Understanding Growth and Malnutrition in Baka Pygmy Children

We determined stunting, wasting, and obesity frequencies in a total 1092 2-to-12 year old Baka Pygmy children from anthropometric and health data gathered in 34 villages in the Djoum-Mintom region in southeastern Cameroon in four health campaigns in 2010 and 2017–9. We compare these to the WHO Child Growth Standards, Amazonian Tsiname growth references for inter-population comparisons and the study population itself. Population-specific growth charts were constructed using GAMLSS modelling. Our results show that Baka children have one of the highest global rates of stunting relative to the WHO child growth standard with 57.8% for 2-to-12 year olds and 64% and 73% for 2-to-4 year old girls and boys, respectively. Frequencies of wasting, overweight, and low BMI were low at 3.4%, 4.6% and 4.3%, respectively, for 2-to-12 year olds. Underweight was at 25.5%, in the upper range for sub-Saharan Africa. Edemas indicated rare severe malnutrition (0.3%). Uncertainties in age estimation had dramatic effects on the reliability of estimated individual z-scores but distributions of z-scores were robust at a population level. In the context of the recent evidence for genetic adaptation of the Pygmies’ small stature to the tropical forest environment we argue that WHO child standards for weight and BMI are applicable. However, standards for height are clearly not adequate for Pygmy people. To achieve UN Sustainable Development Goals, we recommend that Pygmy specific growth standards are developed for the various, genetically differing Pygmy tribes

Gauging Cameroon's resilience to the COVID-19 pandemic: implications for enduring a novel health crisis

Purpose: This article examines Cameroon’s health service resilience in the first five months (March-July 2020) of the COVID-19 outbreak. The motive is to diagnose suboptimal performance in sustaining health care services during the pandemic in order to identify areas for improvement as well as draw lessons for the future. Design/methodology/approach: This is principally qualitative, exploratory, analytical and descriptive research that involves the collation of empirical, primary and secondary data. A conceptual framework (Health Systems Resilience for Emerging Infectious Diseases) provides structure to the article and an anchor for interpreting the findings. The research validity has been established by analysing the aims/objectives from multiple perspectives in the research tradition of triangulation. Findings: Cameroon has exerted much effort to combat the COVID-19 pandemic. Yet, several constraints and gaps exist. The findings reveal limitations in Cameroon’s response to the COVID-19 pandemic in the provision of fundamental health care services under contextual themes of health infrastructure/medical supplies, human capital, communication/sensitisation/health education, governance and trust/confidence. Analysis of the identified impediments demonstrate that Cameroon’s healthcare system is not resilient enough to cope with the COVID-19 pandemic and provides several insights for enhanced response as the pandemic accelerates in the country. Originality: This is one of the first scholarly articles to examine how Cameroon’s healthcare system is faring in COVID19 combat. Underscored by the novel Health Systems Resilience for Emerging Infectious diseases (HSREID) model, this article provides initial insights into Cameroon’s resilience to COVID-19 with a view to enhancing the health system’s response as the pandemic unfolds and strengthens readiness for subsequent health crises