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How Can The Local Level Exist? The Case Of The Decentralisation Of The Health System In Cameroon

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Chapter Summary

This chapter presents three case studies, which were conducted in urban and rural areas in Cameroon. The case studies demonstrate that, given the actual methods of decentralisation and externalisation of development used at the local level, the dynamics of decentralisation underlying the drawing up of a new health map can lead paradoxically to the reinforcement of the central administration and, therefore, of the state. The chapter then describes the nature of the model on which the reform of the health system in Cameroon is based. It then analyses some concrete cases which illustrate the extent to which the negotiations at local level triggered by a reform of this kind are generally resolved at the highest level of the central administration.

Keywords: Cameroon; central administration; decentralisation; externalisation; health system; local level



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