Healthcare financing programs in Cameroon.

There are many healthcare financing programs (HFPs) in Cameroon; however, there is a lack of information on these programs’ economic effectiveness and efficiency. Involvement of local stakeholders in the economic evaluations (EEs) of HFPs is critical for ensuring contextual factors are considered prior to program implementation. We conducted a cross-sectional study to assess the need for EEs of Cameroonian HFPs. Regular staff in supervisory roles aged 18 years and above were recruited in four Cameroonian cities. Data were collected via face-to-face surveys between June 15 and August 1, 2022. Descriptive analyses summarized participants’ knowledge, attitudes, and practices in relation to performing EEs of HFPs. Principal component analyses identified organizational, individual, and contextual factors that could influence participants’ involvement. The total sample included 106 participants. On average, 65% of participants reported being aware of the listed HFPs; however, of these, only 28% said that they had been involved in the HFPs. Of the 106 participants, 57.5% knew about EEs; yet, almost 90% reported that the HFP in question had never been subject to an EE, and 84% had never been involved in an EE. Most participants indicated that they had intended or would like to receive EE training. Using principal component analyses, the organizational factors were classified into two components (‘policy and governance’ and ‘planning and implementation’), the individual factors were classified into two components (‘training’ and ‘motivation’), and the contextual factors were classified into three components (‘funding,’ ‘political economy,’ and ‘public expectations’). The findings of this study highlight the need to invest in EE training to improve participation rates of Cameroonian stakeholders in the EEs of HFPs. Improved knowledge, diversified skills, and increased participation of stakeholders from all levels of the Cameroonian healthcare system are critical to the effective and efficient development, implementation, and EE of the country’s HFPs.

喀麦隆存在诸多医疗筹资计划（healthcare financing programs, HFPs），但目前缺乏针对这些计划的经济有效性与运行效率的相关研究资料。让当地利益相关方参与医疗筹资计划的经济评估（economic evaluations, EEs），对于在项目落地前充分考量情境化因素至关重要。本研究开展了一项横断面研究（cross-sectional study），以评估喀麦隆医疗筹资计划开展经济评估的必要性。

研究于2022年6月15日至8月1日期间，通过面对面问卷调查的方式，在喀麦隆四座城市招募了18岁及以上的常规监管岗位工作人员作为研究对象。研究采用描述性分析总结了参与者针对医疗筹资计划开展经济评估的认知、态度与实践情况；通过主成分分析（principal component analyses），识别了可能影响参与者参与度的组织层面、个人层面与情境层面因素。

本次研究共纳入106名参与者。平均而言，65%的参与者表示知晓本次列出的医疗筹资计划，但其中仅有28%的人称曾参与过相关计划。在106名参与者中，57.5%的人了解经济评估相关内容；然而近90%的受访者表示，其所涉及的医疗筹资计划从未接受过经济评估，且84%的参与者从未参与过医疗筹资计划的经济评估工作。绝大多数参与者表示，他们已有意愿或希望接受经济评估相关培训。

通过主成分分析，研究将组织层面因素划分为两个维度："政策与治理"及"规划与实施"；个人层面因素划分为两个维度："培训"与"激励"；情境层面因素则划分为三个维度："资金支持"、"政治经济环境"与"公众期望"。

本研究结果凸显了加大经济评估培训投入的必要性，以提升喀麦隆利益相关方参与医疗筹资计划经济评估的比例。提升喀麦隆各级医疗体系利益相关方的认知水平、丰富其技能储备并增强其参与度，对于该国医疗筹资计划的高效开发、落地实施以及开展经济评估均具有关键意义。