Date of Conferral

2021

Degree

Doctor of Public Health (DrPH)

School

Health Services

Advisor

JaMuir Robinson

Abstract

Health facilities in Cameroon charge fees for treatment and services, which can affect health outcomes for those unable to pay for services. Some studies have shown that the removal of user fees had a positive impact on child health outcomes in selected African countries. The aim of this quantitative, cross-sectional study was to understand whether there is a link between out-of-pocket expenses and under-5 mortality in Cameron. The study was guided by the social ecological framework. Secondary data from the 2011 Cameroon Demographic Health Survey were used in the study. Chi-square, binary logistic regression, and multicollinearity analyses were used to analyze the data. Results indicated that out-of-pocket expenses were not associated with under-5 mortality when controlling for other significant variables. However, delivery in private hospitals, maternal age, and respondents from the Grassfield, the Bamilike/Bamoun, and the Kako/Meka/Pygmé ethnic group were associated with under-5 mortality. In addition, region was not found to be significantly associated with under-5 mortality when controlling for confounding variables. Based on the results, educating younger women, advocating for health coverage that will reduce barriers to accessing health services, and understanding the different culture of each ethnic group and region and how it may influence a woman’s ability to care for herself and her children are important for interventions to promote positive social change and to reduce under-5 mortality in Cameroon and meet the sustainable development goal of ensuring healthy lives and promote well-being for all at all ages.

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