Study on USAID Non-Project Assistance Programs in

9.0 CAMEROON9.1 BACKGROUNDCameroon experienced relatively rapid economic growth throughout the 1970s and into the mid-1980s. During this period, GDP increased at an average annual rate of 5.2 percent. The substantialexpansion of oil production beginning in 1978 further accelerated this growth to 9 percent annually from1981 to 1986. Per capita income at that time reached approximately $800.Since 1986, the Government of the Republic of Cameroon has endured an economic recession andfinancial crisis, which has resulted in an estimated 21 percent decline in GDP. The recession was mainlydue to steep reduction in world prices of cocoa, coffee, and oil, which drastically reduced export earnings.Beginning in 1988, the Government of Cameroon began discussions with the IMF and the WorldBank regarding stabilization and structural adjustment of its economy. With the support of a Stand-ByArrangement in 1988 and a Structural Adjustment Loan in 1989, Cameroon began to undertake actionsaimed at: curtailing public expenditure growth; strengthening revenue collection; liberalizing the traderegime; liquidating, privatizing and restructuring the parastatal sector; and reforming the civil service.The economic crisis led to a significant reduction in per capita income and the privateconsumption of goods and services. In addition, the Government had seriously reduced the allocation ofresources to the social sectors including health and education. The economic crisis and resultingadjustment programs also had a negative impact on employment and standard of living. In response, theGovernment, in collaboration with multilateral and bilateral donors, developed the Cameroon SocialDimensions of Adjustment Program (SDA). This program has been an effective mechanism to mobilizedonor funding in the areas of health, population, education, employment, and women in development.During the late 1980s and early 1990s, political and civil unrest have reoccupied the Governmentof Cameroon. There have been numerous general strikes and movements aimed at the establishment ofmulti-party democracy and constitutional reforms. Presidential elections were held in 1992.9.2 HEALTH SECTORCameroon’s ongoing economic recession has particularly affected the health sector. The Ministryof Public Health (MOPH) budget has registered a sharp decline since 1986. In 1988, MOPH funding wasreduced by 50 percent, causing an almost complete cessation of service delivery. As a result of thisreduction, the supply of drugs virtually ceased, utilization rates and confidence in the system deteriorated,and personnel were poorly motivated because they received no support. While the health budget has beenpartially restored, serious problems persist in the delivery of services, and personnel costs consume a highpercentage of total resources.26