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Health Promotion International, Vol. 14, No. 4, 301-306,
December 1999
© Oxford University Press 1999
Towards sustainability in village health care in rural Cameroon
International Development, William Carey International University, Pasadena, CA, USA
Address for correspondence: Ruby Norma Eliason, 203–730A Heritage Lane, Saskatoon, Saskatchewan, Canada, S7H 5M6
The Life Abundant Programme (LAP), a church-sponsored primary health care project in rural Cameroon, was founded on the principles of community participation and self-reliance. Beginning in 1980 in four villages, the project is now active in 40 Primary Health Centres and 14 Integrated Health Centres. The purpose of this paper is to evaluate the sustainability of the first 16 LAP-associated Primary Health Centres after 17 years of field practice, and to share lessons learned from that experience. After 9 years, 13 (81%) communities were active; and after 17 years, 14 (87.5%) were active. Village factors contributing to sustainability include community management of their own health programs, community financial self-reliance, village integrity in money management, annual continuing education for all health workers, and continuing support by Project staff. Factors contributing to sustainability at the Integrated Health Centre level are: receipt of adequate fees from patient curative services; the clinical expertise of health workers as well as their positive relationships with the community people; and continuing medical and LAP support. At the Project Administrative level, factors include adequate staffing, a close working relationship with government health authorities, and financial support from within the country as well as continuing donor agency support from outside. At all levels of LAP activity, commitment to the Biblical philosophy of love, compassion and integrity contribute to sustainability.
Key words: commitment; participation; self-reliance; sustainability