ObjectivesTo assess the burden of emergent illnesses and emergency care system usage by Yaoundé residents and to evaluate unmet needs for emergency care and associated barriers.DesignA cross-sectional study using a community-based survey.SettingYaoundé, Cameroon.ParticipantsAll residents living in Yaoundé were selected as the target population to investigate the needs and usage of emergency care in Yaoundé. 14 households in every health area (47 in total) were selected using 2-stage sampling.Primary outcome measuresUnmet needs for emergency care.ResultsAmong the 3201 participants from 619 households who completed the survey, 1113 (34.8%) with median age of 22 experienced 1 or more emergency conditions in the previous year. Respondents who experienced emergency conditions used emergency units (7.0%), outpatient clinics (46.5%) or hospitalisation (13.0%), and in overall, 68.8% of them reported unmet needs for emergency care. The primary reasons for not seeking healthcare were economic issues (37.2%) and use of complementary medicine (22.2%). Young age (adjusted OR (95% CI) 1.80 (1.23 to 2.62)), rental housing (1.50 (1.11 to 2.03)) and moderate household income (0.60 (0.36 to 0.99)) were associated with unmet needs for emergency care.ConclusionsResidents of Yaoundé had a high demand for emergency care, and high unmet needs were observed due to low emergency care usage. Development of a cost-effective, universal emergency care system is urgently needed in Cameroon.

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In effort to address the shortage of emergency medical care in Cameroon, the Yaoundé Emergency Center (CURY) was established in June, 2015 in Yaoundé, Cameroon. To evaluate its impact on the communities of Yaoundé, we assessed the changes in utilizations of emergency medical care since the establishment of the CURY. In 2014 the first survey was conducted on randomly selected 619 households (3,201 individuals) living in six health districts of Yaoundé. In 2017 the second quantitative survey was conducted on 622 households (3,472 individuals) using the same survey methods as the first survey. In both surveys, data on demographic information, socioeconomic status, and utilization of healthcare, including emergency care in the past year were collected on every member of the households via face-to-face interview. Data on two surveys were compared. Participants in the both surveys had similar age and gender distribution with mean age of 21–22 and 46% being male. In 2014 survey, healthcare utilization rates for emergency unit, outpatient, and hospitalization were 4.8%, 36.7%, and 10.0%, respectively. In 2017 survey, corresponding rates were 5.8%, 32.5%, and 9.2%%, respectively. The increase in the utilization of emergency unit between two surveys showed a marginal statistical significance (p = 0.08), while outpatient utilization showed statistically significant decrease from 2014 to 2017 survey (from 36.7% to 32.5%; p <0.001). After the establishment of a dedicated emergency medical center in Yaoundé, Cameroon, the utilization of emergency care was increased in the Yaoundé community. Further studies are warranted to examine the direct effect of the establishment of the CURY on healthcare utilization in Yaoundé.

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