Readiness assessment of health facility services in Yaoundé, Cameroon

This study employed an analytical cross-sectional design with three specific aims: a) to describe health facility characteristics, b) to evaluate service availability, and c) to measure the service readiness index. These analyses were conducted to identify factors associated with health facility readiness in Yaoundé. It was conducted from November to December 2024 in the city of Yaoundé, the capital of Cameroon, located in the Centre region. Yaoundé is a metropolis with nearly 5 million inhabitants and comprises eight health districts: Biyem-Assi, Cité Verte, Djoungolo, Efoulan, Mvog-Ada, Nkolbisson, Nkoldongo, and Odza. Our study targeted all functioning health facilities within the eight health districts. A sample of 205 health facilities was drawn from the master facility list (MFL), which contained 666 facilities. The sampling frame for this study was the Yaoundé Master Facility List (MFL), maintained by the Ministry of Public Health of Cameroon, which enumerated all registered health facilities across the eight health districts of Yaoundé at the time of study initiation. The MFL was cross-validated against district health office records and updated immediately prior to sampling to minimize coverage error. A stratified random sampling design was employed to ensure proportional representation of health facilities across key structural dimensions. This approach was selected over simple random sampling to guarantee adequate representation of each health district and ownership type. The sampling frame was first stratified by health and then by facility ownership type within each district (public; private secular; private denominational). Within each stratum, individual health facilities were selected by simple random sampling without replacement, using computer-generated random numbers. The number of facilities allocated to each stratum was proportional to the stratum's share of the total MFL.