FOCUS ON DECENTRALISATION PROCESS
Cameroon is now far advanced in its decentralisation process, supported by ESTHER twinning projects and France´s debt relief and development contract (C2D).
ESTHER has since 2005 supported the initial project to decentralise care by mentoring in Centre province with the CTA of Yaoundé central hospital in partnership with Montpellier teaching hospital and 12 care units (UPEC), in three strands :
Training: workshops, on-site training, internships, specialisation of staff (doctors, nurses, midwives, laboratory workers, pharmacists, socials assistants and community liaison agents) involved in care.
The CTA and its UPECs have been provided with equipment for laboratory testing, inputs and consumables and a starter kit (ARVs and drugs to treat opportunistic infections).
Computer equipment and ESOPE software have been set up to provide clinical monitoring of care.
Under the debt relief and development contract (C2D) signed by Cameroon and France in December 2008, health is one of the four priority sectors. The Cameroon national authorities have chosen to focus on a programme of "decentralisation of HIV/AIDS care by mentoring". Its objectives are to strengthen the health system and scale up care for people living with HIV/AIDS (PLWHAs). This project is part of the national operational AIDS control plan and is linked to action funded by the Global Fund and the national AIDS control programme.
This mentoring strategy was chosen to accelerate the decentralisation of quality care. The expected benefits are: harmonisation of practice, operational decentralisation of HIV/AIDS care adapted to the situation in each province, and the availability of human, material and financial resources to ensure coordination and effective supervision.
Ultimately :
- 23 CTAs will acquire mentoring capability over five years;
- 101 UPECs will over five years develop capabilities for the comprehensive care of PLWHAs;
- Care staff at all levels will be trained in the comprehensive care of PLWHAs and provide quality service via harmonised practice.
Mentoring may be defined as accompanying lower-level health training to set up effective, sustainable services for the comprehensive care of PLWHAs.
It prepares health structures in the long term to assume their autonomy and take over by accompanying health training courses at lower level still.
This basically technical assistance is based on a multidisciplinary approach, standardisation of practice and integration of activities into the existing health structure.