A Qualitative Inquiry and Review of Telemedicine: A Case Study of Cameroon

Cameroon is classified by the World Health Organization (WHO) as having a critical shortage of health personnel despite healthcare being one of the nation’s Millennium Development Goals. Telemedicine has the potential of addressing the issue of shortage of health personnel in Cameroon and improving on the health conditions of rural patients. The concept of Telemedicine refers to the use of information and telecommunication technologies to develop information and expertise necessary for healthcare services provision. It also involves collaboration in order to develop geographically separated participants, including physicians and patients. Cameroon has been slow in implementing and sustaining this concept unlike other African countries such as Ghana, Mali, South Africa, Uganda. People in the rural areas are still moving to urban spaces in search of better health facilities instead of staying where they are and using new technologies to reach the specialists both nationally and internationally. Hence, in this paper we present an extensive literature review that produced peer-reviewed interventions of telemedicine in sub-Saharan Africa. This study was performed to assess the level of knowledge and perception of the target population towards Telemedicine in Cameroon.


Introduction
Cameroon, a country located in the Central Africa that shares borders with Nigeria and Chad. With a population of roughly 24 million people, Cameroon has seen a rise in poor healthcare and premature deaths due to A good start to running a telemedicine program is conjoining a rural kiosk through which medical information can be sent to a doctor who is in an urban area.
However, history shows that people used to visit the kiosk when it first started, but numbers began to decline. Even though there were challenges with the kiosk project in the beginning, it later became a functional project in the end [1]. Currently the status of telemedicine in Cameroon is dwindling. A South African tech expert, John Akintosin stated that there has been impressive broadband access that is even good in rural areas [1]. Despite this, Telemedicine has become more difficult to deploy to rural areas.
While some countries have corporations that help with providing telemedicine, Cameroon has continued to suffer a major setback.
In this paper we will cover the present status of telemedicine in Sub-Saharan Africa and how it has either improved or remained constant since the first project back in 2000. Different studies will also be discussed as far as how they have worked and if there were any pros or cons to the methods being used. Lastly, we will discuss the possible future of telemedicine in Cameroon with either improving current methods or starting new ones.

Literature Review
The search for interventions of telemedicine in sub-Saharan Africa was restricted to English language and was carried out by a wide search on Google-Scholar. This wide search includes peer-reviewed journals, conference proceedings, books and archives from World Health Organization. To retrieve best results, the following databases and literature resources, PUB MED and Southern University Online. Library. In all, we identified around 110 sources, which were reduced to 20. This reduction was based on our inclusion criteria which are our keywords. The result of database search, that is, the peer-reviewed definitions are listed below (Table 1). insurance at all [2][3][4][5][6]. Mobile Health and other ICTs in this case is the better way to reach out to patients in remote areas with chronic diseases and lack of medical personnel to attend to them due to poverty which prevents them from moving to larger cities for treatment. This is evident from the results of case and pilot studies carried out in this communities to assess the impact of mobile Health and other ICTs which yielded positive results to a greater extent [6][7][8][9][10][11][12].

Research Design
The purpose of this study was to use a qualitative method to determine the current state and investigate quality in Healthcare and telemedicine interventions in Cameroon. One overarching research questions guided this research: "What is the current state of healthcare in Cameroon".

Participant
The study participants that volunteered to participate in the interview were medical practitioners in Cameroon's public hospitals. Participants in the study are very familiar with the use of health information technology tools. Participants signed an informed consent form.

Data Collection
The study adopted a qualitative data collection method. The interview method was chosen to obtain in-depth information in regard to telemedicine interventions

Data Analysis
Indicators from the interview protocol were identified to assist with the coding. Researchers coded the interview transcript.
Themes and patterns were then compiled according to the research questions. Results from the analysis are discussed in the following sections.

Results indicate several trends in telemedicine and Health
Information Technology as well as various challenges that confront them in Cameroon.

What Do You Think About the State if Healthcare in Cameroon?
Interviewee A felt that It is a mess. "Despite the number of doctors being trained in Cameroon each year, we still face a very high patient to doctor ratio (we have a lot of brain drain). It is even worse at the peripheries and villages. Few doctors agree to practice there, and so there is very minimal access to specialized health care. As a result of it, multiple clandestine "clinics" are opened up and manned by unqualified nurses". Interviewee B felt that A lot is wrong with the health system, not even sure where to start: Limited resources is a real problem coupled with lack of Universal Health coverage or some sort of pension scheme makes things worse. This Interviewee A felt "While telemedicine can never replace one on one patient contact, it will go a long way in solving some of the health problems in Cameroon [14][15][16][17][18][19]. Take  we can consider doing a pilot study to assess its acceptance, uses, and challenges in our own context".

Discussion and Conclusion
The current study offers several implications for practice Sustainable Development Goals, the result of our reviews prove that the immediate solution to the deplorable state of healthcare in Cameroon is for government to implement sound health policies rather than go the way of Telemedicine because an average Cameroonian will not be able to afford the cost of health associated with telemedicine infrastructure.