Research article

Provision of Healthcare Facilities In Douala: A Geographical Analysis

Abstract

Background: Douala, Cameroon’s largest city, faces persistent healthcare access challenges rooted in rapid, unplanned urban growth. Despite a high concentration of medical facilities and personnel, infrastructure development has not kept pace with population expansion, resulting in spatial inequities that disproportionately affect vulnerable communities. Objectives: This study maps and analyzes the distribution of four healthcare provider types - public, private (for-profit and non-profit), traditional, and alternative - across Douala’s urban landscape. It evaluates geographic equity in access across neighborhoods and socioeconomic groups using a mixed methods approach. Methods: Healthcare facilities were mapped using GPS data and official records, while informal providers were identified through community-guided sampling. Spatial analysis in ArcGIS Pro included kernel density estimation, network analysis, and service area delineation based on a 30-minute travel time threshold. A spatial equity index was developed by integrating facility counts, population density, and accessibility metrics. Qualitative interviews with health officials, providers, and residents added contextual depth through thematic analysis. Results: Findings revealed a concentration of facilities in central urban zones, with peripheral areas underserved. Public sector coverage was inadequate relative to population needs, while private providers dominated wealthier districts. Traditional and alternative practitioners filled critical gaps in informal settlements. Many residents in outlying areas exceeded the 30 minute travel threshold to formal care. Conclusion: The study underscores the need for equitable urban health planning, recommending targeted expansion of public services and strategic integration of diverse provider types to improve coverage across Douala’s diverse urban landscape.