§2: Availability of Health Facilities and Human Resources 227- (REC. 15) As at August 2018, the health map of Cameroon was expanded to reach 201 Health Districts including 7 General Hospitals of the Category I; 8 Central Hospitals of Category II; 14 Regional Hospitals of Category III; 189 District Hospitals of Category IV; 234 Subdivisional hospitals of Category V, and 1,981 Integrated Health Centers of Category VI. 228- Some new health facilities that went operational during the reference period include the Referral Hospital of Sangmelima, the Gynaeco-Obstetrics and Pediatric Hospital of Douala, the Emergency Centre of Yaounde, and the Gynaecological Endoscopic Surgery and Human Reproduction Teaching Hospital of Yaounde. 229- The State continued to train medical staff and recruit same. In this regard, some midwifery schools which had been closed were reopened and as at 2017, there were 10 midwifery schools nationwide and their graduates were recruited into the Public Service. In order to improve on the working conditions of healthcare staff, the Prime Minister signed Decree No. 2016/6447/PM of 13 December 2016 to lay down the terms and conditions of allocation of bonuses calculated from paid services to some medical and paramedical staff working in public health facilities. 230- In addition, Decree No. 2017/80 of 6 March 2017 to grant allowances to State medical and paramedical staff governed by the Labour Code and Order No. 561/MINSANTE/CAB of 16 February 2017 to lay down the terms and conditions of provision of care and medical fees not charged on the Service of public health staff were signed. From 2012 to 2017, the number of staff under the Ministry of Public Health stood at 5,489. Recruitment of staff over the years did not fill the gap created in a context where the health system has already recorded a severe shortage of staff. Indeed, there are 3,996 new members of staff recruited by the Ministry of Public Health. However, there is still a staff shortage of 1,493. 231- In 2016, the Doctor/population ratio stood at 1:16,000 compared to the World Health Organization (WHO) standard which is 1:2000. Between 2016 and 2017, there were 2,842 medical doctors, 80% of who were general practitioners and 20% specialists. 232- In a bid to ensure that staff is evenly distributed across the country, the Project to retain staff in the most staff-deficient health facilities was initiated. In 2016, 318 staff working in remote and enclaved areas in South West Region and the northern regions of the country were offered financial incentives. In 2017, 269 staff were concerned. These incentives paid quarterly helped reduce the imbalance in the distribution of staff in Health Districts. §3: Accessibility to Healthcare Services 233- Accessibility to healthcare services generally was improved and measures taken to enhance access to reproductive health services including family planning and sexual education A: Accessibility to Healthcare Services Generally 234- In order to improve on accessibility to healthcare services, on 22 April 2016, the Minister of Public Health issued Directives on consultation procedures of patients in Public health facilities. These Directives were issued as a result of findings on challenges encountered by patients in accessing healthcare. The Directives require functional reception and orientation desks for patients and users and visible orientation plan of services and signposts to guide patients and users. Concerning treatment of patients, the Directives provide that in the event of an emergency, treatment should be immediate and without any prior condition of payment, thus, live-saving drugs and consumables must be available 24 hours a day at Emergency Wards. 46