Introduction

One of the objectively verifiable indicators of a society’s level of development is good health and a high level of education. In Cameroon, while the literacy rate is generally above 75%, health coverage is lagging behind. In a context of continuing widespread household and family poverty, political instability in some regions, lack of social (and therefore health) coverage for the population, including the elderly, inadequate health care facilities specialized in geriatric care, and job insecurity, one may wonder about the factors that contribute to the use of health care by the elderly.

The health path of the elderly

Considering that free health care for the elderly is not a reality, that urban centers are where most of the existing health care facilities are concentrated, and that this already bitter cocktail of inequality includes the increase in the number of elderly people, it is urgent to examine the mechanisms of action that lead to this observation. The old-age index in Cameroon hovers around 5%, and about one third of the elderly continue to be active to support their large and multigenerational families. Indeed, the elderly practice a mode of cohabitation that could be described as “win-win” insofar as they benefit from the support of their entourage in their health trajectory. How urban-rural dualism is a factor of inequality in modern health care for the elderly.

Health care for the elderly in big cities and elsewhere

Two groups can be distinguished by analysis. The first group is made up of elderly people who use health care. They are mostly migrants, reside in the two major cities (Douala, Yaoundé) and therefore in the urban centers, are male, retired and living in a house, have a secondary or higher level of education, are between 60 and 69 years old, work as employees or senior managers, live in a union and are Christian, and are related to the head of the household. The second group is made up of elderly people who do not use health care.

They are mostly non-migrants, reside in the Great North and the Great Center, live in rural areas, are female, are not housed, have a primary level of education older than 70 years of age, are self-employed (personal) in the agricultural sector, and marital status, are single, widowed or separated, and are either Muslim or religion or other religion. They are mostly from small (or isolated) households. They are mostly from small (or isolated) households of one generation, with a poor standard of living in which there is an average of more than 50% of elderly people, and where more than half of the members of the household work and they are heads of the household. They are mostly from large three- and four-generation households with a high standard of living, in which on average less than 25% of the elderly are employed, and in which less than half of the household members work.

Two significant facts

Further analysis of the context of residence and health care use guides health care decision making in Cameroon. The analysis of the fourth Household Survey (ECAM4) is quite revealing on this fact. Two of the salient facts are that: in Cameroon’s major cities, only half of the modern elderly are in good health. Also, elderly “widowers” and landowners are more likely to use urban and rural health centers because of their relative financial affluence.

In conclusion: the urgent need to act for the health of the elderly

 The State of Cameroon, in its policy of decentralization, must absolutely promote access (geographic and financial) to geriatric care in the two major cities as well as in the other regions. In addition, social and economic measures backed by the labor code and aimed at the sustainable support of the young active population of today would be welcome because these young people are certainly the seniors of tomorrow.