# Knowledge, attitude, and practices of stakeholders involved in healthcare financing programs on economic evaluations in Cameroon

## TL;DR

This study explores the knowledge, attitudes, and practices of healthcare stakeholders in Cameroon regarding economic evaluations of healthcare financing programs.

## Contribution

The study identifies a significant gap in economic evaluations and highlights the need for training to improve stakeholder involvement in Cameroon.

## Key findings

- Only 28% of participants reported involvement in healthcare financing programs despite 65% awareness.
- 84% of participants had never been involved in an economic evaluation despite 57.5% knowing about them.
- Participants expressed strong interest in receiving training on economic evaluations.

## Abstract

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.