this arrangement as it is experienced in the Catholic Maroua-Mokolo Diocese in the Far North Region of Cameroon. This study finds that although PPP is considered to be helpful in strengthening the national health systems functioning –in this case, all of the focus has been on the secondment mechanism and visible resourcing. Not enough attention has been given to the less visible aspects of partnership such as clashes between workers’ aspirations or organisation cultures. This study demonstrates the problems inherent in an applied systems intervention that disrupts existing modes of operation, and does not answer to individuals' aspirations. It is demonstrated that such an intervention mainly results in various forms of resistance rather than immediately strengthened partnership.
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Department of Public Health and Family Medicine