ABSTRACT
Over the past decade, donors have engaged Christian faith-based organisations (FBOs) in health system reforms and health programmes in numerous sub-Saharan African countries. This research describes the encounter between donors and FBOs that operate in the Cameroonian health system. The study focuses on faith-based Centres of Excellence in Cameroon, which hold a prominent position in the national health policy discourse. These organisations provide a specialist service, in terms of training as well as services provided. Some of these types of FBOs can be found in the most remote areas in Cameroon. They receive large sums and consistent funding from international religious organisations or networks and specific multilateral or bilateral donors. This research explored why donors engage these FBOs, how they engage them and with what effect. It draws on 39 interviews with FBOs, Ministry of Health officials and donors in Cameroon, as well as on observations and focus group discussions. The findings show that donors have two assumptions about faith-based Centres of Excellence: that they are integrated into the Cameroonian health system and that they provide very good quality of healthcare and health professions education. However, data presented in this study challenges these assumptions, suggesting that, whereas donors have considered collaboration with these particular FBOs as a panacea in the improvement of healthcare, their lack of understanding of the complex relationship between the Cameroonian health system and the FBOs and with that the wider implications for the health system. This in turn has potentially created a more complex health system landscape, inevitably affecting the quality of care provided and potentially deepening inequalities in accessing healthcare for people in Cameroon.
