The policy basis for community health financing in Cameroon: establishment of the North West Provincial Special Fund for Health.

National health systems in Africa and around the world have and are still undergoing reforms in response to the Alma Ata Declaration. In Africa, people centred, community based and locally managed strategies are widely accepted. And in many countries like Cameroon, revolving funds for essential drugs have been adopted as an entry point to the implementation of primary health care elements in community health centres. The current reforms are leading to a sharing of financing responsibilities between people and government, with catalytic support from external agencies. Economic, social and political crises in Africa in the past decade have earned the countries stiff structural adjustment policies with severe consequences on health budgets, health manpower, and health status. This paper describes the policy basis for community financing in Cameroon. It suggests that revolving essential drugs funds (as proposed in the Bamako Initiative) cannot be viewed in isolation, but as part of the community and national response to the crises situation; it also demonstrated the capacity of the health sector to fight back to overcome the ill effects of structural adjustment. And last but not the least, these funds have provided an opportunity for the exercise of democracy and the participatory management by these officials of public goods and services.