DOCTORS TO BIYA: REFORM THE HEALTHCARE SYSTEM

DOCTORS TO BIYA: REFORM THE HEALTHCARE SYSTEM
PREAMBLE
 
We are Cameroonian doctors in our country and around the world, united by love of our country, our profession and our patients. We decided today to leave the reserve that characterizes our work in writing this manifesto.
 
Our goal is to contribute to the improvement of our health system, to the satisfaction of all.
Our health system is experiencing a dramatic crisis affecting our lives, our bodies, our souls and our honor. Thousands of men, women and children die every day in the health facilities of the country, unable to meet the costs of their care. We are witnessing a recurrence of screaming malfunctions sign that it is time for a profound reform. Because the weight of these failures is endorsed by all health care providers with a stoicism pushed to the limits of endurance, in our souls and consciences, and at this crucial time in the history of the medical profession in Cameroon
 
We CAN longer remain silent over the deterioration of the quality of care in care facilities in the public and private sectors in Cameroon.
We CAN NOT more helplessly to all these preventable deaths at all ages in different health facilities in the country for financial, infrastructure and equipment, throughout the course of care.
We are outraged by the resurgence of denigration against care givers held responsible for all the ills of the health system in general indifference.
We REFUSE to bear the responsibility for public health policy as we are not alone policymakers strategic directions, including aspects of health financing and accessibility of care.
We refute allegations that the absence of a universal health insurance system would be the result of a lack of resources while poorer countries than ours succeeded, proof that solutions exist.
We denounce the commercialism and bad practices in our profession and we will continue to participate in combat in accordance with the code of medical ethics.
We REGRET the failure of the technical means available to us forcing us to often anachronistic practices, sometimes approximate and not in line with international recommendations based on scientific evidence.
We REGRET the low involvement of the population in the issues of health, on such aspects as prevention, community involvement, but also the process of decision making.
We REGRET shy regulation of consumption of products harmful to health (alcohol, tobacco, soft drinks, contaminated food …) and the products of our traditional medicine, and the low Suppression of Unlawful sale of counterfeit drugs in the streets of our cities.
We REFUSE iniquitous material condition that is ours and the condescension with which we are treated in our home institutions, governments, our employers and some of our fellow citizens.
We INSURGEONS WE AGAINST the low remuneration of our practice and ask the revaluation thereof for doctors in public and private sectors, as well as nurses and other staff of health, up to the cost of living, level of studies, and the risks they face.
We denounce the unfair redistribution of hospital revenues from our own benefit, and taken hostage by leaders in our places of attachment.
We challenge the authoritarian management of some leaders of our hospitals and cliniquesd’exercice that do not reflect our aspirations for optimal working conditions for the benefit of our patients.
We REGRET mediocrity of the doctor’s career profile, centralization and arbitrariness of human resources management, which takes into account neither the performance nor the competence nor the real needs in hospitals.
We REFUSE the sidelining of key health stakeholders such as doctors, nurses and other health personnel in the institutional debates and decision making on health in general.
We HEAR bring our collective proposals force from consensus within an umbrella organization,
 
CONCERNING:
 
I. THE RIGHT TO HEALTH
It is essential to ensure that every citizen of our country, and in the spirit of the Act N ° 96/03 of 04 January 1996 on the Framework Law of Health in Cameroon, an assumption that in the absence of be universal immediately, the exemption actually pay for access to care in the critical emergency situations. The institutionalization of universal health coverage will be gradual and adapted to the local context.
 
II. THE HEALTH FINANCING
Health has no price but it has a cost and we are aware. The increase in the allocation of state budget to the health sector would be currently around 9%, should reach the minimum of 15% adopted by the African Union. Increased funding of the health sector is an investment in national human capital, essential condition to ensure the emergence of Cameroon. We aim to find innovative ways based on new technologies and the availability of mobile phones to promote, facilitate and secure the financing of health. For example, the possibility of charging a bill to a phone number or payment by third persons away. We advocate the development of a local pharmaceutical industry capable of manufacturing of essential drugs and consumables.
III. THE RIGHT TO QUALITY SERVICES FOR PATIENTS
It is essential to ensure in health facilities at all levels of the pyramid, a minimum package of essential care guaranteed under all circumstances. It is necessary that:
– Create a platform for coordination and inter-hospital emergency management to avoid wanderings sources of fatal destinies.
– Work to develop the concept of quality care, according to recognized indicators.
– To ensure the comfort and safety of patients in care facilities.
– Establish a unique identifier and standardized computer medical records to allow monitoring of each patient within a hospital and between hospitals.
– Establish and systematize a system of appointments payable in advance by specific periods, to reduce the waiting time, and size of the services.
– Adopt a regulatory minimum consultations (30 – 60 minutes depending on specialty), including time for medical documentation.
 
IV. MEDICAL EDUCATION
In order to improve the practice of medicine, ethics and performance of careers, we recommend establishing:
– A development at all levels, medical training programs on ethics, ethics, crisis communication and inter professional communication with patients,
– Strengthening the teaching staff of training institutions, improving substantially the number and income (salary and bonuses Research)
– A mandatory continuing professional development system after the initial training. As well as a national credit system for ” recertification ” periodically under the supervision of the National Order of Doctors of Cameroon (ON ™).
– To do this, it is necessary to provide professional, skills development means regulated such as continuing medical education online, Postgraduate Courses (UPE) and research activities in hospitals and institutions of the MOH at district, regional and national, and participation in national and international conferences.
 
V. HUMAN RESOURCES IN HEALTH
We recommend:
– Consistent distribution, fair and harmonious human resources in health based on medical density. A strict rotation, periodic and systematic in positions,
– The right to medical specialists to perform private consultations in public facilities under certain conditions not causing any deterioration of public service.
– The maintenance of the competitive civil servants doctors and hospitals by creating a scholarship from the centralized job through which positions will be formally advertised.
– The professional activity under contracts of varying duration, renewable on the basis of an assessment of the performance to the satisfaction of both parties,
– Creating incentives with appropriate equalization promoting equitable distribution of health professionals across the country.
– The creation of an independent office of the Human Resources Department but under supervision of the Ministry of Public Health, which would be dedicated to the management of the training of medical and health personnel.
– The acceleration of the decentralization of the management of career records process for applying automatic procedures for advancement and progression.
 
VI. OCCUPATIONAL HEALTH COMMUNICATION AND INFORMATION RETURNS
It is vital that the promotion of a culture of communication between caregivers and patients is in place and regulated.
It is essential to develop and systematize communication tools and exchange of business information within and between health facilities throughout the territory of Cameroon.
New technologies can and should be used for the implementation of an independent and anonymous mechanism of citizen watch to assess real-time customer satisfaction / patients in our clinics.
 
VII. PROFESSIONAL STATUS
We want to doctors and paramedical staff of public health facilities:
1. Simplifying and reducing the cost of integration procedures in the Civil Service.
2. Reducing the time taken of costs, following the integration
3. The guarantee of an advance of systematic balance during integration periods, especially before deployment.
4. The guarantee of decent housing and secure in landlocked assigning positions, high arduous or dangerous,
5. The harmonization of various statutes of the State of active agents in health (HIPC Officials vs vs vs 25,000 Contract vs Decision makers, etc. …)
6. The postponement of the retirement age from 55 to 60 years to overcome the deficit in experienced staff as well as in hospital practice in education.
We wish for all:
1. The promotion of telemedicine and the creation of communication tools between professionals,
2. Encouragement and support for research and innovation in all areas of health,
3. The incentives (organizational, material and financial) to mobilize all the medical expertise of the Cameroonian Diaspora for the care and teaching.
 
VIII.LA REMUNERATION OF HEALTH PROFESSIONALS
We want the revaluation of bonuses and allowances of health workers in the public and private sectors based on the cost of living, skills, training requirements, and constraints and risks.
We want to physicians, nurses, paramedics and the private sector
1. The revaluation of the salary scale of the tertiary sector in favor of health professionals
2. Harmonization, and the strict application of the above mentioned revaluation by collective agreements in all private care facilities.
We want to physicians, nurses and other paramedical staff, the public sector increased:
– Housing allowances up to the current base salary
– Premiums on call
– Technical Premiums
We also wish to medical officers:
– Harmonization regulated the allocation and calculation of the amount of assessments based on the effective yield in public hospitals to equal category,
– The consistent improvement of the level of experts from the reclassification
– The introduction of regulated private consultations at the hospital out of hours service and in agreement with the management for two half-days per week for specialist physicians, and half a day for general practitioners,
– The introduction of bonuses and special allowances, including:
* Lump Risk premium
* Lump Transport compensation
* Flat rate for night work, Sundays and holiday
* Flat rate shoes and work clothes
* Flat rate for dangerous, unhealthy or obnoxious
* Residence allowance or premium remoteness, incentive target on the scene of landlocked and dangerous assignment, according to an equalization based on the distance.
 
IX. ADMINISTRATION AND MANAGEMENT OF HOSPITALS
We wish :
1. The establishment of colleges ‘internal’ to health facilities to ensure the appointment of directors from qualified candidates from a recognized specific training,
2. The management of health districts by public health specialists,
3. The promotion of good medical practice and nurses in the emergency services,
4. Management of ethics by a dedicated committee within the hospital structures,
5. The re-certification of health professionals by Independent Body as part of continuing medical education accredited by the National Order of Doctors of Cameroon (ON ™).
6. The appointment hospital officials by a peer college.
7. The management of hospitals by doctors trained in management. The administration can be delegated to a business school graduates in the sector “Administration hospitals” (ENAM in this case).
Concretely we propose:
– Promote a medicine based on the evidence generated by clinical research whose promotion must be made and which specific budgets should be allocated annually,
– Assign a share of hospital revenues improved techniques and knowledge for better performance,
– Ensure a multidisciplinary medical and collegial constituting whatever level health teams comprising at least 2 people per health center (ideally four persons including one for each major group of disorders).
– Condition the deployment of young doctors in peripheral health facilities, implementation of an impregnation period under supervision / mentoring 6 – 12 months in regional hospitals.
X. SAFETY AT WORK FOR DOCTORS AND PERSONAL CARE
We recommend :
1. Installation and regulated control of the functionality of infrastructure and furniture work in public and private health facilities,
2. The installation and monitoring decent amenities on the workplace: running water, electricity, toilets, changing rooms,
3. The implementation of preventive measures and the full support of all accidents involving biological hazards in hospitals:
hydro-alcoholic solution of local production for disinfecting hands, available for all, actual vaccinations, compulsory and free for all existing workers in public institutions against health; hepatitis B, polio, tetanus, diphtheria, tuberculosis and pneumococcal and meningococcal in areas at risk. This also applies to interns and students.
4. Upgrading of the technical platform of health facilities, according to their level in the health pyramid.
5. The introduction of health policy at work for regular monitoring of practitioners to assess and define the impact of occupational conditions on the physical and mental health.
 
RESOLUTIONS
Deeply attached:
the principle of equal quality medicine for all, and social security solidarity nationally, the relationship of trust caregivers / carers and carers / cared necessary for quality of care, the need to treat all patients in our conscience, in decent conditions;
WE:
praise the current government initiative to reform our hospital system, and appreciate the openness to physician groups, declare as doctors Cameroon, our resolve to work with the sovereign bodies to contribute to the improvement of the system Cameroonian health.

 

THE April 22, 2016
 
NB/ BaretaNews translated the french document through google translate. We still await the English version.

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